Thinking big in mental health
The past year has seen major developments in our understanding of mental health, and Edinburgh is at the forefront of vital research. We spoke to Andrew McIntosh, Professor of Biological Psychiatry, about the challenges, personalised treatments and big data.
Chatting with Andrew McIntosh at his base in the Royal Edinburgh Hospital’s Kennedy Tower – home to the University’s Division of Psychiatry – he is clearly enthused about the future of mental health research and the role Edinburgh will play in it.
“As a field, we have been making terrific advances in our grasp of mental health conditions,” says Andrew. “In particular, in the area of genetic risk factors. This means we can more easily identify how genetic factors can contribute to the chance of developing an illness.
“We really have to remember that there is a growing burden of chronic disease worldwide – perhaps contrary to popular belief – and this is especially pronounced in mental health conditions such as depression. It affects more than 300 million people around the world – a statistic that simply astounds some, but also galvanises others into action. These global problems demand global solutions, devised by the best people.”
Andrew works as part of a cross-disciplinary team that includes researchers from the fields of biomedical, psychological and social sciences. They are looking at how depression and other common mental illnesses emerge, change and affect people over the life-course.
“Societal changes in the past 20 years have transformed the way we work, exercise, learn – basically how we live,” says Andrew. “So it’s our responsibility to make sure that healthcare also evolves in response to these changes and the challenges they bring. We have huge amounts of data at our fingertips that includes statistics on health, physical activity, neighbourhoods, environmental influences and lifestyles, and we’ve begun to maximise these digital resources. They can make such a positive impact on our research.”
Healthcare, Andrew admits, has been slower than other fields to harness the effects of the information age, but a new focus on data science could have major implications for research into the causes and consequences of mental health conditions. Big data – massive data sets that can be analysed to spots trends and sequences – will be particularly crucial.
“I think of big data in terms of ‘the 3 Vs’,” says Andrew. “Volume, velocity and variability: the data is massive, often covering whole populations; it’s developing at great speed; and it’s also available from multiple sources, be it health records, wearable devices, and, of course, our own research.”
The University of Edinburgh now has access to data collected from several large cohort studies, each covering a different part of the life-course. When combined with existing research results, as well as routinely-collected NHS data, Andrew says we cannot underestimate its potential:
“The UK – and Edinburgh in particular – has been developing the tools, people and infrastructure needed for this kind of health data research – and that includes developing access to population-wide records. This places us in an extremely strong position to take our work forward.”
But how will the analysis of ‘big data’ work in practice? Andrew points to a recent example that used information held about prescribed and dispensed medicines – routinely collected for planning purposes – to study the efficacy of treatments in individual patients.
“The data is already essential to the health service,” he says, “but the opportunity arose to use it in a special project being run as part of Generation Scotland [a Scotland wide study of the genetics of common complex disease] that allowed us to link the NHS data with the statistics that had already been collected for the project. We could then look at factors associated with effective medication use and explore the future possibility of using the data to predict who will respond to which treatment, and why.”
Andrew calls this approach “personalised medicine”, and it is already being used with great effect in the treatment of cancer patients. He believes the University can help bring similar benefits to those living with mental health conditions.
And the Medical Research Council agrees. As part of its prestigious Data Pathfinder Award scheme, the organisation and University recently awarded Andrew and his team a £2.2 million grant, allowing them to hire several new members of staff and make a significant start on their research.
Other crucial stakeholders are being fully involved, too. An advisory group has been established that will consist of people who have experience of mental health conditions, both professionally and personally.
“We are very proud of the group and their aspirations for mental health data science” says Andrew. “We’ll work closely with them throughout the project allowing them to input into all of our activities. And we’ll also work with charities and individuals to co-develop guidelines on ‘best practice’ in data science. We hope these will be adopted by other groups around the UK – that way we can ensure that these sorts of big data approaches are built on firm ethical and moral foundations.”
The project is proving timely, too, coinciding with the Edinburgh and South East Scotland City Deal, announced by the UK and Scottish governments last year and which signalled one of the largest single investments in multidisciplinary data science to date. Part of the Edinburgh region’s quest to become the ‘data capital of Europe’, the City Deal will bring much-needed new infrastructure and investment to allow researchers to strategically address the growing local and global burden of chronic disease.
And Andrew is clear about the implications for society from such a wide-ranging and collaborative project:
“The knowledge held in big data is vitally important for mental health research but it needs the right people and tools, and, crucially, the public’s trust in order to thrive. Our project is bringing these components together and will reap real benefits for those millions who live with mental health conditions.”
If you would like to find out more about Professor Andrew McIntosh’s work and further opportunities for involvement, please contact Development and Alumni on +44 (0)131 650 2240 or firstname.lastname@example.org.
Division of Psychiatry