Written by Beth Barker

January saw the publication of a new piece of research from two members of the pPOD team, Christine O’Farrelly (PEDAL, University of Cambridge) and Beth Barker (Imperial College London), in collaboration with Ailbhe Booth, from University College Dublin, and Mimi Tatlow-Golden, from The Open University.

The Children’s Thoughts about School Study (CTSS) aimed to examine children’s own priorities for their educational experiences, in an effort to enrich the knowledge we already have about preparing children for the best start in school. The CTSS was part of the Preparing for Life (PFL) evaluation, which tested the effectiveness of an intensive parenting programme in promoting the school readiness of children living in a socioeconomically disadvantaged community. Few studies before this have attempted to incorporate what is meaningful to children themselves, when developing programmes that aim to improve children’s school readiness.

In the CTSS we spoke to 4- and 5-year-olds from Dublin, Ireland and asked them to: 

Children's answers formed four big ideas about what matters for a good start in school: 

• Feeling able and enthusiastic for school 
• Knowing how to navigate peer interactions
• Having supportive environments with opportunities to play 
• Strong links between school and family

You can find out more about the children’s key priorities in the two-minute video below. These priorities are important for those interested in promoting children’s early experiences and outcomes, particularly as they add to the ideas adults already think about when measuring school readiness. 

The full paper can be found here: https://www.sciencedirect.com/science/article/pii/S088520061830149

Written by Beth Barker

​pPOD tops off 2018 with the publication of research from the Avon Longitudinal Study of Parents and Children. The research was a collaboration between Leticia Gutierrez-Galve from University College London, Alan Stein and Lucy Hanington from the University of Oxford, Jon Heron of University of Bristol, Glyn Lewis from UCL, and pPOD’s very own Paul Ramchandani and Christine O’Farrelly from the Faculty of Education at the University of Cambridge.

The research followed up over 3,000 families from Bristol, UK and examined how factors measured when the children in the study were born could influence their outcomes at 18 years old. One of the key findings of this paper was that signs of depression in dads early in their children’s lives, was linked to higher levels of depression in their daughters later in life. Interestingly, this pattern was not seen with dads who had sons.
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Read more about the research here: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2719453  

Written by Christine O'Farrelly, Shu-Tsen Liu & Beth Barker

Last week I was really pleased to have the opportunity to meet Mark Williams, a long-standing campaigner on mental health, particularly on fathers mental health. He set up Fathers Reaching Out and also established the International Fathers Mental Health Day, held each year on the Monday after Fathers Day.

Mark was in London taking part in the filming of a documentary, and this gave us the chance to meet in person for the first time.  I’d followed and admired his campaigning work for many years, and had narrowly missed meeting him on a couple of occasions, but this was the first time we had managed to actually meet face to face.  There was a lot of filming to do, so we only had limited time to talk off-camera, but it was great to have the chance to meet him at last.

Mark brought along a copy of his new book, Daddy Blues. I read it this weekend. It is an autobiographical account of his experience. In it he writes about the birth of his son and his struggles with that experience. He also writes about his wife, Michelle’s, experience of postnatal depression and Mark’s own experience of mental health problems, including depression.

It’s an open-hearted and challenging account of trying to understand what is happening when you don’t have much information. This relates both to the experience of childbirth and also seeing someone you love experience depression.  It is so important for all of us to hear this kind of first-hand experience. The experience of mental health problems is so very personal, and people are often reluctant to talk to others (indeed Mark writes about this in the book).  Consequently, when others have the same experience they may never have heard or read anything to give them a clue that many others go through similar things.

As well as writing movingly about his own experience, Mark’s book also highlights how complex the experience of mental health problems can be.  For example, his own experience could be described as depression (and he uses this term), but it also overlaps with experiences of anxiety, heavy use of alcohol and the re-experiencing of traumatic images and memories of his son’s birth. It’s important to be reminded of how these experiences so often overlap and also how important it is for a partner to be supported when someone develops depression (whether that’s a mother or a father).
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I’m grateful that Mark Williams has shared his story in a book. It’s a moving and important read. I now have a copy, if you want to borrow it. Better still, buy your own copy and support the important work that Mark and his colleagues and family are doing.
 
Author: Paul Ramchandani

This week we were extremely grateful to attend the first CNWL Research Conference held at the Wellcome Collection in London. The purpose of the day was to showcase current research activities across CNWL and link clinicians with research groups.

Professor Sir Simon Wessely – King’s College London
The talks began with a lively presentation by Professor Sir Simon Wessely highlighting the importance of research in understanding individuals’ reactions to adversity. Touching upon the London 2005 bombings, the Litvinenko Affair, and the Blitz he highlighted the resilience of mankind and launched into a spirited discussion on the use of psychological debriefing at the time of tragedy. Previous expertise has favoured the use of psychological debriefing at the time of a terror attack, however his Cochrane Review found that people preferred to talk to family and friends rather than a medical professional. He outlined that, for those with a typical emotional reaction to an attack, debriefing by a clinician is unnecessary and in some cases can do more harm than good! 
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​Professor Dame Anne Johnson – University College London
Second to the stage was Professor Dame Anne Johnson who spoke passionately about growing concerns regarding public health. The ever growing number of chronic conditions and increasing levels of obesity in the population have heightened the need for more research into preventative medicine. She presented the COPD value pyramid displaying the cost of the most common interventions in COPD. Flu vaccinations and stop smoking interventions were the cheapest and Triple Therapy was amongst the highest. Following on from this, Prof. Johnson presented the most common treatments used in clinics and showed that, frequently, the most favoured treatments were the more expensive options. Only 11% of patients received stop smoking interventions, one of the more cost-effective interventions, versus 37% being offered Triple Therapy. Patients need to be reached earlier to prevent these illnesses getting out of hand and thought needs to be placed on population based change to be more receptive to preventative measures. Prof. Johnson spoke of the importance in embracing the digital revolution to better inform researchers and the population in health preventative measures.

​Workshops
An array of workshops were on offer; Professor Paul Ramchandani on the needs of children and adolescents with mental and/or physical health problems, Dr Richard Gilson on promoting sexual health and well-being, Professor Anne Lingford-Hughes & Professor Andrew Hayward on tackling health inequalities and inclusion, and Professor Mike Crawford on interventions and treatments for adults with mental health problems.
I was lucky enough to attend Prof. Paul Ramchandani’s workshop which included four presentations on current research taking place. First to present was our own Dr Christine O’Farrelly who introduced the Healthy Start, Happy Start study, using clips of VIPP in action, and outlined the important role CNWL played in getting HSHS to its recruitment target of 300 families in the summer of this year, with an impressive 105 families coming from the trust.

Second was Dr Georgina Corbet Burcher who presented her findings of a link between PTSD in infants after discharge and levels of inflammation in the brain during their stay in the PICU. Dr Tami Kramer was next discussing the prevalence of adolescent sexual assault and the extreme need for extra specialised clinicians in this service. She reported that, due to the findings of her research, she has recently gained funding for a Clinical Psychologist specialising in adolescent sexual assault in CAMHS. This talk in particular highlighted the real change that can come from research. Lastly, Dr Matthew Hodes spoke of his project investigating the use of brief CBT for maternal anxiety associated with children with food allergy.
Discussion followed surrounding the steps that can be taken to increase the range and opportunities for staff in research within CNWL. Many ideas were put forth, such as including research into the NHS induction, opening up research to other specialities such as Occupational Therapists and Physiotherapists, and compiling a list of current research occurring within the trust so others are aware and can contact to become involved.

Following the workshops we had a lovely lunch provided and settled in to chat about our morning. We then settled in to the comfy Henry Wellcome auditorium to begin the afternoon session.

Professor Mike Crawford – Imperial College London
To begin the afternoon Professor Mike Crawford delivered a speech regarding the prevalence of sexual health problems amongst those with mental health conditions. His work has shown that sexual health problems are most prevalent in individuals with a diagnosis of Personality Disorder. However, many clinicians in mental health clinics aren’t asking about sexual health during appointments, which is concerning as these can be common side effects with medication. He also spoke of the Respect study run by Professor Liz Hughes which promotes sexual health for people with serious mental illness. 
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Workshops
Another great variety of workshops were on offer for the afternoon. From responsibilities of a principal investigator by Dr Sarah Yardley & Lynis Lewis, to involving patients and public in research by Dr Rose Thompson. I was fortunate to attend Dr Tim Weaver’s workshop about qualitative interviewing. Dr Weaver presented the different methods of analysis and practical advice for helping a participant open up to questions. A lively discussion followed, with calls for more opportunities for qualitative interview training and uses within NHS research.
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Plenary
After a quick break and browse of the posters we then attended a plenary session to hear the feedback from the various workshops to best raise the level of research within the trust. Four common themes emerged from the discussion; time, funding, training opportunities, and awareness. Ideas were discussed surrounding ways in which these factors can be built upon and increased throughout the trust.  One really interesting idea was for the creation of a clear and widely-used website where research groups can update information of their current projects and clinicians can update their personal profiles to include research interests.

Closing Remarks
Professor Richard Watt concluded the day with closing remarks and summarised the feedback. He highlighted the importance of a regular R&D conference to inform staff within the trust of the range of research underway and in linking clinicians and research groups and promoting collaborations.
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The day was an exciting whirlwind of presentations and workshops and it was a great opportunity to see the current research taking place. It was wonderful to see and hear everyone’s enthusiasm for research and the ideas for different projects going forward!

Author: Holly Mattock