Publications and reports

Mental Health Research for Innovation Centre Progress Report | September 2023

• Consolidate and secure partnerships with companies/groups providing apps / interfaces for service-users use over symptoms/other experiences.
• Publish a model for integrating personalised interaction profiles into care records.
• Set up at novel test environment, enabling study of “sleep avatars” and hypnograms linked to care pathways.

Develop new insights from Avatar

• Work with Our Future Health to enhance their interactivity and longitudinal data fidelity and care-record linkage.
• Partner with regulators to improve the validation of algorithms for personalised interaction.

• Our Mental Health Avatar project is well underway to improve how data is collected, processed, and linked to electronic care records – then used in near real time – to benefit treatments for patients.
• The ESNTL Wellness pilot trial, in partnership with Apple and Concentrix, is underway, using smart technology (wearables) for Mersey Care NHS Foundation Trust staff to monitor health and wellbeing.
• Work is also underway in secondary care data to develop models, in collaboration with colleagues in Oxford.
• Additional NIHR funding has been provided SEISMIC development award: SysteMatic, with the added intention of researchers bidding for a Systems Engineering Centre.
• Ethics application is in development to allow the collection (with consent) of high-quality data for research re-use, maintained in electronic form.

• Establish “consent-to-contact” cohorts on CIX for pharmacological, psychological, digital and medical device trials in depression prevention, difficult to treat depression (DTD), treatment resistant depression (TRD).
• Extend recruitment into trials from non-medical settings such asthe Life Rooms and The Reader.

Fuel innovative services

• Establish a regional mood disorders treatment centre integrating primary and secondary care management of mood disorders and routine seeking of “consent-to-contact”.
• Pursue rapid innovations through CYP2D6/CYP2C19 polymorphism information informing DTD/TRD therapies/pathways.

• A mechanism of data navigation is underway to identify those patients most in need of innovative methods to help people with difficult to treat depression.
• An integrated mood disorder service pathway – one of the first in the UK – is in the set-up phase. This will act as a ‘follow on’ assessment service, and a multi-disciplinary (psychiatry, psychology, nursing, occupational therapy, dietetics) team of staff is being convened. The first cohort of patients suitable for the service has been identified, and they will collaborate side-by side with our clinical staff and researchers to co-produce/design the service pathway for the benefit of future patients.
• Other activity revolves around studying the mixed presentation of anxiety and depression, and the implications of taking multiple medications.

• Link the Children Growing Up in Liverpool (CGULL) birth cohort study into CIX and TRC research and enhance its mental health data linkage and curation.
• Enhance digital phenotyping of pregnancy in C-GULL study with work package 4 and 4youandme.org.

Co-produce and evaluate digital interventions

• LIFE (Life skills For Everyone): Develop and feasibility test web- based dialectical behavioural therapy for children and young people experiencing emotional distress and difficulties with emotional regulation.
• Mindset Sketchpad: Hone and evaluate an existing web-based positive psychology intervention to understand its effectiveness in UK school and community settings.

• Our researchers are working with adolescents in trialling MindAR (therapeutic game and speech biomarkers). The mechanisms of age-appropriate involvement for our younger age group of patients and service users not only in the way in which we undertake our trials within this work package, but also their input into co-design, is fundamental.
• CAMHS digital health is a theme in the Global Mental Health programme, and work is already underway to reverse translate some of those principles into M-RIC’s context, more specifically with service and clinic providers within Mersey Care NHS Foundation Trust.
• Our researchers are developing an application which reviews a predictive tool to assist clinicians in mental health interventions at the right level in perinatal women, which can subsequently impact a child’s or adolescent’s mental health. The CGULL birth cohort study, as a triad design, is ideally placed to potentially validate the predictive tool.

• Build capability by training clinicians in delivering proof of concept (PoC) studies (via the TRC).
• Use CIX to identify well-characterised patients and seek “consent-to-contact” for studies from 6 Early Intervention Services.

Identify and use novel biomarkers and phenotypes

• Contribute blood for whole exome sequencing and genome-wide genotyping (with NIH/Regeneron study led by Walters (TRC: EP).

• We are creating an infrastructure for innovative immune therapies for schizophrenia by co-designing a feasibility study with patients whose symptoms persist despite treatment and with a developing first-instance psychosis PPIE Group.
• We aim to test novel ideas about the role of the cellular immune system in psychosis and will be profiling immune cell populations with Prof Lance Turtle at the Institute of Immunology in the feasibility study.
• Our group are defining neuro-degenerative biomarkers which may relate to immune changes. We collaborate with patients and research teams in Birmingham and Oxford in related studies.
• Common factors between work package 5 and work package 1 are emerging to deploy CIX to assist in the identification of potential participants and identify impacts of general health and wellbeing.

• Recruitment of core personnel in line with equality, diversity, andinclusion policies.
• M-RIC governance structure defined and implemented (board; steering group; management and operations groups with terms of reference and associated oversight structures in place).
• Multi-sector collaborations with stakeholders built upon including cross-MH TRC synergies) evidenced by stakeholder mapping, onboarding processes, new partners documented and contracting model agreed.
• Centre wide monitoring and evaluation framework defined and operational, feeding into national reporting mechanisms. Evidenced by progress reports, baseline and ongoing metrics recorded, theory of change defined and reviewed.
• Internal/external communication strategy developed.

• We have worked swiftly and agilely, and M-RIC is fully operational.
• We have firmly established our identity throughout Liverpool and beyond! Our dynamic, interactive presence is evident on X/Twitter and LinkedIn, and we have launched M-RIC’s dedicated website.
• We have met our year 1 target of recruiting research and operational expertise across a variety of disciplines. This includes specialist HR, finance, communications, contracts, and project management staff.
• We have demonstrated spend to profile for Q4 of Fiscal Year 22/23 and Quarter 1 of Fiscal Year 23/24.
• We have set up robust contractual agreements with third parties and Industry partners.
• We have created a framework of governance for M-RIC which meets the complex assurance needs of a trans-organisation, and cross-sector environment.
• We formally announced M-RIC on 26 May 2023, bringing to life a cross-organisation communications plan.

• Clinical research capacity building programme developed with support of the MH TRC capacity building theme.

• In alignment with the UK Mental Health Mission, we are taking seriously our commitment to future-proofing the research and innovation workforce of the future by nurturing and encouraging our home-grown talent.
• We are well underway in the process of undertaking a scoping exercise aimed at capturing how involvement – ranging from support to frontline delivery – of research and clinical trials varies across not only the spectrum of professional development but also the healthcare professions at Mersey Care NHS Foundation Trust.
• Through close alignment with the NIHR Mental Health Translational Research Collaboration (MH TRC) Capacity Theme, we are building further capacity and have already created 30+ honorary posts and secondments, including academic clinical fellows, to achieve a critical mass of clinical research at Mersey Care NHS Foundation Trust.
• Discussions are taking place with the Capacity and Capability Lead for the UK Mental Health Mission to build a short, 3-day certificate training programme for peer researchers who will provide valuable input into the way in which service user feedback is captured to ensure ongoing contribution and co-design and build a wider group of peer/lived experience advisors.

• Establish an expert group of service users and public advisors to assess performance against our Equality, Diversity and Inclusion (EDI) commitments.
• PPIE strategy established to complement existing Liverpool and TRC structures with the first phase of engagement, and training operation.
• Monitor local community representation/engagement by
  • increased numbers of service-users trained and attending
  • co-production workshops and meetings.
• Take a multi-experience, life-course approach to reflect place-basedclusters of mental health risks and experiences across age groups.
• Invest in civic, system-wide communications (co-created with service-users) to highlight M-RIC’s ambitions and activities.

• PPIE Strategy and Engagement Delivery Plan has been drafted and circulated internally.
• The PPIE service-user role descriptions are completed, and patient recruitment frames of reference are in development via co- production with service users.Our PPIE partnership networking has commenced:
• Partnerships established with PPIE leads at Mersey Care NHS Foundation Trust and the University of Liverpool.
• We attended Mersey Care Service Evaluation showcase.
• Introductory meetings held with PPIE teams – ARC NW / Mersey Care.Our service user co-production involvement has commenced:
• We held our first introductory workshop for service users in June 2023.
• We have held three PPIE preparatory meetings with key service user representatives.
• We have engaged with third sector organisations with diverse populations such as Mary Seacole House, African Caribbean Centre, the Black Women’s Health Network, and the Walton and Southport Life Rooms.
• We are currently co-producing a workshop with participant service users for World Mental Health Day (10.10.23)

Further information can be found below.