The South West Mental Health Gap Practice Research Network (PRN)
The South West Mental Health Gap Practice Research Network (PRN) is currently being formed. Join our mailing list or follow us on social media to hear the latest updates and news about the upcoming launch.
We bring together practitioners (e.g., voluntary, community and social enterprise (VCSE); NHS), researchers, and Experts by Experience (EbE) across the South West of England to co-design and deliver research to support the needs of clients who fall into the treatment gaps between mental health services.
Our mission is to:
- Provide training and development to upskill practitioners
- Have co-design with lived experience members at the heart of the network
- Support local innovation and evaluation in real world settings to solve problems identified by services (practice based evidence)
- Support the delivery of high-quality formal research innovating and evaluating novel treatments and treatment delivery pathways (evidence based practice)
- Network with local and national services to co-deliver research
The South West Mental Health Gap PRN has grown around the AccEPT Clinic at the University of Exeter which is an NHS commissioned services innovating and evaluating novel psychological therapies service for adults who fall into the gap between primary and secondary care mental health services in Devon.
The South West Mental Health Gap PRN is jointly co-ordinated by the AccEPT clinic, University of Exeter and Plymouth University.
Our continuing professional development (CPD) training opportunities for practitioners will be jointly co-ordinated by the South West Mental Health Gap PRN and Cedar Create, a knowledge exchange and research hub at the University of Exeter.
Funding
The network is supported by funding through AccEPT Clinic from the Mental Health Mission (MHM) which is funded by the National Institute of Health Research and Office for Life Sciences. The AccEPT Clinic is one of 14 research-focussed clinics in the Mood Disorders workstream that are local hubs to support the co-design and delivery of research for difficult-to-treat depression.
Who we are:
Dr Asha Ladwa, AccEPT Clinic, University of Exeter
Asha is a Postdoctoral Research Fellow in the AccEPT Clinic, funded by the MHM to develop and run the South West Mental Health Gap PRN. Her research focuses on understanding how best to support clients with hard-to-treat depression in primary care psychological therapy services.
Professor Barney Dunn, AccEPT Clinic, University of Exeter
Barney is a research and Clinical Psychologist whose work aims to develop, evaluate and implement novel psychological therapies to improve wellbeing and functioning in depression and related mental health conditions. He is also co- lead of the AccEPT Clinic.
Professor Richard Byng, University of Plymouth
Richard is a Professor of Primary Care Research, General Practitioner and research with an interest in Primary Care Mental Health. Richard is also the Deputy Director of the Peninsula ARC for the South West Peninsular (PenARC).
Upcoming CPD events and training
Come back soon to see details of the CPD events delivered by the South West Mental Health Gap PRN.
Coming soon
Example Projects
This is one example of innovation within existing services that this network can support with.
A Prolonged Grief Disorder (PGD) pathway was established in response to a local NHS Talking Therapies for anxiety and depression (NHS-TTad) service identifying a significant subgroup of clients were presenting with prolonged grief reactions alongside depression, anxiety and/or PTSD in the aftermath of the COVID-19 pandemic.
What were the aims?
This led to an evaluation of the feasibility and effectiveness of the PGD pathway and the delivery prolonged grief disorder therapy (PGDT) within the Devon NHS-TT service.
Who were involved?
Sarah Goff (Operational and Professional Lead in TALKWORKS Devon NHS TTad service), led the evaluation in partnership with the Mood Disorders Centre, University of Exeter, and a specialist Prolonged Grief centre at Columbia University, USA
How was the evaluation run?
Experienced high-intensity therapists in the service were trained to deliver PGDT. This was supported through a bespoke training and supervision pathway within the service.
During the pilot of the pathway (April 2022-April 2024) 91 clients received PGDT, 81 of whom were included in this evaluation.
What were the findings?
- PGDT was feasible in this NHS-TTad service - 83% (67/81) completed at least 4 treatment sessions and drop out rates were low (16%).
- PGDT was effective in this service
- There were large improvements in combined depression and anxiety outcomes (82% reliable improvement; 72% recovery; 68% reliable recovery)
- and large improvements in grief symptoms (77% achieved reliable improvement on the 'Brief Grief Questionnaire' and 63% recovered)
The take home message- It is feasible and probably effective to implement a PGDT pathway in an NHS-TTad service
You can find the full evaluation article here
What's next?
The pathway has continued in the Devon NHS-TTad service and the hope is to run a larger trial and deliver PGDT in more NHS-TTad services around England.
This co-produced article between Experts by Experience (EbE) and scientific experts for a special issue in Nature Reviews Psychology focuses on how to manage the emotional impacts of co-production work in mental health research.
The article outlines a framework that can be helpful when supporting collaborators and professionals involved in co-production work. The framework highlights:
- The need to build a sense of validation and acknowledge the emotional nature of the topic
- Build a sense of safety around the location, timing, and if working online around joining a meeting, with clear confidentiality boundaries
- Predictability to build mutual trust. This may include having a transparent and fair collaborator recruitment process, clear and timely communications, a terms of reference and complaints procedure, and clear guidance around reimbursement
- Promoting agency by agreed realistic and achievable goals, consultation with collaborators, training opportunities, key acronyms and language explained, and collaborators meaningful involvement across the project lifespan
The full article by Amy Burnham, Katie Marchant, Trish Oliver, Mary Ryan and Barney Dunn can be found online here: https://www.nature.com/articles/s44159-025-00415-3
This trial was developed through Lived Experienced individuals voicing the need for next step treatment options for individuals who are still unwell following high-intensity treatment for depression in NHS Talking Therapy (NHS-TT) services. For these individuals there is little next step psychological treatment options.
One option may be Mindfulness Based Cognitive Therapy (MBCT). MBCT is an evidence based psychological therapy, which combines mindfulness practices with elements from cognitive therapy to support individuals manage and prevent recurring depression. MBCT is an 8-week group intervention currently available in NHS-TT services to support depression clients with relapse prevention. The RESPOND trial was set up to understand whether MBCT can be used within NHS-TT services to support clients who have not previously responded to high-intensity depression therapy.
What were the aims?
To look at the cost and clinical effectiveness of delivering MBCT for individuals who had not previously responded to high-intensity therapy in NHS-TT services.
Who were involved?
The trial ran between January 2021-January 2024 and recruited from three sites in England; Devon, London and Sussex. The chief investigator for the trial was Professor Thorsten Barnhofer. The AccEPT Clinic and Devon Partnership NHS Trust recruited for the Devon site. Barney Dunn was the Principal Investigator of the Devon site, and Asha Ladwa was the trial manager (June 2022-September 2023).
A patient and public involvement and engagement (PPIE) panel led by Mary Ryan supported the trial.
The trial was funded by the National Institute for Health and Social Care Research (NIHR) Research for Patient Benefit (RfPB) Programme.
How was the trial run?
Individuals were recruited for the trial through NHS-TT services in England. A total of 234 participants were recruited who had not responded to a high-intensity psychological therapy for depression and had current depression at intake into the trial.
Participants were randomly allocated to received MBCT+ treatment as usual (TAU) or TAU only. MBCT consisted of 8 weekly group sessions online (delivered via videoconferencing) with an experienced MBCT practitioner. Individuals in the TAU condition were free to access treatment if they wished. Assessments were carried out at baseline, 10-and 34-weeks (6 months) post-randomisation.
More details about the inclusion criteria and methods of the trial can be found in the trial protocol.
What were the findings?
A total of 118 participants were randomised to receive MBCT+TAU, and 116 to TAU.
At 34-weeks (6 months) post-randomisation follow up, individuals in MBCT+ TAU group had significantly lower depression symptoms than those in the TAU alone group. These effects were small to moderate.
MBCT+TAU was also superior to TAU in reducing generalised anxiety symptoms and increasing mental wellbeing.
MBCT+TAU was cost effective, and cost £10.12 per person per session, assuming a group size of 13.
What are the implications of this trial?
MBCT should now be offered as an option for these individuals who are still unwell following previous high-intensity therapies for depression.
What's next?
The trial will be published in a peer reviewed academic journal in May 2025.
A series of research from the trial examining patient and therapist perspectives on feasibility and acceptability is also being conducted.
The next step is to implement MBCT groups for individuals who have not responded to depression treatment, within NHS-TT services. We will be evaluating the implementation of this at the Devon NHS-TT service in Autumn 2025 (see further details in the tab below).
As a result of the RESPOND trial (see tab above) we are working with the local Devon NHS Talking Therapies (NHS-TT) service to run mindfulness based cognitive therapy (MBCT) groups for clients who have not responded to high-intensity therapy for depression.
Project status: We hope to start running the MBCT groups and evaluating this in Autumn 2025.
UpLift-X is a multi-site trial evaluating the clinical and cost effectiveness of an online, Cognitive Behavioural Therapy (CBT) informed transdiagnostic group therapy (Barlow's Unified Protocol) for emotional difficulties in NHS Talking Therapies services.
This trial will give patients more choice of 'high-intensity' (also known as 'Step 3') treatments in NHS Talking Therapies services and is a potential way to reduce waiting lists.
This trial is funded by Innovate UK. The core trial team at the University of Sheffield and Rotherham Doncaster and South Humber NHS Foundation Trust, together with industry partners have developed a novel digital platform for remote group therapy which will support clinicians and participants throughout the therapy and trial.
Therapists involved in this trial will be delivering five different versions of the group therapy. All five versions cover the same therapy skills, but are in different order. This may help to tell us which aspects of therapy might support early response within treatment.
The Devon site (PI: Dr Asha Ladwa) is one of a number sites around the country recruiting to the UpLift-X trial.
Project status: The Devon site will commence recruitment in local NHS Talking Therapies services in Spring 2025.
Have an idea or project in mind?
Complete the project proposal form and have a look at the funding opportunities and resources of support.
- UK Research and Innovation (UKRI) funding finder
- NIHR PenARC Knowledge Mobilisation Fellowships (not currently open) https://arc-swp.nihr.ac.uk/news/kmob-fellowships-2024/
If you have an idea of a project, please complete this form
Once we have received this form we will review it and link you up with others in the network to support the project plan template.
If you have discussed a project proposal with PRN members, please complete the project plan template
Coming soon
- NIHR Research Support Service- support to develop competitive funding applications for health, public health and social care research
- PenARC PPIE advice clinics