Translational mental health strategy

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Translational mental health strategy

Translational mental health strategy

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Translational impact

Translational mental health strategy

A national translational research strategy ideally guides and supports a country’s overall mental health strategy. Our respective overarching mission is to improve the population’s mental well-being and mental health by innovative translational research.

Our mental health strategy is based on a broad review by experts and representatives of peers and carers (incl. families) of the current and future mental health challenges in Germany. The results are summarised under “Experiences & facts about the German mental health system – today and in the future”. They show that Germany, like other countries, is facing major mental health challenges – today and in the future.

 

Experiences and facts about the German mental health system

Our mission

The Mental Health Translational Research Network Hamburg (MH-TRN) unites internationally highly visible neuroscience, innovative therapeutic interventions for undersupplied groups and a unique expertise in the development of evidence-based and efficient healthcare models. A particular feature of the MH-TRN is the involvement of patients, carers, families and the public.
 
Our interdisciplinary research team is targeting on Serious Mental Illness (SMI) as one of the most urgent challenges in healthcare. It is our vision that millions of individuals with SMI in Germany will significantly benefit from our translational approach comprising neuroscientific studies of development and motivated behaviour, research on epidemiology and risk factors, prevention, early detection and intervention as well as personalised psychosocial interventions embedded in evidence-based, stepped and collaborative care models.
 
Our mission is to unite neuroscience, clinical and health services research to substantially improve mental health.

Our priority topic

We support translational research for all aspects of mental health and wellbeing! However, policy, professional societies, healthcare experts and patient and carer associations state that the mental healthcare for people with Serious Mental Illness (SMI) is particularly fragmented, uneven, costly and not leading to significant changes in mental health outcomes.

Our priority topic is therefore

Translational research within the field of
Serious Mental Illness (SMI)

What is Serious Mental Illness (SMI)?

  • Definition: SMI is defined as a mental, behavioural, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.

SMI mainly includes:

1. Severe Common Mental Disorder – refers to individuals who have episodes of illness interspersed with periods of mild to moderate symptoms and disability or even remission. This group comprises about two thirds of all adults who have a severe mental illness.
2. Severe and persistent mental illness – refers to individuals with a SMI where symptoms and/or associated disability continue at high levels without remission over long periods (years rather than months). This group represents about one third of all adults who have a SMI.
3. Severe and persistent illness with complex multiagency needs – the most disabling of the severe category requires significant clinical care (including hospitalisation), along with extensive support from multiple agencies to assist in managing most of the day to day living roles.

SMI is mainly characterized by:

  • Severe episodic or chronic functional disability
  • Frequent and often multiple and severe comorbid mental disorders (e.g., substance use disorders)
  • Frequent and often multiple and severe comorbid somatic disorders
  • Multiple and complex social disabilities and support needs

Epidemiological data suggest that approximately 2,5 to 3,4 million German adults and adolescents (13-79 years; 3% to 4%) suffer from a SMI. Young adults aged 18-25 years has the highest prevalence (7,5%).

Translational research model

Translational research comprises “the multidirectional integration of basic research, clinical research, and health service research, with the long-term aim of improving the health of the public”. Based on this and other definitions, systematisation and prioritisation of research within the field of the priority topic is based on a translational model that we recently developed on the basis of literature review.

“From bench to bedside to community and back“

Fig. 1 Translation (Research) Model (according to German Research Foundation, German Science Council for Further Development of the German centres of the Health Research, National Centre for Advancing Translational Sciences (NCATS), Research Domain Criteria (RDoC), Hierarchical Taxonomy of Psychopathology (HiTOP), Power Threat Meaning Framework, PTM).

The model comprises research areas and connected translational pathways (T1 to T3). Additionally, it highlights the required structures for relevant and efficient translational research. Patients, carers, and the public are active partners at all levels and constitute a fourth research area with a general strategic agenda within research, services, and relevant organisational structures. The components of the translational model:
Research areas:
  1. Basic research: Preclinical, animal, and proof of concept research.
  2. Clinical research: Translation to humans and patients with phase 1 to 3 clinical trials.
  3. Health service research: Translation to practice and community with phase 4 clinical trials, public health, and other population-level outcomes research.

 

Translational pathways (“Ts”; goals in the legend of the figure):

1. T1: Developing more effective interventions from neurobiological research and feedback.

2. T2: Testing the efficacy and effectiveness of these interventions in practice, community and healthcare system and feedback

3. T3: Dissemination and implementation research for system-wide change, feedback to basic science.
 

Structures for relevant and efficient translational research:

  1. Translational infrastructure: e.g., peer-supported governance, policy, education, training).
  2. Translational research activities: e.g., peer-supported assessment of relevance and quality of research).
  3. Output: e.g., peer-supported publications, patents, medical devices
  4. Impact: e.g., peer-supported medical guidelines, implementation, legislation, transfer.

 

Involvement, patient-centered care, PROMS, and PREMS: 

1. Involvement of patients, carers (incl. families), and the public, patient-centered care, patient-reported experience measures (PREM) and -outcome measures (PROM).

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