Information for investigators

Some localities in England are already discharging service users with severe mental illness into primary care. We know that alternative provision needs to be evidence based and clearly thought through or risk unintended consequences.

We worked with a Community Mental Health Team (CMHT) in each of our three localities (Birmingham, Lancashire and Devon) and from secondary care and primary care notes, observed the care pathways of people with a diagnosis of schizophrenia or bipolar over the previous 24 months. By care pathway, we mean the basic pre-defined structure, process and outcomes of care from routinely recorded data on each of the 100 individual service users in their notes, in each of the three CMHTs. This will describe the outline of care received.

A survey with clinical leads and team managers has been carried out to help us to describe the process of current care for this cohort of in the three geographical study sites. This will help us to better target those who could benefit from collaborative care and assess potential risk and safety issues.

If you are interested in any of the work described here, please contact us

Randomised control trials can provide robust evidence to inform the clinical care of mental health patients. Outcome data from trials may help inform decisions regarding individual care and also at a national level informing health policy. Mental health trials often assess a wide range of outcomes that may not be relevant to all service users. Through this research we identify outcomes that are important to people with a diagnosis of schizophrenia and bipolar in a community setting and their carers. As the outcomes of interventions are also important to people responsible for clinical care, commissioning and researching the effectiveness of mental health services we will also ask clinicians, researchers and commissioners to be involved too. We asked people about their views and opinions on outcomes using a focus group approach and searched the literature to identify other potentially important outcomes. Participants will be asked to prioritise the most important outcomes through a series of surveys to produce a ‘core outcome set’ for use in future mental health trials. 

We have successfully completed a Delphi Survey to formulate the core outcome set for bipolar. The Delphi Survey for schizophrenia will go live in 2018.

If you are interested in any of the work described here, please contact us

Collaborative care is the name given to a particular way of healthcare professionals working together and includes Psychiatrists, General Practitioners (GPs), practice nurse (PNs), Community Psychiatric Nurses (CPNs), Psychologists and others. With collaborative care a ‘care partner’ (who might be a CPN) works with the service user to coordinate care delivery and ensures that all the different aspects of care a patient receives including psychological and physical care are brought together so the service user gets the most benefit. A key element of collaborative care is that the service user is recognized as being an expert in their condition and an important part of the team.

In this study, we worked with service users and care partners to organize care more effectively with GPs and other health and social care professionals. We tested a version of collaborative care and ask service users how they felt about the care they received within the model. We also spoke to GPs and other members of the healthcare team about their thoughts on carrying out the care package.

If you are interested in any of the work described here, please contact us