How Cambridge researchers are tackling mental health

02 June 2016
Almost every day there are reports of how we should be looking after physical health through exercise and healthy eating, but one of the other things most of us forget is to look after our mental health.

Every year, it is estimated one in four of us in England will experience a mental health problem, but hundreds of people are going undiagnosed and are struggling in silence. 

Mental health is an umbrella term for many conditions. It affects how we think, feel and act. Most people relate mental health problems with symptoms such as anxiety, depression, panic attacks, phobias or obsessions and compulsions. However, there are other, more severe disorders, such as psychosis which are associated with an altered sense of reality due to changes in thinking and perception.

Professor Ed Bullmore is leading his team of researchers from the NIHR Cambridge Biomedical Research Centre (BRC) at Cambridge University Hospitals (CUH) to look at the mental health spectrum, and implement new research studies to find new treatments for these conditions. “Mental health comprises  a whole range of symptoms and disorders, nearly everyone in the UK will have or know someone who has a mental health condition. As part of the Cambridge BRC we provide the infrastructure to focus mental health research on three different platforms - immunology, imaging and informatics.

“Immunology means we are trying to understand how the immune system is abnormal in people who have depression or psychosis. It may sound surprising that the immune system should be involved in mental health but in fact the links between depression and inflammation are very strong: for example, just think about how you felt last time you had flu. The BRC provides us with the lab support to investigate the links between the immune system and mental health much more deeply and with a focus on developing new treatments for mental health that work by targeting the immune system.

“Imaging means we are using advanced brain scanning to study how the brain is related to mental health disorders. One of our main projects is focusing on brain development during adolescence. This is important because most mental health disorders appear for the first time during adolescence or early adult life. We think this must be related to the fact that the brain is actively developing and changing its organization during adolescence. Supported by the BRC, we have already been able to show that normal adolescents have developmental changes in the hubs of their brain networks and this may be related to risk of schizophrenia. In future we will be able to strengthen the imaging research in mental health by accessing the powerful new scanners that have recently been installed in Cambridge.

“Informatics means using computers to handle large quantities of data more efficiently and informatively. A key focus is linking the results of lab and imaging research together with the clinical records of patients who are receiving mental health care in Cambridgeshire & Peterborough NHS Foundation Trust. This is an important step in making sure that research really makes a positive impact on patient outcomes but of course it needs to be done carefully to protect confidentiality. Working with the specialist BRC for mental health in south London, we have set up a system that allows us to anonymise patient records so that they can be safely used for research studies.”

The NIHR Cambridge BRC is doing lots of work, looking at several different research strands of the mental health spectrum. Ed said: “One of the areas we’ve been looking at is psychosis. Professor Peter Jones and colleagues found that around five per cent of people who came to the psychiatric clinic for the first time had antibodies in their blood which bind to particular signalling proteins or neurotransmitters in the brain. They found that if the antibodies were removed from the blood the patients’ psychotic symptoms improved. We’re quite excited that this could be a potential new explanation for why some people suffer psychosis. We now have a treatment trial which is funded by the Medical Research Council to further investigate this. This is a great example of how the BRC is supporting mental health research.

“We have two Wellcome Trust strategy awards: one in neuroimmunology and another in brain development and mental health in adolescents. We have programmes in addiction, particularly cocaine dependence, and there’s lots of work going on in autism. All of these and other programmes depend on the immunology, imaging and informatics support provided by the BRC.”

Many forms of mental health can affect you and for some people it can be a lifelong impact. The Mental Health Foundation reports that in England 4-10% of people in England will experience depression in their lifetime and women are almost twice as likely to be diagnosed with anxiety disorders. Ed explained: “Mental health research is really important in addressing this major public health challenge. Particularly for working age adults of 15-45, mental health is one of the main causes of disability and loss of productivity. There are so many aspects of mental health we don’t understand very well, but we are making good progress. We are hoping to see substantial progress towards new treatments in the next 5-10 years - there is a lot of work to do to drive down the economic and social impact.”

Mental health doesn’t just affect adults but also young people too. 1 in 10 young people will experience some form of mental health symptoms. The Duchess of Cambridge is a campaigner for children’s mental health and a patron of several charities who guest edited the Huffington Post in February, voicing how it can be a problem for younger people too. “Mental health disorders are highly likely in young people, the peak age is around 15-30 years old. If you’re going to have a problem with depression, OCD, bipolar disorder it typically first appears around that age group, and that’s because it’s a period of time when the brain is developing and people are changing – learning new skills, their sexual and professional status. This period is stressful and the brain is actively coping with all those changes from a child to an adult. Men tend to be more vulnerable for many brain development disorders whereas depression, anxiety and self-harm is particularly common in adolescent women.” Ed said: “Cambridge has a big focus on mental health research in younger people ranging from autism and learning disabilities in the first 10 years of life to psychosis and depression in early adulthood.”

There is still a stigma around mental health problems and some people refuse to discuss them, but these issues can happen to anyone and can be triggered at any time like having a baby, loneliness, loss of a close relative or friend, loss of a job or being in debt. Ed explained: “If you look back into the history of medicine, whenever we’ve not understood a disease or been frightened of it, we have tended to stigmatise it.  Just think about we used to treat patients with leprosy or epilepsy before those diseases were better understood. Mental health is in a similar position today – it is stigmatised largely because we don't yet understand it as clearly as some other disorders. We’re very lucky in the UK that we can have an increasingly open conversation about mental health. I believe that if we can keep talking and continue to make progress in research to understand new causes and treatments for mental health problems the stigma will melt away.”

Despite the stigma, several famous faces have spoken up about their own lived experience of mental health. Actor and presenter Stephen Fry, boxer Frank Bruno, five time gold medallist Olympic swimmer Ian Thorpe and writer and comedian Ruby Wax are some of the celebrities who have supported mental health awareness. “Their support is so valuable and really does help highlight the issues. Anyone who has a public profile with a mental health disorder gives out a positive message, it shows that anyone can be diagnosed with a mental health illness, from any walk of life, and that experience of mental health symptoms is not incompatible with high levels of achievement and success” added Ed.

In February 2016, David Cameron called for more action on mental health services after an NHS England taskforce found that three-quarters of people with mental health problems received no help at all. Ministers plan to increase funding in mental health services to give people the help they need, such as more support and talking therapies. The hope is to increase services so people can get the help they need faster and not suffer in silence. The plan will help alleviate the pressures on A&E departments and people will have more access to specialised inpatient wards. Ed said: “It’s a great idea for more funding, and the government have made much more money available to dementia support recently, so to expand the funding to other areas of mental health can really help. The NIHR, which funds the BRC, has highlighted mental health research as one of its highlight or priority areas. The hope now is that we will have stronger support for mental health research and developing new treatments in the future.”   

It is always best to seek help if you are concerned about yourself or someone who may be suffering with a mental health illness. Your GP is the best place to start and there are lots of support services in place to get you the right course of treatment. “There are things that can be done to try and avoid a mental health disorder, like a sensible lifestyle - not drinking too much, avoiding drugs, having a strong social network of family or friends can be very helpful to people. Physical exercise and staying physically fit can also be advantageous to your mental health.” Ed advised.

The future of mental health research in Cambridge is bright, “we’re in a very strong place, we have a very good neuroscience research community in Cambridge and a lot of our colleagues in neuroscience are interested in mental health and want to translate their ideas from basic neuroscience to understand mental health disorders, which is really important” explained Ed. “We have a good relationship with our researchers, CUH and the Cambridgeshire and Peterborough NHS Foundation Trust. We’re working to bring mental health more into the mainstream setting and we aspire to treat the whole patient - physical and mental. Having the mental health theme incorporated as part of the NIHR Cambridge BRC is really important to find new treatments.”

Mental Health Awareness week recently ran from the 16th to 22nd May. There is lots of information available and lots of places for support if anyone is concerned about themselves or someone they know. The research team in Cambridge support Mental Health campaigns and ask us to make sure we look after ourselves not just physically but mentally as well. Ed added: “Anything that can highlight mental health is a good thing, people should feel more comfortable to talk about issues they have struggled with, without being ashamed of it. These conversations can become very powerful and change the way people think about mental health problems. It’s all about the stigma, it shouldn’t be a shameful secret but should be more openly acknowledged and discussed. The more we talk about mental health the more likely we are to make progress in understanding and treating mental health symptoms even more effectively in future.”