Theme lead: Paul Harrison

Mental health disorders are leading causes of disability and morbidity worldwide. They also shorten lives: the life expectancy for severe mental illnesses like schizophrenia and bipolar disorder is reduced by 10 to 20 years, and about 1 in 10 people with these disorders die by suicide. As well as the personal tragedies, these facts also make mental disorder very expensive to society – at least £65 billion per year in the UK.

Unfortunately, although we have some effective psychological and drug treatments for most mental disorders, many patients are left without a treatment that works for them, and even when the treatments work, side effects are common.

The lack of significant new treatments in recent years is disappointing, and the continuing burden of mental disorders is unacceptable. Improvements in the understanding, prediction and treatment are an urgent priority. Our BRC Theme seeks to tackle these issues, and help achieve transformational change, for the benefit of people with mental disorders, their families, and the public.

What are our aims?

• To transform our approaches to adult psychiatric disorders, especially mood disorders and schizophrenia.
• Innovate new diagnostic tests and therapeutic treatments.

How will we achieve this?

• Implement more rapid and evidence-based diagnosis. Our ‘digital phenotyping’ approach uses smartphones, apps, and other new technology to better measure and understand adult psychiatric disorders. This has the potential to make diagnoses more rapid, more accurate, and more meaningful.
• Ensure better prediction of course and treatment response. We think these same technologies can also help us better predict whether a person will get better or worse, and can help predict which treatment will suit them best. We are working with mathematicians and other scientists to help us make the most of the data and gain new insights. Our experimental medicine studies are revealing biomarkers suggestive of response to specific drug therapies. We aim for this potential to be extended to other disorders, and to psychological treatments.
• Enable more effective and cost effective treatments. At the heart of our BRC is our work to identify new targets for treatments, and to inform the development and testing of new drugs aimed at these targets. We do this by combining the digital methods with our expertise in rapidly and carefully detecting whether a drug is working, both in health volunteers and in carefully selected patient groups.
• Involve patients and public and address the ethical issues. We are mindful of the need to fully engage users and carers in this enterprise and we have a strong track record via our OXTEXT public engagement events (lectures, workshops, seminars) for people with bipolar disorder, and our specific BinvolveD engagement programme. We will also address the ethical aspects of our work (e.g. the acceptability of data capture via smartphone) and will have an ethicist working within the theme. Find out more in the PPI Theme.
• Transform the nature of psychiatry. Finally, underlying this Theme is our strong belief that psychiatry needs to take full advantage of new approaches and technologies, applied with the same methodological rigour and on the same scale, as is occurring in all other branches of medicine. This is essential if there is to be transformational change in our ability to identify new treatment targets, understand therapeutic mechanisms, and evaluate new interventions – and thereby ultimately revolutionise outcomes. We intend that our BRC will provide a flagship for this contemporary vision of psychiatry.

For researchers interested in working within the Adult Mental Health theme, please contact Liliana.Capitao@psych.ox.ac.uk.