Greatest research achievements in Kent, Surrey and Sussex: a new frontier in treatment for depression

To celebrate 10 years of the NIHR Clinical Research Network, we are looking back at our greatest research achievements over the past decade. This includes Kent, Surrey and Sussex (KSS)-led research studies and those delivered in the region whose results have influenced and impacted clinical practice within the NHS and social care, locally and nationally.

This week's focus is on LIGHTMind2, a mental health study looking into treatment for depression.

Which sites in KSS recruited to this study?

Sussex Partnership NHS Foundation Trust and Sussex Community NHS Foundation Trust.

How many participants were recruited?

410 participants took part as a whole.

What was this study investigating?

This study investigated whether clinician-supported Mindfulness-Based Cognitive Therapy self-help (MBCT-SH) would be more effective than Cognitive Behavioural Therapy self-help (CBT-SH) to treat people experiencing mild to moderate depression.

Why does it matter?

It is estimated that depression will cost £12.15 billion to the economy each year in England by 2026. NHS Talking Therapies (previously called IAPT) is the NHS talking therapies service in England for adults experiencing anxiety or depression. Almost 2 million people are referred to NHS Talking Therapies services each year, and over half are experiencing depression. Where symptoms of depression are mild or moderate, people are typically offered CBT self-help supported by a psychological wellbeing practitioner (PWP). However, over half of people who complete treatment in NHS Talking Therapies still experience depression and less than half complete treatment.

What did this study look like?

410 people experiencing mild or moderate depression were randomly allocated to guiding themselves through either a MBCT-SH or a CBT-SH workbook. Each participant was asked to complete their workbook within 16 weeks and had six PWP sessions during this time. Depression severity, and treatment completion were measured.

Assessments were made at the start of the study and then again after 16 weeks and 42 weeks. 24 participants were interviewed about their experiences.

In this next section, we spoke to Dr Clara Strauss, Chief Investigator for LIGHTMind2, Deputy Director of Research at Sussex Partnership NHS Foundation Trust and Professor of Clinical Psychology at University of Sussex.

Clara, what did we learn from this study?

"We learnt that mindfulness self-help supported by a practitioner was more helpful than practitioner-supported CBT self-help, which is standard evidence treatment for people experiencing depression. This has the potential to broaden the range of treatment options for people living with depression and improve their experience. Mindfulness self-help was also found to be cost saving. It saved on average £500 per person compared to the CBT self-help intervention."

What is the impact of this trial?

"The pathways to effecting clinical practice is through NICE guidelines, which are evidence-based recommendations for health and care in England and Wales. So, the next step is to liaise with the NICE guidelines committee, to see whether the LIGHTMind2 trial can be evaluated within the depression guidelines, which could impact mental health treatment on a national scale.

"However, what we do know is that there is a big gap in healthcare research between randomised control trials demonstrating effectiveness and them being implemented, which can be for many years."

What is next?

"The plan is to conduct research into the most effective ways of implementation, because this can be challenging. We want to look at barriers to implementation for this mindfulness approach, and also the mindfulness approach for depression more generally. The end goal is to make sure that people living with depression have access to different approaches.

"We also found in this research, and other studies looking at psychological interventions, that people from diverse communities are less likely to be offered and take up these interventions in the first place. So, we want to do some work jointly with people from diverse communities to understand these barriers and put things in place to make sure these interventions are equally available to everyone who might benefit."