Working collaboratively to Investigate the Socioemotional Drivers Of severe and enduring Mental illness
Funded by UKRI for £315,023 from January 2026 to January 2029WISDOM is a research project that looks at the human side of serious mental illness, including how emotions, relationships, and everyday surroundings can affect people’s mental health. Instead of focusing only on biology or medication, it explores things like loneliness, distress, and social stress, and how these may shape illness, recovery, and support needs. The project will study warning signs in anonymised health records, look at how local environments influence outcomes, and test whether real-time information about feelings and social connections could help prevent crises. People with lived experience will help lead the work, so that the research stays practical, relevant, and focused on improving care.
Using a National, Interdisciplinary Team to Enhance Drug and alcohol treatment data
Funded by National Institute for Social Care and Health Research for £98,937 from January 2026 to December 2026This project aims to improve the way drug and alcohol treatment services in England collect and use information, so people can get better support at the right time. At the moment, the national data system is hard for staff to use, difficult for researchers and services to learn from, and does not always capture what matters most to people in recovery. The team will work with people with lived experience, frontline staff, and decision-makers to understand what needs to change, learn from good practice in England and other countries, and develop practical recommendations together. The goal is a simpler, more useful data system that improves care, supports recovery, and helps services respond more quickly to changing needs.
Embedding the Public Engagement in Data Research Initiative Good Practice Standards in Data for Research and Statistics - CRIS
Funded by Health Data Research UK for £13,732 from November 2025 to October 2026This project supports the expansion of a secure mental health research system called CRIS, which allows researchers to study anonymous NHS mental health records in an ethically governed way. A key strength of CRIS is that people with lived experience are directly involved in deciding what research should go ahead, helping ensure that studies are relevant, respectful, and useful to service users. Following the merger that created North London NHS Foundation Trust, CRIS is now being extended across five boroughs, which will greatly broaden the data available for research. This funding will help bring in and support a more diverse group of public contributors from across the newly merged Trust, so that lived experience continues to shape how CRIS is governed in a fair and inclusive way.
The acceptability, effectiveness and cost-effectiveness of Enhanced Patient Observation in reducing the risk of self-harm and suicide on psychiatric wards
Funded by National Institute for Health and Care Research for £1,519,760 from December 2024 to November 2027Research questions Is Enhanced Patient Observation (EPO) acceptable to psychiatric inpatients and ward staff? Is it used differentially for specific patient groups? Is EPO effective and cost-effective in reducing risk of self-harm (SH) and suicide during psychiatric admission? Could EPO be improved? Background EPO of patients by staff is used widely on psychiatric inpatient wards in England, consuming significant resources. Although recommended in NICE guidelines there is no good evidence it reduces the risk of suicide and SH. Qualitative evidence and our patient/staff consultation shows that patients can find it intrusive, coercive and unsettling. Newer methods of analysing observational data can overcome the cost and time implications of randomised controlled trials (RCTs) and have equivalent validity to RCT findings, yet have not been applied to this context. Aims and objectives Our aim is to evaluate the effectiveness and cost-effectiveness of EPO for suicide and SH, establish its acceptability and explore suggestions for change. Our objectives are: to collect quantitative (cost/activity) data on the practice of EPO on general adult psychiatric wards in England, and qualitative data on its acceptability to patients, carers and ward staff; to analyse routine clinical data to establish the effectiveness and cost-effectiveness of EPO in reducing suicide/SH; to bring this evidence together to co-produce staff training, patient information, revisions to clinical guidelines, and policy advice to improve the safety and experiences of staff and inpatients. Methods We will collect EPO cost/practice data for all general adult NHS psychiatric units in England, for use in our CEA. We will conduct individual qualitative interviews with current inpatients and clinical staff nationally with experience of EPO to explore their experiences and potential suggestions for change. Using electronic health records (EHRs) for two mental health trusts, we will develop an algorithm that can identify patients on EPO (and indication) for each bed day and describe their characteristics. We will test whether neurodivergent patients and those from ethnic minority backgrounds are more likely to be placed on EPO. Using a target trial emulation approach we will analyse EHR data in two trusts to establish the effectiveness and cost-effectiveness of EPO in reducing risk of SH and suicide on psychiatric wards. Bringing all this evidence together in a set of separate workshops for inpatients and ward staff, we will start a process of co-creating training, patient information, and policy briefings, and suggesting revisions to local/national clinical guidelines to improve EPO’s therapeutic value. Timelines for delivery In Y1 and Y2 we will collect and analyse national cost/activity/qualitative data and create our algorithm. In Y2 and Y3 we will model target trial emulation. In Y3 workshops we will discuss findings to create staff training, patient information, policy briefings, and suggested revisions to clinical guidelines, using diverse methods of dissemination to reach all stakeholders. Anticipated impact and dissemination Our close working with clinical leaders and commissioners will ensure that the staff training package we create will be integrated into existing training infrastructures. This, and our wider dissemination of findings, will ensure that the evidence we create will translate rapidly into benefits to patients, staff and all stakeholders.
Why is the research important? Suicide prevention is an important national public health priority. In 2019 the National Health Service made a plan to focus on reducing self-harm and suicide among people staying in psychiatric hospitals. However, there is currently little evidence to show whether what is done to help these patients is effective or worth the money. What are we interested in? One-to-one nursing (also called Enhanced Patient Observation) is commonly used in psychiatric hospitals. It aims to help patients feel safe and to stop them from hurting themselves but we don’t know if it actually works. Some patients can find it threatening or invasive. With our lived experience experts, we are proposing to carry out research in five stages to learn more about it. How are we planning to do this research? In stage 1, we will ask all the NHS mental health organisations in England about how they use Enhanced Patient Observation and how much it costs. We want to know what they’re doing well and if there are any good ideas we can share. In stage 2, we will talk to current inpatients and ward staff with experience of Enhanced Patient Observation. Our lived experience researchers will interview them to ask them what they think about it and if they can suggest any ways to make it better. This will help patients feel comfortable sharing their experiences. In stage 3, we will use anonymised electronic patient records to look at the different kinds of patients who have…
Health-related Outcomes, alternative Provision, and Exclusion among pupils with neurodivergent Special Educational Needs (HOPE-SEN)
Funded by Economic and Social Research Council for £148,211 from September 2024 to March 2026Special educational needs (SEN) refer to learning difficulties or disabilities which can make it harder for a child or young person to learn compared with other pupils of the same age. Types of SEN can vary widely, including difficulties with communication and interaction, cognitive and learning difficulty, and other social, emotional, and mental health problems. Some of these SEN can be considered in terms of neurodiversity or neurodivergence which describe a person whose brain functions, ways of processing information, and/or behaviours are considered atypical.
Pupils with neurodivergent SEN may receive support from school and/or local authorities yet health and educational outcomes are often worse for these pupils nevertheless. For example, pupils with neurodivergent SEN are more likely to have medically-related absences from school, engage in self-harm, and die by suicide. As well, pupils with neurodivergent SEN are more often subject to formal school exclusion and attend alternative provision. These adverse experiences and outcomes in childhood and adolescence can lead to lifelong disparities in employment, socioeconomic status, and well-being.
Identifying and understanding which risk factors are associated with adverse outcomes can be an important step in designing targeted interventions to support pupils with neurodivergent SEN to succeed in school and in life. For instance, school-based SEN support for neurodivergence can be a crucial factor but not enough is known about how differential SEN support might be causally related to specific outcomes for distinct types of neurodivergent SEN. SEN provision is meant to account for individual needs but can be very heterogeneous in practice. As well, evidence about disparities in who receives support from local authorities through Education, Health, and Care Plans (EHCPs) and how EHCPs may be linked to long-term outcomes can help guide policymaking to improve EHCP provision.
This fellowship proposal aims to apply descriptive epidemiology, data science, and causal inference in three work packages to explore these questions using observational data from The Education and Child Insights from Linked Data (ECHILD) database. Descriptive epidemiological approaches will be used in two work packages to explore relationships between educational and health risk factors and outcomes among secondary school pupils with neurodivergent SEN, including building on existing work examining empirical phenotypes of neurodivergent SEN. These work packages will make use of advanced statistical models which will account for hierarchical, longitudinal, and time-varying data. A third work package will investigate the feasibility of applying causal inference approaches in ECHILD with a proposed target trial emulation. Cutting across these work packages are commitments to advanced data science, meaningful public engagement, and open science and innovative dissemination.