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

这一奖学金的目的是加强我作为一名早期职业研究人员的地位，并为一项研究方案奠定基础，该方案旨在改善常见心理健康问题，特别是抑郁症的心理治疗的机会和有效性。抑郁症是一种常见的、令人衰弱的心理健康问题，它包括情绪低落和/或兴趣丧失的时期。尽管我们有治疗抑郁症的心理疗法，但50%的抑郁症患者没有进行治疗，而在那些进行治疗的人中，只有50%的人好转了。来自不同种族背景的人参与抑郁症治疗的比率甚至更低。我的博士研究集中在那些接受抑郁症心理治疗的人可能会经历抑郁突然好转的时刻，或者他们的抑郁症恶化然后退出治疗的时候。这些抑郁症的变化是有意义的，因为它们与治疗参与度和治疗结果的好坏有关。我发现重要的行为和自信与这些抑郁变化的时间有关，但一些研究表明，个体特征也可能解释症状的突然变化，以及某人如何与治疗互动和对治疗做出反应。到目前为止，还没有人研究个人特征，如种族，如何与治疗中抑郁的突然变化有关。在这个团契中，我将使用现有的数据来探索这些个人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正在做些什么，以帮助不同种族背景的人获得、留在治疗中并受益于治疗，我将在德文郡当地的NHS服务机构Talkworks Talking Treatures for焦虑和抑郁进行安置，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，我还将检查现有的服务数据，以了解为什么这些人没有参加抑郁症治疗的第一个治疗阶段，而是退出治疗。我将把我的发现提交给服务机构和临床医生，这样他们就可以努力改善这些人群获得抑郁症治疗的机会和参与度。这也将为我提供一个平台，以建立网络，与其他学者合作，并培养新的研究想法。此外，我还将建立一个由来自这些背景的公众和患者组成的小组，以提供对我的研究的反馈，并帮助我确保我的研究结果可供各种人访问和宣传。此外，这笔奖学金还将使我成为一名独立的研究员。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任何新的研究成果。为了最大限度地发挥我的研究成果的影响，我将在会议、研讨会和当地活动中向一系列受众展示我的研究成果。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技能。在这个奖学金中进行的研究将成为我未来研究的基础，我将申请进一步的资金，继续研究我们如何能够改善获得、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.