We are extremely proud of having funded several high-quality research ideas.

We aim to make a positive difference in wellbeing through robust research, innovative interventions, incorporation of co-production with service users and carers, and forward-thinking and brilliant teamwork. 

Funded projects via the Collaboration Fund:

2019 to 2020

The project will bring together individuals with severe mental illness (SMI), researchers, providers and practitioners who are passionately committed to the development and implementation of systemic approaches for improving access, provision and promotion of physical activity (PA) for individuals with SMI. It aims to foster a comprehensive and cohesive network, creating partnerships with individuals, groups and organisations working to reduce inequalities in health and wellbeing for those with SMI.

Key contact: Dr Katarzyna Karolina Machaczek, Research Fellow, Sheffield Hallam University, k.machaczek@shu.ac.uk, via Twitter: @KMachaczek

Watch Dr Katarzyna Karolina Machaczek talking about the project on The Research Sofa series.

The project we are conducting is a collaboration between Altered Eating Research Network and the Centre for Applied Psychological Science at Teesside University. The project is exploring the altered relationship with food and eating in women with severe mental illness.

Women with SMI present with multiple psychological and medical comorbidities and a history of trauma and eating disorders. This means they are likely to be on a medication schedule that impacts appetite, weight and senses of taste and smell. The sensory changes may also be compounded by smoking and depression. In addition, we know that when it comes to food and eating, physical environments are also very important which is why we are looking to explore how institutionalised care impacts the relationship with food.

Key contact: Dr Mia Campbell, Research Psychologist & Lecturer in Psychology, Teesside University, and Altered Eating Research Network Co-ordinator  mia.campbell@tees.ac.uk

The goal of the project is to develop a dynamic microsimulation model to better understand the behavioural and economic effects of health policies on lifetime outcomes of individuals with psychosis (e.g. health outcomes, economic outcomes) and help guide decision-making. The resulting findings will have a direct impact on the lives of individuals living with psychosis. Moreover, it will help guide decision makers who seek to provide evidence-based, cost-effective care.

Key Contact: Dr Claire de Oliveira, Reader at Centre for Health Economics, University of York, claire.deoliveira@york.ac.uk

We aim to explore the impact of the increased use of remote primary care consultations (telephone and video) on people with severe mental illness, with a view to developing interventions to mitigate any negative impact of this change. We carried out stakeholder engagement discussions with service users, mental health charity representatives and health care professionals to identify themes, suggested areas for improvement and research questions.

Key contact: Dr Helen Twohig, GP and Doctoral Fellow, School of Primary, Community and Social Care, Keele University, h.j.twohig@keele.ac.uk

Watch Dr Helen Twohig talking about the project on The Research Sofa series

With this group we aim to bring together academic experts, city planners, health practitioners and third sector organisations involved in mental health to identify and promote productive partnerships in the identification of available and production of integrated mental health, environment and socio-economic datasets. We aim to have a multidisciplinary team, with a range of expertise, ready to collaborate on future research applications and with expert knowledge of the datasets available.

Key contact: Dr Joana Cruz, Research Associate and Associate lecturer, Department of Environment and Geography, University of York, joana.cruz@york.ac.uk

Women in prison often have disproportionately higher levels of severe mental illness (SMI), substance use disorders (SUD) and self-harm compared to men in prison. Complicating these high rates is the high comorbidity of SMI with SUD and trauma histories. It is also unclear whether women with SMI in prison access primary care services about their physical health care needs (such as cardio-metabolic problems, access to screening services including cervical and breast screening) and whether these physical health needs are being adequately met.

The aim of this project is to establish a new multidisciplinary, and cross institution, group that will strengthen links between academics, clinicians, individuals with lived experience, charities and industry partners working in the field of primary care in female prisons. We are coming together over a series of virtual days to explore and identify new approaches and ways of addressing inequalities in physical health among imprisoned women with SMI.

Key contacts: Prof Tammi Walker, Teesside University, t.walker@tees.ac.uk, Prof Carolyn Chew-Graham, Keele University, c.a.chew-graham@keele.ac.uk

Watch Prof Tammi Walker and Prof Carolyn Chew-Graham talking about the project on The Research Sofa series

This project will support online consultation events with diverse groups of informal carers of people with lived experience of severe mental illness to gather their perspectives on health outcomes and research priorities. This project represents a close collaboration between those with lived experience of caregiving and researchers based in London, Manchester, and Keele.

Key contact: Dr Juliana Onwumere, Senior Lecturer, Department of Psychology, King’s College London, juliana.1.onwumere@kcl.ac.uk.

Funded projects via the CtG Network+ funds

Summer/Autumn 2020 funding call

We are delighted to announce the outcome of the second allocation of Network+ funds from the Closing the Gap. The aim of our second round of funding (awarded December 2020) was to stimulate and support innovative research into the inequalities that people with severe mental ill health (SMI) experience, and to build a cross-disciplinary research capacity in the field of health inequalities for people with SMI. We sought to generate new knowledge and transformative activity in this area, together with researchers and public service users.

Given the pandemic restrictions, the volume of the research proposals we received surpassed our expectations. In total, we received ten high-quality applications (£291,420) for £295,398 of available funds. We have decided to fund those which were mostly aligned with the aim of the funding round, the purpose of CtG’s Feasibility and Pump-Priming funding, which is to provide short-term support to allow initial investigation of new ideas, collaborations and partnerships, and the mission of the Closing the Gap network in general.

So, we are excited to present the seven projects from the University of York and other institutions around the UK that have received funding, covering a range of our network themes:

In sleep apnoea the throat closes during sleep, so the person partially wakes up. Untreated sleep apnoea is associated with worsening symptoms of mental illness, and increases risk of cardiovascular diseases. People with severe mental illness are more likely to have sleep apnoea. However, we do not diagnose it very often. We want to understand what stops people with severe mental illness getting a diagnosis, and sleep apnoea treatment.

There might be specific barriers, attitudes, or poor awareness - this hasn’t been systematically studied. We will study this by completing and analysing surveys and interviews with patients and staff.

  • Sophie Faulkner, Greater Manchester Mental Health NHS Foundation Trust, co-CI
  • Dr Richard Drake, Greater Manchester Mental Health NHS Foundation Trust/University of Manchester, co-CI
  • Dr Joseph Firth, University of Manchester, co-applicant
  • Dr David Shiers, Retired GP/Carer senior, consultative input
  • Dr Megan Kalucy, UNSW Sydney, senior consultative input
  • Dr Hannah Myles, Northern Adelaide Local Health Network/University of Adelaide, consultative input

Social connectedness is an important part of wellbeing for adults with SMI, who may be disproportionately affected by social isolation. Collaborative musical engagement strengthens social connectedness and empowers participants.

This research project will therefore 1) explore the lived experiences of people with SMI to identify motivations for and barriers to engaging in collaborative creativity through music-making; 2) work with adults with SMI and music facilitators to design and create a video prototype for a collaborative music-making system with supporting mobile App that can be used synchronously or asynchronously. This technology will strengthen existing relationships and bring together new creative communities.

  • Dr Caroline Waddington-Jones, Department of Music, University of York, PI
  • Dr Anna Bramwell-Dicks, Department of Theatre, Film, Television and Interactive Media, Co-I

People with severe mental illness (SMI) have poorer oral health compared to those without SMI. To reduce oral health inequality in this population, interventions and services need to be adapted by understanding population-specific factors relating to poor oral health.

We aim to explore the barriers to, facilitators for, and mechanisms underpinning engagement with oral health care, from the perspectives of people with SMI, their families and the professionals involved in their care. Our findings will inform the development of a fit-for-purpose intervention to improve oral health in this vulnerable group.

  • Dr Masuma Pervin Mishu, University of York, PI
  • Professor Lina Gega, University of York, Co-PI
  • Dr Wael Sabbah, King’s College London, Co-applicant
  • Dr Alexandra Macnamara, Hull York Medical School, Co-applicant
  • Dr Mehreen Faisal, University of York, Co-applicant

Research has already shown that outdoor blue spaces, such as seas, rivers and lakes, can have positive effects on both physical and mental health, but little is known about how these spaces might help people with serious mental health conditions such as Bipolar Disorder or Schizophrenia.

In this project we will ask people with these conditions if outdoor blue spaces already help them, and if so, how. We will also ask what helps and hinders accessing these spaces. Their feedback will be used to develop a framework of ideas as to how blue spaces could benefit people with these conditions.

  • Professor Kim Wright, University of Exeter, Lead applicant
  • Samantha Eden, University of Exeter/University of Bath, Study researcher
  • Dr Lewis Elliott, University of Exeter, Co-applicant
  • Professor Fiona Lobban, Lancaster University, Co-applicant
  • Dr Jasper Palmier-Claus, Lancaster University, Co-applicant
  • Professor Piran White, University of York, Co-applicant
  • Chris Lodge, Lancaster University, Co-applicant
  • Sally Parkin, University of Exeter, Co-applicant
  • Dr Sarah Bell, University of Exeter, Co-applicant
  • Gordon Johnston, Bipolar Scotland, Co-applicant

Access to the internet and knowing how to use digital devices are important for everyday life and work. This study aims to document the extent to which people with severe mental illness (SMI) have the essential digital skills to engage with the online world and identify the sociodemographic and health characteristics that influence this. Another aim is to compare our findings with publicly available data for the general UK population.

The impact of these findings will be to help understand if policies are needed to ensure that people are not left behind in the process of digitalising services used by people with SMI (for example, online appointments with mental health services).

  • Dr Panagiotis Spanakis, University of York, PI
  • Paul Heron, University of York, Recruitment and data manager
  • Miss Lauren Walker, University of York, Lived experience researcher
  • Dr Ruth Wadman, University of York, Project management advisor
  • Professor John Baker, University of Leeds, Senior academic mentor
  • Dr Alice Mathers, The Good Things Foundation, Third sector special consultant

Educational interventions have been shown to improve clinician attitudes, as well as patient outcomes. This proposal aims to evaluate an educational intervention designed to support healthcare staff in having helpful health change conversations with individuals with severe mental illness (SMI).

The intervention will be designed to develop skills in motivational interviewing, and will involve simulation-based training to support learning and promote changes to practice. We will be measuring the impact of the intervention on clinician attitudes towards mental illness, empathy towards individuals with SMI, and observable changes in applying communication skills.

  • Chris Attoe, Maudsley Learning SLaM, PI
  • Dr Gabriel Reedy, King’s College London, Co-PI
  • Marta Ortega Vega, Maudsley Learning SLaM, Research assistant (ECR)
  • Hannah Iannelli, Maudsley Learning SLaM, Research assistant (ECR)

Poor sleep hygiene and low levels of physical activity are linked to poor mental and physical health and higher mortality rates in psychosis. Fitbit wearable trackers, sleep hygiene advice/training and physical exercise advice/opportunities can enhance wellbeing and physical health. An intervention incorporating these factors will be offered through an early psychosis service.

The impact on sleep, exercise, wellbeing and physical health will be evaluated. In-depth interviews will explore participant experience and gain understanding of how participants can best use technology, sleep hygiene and physical exercise. We will explore best-practice integration in mental health services and how to maximise benefits.

  • Dr Chris Griffiths, Northamptonshire Healthcare NHS Foundation Trust, Co-lead
  • Dr Ksenija Maravic da Silva, Coventry University, Co-lead
  • Dr Kate Walker, Northamptonshire Healthcare NHS Foundation Trust, Co-investigator

Summer/Autumn 2019 funding call

We were impressed by the volume and quality of research proposals, and we received far more high-quality applications than we were able to support.

We are now in a position to announce the outcome of the first allocation of Network+ funds from Closing the Gap. The aim of our first round of funding (awarded autumn 2019) was to stimulate research into the inequalities that people with severe mental ill health experience and to build a cross-disciplinary research capacity in the field of health inequalities for people with severe mental ill health. We sought to generate some new knowledge and activity in this area.

We received 22 applications (£329,228) for £100,000 of available funds. We are excited to announce the six projects that received funding, covering a range of our network themes, from institutions around the UK.

People with severe mental illness (SMI), including schizophrenia and bipolar disorder, have poor physical health and reduced life expectancy. Existing research has focused on factors that increase the likelihood of being admitted to hospital for psychiatric illness. We aim to examine patterns and predictors of non-psychiatric hospital admissions for people with SMI using the vast range of data provided by UK Biobank. We will explore various biological, social and environmental factors related to hospitalisations for physical illness using innovative methods and informed by lived experience, which will help to target policy and improve the health of people with SMI.

Investigators: Claire Niedzwiedz, Daniel Smith (University of Glasgow), Rowena Jacobs, Maria Jose Aragon, Stephanie Prady (University of York), Josefien Breedvelt (Mental Health Foundation, University of Amsterdam)

Initial research indicates that people with psychosis/bipolar disorder are more likely to have decayed, missing or filled teeth, and experience severe gum disease. This can greatly impact on their lives. However, the quality of existing research is generally very poor. We want to perform the strongest research to date exploring this issue. We intend to analyse existing data from two large surveys in the UK and US. We will explore whether and why people with psychosis/bipolar disorder have worse oral health. We will also examine the factors affecting whether people receive dental care.

Investigator: Jing Kang, Jianhua Wu, Vishal Aggarwal (University of Leeds), Jasper Palmier-Claus (Lancaster University), Tim Doran (University of York), David Shiers (Retired GP/Carer), John* (Lived experience representative)

*pseudonym

Health of women around the time of conception is a key determinant of pregnancy outcome and next-generation health and offers a unique opportunity to intervene. Little is known about preconception health in women with mental disorders and which factors contribute to the increased risk of adverse outcomes, which disproportionally affect women of Black and Minority Ethnic (BAME) backgrounds. We aim to investigate if preconception health indicators and level of multi-morbidity differ for women with severe mental illness (SMI) compared to those with a history of depression and those with no previous mental health history and explore ethnicity disparities in these indicators, using linked primary care and secondary care data from a deprived ethnically diverse inner London borough.

Investigators: Louise Howard, Raquel Catalao, Michelle Pentecost, Sarah Dorrington, Mark Ashworth (King’s College London) Robert Stewart (NIHR Maudsley)

This research will address two questions to assess the feasibility of a larger scale intervention project:

(1) How do people with serious and enduring mental illness (SMI) perceive, use and benefit from green and blue space?

(2) Does the interaction with green and blue spaces differ between SMI and the general population?

Using an exploratory sequential mixed methods design, peer researchers will conduct qualitative interviews with mental health service users; these data will be used to design a quantitative survey to explore the relevant themes with a sub-sample of the CTG Health and Wellbeing Cohort and a general population sample.

Investigators: Claire McCartan, Gavin Davidson (Queen’s University Belfast), Lee Knifton, Chris White (Mental Health Foundation), Paul Webb (Praxis Care), Liam Bradley, Katherine Greer (Peer Researchers)

People with severe mental illness (SMI) have poorer physical health and lower life expectancy than the general population. Diabetes contributes significantly to this health inequality. The quality of diabetes care for the general population in England has improved in the last fifteen years following the introduction of several national incentive schemes. However, there remain variations in the quality of care by patient demographics, socioeconomic status and co-morbidities such as SMI.

This study will analyse an electronic healthcare dataset in England to estimate: 1) inequality in diabetes care associated with SMI; and 2) the differential impact of care on health outcomes.

Investigators: Lu Han, Najma Siddiqi, Rowena Jacobs,  Tim Doran, Catherine Hewiit, Stephanie Prady (University of York), Diamonds Voice Patient and Public Involvement Group

We are setting up the CtG Youth Study, which uses a questionnaire about physical health and wellbeing in younger people with serious mental ill health. We will have a group of young people who have used mental health services to advise us (CtG Youth Study Research Advisors).

We want to find out if digital technologies (e.g. group chats, podcasts, visual storytelling) can help young people with mental ill health get involved with research as advisors. We will have two interactive workshops with young people to find out how to best use digital technologies to work effectively with our advisory group. 

Investigators: Ruth Wadman, Lina Gega (University of York)