Research into practice

In addition to its key initiatives, Mindgardens invests in a wide range of research projects in mental health, drug and alcohol and neurological disorders that have potential to change how patients are supported and make the service system more responsive to their needs.

The Clinical Course of Bipolar Disorder

Project lead: Dr Jan Fullerton (NeuRA)

Who is it for?

Up to 3 per cent of people experience bipolar disorder, in which cycles of high and low mood can have a severe impact on personal wellbeing, relationships and ability to function in work or education.

What is it about?

Medicare and hospital records for participants in the Sax Institute’s ongoing 45 and Up study will be linked to questionnaire data about their health and quality of life. For those participants who have a bipolar disorder diagnosis this linkage will provide an accurate snapshot of their health care, how this compares to people who do not have bipolar disorder, and most importantly whether the treatment they receive helps them to recover and stay well.

The study is especially promising in its potential to shed light on how people with bipolar disorder use and respond to medications, and engage with health services, in their real lives; most information to date has come from clinical trials where medicines are taken according to strict protocols and patients are closely monitored over short periods of time, which may distort the conclusions.

This project will also use state-of-the-art whole genome sequencing of DNA samples from a subset of 1,200 participants, allowing the researchers to search for genetic indicators of risk for developing bipolar disorder or for poorer prognosis and outcome, and potentially for predicting which medications will be most effective for individuals.

Which organisations are involved?

  •   NeuRA
  •   Mindgardens Clinic – Tertiary Referral Service for Psychosis
  •   Mindgardens Clinic for Depression
  •   UNSW
  •   Sax Institute – 45 and Up study
  •   NSW Centre for Health Record Linkage (CHeReL)
  •   NSW Health Statewide Biobank
  •   NSW Health Pathology
  •   Garvan Institute of Medical Research

Measuring and Promoting Wellbeing

Project lead: Dr Justine Gatt (NeuRA)

Who is it for?

Mental health is more than the absence of mental illness; it is also about positive wellbeing. Across the whole community, fewer than a quarter of people report “flourishing”, or optimal wellbeing, while up to 25 per cent have a diagnosable mental illness. This means that at any given time, the majority of people are not mentally unwell but still have room for improvement in their wellbeing.

What is it about?

This project aims to confirm the validity and importance of measuring wellbeing in various mental health settings, and to develop wellbeing programs using different platforms. Dr Justine Gatt has developed one of the first composite wellbeing scales, called COMPAS-W, which uniquely measures both subjective wellbeing (hedonia) and psychological wellbeing (eudaimonia). Most other wellbeing scales measure only one component, for example life satisfaction or quality of life.

This 18-month project will test the practicality and value of measuring mental wellbeing using the COMPAS-W Wellbeing Scale in multiple settings: in patients of the Mental Health Rehabilitation Unit at Prince of Wales Hospital; among hospital staff attending a wellbeing program (which will be developed in collaboration with LHD nursing education staff); and with young clients of a headspace mental health clinic. The outcomes will inform the development of an online app that will provide a personal report on wellbeing using the COMPAS-W Wellbeing measurement tool, plus recommended self-help and online intervention modules that target six wellbeing dimensions. This app will be suitable for the general population and will also be tested in targeted population groups.

Which organisations are involved?

  •   NeuRA
  •   UNSW
  •   SESLHD

Depression and Pain: A Feasibility Trial

Project lead: Associate Professor James McAuley (NeuRA)

Who is it for?

People with chronic health conditions such as heart disease, stroke and low back pain are more likely also to have a mental health diagnosis. For example, major depression is four times as common in people with back pain, while as many as half of people who have major depression also experience physical pain of various types.

What is it about?

Evidence suggests that if pain is treated effectively, depression may also improve.

People who participate in this Mindgardens study will follow a regime that combines exercise physiology with an NMDA receptor antagonist medication. Each approach has been shown separately to have a positive effect on pain and depression, and the team will now assess whether these effects are amplified when people use both together. Over six weeks, they will attempt first to reduce the intensity of the pain people experience, and then use specialised physical exercises to retrain key brain functions to promote long-term improvements in depression and related disability.

Which organisations are involved?

  •   NeuRA
  •   Mindgardens Clinic for Depression
  •   UNSW
  •   Central and Eastern Sydney Primary Health Network
  •   Black Dog Institute

Chronic Pain Prevalence in People with Suicide Behaviour

Project lead: Dr Julia Lappin (UNSW)

Who is it for?

People who live with chronic pain are more likely to take their own life, but it is not known what proportion of people who attend hospital experiencing a suicidal crisis are suffering from pain, or how treating the pain might influence their distress.

What is it about?

This project will estimate the prevalence of chronic pain in people who attend emergency departments following a suicide attempt or experiencing a suicidal crisis, and assess how these people can best be supported. If treating their pain results in better health and reduced suicidal distress then this may justify routine pain screening and treatment for people who go to hospital because they are at risk of suicide, and the issue will be studied further in a national clinical trial.

Which organisations are involved?

  •   UNSW
  •   SESLHD

Own Your Balance

Project lead: Associate Professor Kim Delbaere (NeuRA)

Who is it for?

Many older people are afraid of falling, and while this can be important in protecting them from injury it may also lead to unnecessary limitations in their mobility and activities.

What is it about?

Previous research has shown fear of falling can be reduced through cognitive behavioural therapy (CBT) and balance exercise programs, but these face-to-face treatments are expensive and not commonly available. This study will evaluate whether MyCompass online CBT modules developed to treat worry and anxiety can be combined with the StandingTall graded activity program to help people aged 65 and over become more active in a way that is safe and consistent with their lifestyle and abilities. The 8-week program will be delivered through mobile phone technology.

Which organisations are involved?

  •   NeuRA
  •   UNSW
  •   SESLHD
  •   Black Dog Institute

Reducing Ventilation after Spinal Injury

Project lead: Dr Euan McCaughey (NeuRA)

About 350 people experience a spinal cord injury in Australia every year. More than half involve an injury to the neck, known as tetraplegia. As well as all four limbs, tetraplegic paralysis also affects the diaphragm and abdominal muscles involved in breathing; about 40 per cent of people with tetraplegia need mechanical ventilation, increasing the likelihood of illness and death, extending hospital stays and delaying rehabilitation.

What is it about?

Electrical pulses to the abdominal muscles, called Abdominal Functional Electrical Stimulation (Abdominal FES), improve respiratory function in tetraplegia and help wean people from ventilation – but the evidence is not yet complete enough to make this routine practice. A definitive randomised controlled study will assess whether Abdominal FES reduces the duration of mechanical ventilation in people with tetraplegia, with the potential to improve their health and rehabilitation prospects and produce significant health system cost savings. The study will also explore how this treatment can be introduced into worldwide clinical practice.

Which organisations are involved?

  •   NeuRA
  •   UNSW
  •   SESLHD

Improving Crisis Care for Suicide Crisis and Severe Anxiety

Project lead: Dr Fiona Shand (Black Dog Institute)

Who is it for?

People who are experiencing a suicidal crisis or an episode of severe anxiety can sometimes become further distressed during standard care in busy hospital emergency departments, but alternative support approaches have not yet been developed.

What is it about?

In collaboration with mental health consumers, families and supporters and people bereaved through suicide, this project will develop a new model of crisis care and then test it a large hospital, comparing the outcomes for patients against standard care at another hospital and also assessing the experiences of clinicians.

Which organisations are involved?

  •   SESLHD
  •   Black Dog Institute

Integrated Care Pathways

Project lead: Conjoint Professor Nicholas Lintzeris (SESLHD)

Who is it for?

People who have co-occurring mental health and substance use disorders often receive separate programs of treatment and support for these issues. Better coordinated, more holistic approaches have the potential to improve people’s health and wellbeing and promote their recovery.

What is it about?

Using a shared clinical information system (CIS), care teams in mental health and drug and alcohol services will develop and implement a Comorbidity Package which will enhance care coordination and collaboration through common training, dashboards, alerts and reminders. The project leaders will bring together clinicians, academics, consumers, service managers and data specialists to iteratively co-design the software, so the resulting package will deliver benefits for all users.

Which organisations are involved?

  •   SESLHD
  •   UNSW
  •   Black Dog Institute
  •   NSW Ministry of Health
  •   Mid North Coast Local Health District
  •   University of Sydney

Patient Prevention Outreach Using Technology (SHAPE)

Project lead: Professor Sam Harvey and Dr Michael Murphy, Black Dog Institute

Who is it for?

People who live with mental illness often also experience severe anxiety about their physical health.

What is it about?

Using online and app technology to screen for anxiety about physical health conditions may allow clinicians to guide mental health consumers, helping them to decide whether or not to present to an emergency department, specialist appointment or GP about their concern. Four out-patient medical clinics are participating in this trial.

Which organisations are involved?

  •   SESLHD
  •   Black Dog Institute