IGHI receives Wellcome funding to advance mental health science

A new Imperial project will explore the importance of social connection in mental health services for young people.

Mental health experts at the College’s Institute of Global Health Innovation (IGHI) are one of a select number of teams funded by Wellcome to review the evidence on which aspects of interventions really make a difference in preventing and treating youth anxiety and depression.

These so-called ‘active ingredients’ of interventions are diverse, covering options such as improving the function of the gut’s microbial ecosystem (the ‘microbiome’), the use of antidepressants and increased self-compassion.

Our team at IGHI will look at quality of social connectedness and whether this is important for mental health services to be effective. Some evidence from more traditional mental health services, such as psychotherapy or talking therapy, suggests that forming a quality connection with another person is important for the intervention to be successful. This is called a ‘therapeutic alliance’.

"For some people, having that human element embedded in an intervention is important for it to be successful. But we don’t know whether digital services can deliver that quality social connection." Dr Lindsay Dewa IGHI Research Fellow

With the rise of digital tools to support people’s mental health, like apps and online services, it will be critical to determine whether this is also true for these types of interventions, many of which are void of human contact, or where human connection is experienced differently to face to face.

Dr Lindsay Dewa, IGHI Research Fellow and project lead, said: “Anecdotally, there has been an understanding that for some people, having that human element embedded in an intervention is important for it to be successful. But we don’t know whether digital services can deliver that quality social connection, or indeed whether this is important for everyone. These are questions we hope to answer with our research.”

For this work, IGHI researchers will be reviewing the available evidence to understand how effective and important social connection is for improving mental health outcomes.

In tandem, the team will also work with young people (aged 14-24) with lived experience of anxiety and depression, from the UK and beyond, to ensure their voices and perspectives are heard. These individuals will form an advisory group who will be involved in every stage of the work, from study design to dissemination of findings. They will also work together to consult both other young people with lived experience and professionals who have experience delivering mental health services – both traditional and digital forms. These will include charity, industry, NHS and academic partners.

Why?

Anxiety and depression are holding millions of people back in life, generally starting in youth. Yet we still know too little about what prevention strategies and treatments work for whom, in what contexts, and why.

As part of this commission, IGHI researchers will help Wellcome identify what the ‘active ingredients’ are for the many treatments, therapies and social tools which already help young people. What are the facets of talking therapies which make them work for certain people? What are the social factors which allow people to escape from loneliness?

In some fields, the active ingredients of successful interventions are relatively clear cut. For example, the molecules in drugs that can kill tumour cells in the treatment of cancer.

“Through this exploration, we’re hoping to understand when and where, and for whom, social connection is effective for preventing and improving mental health difficulties in young people.” Dr Emma Lawrance IGHI Mental Health Innovations Fellow

IGHI researchers want to understand the factors, or ‘ingredients’ that underpin the quality of social connection in mental health interventions, and whether these can exist in digital services.

Dr Emma Lawrance, IGHI Mental Health Innovations Fellow and project researcher, said: “We know that human connections are important for mental health in general. But what does quality social connection mean in the context of digital support? We’ve seen that making a connection with another person is really important for some individuals in digital support, whereas others might sometimes prefer to have an alternative like a self-guided chatbot which can be more flexible, and where there is no fear of judgement.

“Through this exploration, we’re hoping to unpick these differences to understand when and where, and for whom, social connection is effective for preventing and improving mental health difficulties in young people.”

Grace Gatera, a Lived Experience Mental Health Advocate living in Kigali, was part of the application review team. She says:

“The successful proposals have really touched something in me, as they make lived experience a priority in research and are focused on the end-user. I’m looking forward to the work the teams are going to do that pave the way for a future of affordable, accessible mental health care for all young people worldwide, including those from low resource settings”.

The commission begins today and we will report our findings in October 2020.

Find out more about Wellcome’s priority mental health programme here.