Mental ill-health and substance use often co-occur, particularly excessive alcohol consumption, but services struggle to provide patients with appropriate help. If you’re trying to access help for your drinking then you’re often ineligible for support if you have ongoing mental ill-health. Equally, if you’re trying to access support for mental health, then you’re often denied treatment if you’re still drinking. This is what happens when you design systems around health conditions and individual clinical services rather than the complex changing needs of real people.
“Improving the design of health and social care systems so patients can access and benefit from the right care at the right time in the right way is what motivates me in my role as a mental health researcher.”
I came to mental health research with a public policy hat. My first degree was in Politics and my Masters was in Organisational Excellence and then Public Administration. I’ve always been interested in how we can combine theory, technology, and empirical research to improve public services and political systems. Most of my research at the start of my career was focused on labour market inequalities and the welfare system. Mental health didn’t feature in a big way in my work back then, but it is certainly a major contributor to social and economic exclusion, alongside several other challenging factors that can cluster in disadvantaged groups. Then, when I started working in the substance use field, it became even more clear quite how much these issues were interlinked.
Often the problem isn’t a lack of proven therapy or interventions. The problem can be more about insufficient capacity in the system to cope with demand, or a lack of care pathways and services that are easy for patients to navigate, especially those with multiple complex needs. That’s where my work comes in. I think about how we can improve the design of the system rather than the therapy or treatment itself. Day-to-day I talk to everyone involved in our health and care system, from patients that actually use the services, to those people responsible for providing, designing or commissioning care, not just clinical staff. At the moment I am just starting a new NIHR Advanced Fellowship that will explore how care is currently delivered to heavy drinkers with depression across the North East and Cumbria Integrated Care System, and then work with service users to see whether digital technology can help improve support.
“What we don’t have is sufficient capacity in the system to cope with demand, or care pathways and services that are easy for patients to navigate, especially those with multiple complex needs. That’s where my work comes in.”
There probably aren’t too many people with my background who would consider themselves mental health researchers, but I encourage people in public policy to reimagine themselves for a moment. There are lots of opportunities available. I’ve done a series of fellowships for example, with NIHR and other funders. Mental ill-health is all too frequently at the heart of social and economic exclusion, and a major contributor to health inequalities. Non-clinicians need to engage with mental health because helping people get appropriate care is as much a service and societal level issue as it is a medical one.