Understanding how to improve access, engagement, and depression treatment outcomes for underserved people in mental health services.

该奖学金的目的是加强我作为一名早期职业研究员的地位，并发展一个研究项目的基础，该项目旨在改善对常见精神健康问题，特别是抑郁症的心理治疗的获取和有效性。抑郁症是一种常见的、使人衰弱的精神健康问题，包括情绪低落和/或失去兴趣。虽然我们有治疗抑郁症的心理疗法，但50%的抑郁症患者不接受治疗，而在接受治疗的人中，只有50%的人好转。在不同种族背景的人群中，接受抑郁症治疗的比例甚至更低。我的博士研究集中在接受抑郁症心理治疗的人可能会经历突然“啊哈”的抑郁改善时刻，或者他们的抑郁症恶化然后他们退出治疗的时候。这些抑郁变化是有趣的，因为它们与治疗参与和治疗结果的好坏有关。我发现重要的行为和自我信念与这些抑郁变化有关，但一些研究表明，个人特征也可以解释突然的症状变化，以及人们如何与治疗相互作用和反应。到目前为止，还没有人研究过个体特征（如种族）与治疗中突然发生的抑郁变化之间的关系。在这项研究中，我将使用现有的数据来探索这些个体特征是否与治疗中的抑郁变化有关，以及接受治疗的次数，以及这是否对退出和治疗结果有影响。为了帮助我进一步了解心理健康服务是如何帮助来自不同种族背景的人获得、呆在那里并从治疗中受益的，我将在德文郡当地的NHS服务“焦虑和抑郁的Talkworks谈话疗法”中接受安置，该服务为成年人常见的心理健康问题提供心理治疗，包括抑郁症。在这里，我将与营销主管合作，了解他们如何吸引来自这些背景的人参加治疗，我也将检查现有的服务数据，以了解为什么这些人不参加抑郁症治疗的第一次治疗，并退出治疗。我将把我的发现提交给服务机构和临床医生，以便他们能够努力改善这些人群获得和参与抑郁症治疗的机会。这也将为我提供一个与其他学者建立网络和合作的平台，并培养新的研究思路。此外，我还将建立一个由这些背景的人组成的公共和耐心小组，为我的研究提供反馈，并帮助我确保我的发现能够被广泛的人获取和宣传。此外，这个奖学金也将使我成为一个独立的研究人员。我将以我的学术记录为基础，在学术期刊上发表四项已完成的博士研究和在该奖学金期间进行的任何新研究。为了最大限度地发挥我的研究成果的影响，我将在会议、研讨会和当地活动上向各种受众展示我的研究。我还将参加培训课程和研讨会，以继续发展我的研究和分析能力。在这项研究中进行的研究将为我未来的研究奠定基础，我将申请进一步的资助，继续研究我们如何改善接触、参与和我们对抑郁症治疗如何起作用的理解。

The aim of this fellowship is to strengthen my position as an early career researcher and develop the basis of a programme of research that seeks to improve access to, and the effectiveness of, psychological treatments for common mental health problems, specifically depression. Depression is a common, debilitating mental health problem which consists of periods of low mood and/or loss of interest. Although we have psychological treatments available for depression, 50% of depressed people do not engage in therapy, and of those who do, only 50% get better. Rates of engagement in treatment for depression are even lower in people from diverse ethnic backgrounds. My PhD research focused on times when people receiving psychological treatment for depression might experience sudden "ah-ha" moments of depression improvement, or times when their depression worsened and then they disengaged from treatment. These depression changes are of interest as they are associated treatment engagement and better or worse treatment outcomes. I found important behaviours and self-beliefs were related to these times of depression change, but some research suggests that individual characteristics may also explain sudden symptom changes and how someone interacts with and responds to treatment. So far no one has examined how individual characteristics, such as ethnicity, relates to sudden depression change in therapy.In this fellowship I will use existing data to explore whether these individual characteristics are associated with depression change in treatment, as well as the number of therapy sessions received, and if this has implications for drop out and treatment outcomes. To help me further understand what mental health services are doing to help individuals from diverse ethnic backgrounds access, stay in, and benefit from treatment I will undertake a placement at the local NHS service 'Talkworks Talking Therapies for anxiety and depression' which provides psychological treatments for common mental health problems in adults, including depression, in Devon. Here I will work with the marketing lead to understand how they engage people from these backgrounds to attend therapy, and I will also examine existing service data to understand why these people do not attend the first therapy session of depression treatment and drop out of therapy. I will present my findings to the service and clinicians so they can work to improve access to, and engagement of, depression therapy for these groups of people. This will also provide me with a platform to build networks and collaborate with other academics and to cultivate new research ideas. Furthermore, I will also establish a public and patient group of people from these backgrounds to provide feedback on my research and help me to ensure my findings are accessible and publicised to a range of people. Additionally, this fellowship will also allow me to develop as an independent researcher. I will build upon my academic record to publish four completed PhD studies and any new research conducted in this fellowship to academic journals. To maximise the impact of my research findings I will present my research at conferences, seminars, and local events to a range of audiences. I will also attend training courses and workshops to continue to develop my research and analytical skills. The research conducted in this fellowship will form a basis for my future research and I will apply for further funding to continue researching how we can improve access, engagement, and our understanding of how therapies for depression work.