DeSTRESS Project - Understanding and Dealing with Stress

Spin-off Projects

Training for GPs working with poverty-related distress

(Health Education England funded)

High levels of common mental health problems exist within areas of deprivation across the UK. Concurrently, GPs report having to deal with an upsurge in cases in which the underlying causes of patient distress are social and structural, as well as linked to comorbid physical health problems. This can be challenging for GPs who have limited time to address the inherent complexity of these problems. Supporting GPs to respond effectively to this complex and diverse situation and to provide optimal care for those affected therefore requires insight which draws on both the experiences of health professionals and the lived experiences and needs and priorities of people from low-income communities.

Using findings from the DeStress project we are working with Health Education England (HEE) to develop an educational package that will assist GPs and clinicians working in primary care to reshape consultation practice so that it more effectively supports mental health care in areas of deprivation. This package will look beyond issues of basic interaction and empathy to examine how GPs and patients can work more effectively together to i) understand and acknowledge causes of distress, ii) convey medication uncertainties and possible harms; iii) provide tailored support that addresses the difficulties faced by patients, including social isolation and problems accessing talking therapies. Training will focus on using the existing consultation time differently rather than increasing consultation time.

The educational package will include an online fact sheet and an online training session. We are also in discussion with the Royal College of GPs (RCGP) to get these materials accredited, and to work with them to develop a short ‘taster’ session for their e-learning platform, on the issues addressed by the training.

Co-creating strategies to address child poverty

(Engaged Research Exploratory Award, 2017)

Working with Barnardo’s, a Children’s Centre and parents from low-income backgrounds, this work provided a forum for parents to voice their experiences, needs and priorities relating to child poverty. This work fed into the Plymouth Child Poverty Action Plan and has played an influential role in the development of the City Council’s approach to co-creating strategy and commissioning with service users from low-income backgrounds.

Research team:

Felicity Thomas,

Lorraine Hansford

Reducing inequalities in psychological support for people affected by cancer

(Engaged Reearch Exploratory Award, 2018)

High levels of cancer exist within low-income communities in the UK. Since the publication of best practice guidance (National Cancer Equality Initiative 2010), efforts have been made to increase parity of cancer healthcare and treatment. Yet whilst people’s medical needs are increasingly well met, little attention has focused on supporting their mental health and emotional wellbeing, crucial when over half now live for ten years or more following diagnosis (Macmillan 2014). People diagnosed with cancer often report feeling overwhelmed with despair, grief and depression, factors that can be vastly exacerbated when they and their families are living concurrently with material hardship and deprivation.

The NHS Cancer Strategy (2016) calls for accelerated commissioning of support services, such as those provided through specialist counselling and psychological support. However, this is not provided routinely within NHS care, and little is known about the factors that influence referral to, or awareness of, this kind of service, or the long-term impact counselling has on service users. Working with partner organisations We Hear You (WHY); Wessex Cancer Trust and The Harbour, this project seeks to: identify lived experiences and gaps in current service provision for low-income groups; ii) provide a forum for low-income communities to feed in to the development and implementation of local Sustainability and Transformation Plans (STPs); iii) identify research priorities to help reduce inequalities in the provision of psychological support for people affected by cancer.

Research team:

Felicity Thomas (PI),

Lorraine Hansford

Mental health outcomes of early life trauma in Belarus and Ukraine

(MRC TrACES fund 2018 - 2019)

Early life trauma (ELT) is known to be a key determinant of later life health and wellbeing. Within Belarus and Ukraine, high levels of ELT have been associated with some of the highest levels of suicide and substance abuse amongst young people and adults in the world.

Whilst this situation has been widely linked to the significant social, political and economic upheavals experienced in the Central and Eastern European Region over the past three decades, there is a dearth of detailed analysis of the causes of early life trauma in Belarus or Ukraine, or the socio-cultural context in which it is experienced, understood and responded to. This is due in large part to the continuing dominance of psychiatric and biomedical models of understanding, which pay little attention to the socio-cultural factors underpinning people’s lives, and to the lack of funding that has been available for non-clinical research.

This project involves running a series of workshops with partner organisations

Ukrainian Catholic University and Minsk Regional Centre for Psychiatry and Addiction to bring together key stakeholders from diverse disciplinary and service provider backgrounds in Belarus and Ukraine in order to

  1. support key stakeholders and service providers working with those affected by early life trauma to better understand its causes and the ways that multiple traumas interact to establish risk for negative mental health, substance abuse and suicide
  2. identify the factors and mechanisms which promote resilience amongst those affected by ELT and protect against negative mental health, substance abuse and suicide.

Research team:

Felicity Thomas (PI),

Mark Jackson,

Dzmitry Krupchenka,

Olga Kazakova,

Orest Suvalo