One of the seven centres within Cambridge Children’s Research Institute (CCRI) will focus on Neurodevelopment and Mental Health. Our Mental Health Research Lead, Professor Tamsin Ford, says this is vital to the hospital’s integrated model of care.
Professor Tamsin Ford talks about the perfect storm brewing in children's mental health and neurodevelopment
Link: https://youtu.be/_RvUuoAPyWc
Professor Tamsin Ford explains the challenges facing children and young people's mental health and why research funding is essential to improve their future outcomes. Professor Ford has recently contributed her expertise in child and adolescent mental-health epidemiology to a major independent review of mental health conditions, ADHD and autism, and how support can be better matched to people’s needs.
Why is the Neurodevelopment and Mental Health Research Centre within the CCRI so important??
It’s hugely important. Mental and physical health can’t be completely separated. We couldn’t really say that we were offering genuinely integrated services without a research centre focused on neurodevelopment and mental health. It will make a huge difference, and Cambridge, as a major university, should be contributing strongly in this field.
Mental health conditions often begin in childhood and adolescence and can have a very substantial impact. They can take young people out of school, affect their future opportunities and ultimately affect what they are able to contribute to society.
What are the mental health and neurodevelopmental challenges facing children and young people?
As the recently published Prevalence Review (opens in a new tab) shows, we have something of a perfect storm: more children are struggling with anxiety, depression, eating disorders and self-harm. Research studies have shown that in recent years there has been no increase in the number of children who have ADHD and autism, but more of those who DO have the conditions are seeking support. Services are so underfunded that they cannot support everyone.
Additionally, research has shown that children and young people with poor mental health have worse outcomes in adolescence and adulthood. They and their parents are reporting more severe difficulties with worse impacts on their ability to function, compared to previous generations. Services need to increase their capacity to respond.
Eating disorders are a particularly serious example. In the UK, this increase began to become apparent around the mid-2010s, particularly among teenagers and young women. People can and do recover, but the journey can be very difficult and there is an associated risk of mortality. They also demonstrate why integrating mental and physical healthcare is so important. The initial drivers may be psychological, but very low weight, starvation and changes in blood chemistry can profoundly affect physical health, thinking and behaviour. Mental and physical health services and professional training are often separate, so bringing those skillsets together at Cambridge Children’s Hospital will make a real difference to patience experience and outcomes.
The picture with ADHD and autism is somewhat different, as the Prevalence Review shows. Large population surveys suggest that the number of children meeting diagnostic criteria is relatively stable, but the proportion coming forward and asking for help has increased enormously over the past decade. Services are struggling to cope with that increased demand.
Schools are very important because they have long-term relationships with children and families. We can’t expect teachers to be therapists, but we can support school staff to recognise children who need additional help and ensure referrals happen and are acted upon.
What does the research landscape look like for mental health?
Research has a pipeline that runs from discovery science through to implementation in the community.
Discovery research helps us understand how conditions develop and identify potential biological, psychological or social targets. From there, researchers develop possible interventions. That could be medication, a psychological intervention such as talking therapy, or something social and systemic. Often, a combination is needed because physical and mental health cannot really be separated.
Potential treatments then need rigorous testing, such as randomised controlled trials, to establish whether they are effective, safe and value for money. After that comes implementation research: how do we embed a treatment in practice, who needs to deliver it, what training or qualifications do they need, and are there effects that haven’t yet been identified?
Cambridge has considerable discovery and early translational research in physical health areas such as cancer and gut health. There is also interesting work around inflammation and mental health, particularly depression, although much of that focuses on adults. Research with children and young people tends to be more applied, including trials of psychological treatments, evaluations of policy reforms and large national surveys.
Why should children’s mental health research be better funded?
Mental health research is chronically underfunded, even though many adult mental health conditions have their roots in childhood. That matters because mental illness during childhood and adolescence can disrupt crucial developmental years. Six months of illness can represent most of an academic year, at precisely the time when young people are taking important examinations and making choices that affect their future.
We should therefore be front-loading resources into early detection, effective treatment and helping children get back to functioning and back into school as quickly as possible.
Current mental health research trials
- Professor Tamsin Ford (opens in a new tab) is a child and adolescent psychiatrist. She has an honorary contract with Cambridgeshire and Peterborough NHS Foundation Trust and is Head of the Department of Psychiatry at the University of Cambridge.