The initiative, ‘Improving Access to Psychological Therapies’ (IAPT) developed by University of Oxford’s Prof David Clark has been profiled in an article in the NY Times.

Featuring case studies from the Oxfordshire region, the article puts a spotlight on the success of IAPT, delivered via the NHS, helping thousands of people across England access talking therapies.

Extract from the NY Times:

‘In 2005 David Clark, a professor of psychology at Oxford University, and the economist Richard Layard, a member of the House of Lords, concluded that providing therapy to people like Oliver made economic sense.

“We made the case that, just on lost work alone, the program would pay for itself,” Dr. Layard said in an interview in his office at the London School of Economics.

Dr. Clark, in his university office, said: “If someone has a broken leg, he or she immediately gets treatment. If the person has a broken soul, they usually do not.”

The program began three years later, in 2008, with $40 million from Gordon Brown’s Labour government. It set up 35 clinics covering about a fifth of England and trained 1,000 working therapists, social workers, graduates in psychology and others. The program has continued to expand through three governments, both ideologically left and right leaning, with a current budget of about $500 million that is expected to double over the coming few years.’

Expanding the reach

As the article continues, one issue emerges: that of demand outstripping supply:

‘John Pimm, the psychologist who directs the Buckinghamshire center, found in 2013 that he could strikingly raise recovery rates by having his therapists give some patients two or three extra sessions; and by extending call times for phone therapy, working more carefully at the critical junctures, when people begin, or end, therapy.

“We have created this program, and now we are playing catch-up,” Dr. Pimm said in an interview in his office in High Wycombe. “We cannot train therapists fast enough, and the low-intensity phone therapists turn over pretty quickly. We have to figure out how to keep them in the job longer.”

This is where the online therapy software programs, still relatively new, may play a crucial role. Young men in particular, who can be difficult to bring in for face-to-face therapy, are often willing to work diligently on the computer and by phone. “The online and low-intensity options have been absolutely crucial for us,” said Judith Chapman, who runs the Berkshire service. “And we have gotten good recovery rates with them.”’

Crucially, this is an area which the NIHR Oxford Health Biomedical Research Centre is exploring in its Precision Psychological Therapies theme led by Professor Anke Ehlers.

Scaling up therapeutic treatments by delivering them digitally is one area of research that is promising to help thousands more within the UK, and millions more across the globe.

Dr Claire Sexton, who is part-funded by the NIHR Oxford Health BRC, has won an Early Career Researcher award in this year’s Vice-Chancellor’s Public Engagement with Research Awards.

The awards celebrate public engagement work across the University, and last year’s winners include Dr Liz Tunbridge, our training theme lead.

The award win was announced at a ceremony at the Oxford University Museum of Natural History on 28 June, hosted by Vice-Chancellor Professor Louise Richardson.

Dr Sexton, who is a researcher at the Oxford University Department of Psychiatry, said; “I am delighted to be awarded a Vice-Chancellor’s Public Engagement with Research award.

My public engagement work aims to increase awareness about dementia and how healthy brain ageing can be encouraged through non-pharmacological means, which is my particular research focus. Public engagement activities are crucial to bringing research findings in this area to wider audiences, and it’s fantastic for this work to be valued by the University.”

Dr Sexton has worked to engage the public with her research on healthy ageing – she is the Founding Chair of the Dementia Friendly Chipping Norton, and she has worked with the ‘Dementia Friends’ initiative, giving public talks and information sessions about her research to over 900 people, and organising film screenings of the documentary “The Age of Champions”. The Dementia Friendly Chipping Norton group aims to bring together people living with dementia, caregivers, community organisations and researchers to increase awareness of dementia locally and improve inclusion and quality of life.

Dr Sexton has also built capacity for public engagement, encouraging, training and enabling other researchers at Oxford to take part.

The Vice-Chancellor’s Public Engagement with Research Awards recognise and reward those at the University who undertake high-quality engagement activities and have contributed to building capacity in this area. Dr Sexton was one of five Early Career Researcher winners at the awards.

Watch Dr Sexton deliver a presentation on her research and outreach:

Professor Louise Richardson, Vice-Chancellor says: “I have been deeply impressed by the quality of the public engagement with research projects submitted for this year’s awards. The breadth and diversity of the activities taking place show how seriously the University takes its commitment to public engagement. It is inspiring to see the positive impact these activities have both on research and on the individuals and communities that have been involved, from warriors in Tanzania and young adults in Brazil, to local communities affected by dementia.”

Professor Alison Woollard, the University’s Academic Champion for Public Engagement with Research says: “Public engagement enriches both research and society and the University is committed to enabling our researchers to inspire, consult and collaborate with the public. I’m delighted that we are able to recognise and highlight the fantastic work our researchers are doing and hope these awards encourage more colleagues across the University to carry out their own public engagement with research.”

Dr Sexton is funded by: The National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) based at Oxford University Hospitals NHS Trust and University of Oxford, the NIHR Oxford Health BRC, Oxford Alzheimer’s Research Trust Network.

Theme leads, Professors Clare Mackay and Simon Lovestone, reveal details of the world’s biggest and most in-depth studies into dementia on BBC Radio 4’s World at One. Known as the ‘Deep and Frequent Phenotyping Study’, it is hoped that the broad range of tests on people in their middle ages will open up paths to early diagnosis and offer clues to effective treatments for Alzheimer’s disease before major damage to the brain has been done.

Reporter, Andrew Bomford, visits Older Adults and Dementia theme lead, Professor Mackay, at one of the NIHR Oxford Health BRC’s core facilities – the Oxford Centre for Human Brain Activity (OHBA) (pictured above) – to look in on an MRI scan. It is one of the wide range of tests that is part of the study. Listen to his report for BBC Radio 4’s World at One, 26 June 2017:

The Deep and Frequent Phenotyping Study is going to do every one of these tests that anybody has ever explored. We’re going to see if any one of them measures change before people have symptoms, and then we’re going to combine them using big data analytics.” Professor Simon Lovestone, Informatics / Digital Health theme lead

In a follow-up report on 27 June 2017 for the World at One, Professor Clare Mackay talks about the big data approach, and Professor Simon Lovestone considers what has been the greatest obstacle to progress so far. Is it our understanding of Alzheimer’s disease, the drugs, or the clinical trials?

Listen to the second report by Andrew Bomford for BBC Radio 4’s World at One, 27 June 2017:

In a cartoon version you’d imagine that people go all the way through their lives performing at a particular level, and then they just start to decline very gradually when they reach a particular age. This is people who would go on to develop disease. And that very early stage of that, the gradient is very, very shallow, so we need really sensitive measures to be able to pick it up.” Professor Clare Mackay

“It might be that everything that we’ve learnt about Alzheimer’s disease is wrong? I don’t think that’s the case. It might be that everything that we know about Alzheimer’s disease is right, it’s just that the drugs are not very good? I don’t think that’s the case either. Or it might be that what we know about Alzheimer’s disease is right, and some of the drugs we’ve developed might work, but the clinical trials are not good enough? I think that’s the case.” Professor Simon Lovestone

The Deep and Frequent Phenotyping Study is a multi-site study, led by Professor Simon Lovestone at the University of Oxford, and is funded by the MRC and NIHR as part of Dementias Platform UK – a UK-wide infrastructure network designed to support large, multicentre studies into dementia.

Read the related BBC Health online article – ‘Spotting the earliest signs of Alzheimer’s‘.