"This is very much what the mental health field needs"
Professor Pim Cuijpers, one of the world’s foremost experts on depression, explains why he believes Wellcome’s new mental health priority area is crucial to transform the field and lead to personalised, targeted treatments.
In December 2017, Wellcome contacted me and asked whether I was interested in chairing the preparatory work for the mental health priority area. The idea was to develop a programme that would help mental health research to take a major step forward. I didn’t hesitate for a second to get involved.
This programme is very much what the mental health field needs – something ambitious that will make the changes that are needed.
It has been very gratifying to see great ideas take shape. I think that what we’ve developed has the right balance between ambition and being realistic about what Wellcome can achieve in the current situation to drive the field forwards.
The programme is aimed at the whole mental health field – researchers from different disciplines define themselves as working in mental health research, instead of their own individual discipline. We all work together on the same problem, namely the huge disease burden of mental health disorders. And we all have a common goal regardless of our specialty, whether we’re psychologists, psychiatrists, neuroscientists etc.
Depression and anxiety are the biggest problems from a public health point of view. We believe that if we act early in the course of disease and early in life, we can realise a breakthrough.
My motivation for getting involved is that I worked in mental healthcare as a psychologist for ten years before I became a researcher. I saw how people struggled with mental health problems and how difficult it was to help many of them. I also saw that mental healthcare requires considerable resources and wondered whether there was a way to reach more people with mental health problems without an increase in resources.
When I went into research, I focused on whether it was possible to minimise therapies without reducing beneficial effects, and on the disease burden of mental health problems, especially depression and how to prevent it.
I’ve always tried to move away from a narrow focus on therapy, and what happens between a patient and a therapist, and to take a public health perspective, to see how mental healthcare can help more people, earlier, and more efficiently.
Mental health research is very exciting because it is such a large problem that affects almost everyone, either directly or indirectly through relatives and close friends. It’s very much part of human life, but it’s also very complex because we understand very little about it.
- We don’t know what mental disorders are and what causes them.
- There is a lot of research, but no clear explanation yet of why some people are affected and others in the same circumstances aren’t.
- We don’t have a good test to examine whether someone has a mental health problem.
- We know how to treat most mental health problems, but we don’t know how these treatments work or for whom.
- Unfortunately, treatments don’t work in all patients and people who recover after treatment have a big chance of relapsing.
This is a huge challenge as a researcher. How can we understand mental health problems better and do something about them?
There’s no guarantee that there will be a breakthrough in mental health research but if there is, I believe it will be through the priority area work. I think it’s aimed at exactly the right targets, and is making use of the possibilities and innovations that are currently available in research.
"I anticipate that the programme will lead to more personalised and targeted treatments that can be applied on a large scale."
I anticipate that the programme will lead to more personalised and targeted treatments that can be applied at large scale. Psychological treatments offer the best possibilities because they can be adapted to the personal situation of a patient.
The priority area is dedicated to innovation – to improving our understanding of mental health problems and how best to treat them. It is in addition to, not instead of, the work Wellcome already supports through its funding schemes.
Next steps
The first priority is to recruit an outstanding leader, with vision and ambition, to head the programme.
We think researchers will realise that this programme will change the mental health field and make a real difference to the lives of huge numbers of people.
It’s vital that patients are able to help shape what we do, because treatments are only effective when they resolve the problems that patients feel are the most debilitating.
I am very curious about how the mental health field will look after the first five years of the priority area. I expect the landscape to have changed considerably. It won’t be possible to ’solve’ this challenge in the short term, but contributing to a solution in the future is very rewarding.
Pim Cuijpers has been Chair of the development phase of the mental health priority area. He is Professor of Clinical Psychology at Vrije Universiteit Amsterdam.