Learning from attending the 2019 Society for Mental Health Research Conference

A broad range of research underway was on show at the 2019 Society for Mental Health Research conference. This year had a particular focus on non-medicinal interventions such as social psychiatry, dietary interventions, and pharmaceuticals. In addition to this was the novel work of the impressive Brain Park center which seeks to utilize VR technology and gamified neuropsychological tools to work on issues such as Obsessive Compulsive Disorder and Addictive Behaviors. Other areas of focus were brain imaging of different disorders and techniques for reducing discrimination through school, workplace and online psycho-educational programs.

The CPN team was impressed by the feminist research-based advocacy at play in Melbourne University's Dr Tanya King whose work explored the impacts of labour force participation by gender on children. Their findings showed that despite common discourse to the contrary there are no negative consequences when a female parent in a heterosexual couple works full-time or part time. There was however a modest finding of impacts of a male parent in a heterosexual couple working full-time.

Interesting advances in psycho-pharmaceuticals presented findings on the efficacy of cannabinoids for anxiety disorders and South American psychedelic compound ayahuasca for treatment resistant depression.

Consumer academics in attendance were a little concerned about a focus on pharmacological responses to side effects of anti-psychotics presented such as interventions for sleep apnea and weight gain with little discussion of the need to find alternative treatments which do not bring on these side effects in the first place. Would be nice to see more research like the trauma focused approaches like 2018 Nurse of the year Matt Ball, in future research symposiums.

A standout plenary session discussed ’Models of psychopathology’, pitting three perspectives on the direction categorization in mental health research should take. Speakers were Dr Bruce Cuthbert director of Division of Adult Translational Research University of Pittsburg, Prof Patrick McGorry from Orygen and Prof Melissa Green from Neuroscience Research Australia. Dr Cuthbert spoke about the potential for wider research utility of shifting the ways be label behavioral presentation to the Research Domain Criteria (RDoC) *link*, this model, said Cuthbert should allow for greater comparisons with animal study findings, is more dynamic and is less deterministic, with a focus on the meaning a person is making in the present moment. He says the rationale for RDoC: recognition that simple diagnostic entities have outlived their utility. Emphasis on neurodevelopment and integration across biological and behavioral constructs.

Prof McGorry advocated for a model that has been developed in conjunction with Prof Ian Hickie called a clinical staging model, this model is said to have parallels with oncology models, aiming to track courses of deterioration in illness with an aim to develop precision responses as early as possible. “This panel is fuelled by the idea that psychiatric diagnostic categories don’t really work... they are still trying to find these schizophrenia risk genes and bipolar risk genes as if they really exist.” McGorry called for a transdiagnostic, staged approach, citing the fact that we already have medications that are used beyond diagnostic categories.

In stark contrast to these proposed models was Dr Green’s epidemiological, neuropsychiatric perspective which privileged a consideration of life stressors at key ages in the development of mental distress. Green was clear that current thinking and even the term psychopathology evokes a disease model that assumes pathological processes underpin mental distress. Green implored researchers to “stop pretending” that news models such as those proposed by her co-presenters are going to fit into super strata categories and be a genuinely novel or appropriate step forward. Green’s perspective asks us to think about developing a science responsive to the range of stressor and environments people encounter and the meaning they give to these events.

CPN’s own Helena Roennfeldt was part of a team that won the SMHR research pitch competition, this competition paired up researchers from desperate areas to co-create something for further investigation. Roennfeldt and Dr Magenta Simmons from Orygen combined their respective interests in youth peer support and service user experiences of presenting to emergency rooms to come with an idea to develop resources to prepare youth people presenting to ED in mental health crisis. There was a broader call for researchers and organisation in the clinical and community mental health sectors to pool resources in order to advance outcomes for service users in a fiscally efficient manner, especially in the context of reduced federal grant funding.

In another panel discussion on big issues in mental health Melbourne University Faculty of Medicine, Dentistry and Health Sciences Prof Shitij Kapur reflected on how mental health research was hoping that ehealth and associated technologies would be a silver bullet for developing evidence based interventions. He mentioned that had this been found it would have been a nice and an easy option to progress, just as it would have been helpful if there had been a genetic marker found for ‘schizophrenia’ or ‘bipolar disorder’. Prof Kapur implores us to accept that we haven’t found these and perhaps won’t anytime soon. He calls for us to return to looking at interpersonal, social foci in our research endeavors.

The question might be, how do we sell less shiny project ideas to funding bodies, a challenge also given the fuzziness of existing psychological categories currently available for use in research. The question more pertinent to consumer academics attending the conference was ‘Are the things being examined relevant to our experiences?’. The thought occurred to them that nurses might be well placed to get more involved with clinical research where possible to bring practice relevant voices to these spaces.