$3.3 million in NHMRC grants for mental health prediction program and headspace staged care model

$3.3 million in NHMRC grants for mental health prediction program and headspace staged care model

8 October 2020

Two Orygen research teams have been awarded a total of more than $3.3 million in National Health and Medical Research Council (NHMRC) grants to improve health outcomes for young people experiencing mental ill health and translate research outcomes into policy and practice.

The grants were awarded under the NHMRC’s Centres of Research Excellence scheme and Partnership Projects scheme.

Orygen’s Professor Barnaby Nelson will lead the Centre of Research Excellence (CRE) in PREdiction of Early Mental Disorder and Preventive Treatment (PRE-EMPT), which received a $2.5 million NHMRC grant.

The PRE-EMPT CRE involves partnership with researchers at Telethon Kids Institute (Associate Professor Ashleigh Lin), University of Adelaide (Dr Scott Clark), University of Queensland (Professor Christel Middeldorp), University of Groningen (Netherlands) (Professor Marieke Wichers)
and Ludwig-Maximilians-Universit√§t M√ľnchen (Germany) (Professor Nikolaos Koutsouleris).

Professor Nelson said the CRE would deliver a program of work examining how mental illnesses develop, and identifying risk and protective factors.

“At the moment it’s very difficult to know whether emerging symptoms of mental disorder in young people are a transient episode of symptoms; whether they’ll be persistent mild to moderate symptoms; or whether the young person is in the early stages of severe and prolonged mental disorder,” Professor Nelson said.

“What this CRE aims to do is to improve our ability to predict these clinical outcomes early on in the course of symptoms. Ideally, this will be translated into tools, such as risk calculators, that can be used in clinical practice. The work will be led by early career researchers drawing on a range of clinical and epidemiological datasets.”

Professor Nelson said the research would focus on transdiagnostic outcomes such as increasing predictive accuracy for a range of clinical outcomes, rather than one particular disorder, and that the CRE ultimately aimed to help improve treatments.

“There are a number of benefits of developing these sorts of prediction models. They can help with decisions about how to structure and deliver clinical services – for example, you might want to provide longer or more intensive treatment to young people at high risk of poor clinical trajectories; help direct research into understanding the causes of serious mental disorder; and also point towards risk factors that might be targeted in preventive treatments,” Professor Nelson said.

“Because our prediction tools aim to be dynamic rather than fixed, meaning that they can be updated over time, they might also be useful in clinical settings for providing early warning signs of clinical deterioration.”

The second NHMRC grant, worth $857,288, was awarded under the Partnerships Project scheme and will support the delivery of a model for meeting the diverse needs of young people accessing headspace services. 

The five-year project – the 5W research program – will look at the who, why, what, where, and when of youth mental health primary care provided via headspace centres around Australia.

Chief investigator Professor Sue Cotton said the aim of the research was to develop acceptable, fair and efficient ways of improving the reach and effectiveness of the headspace intervention model.

“headspace, Orygen, and the Productivity Commission have highlighted the need for headspace to move towards a stepped or staged care model in order to be able to better identify the different needs of young people with mental ill health,” Professor Cotton said.

“We need to identify and respond where less intensive care options may be appropriate, and we also need to identify and respond where more intensive supports are needed to help young people with more complex needs.”

Ultimately the 5Ws research program aims to develop a shared decision-making aid to help headspace centres and to guide service reforms.

Initially the 5W research program will use machine learning on clinical and treatment data of young people attending headspace centres.

“We will use machine learning to identify subgroups of young people presenting at headspace and other health services. The subgroups will be based on the clinical and service needs of young people, as well as treatment gaps,” Professor Cotton said.

“This data-driven work will then be validated through stakeholder engagement, before we undertake economic modelling to simulate alternative service configurations and compare them for acceptability, fairness and value for money.”

Professor Cotton said the final product – the shared decision-making aid – would help guide policy and practice in Australia and beyond.

“The results will translate internationally and help place Australia at the forefront of youth mental health service provision at this crucial point in time,” Professor Cotton said.

The 5Ws project involves partnership and collaboration between Orygen, headspace, Ambulance Victoria, and the Victorian Government, as well as researchers from University of Melbourne, University of Canberra, University of Sydney, Deakin University, Victoria University, Monash University and University of Auckland.