Project Areas of Interest

Discussions with services in the South West Region and with the Gap Project group (which incorporates representatives from Plymouth and Exeter Universities and people with lived experience of local services) has identified the following areas of interest:

1. Adapt, innovative or implement therapeutic approaches for people in the gap. This is building upon the work being undertaken at Exeter University in Talking Therapies services (see appendix 1) Examples of further projects could include adaptation and evaluation of approaches which are being offered in current services. An example of this could be for people struggling with emotional regulation treated in a primary care setting using DBT approaches adapted into a shortened form which are currently being used across a number of services in the south west
2. Supporting people with SMI stepping down from Secondary care – This group of people are not currently well served in mental health services unless they are in secondary care. Possible interventions to be evaluated could be the development of a recovery and resilience pathway offering mindfulness and social prescribing or using the PARTNERS approach providing support to people in the gap (https://mcpin.org/project/care-partners-research-programme/).
3. Exploring options for medication support in the gap – exploring an 'exit' pathway for more complex depression. This could include deprescribing when appropriate and supporting primary care staff (GPs and community pharmacists) to facilitate this, with expert consultation from psychiatry This Approach could be implemented alongside evidence based treatments like MBCT available at point of tapering and offering social prescribing as an alternative option
4. Working alongside families and carers- Offering psycho-education to families and carers in primary care as a preventative mechanism. This might include parents of children becoming involved in coaching young people regarding their mental health. Or focussing upon the importance of families and carers being involved in a person’s care from the beginning of their mental health journey could demonstrate the often hidden benefits of their involvement.
5. Exploring system issues- What is needed to create system balance across mental health services. This might include an exploration of partnership working across diverse agencies in both voluntary and statutory services and understanding the barriers to provide seamless care.
6. Examining the challenges in changing the culture of services – An example of this could include trying to understand what is necessary for trauma informed care to take place ( Gloucestershire’s project with police and ambulance services might be an interesting study to look at) Exploring the principles of needs led provision rather than diagnostically driven protocols and pathways and the impact which these cultural changes offer to care.
7. The role of peer support workers in the gap – Many services have employed peer support workers to work in this area but their offer is diverse and varies across systems. It would be useful to understand what might be a useful and effective role for these workers to engage in that can add to the community space
8. Understanding the interface between substance misuse services and the gap – What might be needed in the gap to support people with substance misuse and how might the system as a whole respond to this group.