Title: UCL and King's Integrated Policy Research Unit for Mental Health
Funder: Department of Health and Social Care

Abstract: Overall strategy Given the breadth of the brief, we need to establish a team that can work flexibly to meet a variety of requirements, and that will maximise use of efficient approaches to research: the budget gives relatively little scope for new data collection. Thus our strategy will be: - To establish a core team of experienced researchers with a range of expertise that can be augmented by additional staff to work on specific projects. - To involve a co-applicant team whose expertise spans the main clinical specialties and methodological approaches required. - To augment this with a network of international leaders in relevant specialist areas. - To prioritise having capacity to meet rapid response requirements. - To embed PPI and co-production in the PRU s work, ensuring through multiple mechanisms for involvement and a substantial budget that service-user involvement will be meaningful and valued. - To establish a research programme that uses efficient methods to assess impact and implementation of current policies, and to inform development of future policies. - To become a national hub for development of research to underpin mental health policy, informing, facilitating and helping to disseminate the work of research teams beyond the PRU. Strategy in approaching the three tiers of PRU work 1. Rapid response: The core team, especially Deputy Directors, will be first contact point for rapid response, involving our co-applicants and collaborators as needed. Where useful, our Advisory Network will help us to contact specialist groups within their own networks. 2. Research studies: The PRU will conduct a series of research studies that are relevant to policy evaluation and formulation, and have international impact. The dual focus will be on examining the implementation and impact of current policies, and on delivering evidence to support future policies. The most valuable approaches within our budgets and timescales will be efficient methods maximising use of existing data. Examples of approaches to addressing priority research questions will include: - Evidence synthesis, including rapid reviews and full systematic reviews: We include funding for an experienced systematic reviewer linked to the National Collaborating Centre for Mental Health, drawing on their extensive experience of evidence synthesis for NICE guidelines and NHS England programmes. - Analysis of existing datasets: We will make use of extensive experience in both UCL and King's teams of analysing big epidemiological, service and research datasets for efficient ways of addressing questions on service needs, gaps between needs and provision, and inequalities in access and implementation of policies and interventions. - Economic analyses will use modelling techniques to maximise use of existing data, prioritising providing clear evidence on likely costs and savings associated with models of interest. - Mixed methods case studies: We will elucidate findings of large-scale quantitative analyses through case studies incorporating a co-production approach and qualitative and implementation science methods. Approaches wil include exploring stakeholder experiences, investigating how inequalities arise, applying implementation science methods to understand how implementation challenges arise and may be addressed, and examining potential models of good practice. 3. Horizon scanning and formulation of research questions: Another PRU role will be as a seed-bed for policy-relevant research. This work will focus on topics identified as important by stakeholders, but which lack robust evidence. We will scope relevant literature and theories, consult experts and stakeholders, and examine models of interest nationally and internationally, enabling us to formulate and disseminate questions for further research. Risks and challenges, and responses to them: Cohesion with a team based at two sites: Basing staff both at UCL and King s has benefits in access to expert colleagues and university resources. We have a track record of delivering applied mental health research from teams based across both institutions. Any risks of lack of cohesion in the team will be offset by effective management teams at both sites, core research team meetings at least fortnightly, and use of an electronic platform such as Slack for communication and joint working. Avoiding a London-centred approach: Our London location is advantageous in terms of concentrations of mental health researchers and policy networks, and has good transport connections. However, we will always be mindful of the need to maintain a national focus. We hope that monitoring our own programme for regional inequalities in coverage, a steering group drawn from around the country, the national focus of many available datasets, our extensive experience in nationwide multicentre studies (e.g 75 teams nationwide enrolled in the CORE crisis team fidelity study), and selecting case study locations at varied locations will help achieve this. Meeting needs for rapid response: Our core staff will have capacity to respond rapidly to requirements for evidence, pausing ongoing projects if needed, and there is a good supply of experienced researchers to augment them. Our expert collaborators confirm willingness to get involved at short notice. Thus we are confident that we can offer considerable capacity for rapid response. There is nonetheless a risk of being overwhelmed by high demand, especially as requests may come from a range of sources. During the set-up phase, we will work with the DH and associated bodies to agree which types of request we should prioritise. Delays resulting from ethical and research permissions: This issue is discussed in the Responses to Comments section. We will seek to reduce unproductive time by developing a clear understanding of permissions required for relevant datasets, by maximising early use of datasets for which we do not need independent ethics approval, and by applying for one umbrella approval that is likely to cover a range of PRU s activities. Breadth of the brief: Prioritising will be a challenge, as so many important questions fall within the scope of the brief. The DH and our co-production group will support us in prioritising, and we will use efficient methods to maximise productivity. We will maximise value from the PRU by encouraging and supporting other policy&ndash;relevant research, in our institutions or elsewhere: through publicising our findings and methods promptly, and through disseminating to other research staff and research funders questions and models for further investigation.

Lay abstract: We propose to set up a Unit jointly led by University College London (UCL) and King s College London (King s). The main aim is to help the Department of Health and others involved in making nationwide plans for mental health services to make decisions that are based on good evidence. The Unit will do this by making available a range of expert views and evidence to policy makers in a timely way, and also by carrying out our own programme of high quality research that is directly useful for policy. The team will include researchers who are also health professionals. We will also have experts in economics, in analysing big datasets, in investigating service users experiences, and in ways of making sure treatments that work are available to everyone who needs them. People who have used services, some of whom are professional researchers, will also be in the research team, and an approach called co-production will be used to make sure they contribute their perspectives to the programme on equal terms. A wider network of experts, most of them international leaders in their fields, have agreed to get involved when we need advice in their fields. Over the past two years, the NHS has published important new policies that are aimed at improving mental health services and meeting needs better and more quickly. Some are being put into practice now; the details of others still need working out. Examples are plans to make sure everyone has speedy access to care when they are in a crisis, and that people becoming unwell with psychosis for the first time get really good care. Our suggestion is that we begin by looking at these new policies. We will aim to see what their impact has been, and to find out whether people from different areas and different groups in the population have benefited equally. We also want to discover the best ways of making sure new policies are put into practice as intended. We also plan to provide evidence that will help policy makers work out the details of their future plans. For example we can tell them how many people are likely to need particular kinds of service, how much this might cost and what ways of organising services seem promising. The three main areas we will be studying are strategies for preventing people developing significant mental health problems, ways of making sure people get quick and easy access to care, and strategies for improving care and making sure people are offered treatments that are likely to work. Communication will be crucial at all stages to make sure that evidence is understood and used by policy makers and others with an interest in mental health, including service users and carers. Ways of doing this will include easily understandable summaries of the best available evidence, meetings and workshops, and use of social media such as blogs and Twitter (the leader of the well-known Mental Elf evidence blog will be involved in the Unit).

Research activity codes: 8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE;8.5 RESOURCES AND INFRASTRUCTURE (HEALTH SERVICES)
Health categories: MENTAL HEALTH