Improving the nation’s mental health

The UK needs a pool of talented ‘academic psychiatrists’ who can both strengthen our understanding of mental illness and push the boundaries of exciting scientific progress in prevention, diagnosis and treatment. Academic psychiatrists are doctors who carry out research into the causes and treatments of mental illness, alongside their clinical work.

Following the Medical Research Council’s (MRC) 2010 review of mental health in the UK, we – along with the MRC – invested £2 million in the PsySTAR (Psychiatry: Scottish Training in Academic Research) PhD training programme to bridge the gap between cutting-edge discovery science taking place in laboratories and clinicians who care for people with mental health problems.

Translational neuroscientists

“PsySTAR was a response to the need for more ‘translational neuroscientists’,” says Professor Stephen Lawrie from the University of Edinburgh, who leads the programme. “It’s vital that lab-based scientists are exposed to clinical issues and that clinician scientists spend time in cutting-edge discovery research laboratories, so they become familiar with the strengths and limitations of different experimental techniques.”

PsySTAR’s nine trainees are tackling a range of mental health problems across the lifespan, from predicting how childhood adversity affects later mental health and improving treatments for depression, to exploring the relationship between mental health and ageing.

“A really important part of PsySTAR is interaction with patients, as we feel very strongly that trainees need to do research that has a direct benefit to patients,” explains Stephen. “It’s too easy for researchers to lose touch of the realities, experiences and everyday needs of patients, so our trainees have regular contact with people affected by the devastating disorders they are trying to diagnose, prevent and treat.”

Between them, the PsySTAR trainees have already published their discoveries in more than 50 research papers, including publications in high impact journals such as the British

Medical Journal and the Proceedings of the National Academy of Sciences. Collectively, they have secured more than £400,000 in additional research funding and won three academic prizes for their work.

The PsySTAR programme provides opportunities for talented doctors to work with leading basic and clinical scientists in the fields of psychiatric genetics, behavioural neuroscience, brain imaging, epidemiology, biomedicine, social and public health sciences, and clinical trial methodology.

Interaction with patients is encouraged and aided by the presence of at least two lead supervisors – one from a discovery science background, and the other a clinical specialist.

Reducing stigma

PsySTAR also strives to reduce the stigma of mental health disorders, by providing the trainees with guidance on communicating with the general public. The trainees have all been very active in various forms of public engagement, including presentations to schoolchildren and at the Edinburgh Festival Fringe.

“I think this is critical for early career psychiatrists and scientists – that they can talk passionately about the research they’re doing and its potential, as well as correcting myths and giving more realistic messages about psychiatric disorders,” says Stephen.

As Director of PsySTAR, Stephen has gone on to become a Director of a £5 million Wellcome Trust Translational Neuroscience PhD scheme. “The PsySTAR funding provided by the Foundation and the MRC has changed the landscape of academic psychiatry in the UK, and leading organisations have taken note of our work,” says Stephen.

“Although it will still be some time before the full impact of PsySTAR is felt, we’ve given our trainees the tools they need to become future leaders of mental health research in the UK. They are already offering new insights into major mental illnesses, which will put us in a much better position to diagnose and treat the conditions that all too often blight people’s lives.”

Dr Lucy Stirland completed her PhD on mental health and ageing in 2020, and credits PsySTAR with helping her secure a clinical lectureship at the University of Edinburgh.

Lucy’s PhD explored the mental health of people with two or more co-existing physical health conditions, who used multiple medications to treat these conditions.

“My passion in clinical work is for older people, who bring along their own life histories and often have a complex mix of health problems. As people increasingly live for longer, often taking numerous medications over many years, we need to look at the whole picture of their physical and mental health,” says Lucy.

“PsySTAR was an unmissable opportunity and I wouldn’t be leading my own research today without it. I thoroughly enjoyed my PhD, mostly for the chance to work independently on something that gave me such a sense of achievement.

“I’m most proud of my research paper published in the British Medical Journal, which reviewed different ways of measuring multiple conditions, to help guide clinical decision making.”

Lucy was awarded the Royal College of Psychiatrists’ Scottish Division Research Prize in 2019, and in the same year she presented her findings at the world’s largest Alzheimer’s research conference – the Alzheimer’s Association International Conference in Los Angeles, USA.

To stay grounded in what her work could mean to real people, Lucy has been in regular contact with Mary Nisbet, a member of the general public, who has contributed to Lucy’s research.

“Discussing my research ideas with Mary has been really valuable, as it reconnects me with the people at the heart of what I do,” Lucy explains.

Now a Clinical Lecturer in Old Age Psychiatry at the University of Edinburgh, Lucy is investigating multi-drug treatment use in a large Scottish research cohort, looking for potential links with dementia and depression over time.

“My PhD was about so much more than just writing a thesis. Thanks to PsySTAR, I’ve learned immensely valuable skills in critically analysing research, speaking confidently about my work at conferences, and collaborating on large and complex research projects.”