World Mental Health Day: what questions do we need to answer?

World Mental Health Day takes place on October 10th every year, and aims to raise awareness of mental health issues on a global scale.

It also encourages those who work in mental health to discuss what they think are the most pressing issues in their field, and to identify possible solutions.

We asked a few of our world-leading researchers in the Department of Medicine to pinpoint the most pertinent questions facing them in their work, and to share their views on the importance of World Mental Health Day.

Professor Michael Crawford - Professor of Mental Health Research

Professor Michael Crawford

My focus is on personality disorders, which are severe and distressing mental health conditions. Psychological treatment can help, but current treatments are lengthy and very few people receive them.

We are in the process of developing and testing shorter psychological treatments and finding out whether these, combined with pharmacological treatments, can help ensure that more people get the help they need.

There have been important strides to reduce stigma associated with mental health in recent years. However, sadly too many people in Britain who become unwell do not get the help they need. World Mental Health Day plays an important part of efforts to increase public understanding of mental illness and help make sure that people with treatable mental health conditions are not left to suffer in silence.

Professor Anne Lingford-Hughes - Chair in Addiction Biology

Professor Anne Lingford-Hughes

We need to characterize brain mechanisms underlying substance misuse and addiction to inform that which underpins vulnerability to these psychiatric disorders, and how they are best treated.

Currently, we are using two types of neuroimaging – positron emission tomography and magnetic resonance imaging – to image the neurotransmitters (chemicals) in the brain and brain responses during processes involved in addiction viz reward, impulsivity and emotional dysregulation as well as cue reactivity. In addition we link these with pharmacological challenges to see how the system responds and if it differs in controls vs addicts.

Many individuals experience mental health challenges but the stigma surrounding them means they are often hidden. It is therefore very necessary to continue to raise awareness.

Dr Ashwin Venkataraman - Clinical Research Fellow

Dr Ashwin Venkataraman

My key research question is: does alcohol dependence contribute to Alzheimer’s disease? Excessive alcohol drinking is commonly recognised as leading to brain damage and cognitive difficulties, however importantly it also increases the risk of other dementias. For instance, alcoholism is associated with diabetes mellitus, hypertension and head injury which all increase the risk of Alzheimer’s disease or vascular dementia. All of these conditions and alcohol consumption result in inflammation in the brain, and in Alzheimer's disease neuroinflammation is associated with beta-amyloid deposition in the brain.

We will investigate if alcoholism also leads to beta-amyloid deposition in the brain by using the only imaging technique that can measure beta-amyloid in the brain, Positron Emission Tomography (PET). We will assess if beta-amyloid is related to memory, genetics, and changes in the brain using Magnetic Resonance Imaging. If beta-amyloid is found, this provides a potential mechanism by which alcoholism may result in Alzheimer's disease. This will allow us in the future to identify the underlying mechanisms of alcohol related brain damage and how this links with Alzheimer’s disease to possibly inform new prevention and treatment strategies.

Awareness-raising events like World Mental Health Day do a huge amount to raise the profile of psychiatric illnesses. This is important as these illnesses often have little resources and funding in many areas of the world, and in some suffer significant social, cultural and political barriers to access evidence based care. I firmly believe “there is no health without mental health”, and feel the need, alongside my colleagues, for parity of esteem for Psychiatry. Events like World Mental Health Day are necessary, and do contribute to this. 

Ms Rachael Ryan – Research Assistant (pPOD Research Group)

I work as part of the Perinatal Psychopathology and Offspring Development (pPOD) research group led by Professor Paul Ramchandani at the Centre for Psychiatry. The group is interested in understanding how best to prevent mental health problems in children. We particularly focus on the perinatal period and the first few years of life. I believe a key research question in this field is: how can we develop and test innovative interventions to create meaningful outcomes for families and children?

At the moment, I am in involved in a study called Healthy Start, Happy Start (HS, HS), led by Professor Ramchandani. The research is funded by the National Institute for Health Research Health Technology Assessment to test the clinical and cost effectiveness of an early intervention programme for young children at risk of developing behavioural problems. Research has shown that behavioural problems affect 5-10% of children. Children with established behavioural problems are at risk of significantly worse outcomes through childhood and into adult life including their educational achievement, and mental and physical health.

A key risk factor for the development of behavioural problems is the quality of the parental care that children receive: low levels of sensitive parenting and greater use of harsh discipline have been causally linked to the development of behavioural problems. Crucially, parenting is amenable to change and HS, HS is investigating whether a brief parenting programme that uses video-feedback  (Video Feedback to Promote Positive Parenting and Sensitive Discipline; VIPP-SD) is effective in improving parenting behaviour and child outcomes. VIPP-SD has a developing evidence base as a preventive intervention and if shown to be effective in the UK, could be delivered widely across the NHS. A key innovation of the HS, HS study is to offer VIPP-SD to one or two caregivers including dads, mums and grandparents. The study has enrolled over 160 families so far with over 30 families involving two caregivers.

I feel it is really important to raise awareness around what mental health is, specifically on days like World Mental Health Day, but also through an ongoing conversation for the other 364 days of the year. Mental health, like physical health, is important through all stages of life but starts from conception.  Through raising awareness of the value of early support for children, we can reduce stigma and develop accessible services. Just because someone has experienced a mental health problem at some stage in their life, it doesn’t mean they will always have this problem or should be treated differently. Mental health is often misunderstood, with newspapers and television frequently portraying children, young people and adults with mental health problems in a negative light. That’s why I think World Mental Health Day is a fantastic opportunity to share the truths and dispel myths about mental health.

For more information on World Mental Health Day, please visit the World Health Organization (WHO) website.