Blog: Inaugural Mental Health Hub Meeting 2019

The Mental Health Hub held its first meeting on 8 February at the Royal College of Psychiatrists. The event welcomed 48 professionals from across disciplines to discuss and develop ways of improving mental health services for people affected by Parkinson's. Read on for a summary of the day. 

The Mental Health Hub held its first meeting on 8 February at the Royal College of Psychiatrists. The event welcomed 48 professionals from across disciplines to discuss and develop ways of improving mental health services for people affected by Parkinson's. Read on for a summary of the day. 

Following recommendations in 2018 from the All-Party Parliamentary Group (APPG) inquiry to improve access to psychological support for people with Parkinson’s, the UK Parkinson's Excellence Network Mental Health Hub has been established to help foster sharing and development of best practice within the Parkinson’s community.

The meeting on 8 February 2019 officially launch the hub at the Royal College of Psychiatrists in London, and was chaired by Clinical Neuropsychologists, Dr Andrew Paget and Dr Jennifer Foley from the National Hospital for Neurology and Neurosurgery.

The conference featured presentations highlighting some of the good practice that already exists and facilitated development of two working parties to improve services further.

Good pathway examples and gaps

The day's presentations started with a case example of a good care pathway with Dr Jennifer Foley and Dr Andrew Paget sharing their needs-matched multidisciplinary model of care for mental health in Parkinson’s.

They outlined reasons for psychological distress in Parkinson’s, types of referrals received and the range of psychological interventions that they offer, including individual-, couple- and group-based therapy. They also highlighted some of the gaps in service provision that they have encountered in the NHS, particularly for the support of carers.

Cross-discipline research

The second session focused on innovative research in mental health services for people with Parkinson’s.  Dr Catherine Hurt, Senior Lecturer in Health Psychology from City University, presented her recent work identifying the barriers that stop people with Parkinson’s communicating non-motor symptoms, including anxiety and depression, to healthcare professionals. She described a novel intervention that her team has developed to help empower people to communicate better their health needs (PD-Help study).

Dr Andrew Paget outlined an intervention for people with Parkinson’s and freezing of gait, using the principles of cognitive behavioural therapy. He presented a case study from his clinical work to demonstrate the potential for this intervention. Many in the audience felt this was an intervention that could also be applied to help reduce the distressing impact of a range of other motor symptoms.

Prof Anthony David, Professor of Cognitive Neuropsychiatry at UCL, delivered an excellent presentation on his and Dr David Okai’s large study trialling cognitive behavioural therapy as an intervention for impulse control disorder, which informed the recent NICE guidelines. He also described predictors of success, which will allow improved targeting of future psychological interventions.

Prof Eileen Joyce, Professor of Neuropsychiatry at the Institute of Neurology UCL, gave a well-received presentation on working with complex cases, such as psychosis and impulse control disorder. She highlighted the need for better service provision for the use of clozapine for people with Parkinson’s. This generated a lot of interest in the audience and a working group to support this was formed on the spot.

Prof Iracema Leroi, Professor of later life psychiatry in the Department of Neuroscience and Experimental Psychiatry at the University of Manchester, gave an impressive talk on her recent Individualised Cognitive Stimulation Therapy (INVEST) project. She described how the psychosocial intervention cognitive stimulation therapy can be adapted with good success for people with Parkinson’s dementia.

Supporting carers

The next session focused on the important role of carers, their needs and how we can support them better.

Dr Annette Hand, Associate Professor from Northumbria University and Parkinson's UK Excellence Network Clinical Lead for Nursing opened this with a passionate talk providing an excellent overview. She described her extensive research and made a plea that we acknowledge the carer as a fundamental partner in the healthcare of the person with Parkinson’s and work with the carer to support and maintain their critical role.

Prof Iracema Leroy then presented the PhD work of Dr Sabrina Vatter on the impact of Parkinson’s dementia on loving relationships and carer burden. It highlighted the complexity that dementia adds to caring for someone with Parkinson’s.

Following this, Dr Jennifer Foley announced a new and exciting project at the National Hospital for Neurology and Neurosurgery, funded by The National Brain Appeal Small Acorns Fund, to provide psychological support to carers of people with Parkinson’s-related dementias. Jennifer and Dr Rimona Weil, Consultant Neurologist at the National Hospital for Neurology and Neurosurgery, have developed an 8-session manual-based individual coping intervention for Parkinson’s carers adapted from the ‘Strategies for Relatives’ for dementia carers. This intervention can be delivered either by phone or face-to-face.

Recommendations for the future

The final session looked to the future. Dr Jane Simpson, Research Director and Senior Lecturer in Health Research at University of Lancaster, announced her new Minds and Movements project which has been tasked with producing psychological guidance for people with motor neurodegenerative disorders. She invited people to be actively involved in this project, which will ultimately inform how psychological services can best support people with Parkinson’s.

Claire Hewitt, Education Adviser for Parkinson’s UK, closed the session with an introduction to an online course currently under development, which will help professionals learn more about mental health in Parkinson’s.

And finally…

The meeting finished with the suggestion of two working parties: (1) to improve service provision of clozapine for people with Parkinson’s and (2) to develop pathways for future service development.

To continue communication, sharing ideas, keep informed and join the working parties contact [email protected] to join the Hub's online collaboration space on Basecamp. 

Finally, a big thank you from Jennifer and Andrew to everyone who attended making it such a successful launch and we hope you will continue to work with us to help improve mental health services for people with Parkinson’s. See you on Basecamp!

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