Severe mental illness

Report brings together key research on severe mental illness

Date: 13 March 2018

A new report from the National Institute for Health Research brings together findings from key research projects it has funded on severe mental illness and emphasises the need for early detection and intervention in conditions such as schizophrenia.

The report, Forward Thinking: NIHR research on support for people with severe mental illness, features 30 published studies and 19 ongoing research projects on early detection and intervention, crisis care, managing physical and mental health, and supporting recovery.

“Worldwide, mental illness attracts too little research given its high prevalence and impact, but the NIHR has consistently funded high quality studies into better understanding and management of these important conditions,” says Professor Peter Jones, Director of NIHR Collaborations for Leadership in Applied Health Research and Care East of England and Professor of Psychiatry, University of Cambridge.

“The review distils the wisdom from this investment, and has strong messages for patients, the public, social care and the health service, alike.”

A long delay between the onset of psychosis and starting medication is likely to result in poorer outcomes for people experiencing their first episode of psychosis. One study featured in the review found that an educational programme targeted at GPs doubled their identification and referral of young people with high-risk mental states, first-episode psychosis and other mental health problems.

But another study, in Birmingham, found that despite the availability of early intervention services in the city, a third of the 343 people in the study had not been treated more than 6 months after the onset of psychosis. The delay appeared to be due to structural barriers and suggests mental health services as they are currently configured are a barrier to early intervention and that a ‘psychosis pathway’ is needed to improve recognition, engagement and treatment delivery.

Other key findings from the report include:

  • Alternatives to hospital stays for mental health crises (including crisis houses and acute day hospitals) appear to be as clinically effective as inpatient treatment and rated more highly by service users.
  • A package of evidence-based interventions (Safewards) was shown to be effective in reducing conflict and containment, such as the need to sedate patients.
  • Financial incentives improved adherence to medication and outcomes for people with schizophrenia, although the effect did not last after payment stopped.
  • Web-based interventions may prove an important, inexpensive, feasible, and acceptable step forward in creating a choice of evidence-based interventions for people with bipolar disorder at different stages of recovery.

The full report is available to download from

  • Summary:
    A new report from the National Institute for Health Research (NIHR) brings together findings from key research projects it has funded on severe mental illness.
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