̽��ֱ�� of Cambridge - Tine Van Bortel

̽��ֱ��power of touch

ta385 — Thu, 17 Jun 2021 05:30:00 +0000

As a major Fitzwilliam Museum exhibition explores human touch through 4,000 years of art, Cambridge researchers explain why this sense is so important in their own work.

Almost a quarter of adults living under lockdown in the UK have experienced loneliness

cjb250 — Wed, 22 Apr 2020 07:56:48 +0000

̽��ֱ��most affected group were young people aged 18-24 years, with more than four in ten (44 per cent) saying they felt lonely, according to the research study. ̽��ֱ��next most affected group were adults aged 25–34, with more than one third (35 per cent) saying they had experienced loneliness as a result of coronavirus.

One in six older people aged over 55 said they had felt lonely as a result of coronavirus, according to the study.

̽��ֱ��survey data, from 2,221 UK adults aged 18 and over, were collected as part of Coronavirus: Mental Health and the Pandemic, a UK-wide longitudinal research project.

̽��ֱ��survey was carried out on 2-3 April and asked people whether they had felt loneliness in the “previous two weeks”.

̽��ֱ��UK-wide project is being led by the Mental Health Foundation in partnership with the ̽��ֱ�� of Cambridge, Swansea ̽��ֱ��, ̽��ֱ�� of Strathclyde and Queen’s ̽��ֱ�� Belfast. ̽��ֱ��charity is seeking to track changes in the UK’s mental health in real time and target issues as they emerge.

̽��ֱ��research also revealed a major surge in feelings of loneliness, which more than doubled across the lockdown period. When the researchers carried out the first round of the survey in March, shortly before lockdown started, 10 percent of UK adults said they had felt lonely. This figure rose to 24 per cent of all UK adults by the beginning of April.

Similarly, shortly before lockdown, 16 percent of young people aged 18-24 said they had felt loneliness because of coronavirus. This figure rose to 44 percent of young people after lockdown had been in force for almost two weeks.

Professor Tine Van Bortel from the Cambridge Institute of Public Health at the ̽��ֱ�� of Cambridge said: “It might feel surprising but what our research shows is that the group most likely to be experiencing these feelings are young people.

“It is worrying that close to half of them said they are concerned about feeling lonely, and special attention should be given to young people. However, we shouldn’t forget that loneliness is also clearly affecting very large numbers of people of all ages.”

̽��ֱ��Coronavirus: Mental Health and the Pandemic research project is carrying out ongoing analysis of the data, which cover approximately 20 topics including the unequal impact on the mental health of at-risk groups, the key drivers of risk to mental health and how people in the UK are coping. Qualitative data is to be added via a Citizen’s Jury and regular detailed briefings will be produced.

Dr Antonis Kousoulis, Director at the Mental Health Foundation: “Our data reveal that millions of people in the UK are experiencing feelings of loneliness – which is a key risk factor for developing or worsening mental health problems.

“ ̽��ֱ��concern is that the longer the pandemic goes on, the more feelings become long-term. ̽��ֱ��impact of long-term loneliness on mental health can be very hard to manage.

“While the initial priority must be to prevent loss of life, we fear that we may be living with the mental health impacts of the coronavirus situation for many years to come. This is especially true of vulnerable groups and it is critical that governments and others are mindful of this in developing policy as we go forward.”

For the latest wave of data-gathering, total sample size was 2,221 UK adults aged 18 and above. Fieldwork to gather the new data was undertaken between 2 and 3 April 2020. ̽��ֱ��survey was carried out online. ̽��ֱ��figures have been weighted and are representative of all UK adults (aged 18 and above).

̽��ֱ��previous wave of data-gathering was as follows: Total sample size was 2,126 UK adults. Fieldwork was undertaken between 17 and 18 March 2020. ̽��ֱ��survey was carried out online. ̽��ֱ��figures have been weighted and are representative of all UK adults (aged 18 and above).

Advice on tackling loneliness.

All figures, unless otherwise stated, are from YouGov Plc.

Adapted from a press release by the Mental Health Foundation.

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One in four adults (24 per cent) in the UK have felt lonely because of coronavirus, according to a longitudinal study that is tracking mental health across the pandemic.

It might feel surprising but what our research shows is that the group most likely to be experiencing these feelings are young people

Tine Van Bortel

Sasha Freemind

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̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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GP clinics could help bridge mental health treatment gap, study finds

cjb250 — Thu, 07 Nov 2019 19:00:42 +0000

̽��ֱ��research was based on a trial in Indonesia, where patients often do not get the treatment they need due to a shortage of practitioners. ̽��ֱ��team at the Cambridge Institute of Public Health say the findings are also relevant to the UK and any other country with a long waiting time for mental health appointments and a growing globalised clientele, as it opens up alternative pathways of care.

In many countries, there is a ‘treatment gap’ for mental health issues, caused in part by a confluence of the lack of mental health professionals and the social stigma attached to seeking help. While the median worldwide treatment gap for psychosis is 32% - meaning that almost in one three people with psychosis do not receive treatment - in low and middle-income countries it is estimated to be almost three times higher, above 90%.

Experts have argued that one way of bridging this gap would be to integrate mental health care into primary care, such as GP practices. Recent research confirmed that primary care clinics are the first port-of-call for most people with mental health problems. However, diagnosing mental health problems in primary care is difficult for several reasons, including time constraints during consultations, lack of mental health expertise and problems with referrals.

In 2008, the World Health Organization (WHO) launched the WHO Mental Health Gap Action Programme to support countries in scaling up services for mental, neurological, and substance use disorders, with a free online Intervention Guide and Training Manual. In 2015, the Indonesian Ministry of Health introduced the programme to selected pairs of GPs and nurses at its network of community health centres, with the aim to rolling it out nationally.

Researchers at the Cambridge Institute of Public Health carried out a study to evaluate the effectiveness of this programme in Indonesia. 153 patients completed treatment at 14 primary care clinics that had received the WHO training, while 141 patients at 14 other clinics received treatment from specialist clinical psychologists co-located in primary care. ̽��ֱ��findings are published today in PLOS ONE.

Dr Sabrina Anjara, a Gates Cambridge Scholar who carried out the research while at the ̽��ֱ�� of Cambridge, said: “Mental health care provided by a GP proved to be just as effective for mild to moderate conditions as care by a specialist, such as a clinical psychologist. GPs also helped large proportions of participants go into remission.”

Both groups experienced a similar improvement in health and social functioning, quality of life, and disability reduction at the six-month follow-up. A large proportion of participants from both study arms were considered in remission (152 from GP clinics, 134 from the specialist arm of the trial). ̽��ֱ��improvement was quantified using the Health of Nations Outcome Scale, the European Quality of Life Scale and the WHO disability assessment schedule.

To directly inform policy decisions, the researchers conducted an economic analysis. Its results suggested that the cost of treatment from specialist services was lower on average, despite their patients experiencing similar improvements in symptoms as GP patients.

Dr Anjara added: “Not only were GPs able to manage mental health problems, but patients were more likely to return to see them for follow-up treatments. However, GP workload needs to be considered alongside the cost-effectiveness of various options. We found follow-up appointments with a clinical psychologist to cost the Indonesian health system less, so the co-location of specialist mental health professionals in primary care may be a more feasible option in the long run.”

̽��ֱ��researchers say that the findings provide potential learning points for other countries, which may not be considered low and middle-income countries, but have similarly limited resources for mental health services due to a structural imbalance of supply and demand. In the UK, for example, the British Medical Association found in 2018 that the waiting time for a clinical psychology appointment surpassed two years in some NHS trusts.

“NHS England has committed to transform mental health services and also plans to recruit mental health therapists to be integrated into primary care settings such as GP practices,” said Dr Tine Van Bortel, senior author and supervisor from the Cambridge Institute of Public Health.

“This transformation aims to put mental health services on an equal footing with physical healthcare. Nine out of 10 adults with mental health problems seek help in primary care settings, and the transformation of mental health service delivery model will also strengthen the primary care and its workforce which will be able to offer a broader range of services for patients.”

“If GP practices provided mental health treatment for those with mild to moderate conditions, the waiting list for specialist services would reduce considerably,” said Dr Anjara, who is now based at ̽��ֱ�� College Dublin. “In addition, getting treatment from their GP is less stigmatising, which will also lead to better continuity of care. Early intervention is key in reducing the economic and societal burden of mental health.”

In addition to fieldwork funding from the ̽��ֱ�� of Cambridge School of Clinical Medicine, School of Biological Sciences, Department of Social Anthropology and the Cambridge Philosophical Society, this research was supported by crowdfunding.

Reference
Anjara, SG et al. Can General Practitioners manage mental disorders in primary care? A partially randomised, pragmatic, cluster trial. PLOS ONE; 7 Nov 2019; DOI: 10.1371/journal.pone.0224724

Patients experiencing mild to moderate mental health issues could be managed effectively by GP practices, suggests new research from the ̽��ֱ�� of Cambridge. This could also help reduce the stigma faced by these individuals. However, specialist treatment may still prove more cost-effective in the long term, say the researchers.

Mental health care provided by a GP proved to be just as effective for mild to moderate conditions as care by a specialist

Sabrina Anjara

kilarov zaneit

Indonesian man

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̽��ֱ��stresses and strains of work and unemployment

cjb250 — Tue, 26 Jun 2018 07:45:07 +0000

When I ask Dr Adam Coutts what we know about the impact of unemployment on health, his response is blunt and to the point: “It’s very bad.”

There’s a pause before he goes on to say that we’ve known for more than half a century that unemployment is bad for mental health and wellbeing, and that this has a knock-on effect on our physical health. Where there is debate, though, is over why it is so bad. Studies suggest that work provides what he describes as “psychological vitamins or functions”, such as structure, routine, a sense of identity and the opportunity to meet people and socialise. “It’s not all about a wage,” he says.

Coutts has been on research placement from the Department of Sociology to the UK government’s Department for Work and Pensions (DWP) and the Department of Health and Social Care (DHSC) Work and Health Unit since June 2016. There, he has been looking to better understand the link between unemployment and mental health, particularly in the context of today’s Britain, and how policy can intervene to help.

He is studying an intervention that aims to get people back to work and to support their mental health needs. ̽��ֱ��programme is adapted from one developed by the Institute of Social Research at the ̽��ֱ�� of Michigan and now being trialled by the DWP. Participants take part in a voluntary five-day course, during which they receive help with CV writing, social support, interview techniques and how to search for a job, including how to see the process from the viewpoint of an employer.

Coutts has been conducting an ethnographic study across five areas of England since the trial started in January 2017 to complement a large-scale randomised control trial evaluation. He has what he describes as “a ringside seat” of the policy process and has seen how the intervention has been designed, implemented and evaluated: a privileged point of access for any academic researcher. He observes course participants and facilitators, and staff at job centres – “everyone from the unemployed to senior civil servants” – to see how these policies actually work on the ground.

“We know these types of interventions have an effect on job search behaviours and a person’s health, but we don’t really know why and who is most responsive. I’m trying to tell a story of what it’s like to go through these programmes, be unemployed and cope with mental health issues in Britain today.”

If the evidence from previous trials in the USA is anything to go by, then the benefits from such an intervention would reach beyond the individual: as well as helping people get back to work, improving their mental health and wellbeing could save money for the NHS, as a result of less reliance on GP or mental health services.

But mental health issues are not just associated with unemployment. There is a growing recognition of the link between employment and our health and wellbeing, too. A recent report for government, entitled ‘Thriving at Work’, included some startling statistics for the UK: 15% of workers have a mental health condition and 300,000 people with long-term mental health problems lose their jobs each year. Mental health costs employers over £33 billion per year, the state over £24 billion and the whole economy over £73 billion.

“Employers need to understand that stress and anxiety, and mental ill health, is a large problem in terms of people not being at work, or being at work and not performing well,” says Professor Dame Carol Black, Principal of Newnham College, and author of several influential reports for government about work and health.

Black believes that training at line management level to identify and support workers with mental health issues is essential to tackling this problem; without this, measures to create healthier workplaces will amount to little more than papering over the cracks, Black says.

However, she has seen enough examples of good practice in companies such as BT, Unilever and Anglian Water to be optimistic that we can tackle this problem. “What you see are pockets of good practice, but I think we need a campaign to really get it out there and say we know this is what we all should be doing – it isn’t that difficult to do.”

Business leaders are beginning to pay attention. In an article earlier this year following the annual meeting of the World Economic Forum, Clifton Leaf, Editor-in-Chief at the influential business magazine Fortune, chose as number one of ‘7 Takeaways From Davos’: ‘ ̽��ֱ��mental health disorder time bomb is upon us’.

One of the problems, however, is the lack of concrete evidence about what works. “People often ask ‘where’s the Cochrane-type evidence?’” says Black, referring to the ‘gold standard’ of evidence reviews in research. “It’s not easy to collect data in the workplace, but we would only have better evidence if more organisations collected data and were willing to share it.”

Dr Tine Van Bortel from the Cambridge Institute of Public Health is helping to build this evidence base. In fact, she was namechecked in Leaf’s article after he attended a mental health event at Davos that she co-presented with the international care consortium Kaiser Permanente.

As part of her mandate with the World Economic Forum Global Agenda Council on Mental Health, Van Bortel has been leading a study looking at policies used by major corporations aimed at improving the health and wellbeing of their workforce. “A lot of these corporations say that a combination of integrated and targeted approaches are really important,” she says.

An integrated approach might consist of providing access to a gym. Targeted interventions might include a willingness to make ‘reasonable adjustments’ such as moving an employee to less strenuous work or allowing
them to work part time.

While Van Bortel believes employers should take responsibility for ensuring the health and wellbeing of their employees, she is a passionate believer that government can – and should – think about our mental health.

“I firmly believe that government should ensure our workplaces are healthy and that we’re not being confronted with some of the stressful, unjust and – quite frankly – inhumane situations that we’re currently seeing.

“Think about zero-hours contracts, or people having to work three jobs to make ends meet, or wage discrepancies and other structural inequalities. This puts a lot of stress on persons, families and ultimately society, and can reflect on work and productivity. More can and should be done. After all, healthy and all-inclusive workforces make excellent business sense.”

Inset image: read more about our research on the topic of work in the ̽��ֱ��'s research magazine; download a pdf; view on Issuu.

A stressful workplace can damage your health. But so too can being out of work. Cambridge researchers are trying to understand why both situations can be detrimental to our health and wellbeing – and help employers and government provide solutions.

Employers need to understand that stress and anxiety, and mental ill health, is a large problem in terms of people not being at work, or being at work and not performing well

Carol Black

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Opinion: How to build a mentally healthy workplace - step-by-step

bjb42 — Mon, 10 Oct 2016 13:28:15 +0000

An estimated one in four people worldwide experience a mental health problem at one point in their life. This bare number might be alarming but even that does not adequately reflect the human suffering, isolation, lost productivity, and brake on human development and general development for countries.

To the individual, mental ill-health can be isolating, exhausting and sometimes deadly, but it also takes its toll more broadly on organisations and businesses around the world. We might think the corporate world is quick to address issues which threaten growth and profits. However, while this common phenomenon drains the economy through absenteeism and healthcare costs, the persistent taboos around mental ill-health slow down the uptake of solutions at businesses, just as they do at the individual and government level.

Financial benefits

It shouldn’t be that difficult. Increasingly, organisations around the world now advocate investment in a mentally healthy workforce as a measure that simply makes good business sense.

It can lower total medical costs, increase productivity, decrease the number of sick days, disability costs, and more. From the perspective of investors and company owners it can simply come down to a matter of better financial performance and enhanced reputation, with the added benefit of a happier, more motivated and engaged workforce.

Profit driver? EPA/FREDRIK VON ERICHSEN

In reality, each company comes at this from a slightly different angle. As part of the work of the Global Agenda Council on Mental Health from the World Economic Forum, 23 global corporate organisational case studies on mental health strategies were gathered and analysed. Analysis of the these global corporate leaders’ investments in mental health in their workplaces revealed no single motivation. Instead, several tend to work in combination.

A healthy and happy workforce is more productive which is good for business and so protecting the mental health of employees makes perfect business sense.
It is the “right thing” to do.
There are clear benefits to the organisation from employee engagement, loyalty and in terms of wider organisational reputation.
It makes sense to manage the costs and liabilities of ill-health (including mental ill-health) of employees.

Taking it on

There is a growing body of evidence on the economic costs related to workplace mental health. This can include absenteeism and presenteeism – where staff spend too long at work despite being ill – as well as the wider costs of staff turnover and recruitment. We also have increasing evidence that there are things companies can do to address risk factors and build resilience to overcome and manage stress for employees.

̽��ֱ��case studies we looked at showed that there is a growing tendency for mental health to be tackled as part of a broader health, well-being and safety strategy. Initiatives are increasingly integrated and built around positive health, prevention and early recognition, as well as support and rehabilitation where needed. So what are these companies actually doing?

One key step is often to focus on the work environment itself. It can be simple stuff like increasing the available natural light, fresh air or bringing in plants. ̽��ֱ��inertia of office routine can be punctured by buying in standing desks – or even treadmill desks. ̽��ֱ��nature and outlook of a workplace can be shifted by social meeting spaces, healthy food options on site, proper lunch break areas and discounted sports facilities on site or nearby, combined with flexible work arrangements to encourage their use.

It is also common for companies to tackle work-related stress. Again they can look like easy wins, but not everyone does it. One measure that has been shown to significantly decrease stress levels of employees during annual leave is to set up email systems to delete messages while out-of-office is activated. Senders are warned to resend the message once the person returns and the recipient doesn’t come home to a deluge of mail.

Dog’s life

At the more extravagant end of the spectrum, some larger corporate businesses bring in professional coaches to provide personal and group coaching, or provide resting areas for power naps or quiet contemplation. Employers could even turn to pet therapy interventions. There is good evidence that spending time watching, patting or walking a cheerful puppy or dog can significantly bring stress levels down.

No one said the dog had to be cheerful. Soloviova Liudmyla/Shutterstock

Other strategies we found include the company making a public pledge to address mental health issues, as well as taking part in national mental health campaigns like See Me, Time to Change or Beyond Blue. These large corporates also invested in mental health training in the workplace, including themes such as managing mental health, mental health first aid and building resilience, the capacity to adapt in face of challenges.

In the 23 global corporate case studies, common strategies to address mental health in the workplace emerge. Flexible working works, as do policies which allow workers to swap pay for leave. Counselling, Cognitive Behavioural Therapy (CBT) and mindfulness services can also work. An open environment can be crucial. Boosting mental health literacy and mental well-being champions can encourage people to speak up and seek help.

Whether it is a small business or a multi-national FTSE 100 company, tackling mental ill-health is a necessity in today’s world. ̽��ֱ��case studies referred to here represent only 23 global corporate businesses, but they also represent practices which can make a difference. Every organisation is different and requires a unique set of policies which meet the needs of its staff. ̽��ֱ��trick then is to identify what those needs are, how a workplace mental health programme could begin to address them, and to bring all employees along as you work out how to implement them.

Tine Van Bortel, Senior Research Associate in Public Health, ̽��ֱ�� of Cambridge

This article was originally published on ̽��ֱ��Conversation. Read the original article.

Mental health has long been the Cinderella of healthcare: left to scrape an existence while the bulk of funding and attention goes elsewhere. As we mark World Mental Health Day, it is clear that policy makers and the public are coming to the realisation that there is no health without mental health. This shift is desperately needed.

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