Website: kcl.ac.uk/iop/depts/pm/research/imparts Follow us on Twitter @IMPARTSP

New developments in IMPARTS: Integrating Mental and Physical Healthcare: Research Training and ServicesWebsite: www.kcl.ac.uk/iop/depts/pm/research/imparts

Follow us on Twitter @IMPARTSP

IMPARTS - recap

AIM

To improve detection and management common mental disorders in medical settings

- web-based screening interface- patient-reported mental and physical health

outcome measurement- embedded in routine clinical practice - informs patient care and referral

Page 3

IMPARTS informatics screening system:

http://217.154.233.99/teleomedic2/resource/KCH/SCREENINGDEMO

IMPARTS – the wider context

Improve detection & management of symptom distress

Inform clinical decision-making

& promotes timely

interventionTrack change over time

Routine collection of

patient-reported outcomes Research databaseEvidence

generation

CLINICAL PRACTICE RESEARCH

Transformation of future care

POLICY

Identifying need & informing resource

allocation

Mental health

services in

general hospital

s

Mental health

training for

non- speciali

sts

The IMPARTS package

Implementation

Acceptability of screening

CLINIC Pts approached

Pts declining screening n (%)

Rheumatology 296 15 (5.1)

Limb reconstruction

177 7 (4.0)

Hepatitis C 31 1 (3.2)

Proportion of patients declining screening:

Depression (PHQ-9)

CLINIC Rheumatology n=432

Limb Reconstructionn=169

Hepatitis Cn=26

Probable Major Depression (MDD)

101 (23.4%) 36 (21.3%) 9 (34.6%)

Severe MDD with suicidal ideation

14 (3.2%) 7 (4.1%) 2 (7.7%)

Severe MDD without suicidal ideation

17 (3.9%) 6 (3.6%) 0

Moderate MDD 42 (9.7%) 17 (10.1%) 5 (19.2%)

Mild MDD 28 (6.5%) 6 (3.6%) 3 (11.5%)

Anxiety (GAD-7)

CLINIC Rheumatology n=432

Limb Reconstructionn=169

Hepatitis Cn=26

Probable Generalised Anxiety Disorder (GAD)

107 (24.8%) 33 (21.3%) 6 (23.0%)

Severe GAD 42 (9.7%) 20 (11.8%) 5 (19.2%)

Alcohol (AUDIT) & Drugs

CLINIC Limb Reconstructionn=169

Hepatitis Cn=26

Probable Alcohol Dependence

4 (2.4%) 0

Harmful drinking

0 1 (3.8%

Hazardous drinking

17 (10.1%) 1 (3.8%)

Probable Drug Dependence

4 (2.4%) 3 (11.5%)

Post-traumatic Stress Disorder PTSD (PCL-4)

Probable PTSD10.4%

Some symptoms22.0%

No problem67.6%

Limb Reconstruction (n=169)

IMPARTS Research Database

IMPARTS screening

data

EPR clinical &

demographic data

IMPARTS pseudonymised

Research Database

RESEARCHER

The database will bring together psychological & physical health outcomes into a single, searchable, anonymised data repository.

Limb reconstruction, rheumatology, Hepatitis C…

Research opportunities (1)

Trajectories of depression, anxiety, alcohol misuse in different clinical populations

Research opportunities (2)

Research opportunities (3)Outcomes of mental health problems in physically ill populations over time…

Depressed at T1

Depressed at T2

No depressio

n at T2

Can we predict likelihood of non-remission?

Research opportunities (4)

- Less social support- Unhelpful health beliefs- Unemployed- More pain

Consent for contact

• We have ethical approval to prospectively request consent for contact via the IMPARTS screening interface

“I agree to be contacted by a researcher to offer me the opportunity to take part in relevant research projects if they think

I may be a suitable participant”.

• It would then be possible to deanonymise patient records to allow researchers to contact potential trial participants –when explicit consent has been given

Yes No More information

Teaching programmes and self-help materials

• Claire Doyle• Katie Steel

• More on breathlessness and anxiety later

• Example of Limb Reconstruction service

Teaching programme

• Risk assessment and referral

• Managing anger

• Supporting adjustment

• Scheduling activity

• Increasing adherence

• Working with thought and expectations

Self-help materials

• Learning to control your anger

• Are you on edge?

• Coping and living well

• Depression: are you struggling?

• Keeping active

• Getting on with your life after a trauma

Other bespoke teaching programmes

• Respiratory ward

• Speech and language therapists

• Rheumatology nurses

Materials of general relevance

…and more specific

Emphasis on strengths

http://www.kcl.ac.uk/iop/depts/pm/research/

imparts/Ee-Self-help-materials.aspx

Join the IMPARTS mailing list

Subscribe at:

//mailman.kcl.ac.uk/mailman/listinfo/mentalphysicalhealthcareinterface

Email the group:

mentalphysicalhealthinterface@kcl.ac.uk

For more information on IMPARTS: Lauren.Rayner@kcl.ac.uk

IMPARTS module in Core Mental Health Skills

Delivered as part of Advanced Practice MSc module Open to all non-mental health specialists interested in

developing their skills Special introductory offer £499 5 interactive taught days with e-learning component (Jan-

Mar) For more info contact: Faith.Matcham@kcl.ac.uk

Prof Matthew Hotopf - Project Lead

Email: Matthew.Hotopf@kcl.ac.uk

Dr Lauren Rayner - Project Coordinator

Email: Lauren.Rayner@kcl.ac.uk

Ms Faith Matcham – Research Assistant

Email: Faith.Matcham@kcl.ac.uk

Dr Jane Hutton – Consultant Clinical Psychologist

Email: jane.1.hutton@kcl.ac.uk

Dr Rina Dutta – Consultant Psychiatrist

Email: rina.2.dutta@kcl.ac.uk

Dr Katie Steel – Clinical Psychologist

Email: Catherine.Steel@kcl.ac.uk

Project Team