Mental Health Research Priorities Research Articles

Building consensus between lived experience and professional stakeholders on mental health research priorities: a Delphi study

ABSTRACT Objective The limited research funding available needs to be directed towards stakeholder-identified priorities that will have the largest positive impacts on mental health. This study aimed to identify consensus mental health research priorities across lived experience and mental health professional panels. Method A modified Delphi study with two panels (lived and professional experience in mental health) was used to identify priorities over three rounds. Priorities were rated on a 9-point scale from not important, important but not critical, to critical. Consensus (≥80% agreement on items rated ≥ 6 in importance across both panels) was analysed descriptively. Results 1015 initial potential priorities and 18 additional priorities were rated by panel members (N = 120, 52 lived experience, 68 professionals), with 608 priorities achieving consensus across 23 mental health domains. Priority themes included: services; prevention, early intervention, detection and health promotion; intersectionality; determinants of mental health; translation; culture, spirituality and wellbeing (identity); suicide and self-harm; data and technology; capacity building; trauma; physical health; stigma and shame; help-seeking and coping; and co-design. Conclusions There was high agreement across stakeholders on mental health research priorities, which may provide a basis for funding allocations for impactful research that would improve the mental health of the community.

Long-term research priorities for mental health of children and young people informed by lived experiences during the COVID-19 pandemic

Long-term research priorities for mental health of children and young people informed by lived experiences during the COVID-19 pandemic

Co-designing action-oriented mental health conversations: the case for integration in home and community care.

Background: The COVID-19 pandemic has reinforced concerns for the mental health and wellness of older adults worldwide. Older adults experiencing poor mental health may face both mental health stigma and ageism, which act as barriers to talking about mental health and seeking needed supports, care, and treatment. In Canada and elsewhere, there is a lack of mental health parity. The healthcare system’s focus on the physical healthcare needs of older adults creates missed opportunities for intentional conversations about mental health between providers and older patients during routine interactions.
 Aims: This project responds to aging and mental health research priorities identified by aging Canadians during the pandemic through surveys (n=1,000) and workshops (n= 52 participants). Top priorities included the need for research and action supporting: 1) skill-building in non-mental health specialists; and 2) the application of user-friendly tools to identify signs of positive and poor mental health. The aim of this multi-year research study is to co-design and test an evidence-based approach to starting mental health conversations between home and community care providers, older adults and/or their family caregivers.
 Methods: This study applies a participatory mixed methods design across three phases, guided by a working group of experts-by-lived-experience (n=30). Phase 1 involved a modified ADAPTE process including online workshops (n= 57 participants) and surveys (n=~1000) of older adults, caregivers, and health/social care providers across Canada. The workshops explored the use of an evidence-based visual model, called the Mental Health Continuum, to guide mental health conversations in home and community care. Phase 2 will involve co-design workshops with community health/social care providers in six communities (n= 3 rural; n=3 urban) across three Canadian provinces. Phase 3 will involve pilot and feasibility testing of the co-designed conversations in routine care. This abstract focuses on the findings from Phase 1. 
 Results: Workshop participants agreed that a visual model depicting mental health as a complex, multi-component construct ranging in state on a spectrum, was a helpful starting point for de-stigmatizing mental health between older adults, caregivers, and health/social care providers. However, participants felt the Mental Health Continuum needed to be adapted for use in promoting conversations in the context of home and community care. Suggested adaptations include the use of generic and action-oriented language across the model, more inclusive use of colours, capturing the element of change-over-time, removing clinical jargon from category names, and revising the signs and signals to be more aging context-relevant. Public consultation survey results are expected by the date of the conference. 
 Learnings: Engaging experts-by-lived-experience in all study phases is crucial for building on existing evidence in new research through a realist lens and ensuring widespread health issues are met with context-specific and relevant solutions. Workshops reinforced research priorities identified during the pandemic and confirmed the study’s potential to address challenges with integration of health and social care for older adults through de-stigmatizing mental health conversations.
 Next steps: The adapted Mental Health Continuum model will guide the co-design and pilot-testing work in Phases 2 and 3 of the research study.

315 Cystic fibrosis mental health research priorities: Qualitative content analysis of cystic fibrosis community and provider survey

315 Cystic fibrosis mental health research priorities: Qualitative content analysis of cystic fibrosis community and provider survey

Keeping the Agenda Current: Evolution of Australian Lived Experience Mental Health Research Priorities.

The value of including consumers’ and carers’ views at the early stages of study design is increasingly being recognised as essential to improving the relevance and quality of research. One method of achieving this is by actively seeking and regularly updating consumer and carer priorities for mental health research. The current study presents priorities for mental health research collected from two virtual World Cafés with consumers and carers (n = 4, n = 7) held in 2021. Over 200 priorities were identified (13 themes, 64 subthemes), which were then compared with two combined data collection activities from 2013 (face-to-face forum; n = 25), and 2017 (online survey; n = 70). There appears to be some evolution in consumer and carer priorities over time. A key difference was that in the previous studies, mental health service issues were at the individual service delivery level, whereas in the current study, a broader focus was on mental health systems of care and issues around service funding, accessibility, and equity of access. It is possible these changes may also have resulted from key differences between the studies, including the methods, setting, and participants. Overall, similar to our previous studies no clear priorities were identified; however, a significant number of important research topics were identified by consumers and carers, providing a rich agenda from which to improve the management of mental health.

A look back, a path forward: Revisiting the mental health and well-being research and practice models and priorities in sub-Saharan Africa

Despite the enthusiasm to promote mental health in Ghana, and sub-Saharan Africa more generally, the models and frameworks that underpin research and practice in these settings have focused exclusively on understanding and treating mental disorders, to the neglect of the mental health needs of the general, non-clinical population. We discuss the limitations of the bipolar and biomedical models as frameworks for (mental) health research and practice in the current paradigm. Using Ghana as a case example, we identify gaps in the mental health research priorities in sub-Saharan Africa, and discuss the limitations of the revised Mental Health Policy of Ghana in ensuring a mentally healthy population. Drawing on a consilience of evidence from the literature, we contend that although important and laudatory, the current research approach and priorities, which remain overwhelmingly fixated on alleviating and treating symptoms of mental disorders, are insufficient to buffer against psychopathology and bolster positive mental health. We argue for the adoption of more global and empirically-tested frameworks and population-based approaches to complement clinical approaches to reduce the population burden of mental health problems.

Priorities for Mental Health and Psychosocial Support Intervention Research in the Context of the Climate Crisis: A Modified Delphi Study

The climate crisis is adversely impacting mental health and wellbeing. Research on interventions to address these impacts remains scarce, particularly in humanitarian settings. This study used a modified Delphi process to identify research priorities for mental health and psychosocial support (MHPSS) and climate crisis research, drawing on the perspectives of those with demonstrated interest, engagement, and/or expertise in MHPSS and the climate crisis. The study consisted of two online surveys. In the first survey, demographic and qualitative data were collected and analysed to generate a list of research priorities and a concept map to describe the area of climate crisis and MHPSS research. In the second survey, participants ranked and rated their agreement with priorities and provided recommendations for modification of individual priorities and the concept map. In total, 91 experts working primarily but not exclusively in MHPSS programming or practice participated in the study. Consensus was reached on 20 research priorities, and 8 top-ranked priorities were identified. Given the urgency of the climate crisis, MHPSS and climate crisis research must contribute to mitigating and adapting to the climate crisis while promoting both mental health and psychosocial wellbeing and just international development.

Global priorities for climate change and mental health research.

Compared with other health areas, the mental health impacts of climate change have received less research attention. The literature on climate change and mental health is growing rapidly but is characterised by several limitations and research gaps. In a field where the need for designing evidence-based adaptation strategies is urgent, and research gaps are vast, implementing a broad, all-encompassing research agenda will require some strategic focus. We followed a structured approach to prioritise future climate change and mental health research. We consulted with experts working across mental health and climate change, both within and outside of research and working in high, middle, and low-income countries, to garner consensus about the future research priorities for mental health and climate change. Experts were identified based on whether they had published work on climate change and mental health, worked in governmental and non-governmental organisations on climate change and mental health, and from the professional networks of the authors who have been active in the mental health and climate change space. Twenty-two experts participated from across low- and middle-income countries (n=4) and high-income countries (n=18). Our process identified ten key priorities for progressing research on mental health and climate change. While climate change is considered the biggest threat to global mental health in the coming century, tackling this threat could be the most significant opportunity to shape our mental health for centuries to come because of health co-benefits of transitioning to more sustainable ways of living. Research on the impacts of climate change on mental health and mental health-related systems will assist decision-makers to develop robust evidence-based mitigation and adaptation policies and plans with the potential for broad benefits to society and the environment.

Virtual World Café Method for Identifying Mental Health Research Priorities: Methodological Case Study.

People with lived experience of mental health problems as both consumers and carers can bring significant expertise to the research process. However, the methods used to gather this information and their subsequent results can vary markedly. This paper describes the methods for two virtual World Cafés held to gather data on consumer and carer priorities for mental health research. Several methodological processes and challenges arose during data collection, including the achieved recruitment for each group (n = 4, n = 7) falling significantly short of the target number of 20 participants per group. This led to departures from planned methods (i.e., the use of a single ‘room’, rather than multiple breakout rooms). Despite this, the participants in the virtual World Cafés were able to generate over 200 ideas for research priorities, but not identify agreed-upon priorities. Virtual World Cafés can quickly generate a significant volume of data; however, they may not be as effective at generating consensus.

Informing the response to COVID-19 in Spain: priorities for mental health research

Informing the response to COVID-19 in Spain: priorities for mental health research

Listening to the autistic voice: Mental health priorities to guide research and practice in autism from a stakeholder-driven project.

Autistic adults are significantly more likely to experience co-occurring mental health conditions such as depression and anxiety. Although intervention studies are beginning to be implemented with autistic adults to address mental health outcomes, little is known about what research autistic adults feel is needed, or what mental health outcomes are of value to them. The purpose of this article is to describe a project that involved more than 350 autistic adults and other stakeholders as coproducers of research priorities on mental health. Through a variety of methods including a large online survey, two large stakeholder meetings, and three face-to-face focus groups, the project team identified five top priorities for mental health research which should be incorporated by researchers and practitioners in their work with autistic adults. These included research to inform trauma-informed care approaches; societal approaches for inclusion and acceptance of autistic individuals; community-available approaches for self-management of mental health; evaluation of adverse mental health outcomes of existing interventions; and improvements in measurement of quality of life, social well-being, and other preferred outcomes in autistic adults.Lay Autistic adults commonly experience mental health conditions. However, research rarely involves autistic adults in deciding priorities for research on mental healthcare approaches that might work for them. The purpose of this article is to describe a stakeholder-driven project that involved autistic adults in co-leading and designing research about priorities to address mental health needs. Through a large online survey, two large meetings, and three face-to-face focus group discussions involving over 350 stakeholders, we identified five priorities for mental health research desired by autistic adults. These priorities and preferred outcomes should be used to guide research and practice for autistic adults.

Commentary: Establishing Scientific Rigor and Excellence in Implementation Science Training to Improve the Deployment of Evidence-Based Mental Health Services.

Real-world challenges continue to impede the dissemination, implementation and sustainment of high-quality, evidence-based practices, resulting in too many individuals not receiving the effective mental health care that they urgently need. The field of implementation science is poised to generate new solutions to address this important public health problem. Training a new generation of researchers in implementation science is one solution. The Implementation Research Institute (IRI) offers one approach to such training. The papers in this series, authored by some of the IRI graduates, illustrate the depth and breadth of the intellectual scope of IRI graduates' contributions to the implementation science field, chronicles important lessons learned, and underscores the IRI's training capacity. This commentary reflects upon the series in terms of a framework and themes that relate to core implementation science principles and to future research that corresponds to the National Institute of Mental Health research priorities and strategic plan.

Global research priorities for youth mental health

Over the past two decades, the youth mental health field has expanded and advanced considerably. Yet, mental disorders continue to disproportionately affect adolescents and young adults. Their prevalence and associated morbidity and mortality in young people have not substantially reduced, with high levels of unmet need and poor access to evidence-based treatments even in high-income countries. Despite the potential return on investment, youth mental disorders receive insufficient funding. Motivated by these continual disparities, we propose a strategic agenda for youth mental health research. Youth mental health experts and funders convened to develop youth mental health research priorities, via thematic roundtable discussions, that address critical evidence-based gaps. Twenty-one global youth mental health research priorities were developed, including population health, neuroscience, clinical staging, novel interventions, technology, socio-cultural factors, service delivery, translation and implementation. These priorities will focus attention on, and provide a basis for, a systematic and collaborative strategy to globally improve youth mental health outcomes.

Advances in CNS PET: the state-of-the-art for new imaging targets for pathophysiology and drug development

PurposeA limit on developing new treatments for a number of central nervous system (CNS) disorders has been the inadequate understanding of the in vivo pathophysiology underlying neurological and psychiatric disorders and the lack of in vivo tools to determine brain penetrance, target engagement, and relevant molecular activity of novel drugs. Molecular neuroimaging provides the tools to address this. This article aims to provide a state-of-the-art review of new PET tracers for CNS targets, focusing on developments in the last 5 years for targets recently available for in-human imaging.MethodsWe provide an overview of the criteria used to evaluate PET tracers. We then used the National Institute of Mental Health Research Priorities list to identify the key CNS targets. We conducted a PubMed search (search period 1st of January 2013 to 31st of December 2018), which yielded 40 new PET tracers across 16 CNS targets which met our selectivity criteria. For each tracer, we summarised the evidence of its properties and potential for use in studies of CNS pathophysiology and drug evaluation, including its target selectivity and affinity, inter and intra-subject variability, and pharmacokinetic parameters. We also consider its potential limitations and missing characterisation data, but not specific applications in drug development. Where multiple tracers were present for a target, we provide a comparison of their properties.Results and conclusionsOur review shows that multiple new tracers have been developed for proteinopathy targets, particularly tau, as well as the purinoceptor P2X7, phosphodiesterase enzyme PDE10A, and synaptic vesicle glycoprotein 2A (SV2A), amongst others. Some of the most promising of these include 18F-MK-6240 for tau imaging, 11C-UCB-J for imaging SV2A, 11C-CURB and 11C-MK-3168 for characterisation of fatty acid amide hydrolase, 18F-FIMX for metabotropic glutamate receptor 1, and 18F-MNI-444 for imaging adenosine 2A. Our review also identifies recurrent issues within the field. Many of the tracers discussed lack in vivo blocking data, reducing confidence in selectivity. Additionally, late-stage identification of substantial off-target sites for multiple tracers highlights incomplete pre-clinical characterisation prior to translation, as well as human disease state studies carried out without confirmation of test-retest reproducibility.

Mental health research priorities in Australia: a consumer and carer agenda

BackgroundThe perspectives of mental health consumers and carers are increasingly recognised as important to the development and conduct of research. However, research directions are still most commonly developed without consumer and carer input. This project aimed to establish priorities for mental health research driven by the views of consumers and carers in Australia.MethodThe project was conducted in two studies. Firstly, a face-to-face discussion forum held in the Australian Capital Territory (Study 1; n = 25), followed by a national online survey (Study 2; n = 70). Participants in both studies were members of the community who identified as a mental health consumer, carer or both. In Study 1, participants developed topics for mental health research in small group discussions, then voted on which topics, developed across all groups and sorted into thematic areas, were a priority. An online survey was developed from these research topics. Study 2 participants were asked to rate topics on a 5-point priority scale and rank the relative importance of the highest-rated topics.ResultsAt the forum, 79 topics were generated and grouped into 14 thematic areas. Votes on priorities were spread across a large number of topics, with the greatest overall support for research relating to integrating care that is sensitive to past experiences of trauma into mental health service delivery (trauma-informed care). Survey responses were similarly spread, with the majority of research topics rated as important by at least 50% of participants and no clear individual priorities for research identified. Amongst items rated as important by approximately 80% of participants, key research areas included the delivery of services, and consumer and carer involvement.ConclusionsAustralian mental health consumers and carers demonstrate a strong understanding of the mental health system and its inadequacies. Although clear specific priorities are difficult to establish, consistent areas of focus are services and the role consumers and carers can play in their improvement. However, for consumer and carer views to be at the forefront of research, it is important to regularly update research agendas and work in partnership across the whole research process.

Mental health interventions and priorities for research for adult survivors of torture and systematic violence: a review of the literature

This research describes the development and findings of a literature review and analysis meant to inform the international torture and trauma treatment community. The review focuses on interventions that have been used among populations affected by torture, based on a review of journals indexed in commonly used search engines. Work on the review began in September 2008 and continued to be updated until March 2014. In total, 88 studies of interventions for torture victims were identified. Studies ranged from randomized controlled trials utilizing evidence-based treatments to case studies employing non-structured, supportive therapies. Based on the results of the analysis, we have included recommendations for interventions that demonstrate effectiveness in treating survivors of torture and other systematic violence who suffer from PTSD, depression and anxiety. Priorities for mental health research for survivors of torture and other systematic violence are also recommended.

F.3. Workshop: Violence and abuse as priorities for mental health research, practice and policy

F.3. Workshop: Violence and abuse as priorities for mental health research, practice and policy

F.3. Workshop: Violence and abuse as priorities for mental health research, practice and policy

F.3. Workshop: Violence and abuse as priorities for mental health research, practice and policy

This is why there is hope for psychiatry

This is why there is hope for psychiatry

Will RDoC hasten the decline of America's global leadership role in mental health?

Will RDoC hasten the decline of America's global leadership role in mental health?