institute of mental health

Pictures of SuccessAnnual Report 2008/09

Promotingresearch

Page 14Providingeducation

Page 10Supporting

clinical practice

Page 18Acting as an expert

resource in promotingbest practice

“The IMH was formed three yearsago to provide a critical mass andfocus for research and educationin the field of mental health inNottingham. We have grownrapidly. We have 120 formalmembers, including academics,clinicians and service-users andcarers. The staff now numbermore than 150, including 20full professors. This makes usan important group in the UK field,second in size only to the Instituteof Psychiatry in London.

“Most of this expansion hasbeen achieved through externalfunding, particularly from theNational Institute for Health

Research, but also the MedicalResearch Council, the Economicand Social Research Council, andthe Welcome and Burdett Trustsamong others. We are gratefulfor their support.

“However this has also onlybeen achievable with the supportand vision of our joint sponsors,Nottinghamshire HealthcareNHS Trust and the University ofNottingham. They have taken therisks involved with such a newventure, and we celebrate withthem the benefits that are alreadyflowing from our joint work.”

Professor Nick ManningDirector of the Institute of Mental Health

03

“It is with great pleasure thatI write this introduction to the firstannual report for the Institute ofMental Health (IMH) in Nottingham.It gives you a brief flavour of ouractivities, our recent achievementsand our future aspirations.

Annual Report 2008/09

Welcome

Perspectives fromNottinghamshireHealthcare NHS Trustand the Universityof Nottingham

“Nottinghamshire Healthcareworks very closely with the Institutein order to improve the outcomesfor people with mental healthissues. It is only throughevidencing what impacts onpeople and their mental healththat we can improve the journeytowards recovery. I’m delighted tosee a first annual report from theInstitute and to see how far theyhave come and what their plansare for the future. Research isessential to develop services thatwe can be proud of and help thepeople who use those services- and we are lucky to work withsome of the very best staff in thearea of mental health researchand development. I look forwardto being part of the Institute’sfuture growth and progress.”

Mike CookeChief Executive of NottinghamshireHealthcare NHS Trust

“The IMH represents collaborationbetween the University andNottinghamshire Healthcare Trustwhich has created a stimulatingand supporting environment tofoster research of the highestquality into improving outcomesin mental health and learningdisability. It brings togetherNHS researchers from differentprofessional backgrounds withUniversity researchers froma wide variety of academicdisciplines. This multi-disciplinaryapproach produces the highquality information required forevidence-based practice andensures its implementation.The recent successes of the IMHhave enabled us to attract staff ofthe highest calibre to Nottinghamto work in research, teaching andthe delivery of services while thetraining opportunities this hascreated will attract and trainboth university and NHS healthresearchers of the future.”

Professor Saul TendlerPro Vice Chancellor ofthe University of Nottinghamand co-chair of the IMH Board

04Pictures of Success

Our purpose

One in four people will developa mental health problem atsome point during their lives.

Mental distress can rangefrom mild depression or anxietyto conditions such as bipolardisorder (manic depression)or schizophrenia where individualsmay experience psychosis.

The Institute of MentalHealth was launched in 2006in Nottingham to help transformour understanding and treatmentof mental illness. We have grownrapidly and can now be consideredas one of the leading mental healthinstitutes in the UK, offering worldclass expertise and insight.

Our mission is to improvepeople’s lives through the useof ground-breaking research andpioneering educational activities.We are dedicated to improvingthe care and treatment of peoplewho use our services throughinnovating, developing, exploitingand distributing knowledge aboutmental health.

Our four key activities are to:• Promote research

• Support clinical practice

• Provide educational courses

• Act as an expert resourcein promoting best practice

The content of this annual reportis based on these four key activitieswhich will help illustrate what wedo and why.

The Institute is a partnershipbetween NottinghamshireHealthcare NHS Trust andthe University of Nottingham.We currently attract £6 million inexternal research grants to fundour work, have 20 full professorsamong our staff and publishapproximately 150 peer-reviewedjournal papers a year.

Our portfolio of training anddevelopment opportunities attractsapproximately 200 students eachyear. Courses offered includeone-off modules, diplomas,degrees and masters qualificationsin mental health.

Our growing reputation wasrecognised in 2008 with an externalaward of £17 million to set upa new service-facing researchcentre. This centre is called theCollaborations for Leadership inApplied Health Research and Care(otherwise known as the CLAHRC).The CLAHRC is designed toaccelerate the use of researchin improving patient careacross the region.

The Institute brings togethera variety of units and networkswith the core task of innovating,developing and exploiting thefield of knowledge about mental

health. This includes embeddedunits such as the CLAHRC, PeaksAcademic Research Unit, Literatureand Evidence Research Unit,Cochrane Schizophrenia Group,a hub of the UK Mental HealthResearch Network, many nationaland international professionalnetworks, and our own uniqueset of 37 Managed InnovationNetworks (MINs).

There are eight sectionsof the Institute:• Health, Behaviour and Society

• Mind, Brain and Development

• Service Evaluation and ClinicalTrials

• Innovation and BusinessDevelopment

• Learning & Teaching Committee

• Personality Disorder Institute

• Forensic

• Children and Young People

05 Annual Report 2008/09

Promoting research

Understandingstaff attitudesin dementia care

Healthcare assistants working atthe frontline of care with dementiapatients can face significantphysical and emotional strainin carrying out their roles.

IMH research, funded by theServices Delivery and Organisationsection of the National Institute forHealth Research, has been carriedout with staff caring for dementiapatients at the Trust to see howthey cope with some of theevery-day challenges.

The study aimed to find outwhat motivates and sustains staffby using data gathered throughparticipant observation on thewards and supplemented fromfocus groups and individualinterviews. Three researchers- Joanne Lloyd, Kezia Scalesand Simon Bailey (pictured above)- worked as healthcare assistantsin different wards for a total of12 months.

Researchers found that closestaff relations and teamwork providesupport, recognition and pride inthe work that healthcare assistantsare unlikely to gain from othersources. They discovered howstaff in the role can adopt an insularteam identity which may havedisadvantages as well as benefits.

The research also showed howconventional relationship-buildingcan be difficult with dementiapatients but that staff establishmeaningful connections withpatients through attentiveness,affection, empathy and humour.Given the growing demand insociety for dementia care, findingsfrom this study will be relevant tothe recruitment and retention of

a trained, motivated and stableworkforce.

IMH staff and Fellows on thisstudy include Nick Manning,Elizabeth Murphy, PatrickCallaghan, Richard Turner andJustine Schneider. Further detailsare available from the website:www.nottingham.ac.uk/~lqzipc/

Professor Justine Schneider


Picture of success:The Institute plans toexpand annual turnoversteadily towards£10 million per year.

Promoting research

Checking onpatients’ progress

Research into the future lifeevents of people dischargedfrom medium secure care hasfound they face significantlyhigher chances of suicide orproblems with the criminaljustice system – when comparedto the population as a whole.

A study has been carried out intodischarges from Arnold Lodge inNottingham in a piece of workfunded by the National ForensicResearch and Developmentfunding stream.

The Arnold Lodge unit providesan in-patient forensic psychiatricservice to adults, aged 18 to 65,who are, or who are thought tobe suffering from a mental disorder,and because of their seriously

disturbed or criminal offendingbehaviour cannot be managedby a general psychiatric serviceor local forensic service withlower levels of security.

Preliminary findings found riskof death was six times that of thegeneral population with 32% ofthose who died committing suicide,49% were re-convicted and 38%were re-admitted to secure care.

These results indicate that thosedischarged from medium securecare have vulnerabilities that requirelong-term input from the low secureand community services thatsubsequently manage them.An update of results from the studywill now be carried out with internalfunding from Arnold Lodge.The lead researcher on thisstudy was Dr Steffan Davies.

Professor Conor DugganForensic


Picture of success:Professor Conor Duggan hascontributed in writing national NICEguidance which aims to ensure that thepromotion of good health and patientcare in local health communities is inline with the best available evidence ofeffectiveness and cost-effectiveness.

Picture of success:32 research bids for externalfunding have been submittedby the Institute this yearwith six awarded, threeunsuccessful and 23 pending.

Promoting research

Group celebrates15th anniversary

The Cochrane SchizophreniaGroup, formed in 1994 and basedwithin the Institute of Mental Health,is concerned with the evaluationof the prevention, treatment andrehabilitation of people withnon-affective, functional,psychotic illnesses.

The work of the groupconcentrates on three mainareas. The first is the preparation,publication and maintenance ofsystematic reviews of the effectsof interventions for schizophrenia.These reviews are publishedquarterly on the Cochrane Library,and are updated periodicallyto incorporate new researchas it becomes availableon the dedicated website:http://szg.cochrane.org/en/index.html

The second is the developmentand maintenance of a specialisedregister of trials relevant to thescope of the group’s work andthis has been a fruitful area oforiginal research.

The third area of work isundertaking real-world randomisedtrials. Large high quality studieshave been carried out in Brazil,India and the UK. The Groupis now working with partnersin Finland, Brazil and the UKdesigning randomised studies thatare truly relevant to everyday care.

The editorial base is locatedwithin the Institute but the editorsare based around the world.The Group works with 500 activereviewers in 21 different countriesto ensure high standards andspread the learning.

Professor Clive AdamsCochrane Schizophrenia Group


Promoting research

Understandingalcohol-related violence

Alcohol-related violence is a majorsocial problem and researchcarried out by the Institute hasattempted to classify violentbehavior with an aim to developeffective prevention andtreatment programmes.

Funded by the AlcoholEducation and Research Council,a team involving Mary McMurran,Mary Jinks, Kevin Howells andRichard Howard set out to classifytypes of alcohol-related violence,which could help to group togetheroffenders with similar treatmentneeds.

Mary Jinks interviewed 149young male prisoners who hadcommitted offences of alcohol-related violence, categorised asviolence for material gain, socialdominance and self-defence.

Violence for material gain wasopportunistic and often motivatedby the desire for more alcohol ordrugs. In these cases, violence,although serious, appeared to bebrief. Some offenders experienceda buzz and they were less likelyto feel any remorse.

Violence with the goal of socialdominance was triggered by aninsult and was accompanied bystrong anger and an adrenalinerush. Attacks were ferocious.Robbing the victim in the processwas not uncommon, perhapsto inflict additional humiliation.Feelings of pride and satisfactionwere common and expressionsof remorse were rare.

Where violence was inself-defence, the person feltunder threat and an attackwas often expected. In somecases, the respondent madea pre-emptive strike. Weaponuse was common in this group.Fear was experienced, but sotoo was anger.

Feelings of excitement were notreported and remorse was common.

We need to do more researchto examine whether these typesof violence are valid and usefulclassifications. From our earlyfindings, we can begin to thinkabout how prevention andtreatment approaches could betailored to suit young men whocommit different types of violence.

Professor Mary McMurran


Supporting clinical practice

Bridging the gap betweenresearch and practice

The Institute is a national andinternational leader in innovationand is positioned to take boldand radical steps in coming atperceived established healthproblems from novel perspectives.One such approach is exemplifiedby the Institute’s unique collectionof Managed Innovation Networks(MINs).

MINs are an Institute successstory and provide opportunitiesto create new, imaginative andcross-cutting collaborationsbetween clinicians, researchersand the wider service-usercommunity. The key aimsof MINs are to stimulate:

• Participation in excitinginnovative projects

• The creation of models ofengagement that may bereplicated and transferred

• Development of clinicalevidence and expertise

• Informed and continued learning

• Appropriate mechanisms forinvolving and supportingservice-users and carers

• Clinically relevant researchproposals with the potentialto attract new funding.

The MINs make a significantimpact through the recognition ofjoint collaboration, expertise andcommitment - improving the livesof people who use our services.They increase staff confidencein their work and enable theapplication of research ina clinical setting.

The Institute is proud to be ableto support 37 MINs addressingpractice or service issues acrossthe full range of Trust services.

The following five exampleshighlight some of the areas whereMINs are making a real differenceto research excellence and

improving the experience ofpatients and service-users:

• ADHD in children, youngpeople and adults – networklead Dr Kapil Sayal

• Anti-stigma - networklead Victoria Baldwin

• Early intervention in psychosis– network lead Dr Tuhina Lloyd

• In-service training in dementia– network lead Dr Norman Upton

• Medical humanity and mentalhealth – the arts in psychiatry –network lead Dr Victoria Tischler

Further information on MINsis available from Veronica Mahony,IMH Business and AdministrationManager, on 0115 823 0588or email:[email protected]

You can also visit the Institutewebsite for further information onMINs at www.institutemh.org.uk/

Gerry CartonIMH Associate Director


Picture of success:Over the next five years, the Institutewill continue to support existing MINsand invite the development of newMINs. There will be a major reviewof their effectiveness with the aimof focusing further support onthe most successful.

Wh

at

Alb

ert

Do

es

byDaveWood


You think, therefore you do

People living with anxiety anddepression find it difficult toaccess psychological therapies– the so-called ‘talking therapies’.The National Improving Accessto Psychological Therapiesprogramme was launched bythe Government to remedythis situation. The Teachingand Learning Section, headedby Professor Patrick Callaghan,was awarded a national grant todevelop and provide trainingacross the East Midlands so thatlocal people could have betteraccess to these therapies.

The training has its roots inCognitive Behavioural Therapy(CBT). This approach has a strongevidence base and high levels ofacceptability among people livingwith anxiety and depression;among other things, it helps themto capture intrusive and distressingthoughts that lead to behaviourwith troubling and unpleasantconsequences. Our training hasbeen very successful. To datewe have recruited more than100 people onto our programmes,we will be graduating our first waveof therapists at the end of 2009and already we are starting to seean improvement in the numberof people getting access tothese therapies.

In 2009/10 we will bedelivering the training to peoplefrom Nottingham, Lincoln, Derby,Northampton, Leicester andLoughborough. We have hadpositive responses to the trainingand early results show that it isequipping people with the skillsto better deliver psychologicaltherapies to a wide rangeof people.

ProfessorPatrickCallaghan

Reducing discriminationassociated with mentalill health

Since Nottinghamshire HealthcareTrust launched its anti-stigmastrategy two years ago, membersof the Institute have contributedto an innovative programmeof outreach and servicedevelopments. These includea Living Library initiative led byMichael Osborne and a footballtournament in which eleven teamsof service-users participated.Victoria Tischler’s research on theattitudes of adolescents towards

mental illness has been takenforward by Andy Peet, while JulieRepper has led the adoption of the‘recovery approach’ to treatment.

The national Time to Changecampaign arrived in Nottinghamduring Mental Health Awarenessweek in October with prominentadvertising on local buses anda stall at the annual Goose Fairto show people that ‘it’s okay totalk about it’. Time to Changeis England’s biggest attempt toend mental health stigma anddiscrimination and improvewell-being. More informationis available on the websitewww.time-to-change.org.uk/.

The impact of this campaignon service-users’ experiences ofstigma and discrimination is beingevaluated by IMH researchers JulieRepper, Chris Beeley and JustineSchneider through a postal survey.A panel of service-users fromThe Rosewood Centre (the Trust’sInvolvement Centre in Ollerton)advised on the development ofthe questionnaire, which measuresa person’s experience of stigmain everyday life.

ProfessorJustineSchneider



Walking backto happiness

A research team led by ProfessorPatrick Callaghan has deviseda new exercise programme,designed specifically to helpwomen living with depression in thecommunity. The value of exercisefor people who are depressed iswell-documented and has potentialbenefits to social, psychologicaland physical well-being. However,previous research by the team hadfound that standard GP prescribedexercise programmes, usually gymsessions, did not work well for thisgroup of sufferers as they find themdiscouraging and lonely, and dropout early on.

Developing an exerciseprogramme that people withmental illness can use successfullyis important because improvingthe physical health of people withmental illness (which tends tobe poor) is a national priority.

We responded with a newsystem of ‘mentored’ exercise,which includes group motivationalsupport and a low effort walkingprogramme. The new programmewas tested by comparing twogroups of women, the firstreceiving the special programme,

and the latter receiving ‘exerciseas usual’ of the type prescribedby a GP. Women on the specialprogramme experienced asignificant improvement in theirmood, physical health, sense ofwell-being, self-esteem and qualityof life. ‘I feel more confident in myphysical self and my emotional self.I do think it’s helped with my mood.’Whereas women receiving ‘exerciseas usual’ did not experience anysignificant benefits, were lesslikely to continue attending,and markedly less enthusiastic.

Professor Patrick Callaghan

In my view...

In this personal view, Dr ChrisBeeley, Senior Evaluation Manager,sets out his thoughts on workingfor the Institute and the closecollaboration with service-users

“My work within the Instituteis explicitly service-user focused,helping frontline services gatherand process the information theyneed to improve how they workand do so in a way which involvesand empowers service-users and

staff. I have been leading serviceevaluations in mental health servicesfor older people, high secureservices and training for alliedhealth professionals. In each case,outcomes for users and the viewsof users have been made centralto data collection and reporting.

“I am involved in severalproject groups which are focusedon outcomes and experiencesof services. As part of the Trustquality account, a new survey- the service-user and carerexperience survey - has beenlaunched and I have contributed toits design and implementation andhave led on analysis and reportingto managers and service-users.

“I am involved with many otherprojects which seek to evaluate anddescribe outcomes and experiences,such as methods of managingself-harm in Arnold Lodge, devisinga comprehensive evaluation incommunity learning disabilityservices, consulting Trust membersregarding the organisationalintegrated business plan andevaluating progress with deliveringracial equality to service-users. Inall these ways I feel we are gettingstrong direction from service-usersin improving mental health servicesfor their own individual needs.”

Dr Chris BeeleyIMH Senior Evaluation Manager



New centre has itsfoot on the accelerator

A dedicated new research centrewas established within the Institutein October 2008 called the CLAHRC(Collaborations for Leadership inApplied Health Research and Care)Nottinghamshire, Derbyshire andLincolnshire. It is a collaborationbetween the University ofNottingham, eight NHS Trusts,the East Midlands Strategic HealthAuthority and two local councils.There are only nine CLAHRCsacross England and this is thesecond in the East Midlands(along with Leicester).

It was established with £17.4mfunding (half from the NationalInstitute for Health Researchand match-funding from partners)to develop new approaches tohealthcare research and enablemore research to be carried out.It includes mental health, butalso covers primary care, strokerehabilitation, younger people,and research and education,and stakeholder engagement.

The core purpose of theCLAHRC is to accelerate thetransition of research into practice.

Within the mental healththeme there are currently four keyservice-facing projects, which are:

• Readiness for treatmentin personality disorder

• Dental and physical healthneeds of people withserious mental illness

• Individual placement andsupport for people withsevere mental health problems

• Chronic mood disorder- randomised controlled trialof specialist depression team.

The mental health themelead is Professor Richard Morriss.More information on this workis available from the websitewww.clahrc-ndl.nihr.ac.uk/

Professor Graeme CurrieDirector of CLAHRC


Picture ofsuccess:Over the next fiveyears, the CLAHRCwill expand intothe forensic mentalhealth field, andelsewhere, andposition itself asa major nationaland internationalsite for healthcareinnovation.

Providing education

On course todevelop staff todeliver improved care

The Institute offers a range ofhigh quality accredited trainingin the form of one-off modules,undergraduate and postgraduateprogrammes in health carepractice. The courses, from entrylevel to MSc, are delivered by ateam of academics, experiencedmental health clinicians,researchers and experts byexperience, from a varietyof locations including DuncanMacmillan House, Nottingham,and The Forest Centre, Mansfield.

Many of the courses are fundedby the local Workforce Deanerywhich means for some local NHSstaff there are no course fees

directly payable by managers.They can be undertaken on aflexible basis to fit in with thelifestyle and professionalneeds of participants.

The Teaching Team has beenplanning for a national first this yearwith a new Masters course whichwill help post-graduate studentsdevelop their leadership rolesin a mental health environment.The new MSc in PsychologicalTherapies for Psychosis combinessupport for practitioners indeveloping specialist rolesalongside learning in changemanagement and organisationalleadership skills. The Institute’scourses are run as a collaborativepartner of Sheffield HallamUniversity and as a partnerinstitute of the Open UniversityValidation Service.

Gerry CartonIMH Associate Director


Picture of success:The Institute runs the International PersonalityDisorder Examination, a semi structuredassessment of personality disorder forexperienced mental health professionals.This course is available approximatelytwice a year. For further informationcontact Kate Dawson on 0116 207 7814or [email protected]

Providing education

View from thelecture theatre...

Institute studentAdam Cliffordreflects on gaininghis BA (Hons)in Mental Healthand PsychosocialInterventions:

“My connections with theteaching team began in 2004,when I undertook my registeredmental health training throughthe trust’s then, WorkforceDevelopment Dept.

“I have always had an interestin alternative therapeuticapproaches for individuals withlearning disabilities and found thatthe BA (Hons) in PsychosocialInterventions was the idealopportunity for me to expand myknowledge and understandingwithin this area.

“The course has helped mein many ways within my currentrole as a community learningdisabilities nurse in Nottingham’sCommunity Assessment &Treatment Team. I feel I havedeveloped new knowledge andskills which I try to apply in myeveryday work with clients andcarers; and it has helped inform

and challenge my therapeuticand professional outlook.

“I completed my coursein August 2008, and I feel thatthe course has equipped me withsome of the hands-on knowledgeand skills I was looking for.The teaching team have helpedme to further my career andtraining goals, and for thisI am very thankful.”

Adam CliffordCommunity Learning Disabilities NurseHighbury Hospital

Kairen Briggs,currently studyingmodules with theInstitute as partof her Learningand DevelopmentPlan, says:

“I work as a clinical supportnurse within the LearningDisabilities Directorate and as partof my learning and developmentplan I was required to completea number of one-off modulesprovided by the Teaching Team.

“The modules have providedme with a lot of new skills relevantto my role. I found the coursehelped me identify learningstyles more effectively, enhancingmy problem-solving skills whilelooking closely at my own waysof working and how to applythese more efficiently.

“I have enjoyed the learningand found the Teaching Team tobe very understanding - theyhelped increase my confidencewhile supporting and encouragingme to overcome my own barriersand limitations.

“I find it extremely important toupdate your skills when workingwithin the healthcare environment.With developing research I think itis our duty to tune back into focusfrom time to time so we provideour service-users with the bestpossible care.”

Kairen BriggsClinical Support Nurse

For more information on coursesplease contact the AcademicProgramme Administrator on07917 837 430 or you can [email protected]


Picture of success:The Institute runs a Trent StudyDay twice a year for mental healthprofessionals. It provides a variedprogramme of themes related toforensic mental health. For furtherinformation contact Kate Dawsonon 0116 207 7814 [email protected]

Providing education

Leading the way inpractice-based education

In December 2007 the Departmentof Health and Ministry of Justicecommissioned the developmentof a national education and trainingframework designed to supportpeople to work more effectivelywith personality disorders. Thepartnership awarded the contractis led by the Personality DisorderInstitute, a section of the Instituteof Mental Health, and also includesthe London-based Tavistock andPortman NHS Trust, Borderline UK(the largest national service-userand carer support group focusingon the needs of those living with theexperience of personality disorder)and the Open University.

The key goal of the frameworkis to improve service-userexperience through developing thecapabilities, skills and knowledgeof the multi-agency workforcesin health, social care and criminaljustice who are dealing with thechallenges of personality disorders.The educational package includesa virtual learning awarenessprogramme, a validatedundergraduate degree anda validated masters degree.

These high quality educationalprogrammes are now beingdelivered by leading practitionersand service-user consultantsworking with the Institute. Theawareness level programme hasa number of packages availableincluding a ‘train the trainers’module. The BSc and MSc areavailable as standalone unitsof learning (single modules)or whole programmes withassociated qualifications.

This educational programmehas positioned the Institute as thekey national provider of personalitydisorder education in the countryand as a world leader in the fieldof practice based education inmental health.

For more information on thenew programmes, please contactVicky Baldwin, BSc ProgrammeLead, [email protected] orDr Neil Gordon, MSc ProgrammeLead, email [email protected]

Vicky BaldwinEducation and Practice Consultant


Picture of success:The Institute is to develop and roll out a nationalsuite of degree programmes in PersonalityDisorder, based on a recently completedcurriculum development. It will also develop,as contracted through the CLAHRC,a Masters in Healthcare Change andInnovation. Finally, a coherent and substantialdevelopment of a cohort of 50 PhD studentswill be located within the Institute.

Providing education

Innovation Workshops

CLAHRC, in collaboration withNottingham University BusinessSchool, has developed workshopsfor practitioners concerned totranslate evidence-based innovationinto practice at the Trust.

This programme is basedaround the ‘ingenuity approach’developed over recent yearsat the University of Nottingham.The focus is upon pre-conceptinnovation activities. These areoften neglected in practice byindividuals and organisationslarge and small, leading, potentially,to solutions that are not the bestand inefficient decision making.Pre-concept innovation activitiesfocus attention upon defining theproblem and working out its causesprior to wide ranging thinking andproducing solutions.

The ‘ingenuity approach’ hasbeen very well received within theNHS and also large private sectororganisations such as Boots aswell as by small high-growthbusinesses, university studentsand academic staff.

Professor Graeme CurrieDirector of CLAHRC

Sharing the learning- every week

When it’s a Wednesday, it’sseminar day at the Institute witha free series of events that runsfrom October to January andFebruary to June.

The multi-disciplinary series isdelivered by Trust employees andnational and international speakerson a range of contemporary mentalhealth issues. The seminars, heldat the Institute’s state-of-the-artpremises on the University ofNottingham’s Jubilee Campus,are open to all Trust employees andInstitute members. Following lunch,the seminars generally run from1pm to 2pm on most Wednesdays.

Sessions set to take place fromNovember 2009 onwards includea review of the primary care useof anti-depressants for mild tomoderate depression, the dominantmodel of masculinity in depression,the impact of frontline crisis workingon morale, burnout and jobsatisfaction, and ‘makingchange happen’.

Veronica Mahony, IMH Businessand Administration Manager, says:“Why not combine attendance atthe seminar with a workstation at

the Institute for your use during theday? We are encouraging as manypeople as possible to takeadvantage of the facilities and theopportunity to meet colleagues.”

Veronica MahonyIMH Business and Administration Manager


Acting as an expert resourcein promoting best practice

Supporting servicesacross the country

Housed within the IMH is thePersonality Disorder Institute (PDI)which seeks to be a centre ofexcellence devoted to the researchof personality disorder and thenational centre devoted to thetraining of all staff involved inthe treatment of severepersonality disorder.

Two examples of our work areshown in this report. The Institute,in partnership with a number of keyexperts in the field of personalitydisorder, has been commissionedto develop a personality disorderstrategy for the Yorkshire andHumber Strategic Health Authority.

We used a staged approachstarting with a comprehensivereview of research evidence,policy context and guidance andnew national guidelines. Followingthis, an extensive consultation tookplace, including a survey, focusgroups and structured interviewswith key decision makers. As wellas staff working in criminal justice,health and social care, we hada major focus on the viewsof service-users.

The consultation highlightedthe principles and direction neededfor the development of servicesfor people with personalitydisorders in the region andan implementation plan.

The final phase involveseducational development workto train all staff who come intocontact with people with personalitydisorders to be aware and sensitivein their day-to-day interactions andto develop approaches toconstructively involve service-usersin the planning, development andinvestment decisions for currentand new services. Alongside this,the PDI has been appointed asacademic partner to Yorkshire andHumber with a view to developingand finding methods of answeringnew research questions in this field.

Professor Eddie KaneDirector of the Institute of Personality Director


Picture of success:The Institute is forecast toachieve a financial break-evenposition for the year 2009-10- thanks to the growth in externalresearch funding grants won.


Supporting servicesacross the country

The PDI has developed aneducational and team developmentprogramme for the Clinical RiskManagement Service (Resettle)based in Liverpool. The initialstages of this work involved detailedindividual and team assessments toenable the practitioners to operateeffectively, focused on the needs ofnewly released offenders involvingstructured day care interventionsand therapeutic groups.

The inputs involved an analysisof team functioning and teamdynamics. There was individualand group feedback, a series ofeducational workshops focusedon working with the complexities

of personality disorder and ananalysis of best practice inthis area.

The final phase of this workup to December 2009 will involvea group work developmentprogramme for practitioners whohave been facilitating groups withinthe new service. The input willbe based on an analysis ofthe challenges that staff haveexperienced in their practice.It is designed to help the teamreflect critically on their clinicalexperiences and enhance theirfacilitation and group work skills.

This work demonstrates how theInstitute is working directly with frontline staff using educational andevidenced based clinical expertiseto enhance service delivery.

Professor Eddie KaneDirector of the Institute of Personality Director


Picture of success:The annual numberof Institute publicationsis set to be sustained,and efforts will befocused on a shiftfrom quantity toquality by trackingand improving theaverage impactfactor of the journals.

Los

tin

Win

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byPaineProffitt


Associates wanted

The CLAHRC (see page 13) hasfour broad areas of work - primarycare, adult mental health services,stroke rehabilitation, and child andadolescent health. If you have aninterest in one or more of thesefields, or in our overarching themeof implementation research andknowledge transfer, we wouldlike to invite you to becomea CLAHRC Associate.

You will receive emailupdates on the CLAHRC’s work,publications and conferences.You may choose to participatein our training courses or researchforums. To join as an Associate,visit www.clahrc-ndl.nihr.ac.ukAnyone in Nottinghamshire,Derbyshire or Lincolnshire may join.Service users and patients, thirdsector and health and social caresectors are all equally importantto us as Associates.

China connection

Representatives of the IMH visitedthe Shanghai Mental Health Centre,the city’s leading service, for a jointseminar last October. This summer,we welcomed two of their leadingresearchers, Dr Chunbo Li andJijun Wang to Nottingham forone month.

Chunbo works closely withProfessor Clive Adams, reviewingChinese research on schizophrenia,while Jijun is collaborating withProfessor Peter Liddle in theanalysis of neuro-imaging data.A committee to take forward theChina collaboration is led by JustineSchneider, and Jun Xia is managingthis project on behalf of the IMH.


Picture of success:The East Midlands Mental Health ResearchNetwork Hub has recently recruited15 Research Assistants to support KapilSayal’s PROMISE Study - PromotingMental health in Schools through Education”www.bath.ac.uk/health/mhrdu/promise.html

Pictured are(front row from left):Dr Steven Wong of thePersonality DisorderInstitute, and ProfessorsPatrick Callaghan,Justine Schneider,Peter Liddle,Eddie Kaneand Clive Adams.Dr Chunbo Li is fourthfrom the left (back row).


Involving service-users

The Institute always strives tomake its research real and relevant,practical and with straightforwardlinks to frontline services. We dothis by involving service-userswhenever and wherever we can.It is the views and insights ofexperts by experience who cantransform our understanding andlead to major steps forward inservice improvements. We workwith service-users in a varietyof situations, involving them asindividuals or representativesof other groups, whether patient,service-specific or widercommunity groups. Two suchgroups are Making Waves andBorderline UK. The Institute has astanding group of users and carerswho regularly teach on a numberof programmes run by the institutethrough Making Waves, a service-led organisation that consists ofpeople with a range of experiencesof mental distress. It aims to use itsmembers’ experiences to transformmental health services, anddevelop new and innovative waysof supporting people experiencingmental distress. Representativesfrom Borderline UK have providedessential input into our BSc and MSccourses on personality disorder.

In my view...

In this personalview, service-userand Institutemember of staffDebbie Butler givesher perspective onthe Institute’s work:

“I first heard of the Institutewhen I worked on therapeuticterms with the Mental HealthResearch Network. I have alwaysbeen interested in research andwas curious as to what the IMHcould do for me and what I coulddo for them. I joined as a Fellowof the Institute after a conversationwith another service-user who hadbecome involved. It felt great thatI had been asked and I was veryproud when I was accepted.

“Following this I attendedthe first Annual Lunch at theUniversity which was quite formal.My involvement grew with theIMH and I became employedtemporarily at the time - I believeI was the first service-useremployed there.

“There are many experiencedclinicians working within theIMH and they often involveservice-users in the work they do.Fellow service-users and carersoften ask me what is going on atthe IMH which is sometimesdifficult for me as I am just ‘hotdesking’ there now. Co-ordinatingwork with service-users may beuseful as out in the bigger worldthere is a lot of talent which couldbe harnessed for the good of sucha prestigious Institute.”


Future visionNext steps

Mental ill-health remains an underresourced field of clinical andresearch endeavour across theworld, including the UK. It costs theUK economy annually more than£74 billion, yet attracts only 12%of health service expenditure,and 6.5% of health research funding(Royal College of Psychiatry, ‘fair dealcampaign’, 2009). The launch andgrowth of the IMH is planned tomake a significant new contributionto this issue.

This year we prepared our firststrategic plan for the IMH, to runfor the next five years. It highlights20 strategic goals across eightareas. The vision is that wecontinue to expand more slowlytowards a 50% growth in externallyfunded research and educationturnover (£10 million per year),together with a consolidation ofour expertise into specific areas,such as ADHD, social exclusion,bipolar disorder, personalitydisorder and general healthand well-being. Opportunisticexpansion will give way toa selective emphasis inmulti-disciplinary quality.

To achieve this we need toattract good colleagues and tolink closely with clinicians andservice-users and carers. We plana major expansion of more juniorstaff (fellows, post-doctorates andPhD students) together with a closeralignment of our work to be servicefacing, through the CLAHRC, andthrough the active mentoring ofclinical colleagues in medicine,nursing and psychology.

Professor Nick ManningDirector of the Institute of Mental Health


Picture of success:For more information on the Instituteof Mental Health including furtherdetails of our work and associatedfinancial information, please visit thewebsite www.institutemh.org.uk

Get involved

Would you like to become moreclosely involved in the work ofthe Institute of Mental Health?

Why not join the growingnumbers of Institute members?

Application of membership isby submission of your CV and asupporting statement detailing howyou see yourself contributing to thework of the Institute over the nextthree years.

For further information,please visit our websitewww.institutemh.org.uk

Please submit your CVand supporting statementto Veronica Mahony [email protected]


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T: 0115 823 1293/4F: 0115 823 1289E: [email protected]

www.institutemh.org.ukwww.nottinghamshirehealthcare.nhs.ukwww.nottingham.ac.uk

This document can be madeavailable in large print andother formats includingtranslations upon request.

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All paper used in the productionof this Annual Report has beensourced from sustainable sources.

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