One of the unintended consequences of writing a blog is that it can be a helpful chronicle enabling you to trace the history of issues and events over many years. There is no better example than mental health research.
So I can tell you that it is three years since the Mental Health Research Alliance was formed (World Mental Health Day, 2014). Eight years since the Research Mental Health declaration (October 2009) when service users and mental health organisations first flexed their muscle on the issue of mental health research funding and support with one voice. My abiding memory of the declaration is of Ruby Wax, comedian and mental health campaigner, telling a reception at No.10 Downing Street that what came out of research – treatments, therapy, interventions – was the only sure-fire way of removing stigma.
A lot has happened in the meantime. Whereas before we had no national charity focused solely on mental health research, now we have two – the ever innovative ‘McPin Foundation’ (2012) ‘ although its origins go back to 2007, ‘MQ Transforming Mental Health Research’ (December 2012) . We have also seen a series of James Lind Alliance Priority Setting Partnerships on depression (January 2016), bipolar disorder (August 2016) and, currently, children and young people’s mental health (2017) to name but a few. In general it has risen up the health research agenda and was a significant theme in September’s ‘Future of Health’ report commissioned from RAND Corp by the National Institute for Health Research (NIHR).
The policy context to these developments is also important. Not least the publication of the Five Year Forward View for Mental Health in 2016 It is in response to a specific recommendation in the ‘Forward View’ that we have the latest development in this chronicle – yesterday’s ‘Framework for Mental Health Research’ (‘Framework’ is the in-word these days isn’t it?) published by the Department of Health but authored by a steering group representing the collective view of service users, voluntary organisations, funders and researchers of what needs to happen in mental health research.
That the service user voice has been involved in the development of the ‘Framework’ is clear from the ten recommendations in the document including this specific recommendation on involvement:
Recommendation 2: Patient and public involvement (PPI) (Stakeholders: Research funders, HRA, INVOLVE, Universities, Charities.
Patient and public involvement in mental health research should continue to be strengthened and systematically embedded throughout research regulation, ethics
and governance, shaping and determining research questions, assessment of research
proposals and research evaluation. User-led research as an emerging discipline,
generating new knowledge and investigating things that matter on a day to day basis to
people experiencing mental health problems, should continue to be strengthened. So too
should co-production in research, combining expertise of practitioners, healthcare
commissioners, service users, carers, policy makers and researchers together within multidisciplinary research teams. There is a need to make involvement more representative particularly by increasing inclusion of children and young people
and people with protected characteristics. Involvement in basic research should
be strengthened and requirements for involvement harmonised across research.
The nods towards user-led research, co-production and young people are important statements, setting expectations to which the mental health research community will be held to account over the coming weeks. But, as important, are statements in other recommendations that recognise the importance of building public involvement capacity and capability in the research system – people, knowledge, relationships and places where the work can take place.
There is less said in the document about implementation. But, alongside yesterday’s announcement of the ‘Framework,’ the NIHR also launched new mental health research funding opportunities for 2018 with a particular focus on ‘the promotion of good mental health and the prevention or treatment of mental ill health. Issues of particular interest include proposals that utilise new digital health technologies or investigate their effects.’ It will be important that all partners – and others as well – follow through on the recommendations with co-ordinated actions and activities.
My chronicle here only serves to demonstrate that policy takes time (frustratingly) to evolve. That its progress can be idiosyncratic, stop-start in nature, and sometimes requires two or three goes at the same idea before it takes off. But it is the overall trajectory that matters most, whether one can answer positively the question: ‘are we heading in the right direction?’
Coming on the back of the recent announcement regarding a new mental health research policy unit it does feel to me that with this ‘Framework’ we are entering a much more positive era for mental health research; founded on collaboration and with a clear place at the table for public involvement. It is crucial that we keep this momentum going.