Improving services for people with common mental health disorders including psychotic experiences
Background
Anxiety and depression are among the most common mental health conditions in the UK, but not everyone experiences them the same way.
Some people with common mental health conditions also have psychotic experiences like paranoia and voice hallucinations. And these people sometimes find themselves in a treatment gap. Programmes for anxiety and depression don’t always address their psychotic experiences, and services that do are scattered and inadequate. This can mean that psychotic experiences go untreated, which can have a negative impact on their health and quality of life.
More than 900,000 people in the UK receive treatment for anxiety and depression through NHS Talking Therapies, and a recent study indicated that 30% of them also have psychotic experiences. NHS Talking Therapies services don’t specifically target psychotic symptoms, and evidence shows this population may be much less likely to recover than those without psychotic experiences.
Developing a tailored form of cognitive behavioural therapy specifically for people who have had psychotic experiences could help bridge this treatment gap and better meet the needs of this underserved group. Researchers have developed and evaluated a training and supervision package for NHS therapists, to help them meet the needs of people with common mental health disorders and psychotic experiences.
Because variability is common in scientific trials like this one, it’s important to understand what happened in practice, such as what was implemented, how it was delivered, how it led to change, and how the context affected the outcomes. To explore these questions, THIS Institute carried out an evaluation of the trial itself.
Approach
We interviewed people involved in the trial, including therapists, people who received the tailored therapy, line managers working in Talking Therapies, and study team members, to gather their experiences. We also looked at study documentation, and took notes of team meetings to understand how the trial was working.
We worked closely with a lived experience advisory panel (a group of individuals with personal experience who collaborate with healthcare organisations) throughout the project, which included people who had lived experience of mental health conditions. The panel supported analysis of the findings, provided feedback on study findings and advised on the language used.
This project is also known as Tailoring evidence-based psychological therapY for People with common mental disorder including Psychotic EXperiences (TYPPEX).
Funding and ethics
This study is funded by the Health Foundation’s grant to The Healthcare Improvement Studies Institute (THIS Institute) and the National Institute of Health Research. It is independently led by THIS Institute. The study was reviewed by London-Harrow Research Ethics Committee.