A journey into mental health research.

Dr Yu (Maggie) Fu, a NIHR Three Research Schools' Mental Health research programme project awardee and now an NIHR Advanced Fellow based at the University of Liverpool, shares her journey into mental health research.

I studied medicine as my undergraduate degree and became a junior doctor in 2010. I couldn’t wait to improve patient’s lives. But often I noticed the challenges faced by people living with severe mental illness and identified areas where our healthcare systems could provide more effective support. So I chose to leave clinical practice and pursued further training in public health and applied health research to explore how I could make a difference.

During my postdoctoral work, I have delivered a range of externally funded studies on the management of long-term conditions across primary care, community care, and palliative care settings. A common challenge frequently reported by patients involved the effective management of both physical and mental comorbidities.

My journey with the NIHR Three Research Schools’ Mental Health Programme began when I was a Senior Research Fellow at the University of Newcastle in 2021, where I worked jointly and closely with the NIHR Applied Research Collaboration (ARC) and the Academic Health Science Network for North East and North Cumbria (NENC AHSN). I was supported to develop and lead research programmes related to health inequalities and long-term conditions. My first project gathered evidence to inform how lipid management can be optimized for underserved populations, especially those socioeconomically disadvantaged in the region. Mental health stands out as a significant issue associated with every aspect of their daily lives. The combined ARC and AHSN teams effectively connected me with key individuals and organizations actively working to support underserved populations during the pandemic, which was critical to reaching our target population promptly.

Tapping into established networks and collaborations with key individuals motivated me to focus on making a difference in health services for underserved populations. I was greatly supported by Professors Eileen Kaner, Julia Newton, Chris Price, and Luke Vale at Newcastle, who connected me with senior academics, clinicians, patient and public involvement partners, data processors, and the leading mental health trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW). This enabled me to form an excellent project team with expertise clinically and methodologically, linking both the North East and North Cumbria and Greater Manchester regions for my Three Research Schools' mental health research programme-funded project EVOLVE, which aims to establish evidence for culturally competent mental health services. We focused on ethnic minorities with mental health difficulties living in the North East and Greater Manchester where the gaps were the greatest between mental health prevalence and mental health research delivery.

The EVOLVE project not only identified barriers to accessing mental health services but also highlighted difficulties experienced by patients prescribed antipsychotics. With more conversations with patient and public involvement partners, psychiatrists, and the primary care team, I was supported by Professors Iain Buchan and Dan Joyce to pursue my NIHR Advanced Fellowship, aiming to understand and prevent cardiovascular disease in people taking antipsychotics, in collaboration with Professors Carolyn Chew-Graham and Matthew Hotopf. I experienced the most nervous interview but the most exciting moment when I was notified of the success of my application.

Along the way, I have developed expertise in using a mixture of methods needed to help answer my research questions, including routinely collected healthcare records that allow me to explore clinical pathways and associated outcomes and identify gaps in services received and needed. I also talk to people every day about my research, including patients, public members, university students, academics, service providers, and commissioners. These conversations and working relationships have been greatly enhanced by the collaboration between the ARCs and AHSNs, helping ensure that my projects are evidence-based and driven by the views and preferences of the people the services serve.

Many people find it hard to believe that I left clinical practice after training for so many years, and I still hear this sometimes from my family. But I never feel that I have left my patients; I am providing them with better services in a different way through research.