Blog posts

Mental health services must be a priority in post-conflict Ukraine

Two years on from the invasion of Ukraine, we publish a series of blog posts sharing insights from our Ukraine Health Summit, hosted in partnership with the British Red Cross to further efforts in supporting the delivery and restoration of health services in Ukraine.

The first post addresses the importance of mental health services in post-conflict Ukraine, and is written by Melanie Leis, Institute of Global Health Innovation, Imperial College London, with colleagues.

Ukraine Health Summit 2023
[Ukraine Health Summit 2023]

On April 25th 2023, Imperial College London hosted the first Ukraine Health Summit. This event presented an opportunity to discuss how Ukraine’s health system must be re-built to ensure it addresses the needs of its population in a post-conflict setting. A focal point of the discussion was around the provision of mental health services.

The WHO projects that, of populations affected by conflict at any time during the prior 10 years, 22% will develop a mental health condition. Applying these estimates to the population of Ukraine (44M), this would lead to approximately 10M who will have a mental health condition such as depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia, in addition to existing mental health cases1. Estimates by Ukraine’s government suggest that over 60% of its soldiers are affected by post-traumatic stress disorder, and approximately 50% of the population needs mental health services to cope with the impact of the war2.

Mental health experts at the Ukraine Health Summit agreed that post-conflict mental health service provision should be planned and coordinated across three key themes: policy and regulation, training and education, and family support.

Policy and regulation

The healthcare system in Ukraine, including its mental health services, is a legacy of its Soviet past. Prior to the war, there had been a trend towards reform of the mental health system to address challenges such as limited social services for people with mental health disorders, large institutionalised psychiatric populations (at times associated with human rights violations), and public stigma around mental health3. 

In December 2022, Ukraine’s First Lady launched the Ukrainian Prioritized Multisectoral Mental Health and Psychosocial Support Actions During and After the War: Operational Roadmap4. This roadmap, informed by international and national policies and best practice, aims to provide an overview of mental health and psychosocial priorities to stakeholders involved in the immediate response and the recovery efforts in Ukraine.

One of the issues in the provision of healthcare services in the current conflict setting is the lack of coordination between Government, international organisations and NGO activities. To effectively deliver mental health and psychosocial support in a post-conflict setting the Government must coordinate service delivery. This includes providing greater clarity on service availability, treatment pathways and enforcing regulation to ensure that the services that are delivered meet the highest quality standards. At the same time, non-public sector mental health providers must follow the Government’s leadership.

Training and education

Raising public awareness about mental health issues in the Ukraine is of paramount importance. This includes launching information campaigns and educating the general public about PTSD, depression, panic attacks, and other mental health conditions likely to affect the population.

Crucially, the conflict will have decreased the number of staff available to deliver mental health and psychosocial services. Effective psychosocial support can be delivered by professionals who do not necessarily have to be mental health specialists, but they must be adequately trained. Volunteers who are deployed with no training and are exposed to traumatic events risk developing their own mental health disorders. Furthermore, the impact of inadequately delivered mental health interventions can range from ineffective to ultimately harmful5.

Additionally, those providing mental health and psychosocial support services must have their own mental health needs adequately supported to deliver these services effectively and sustainably. One approach to do this is through mental health providers becoming “trauma informed organisations”, where safeguards are in place to provide physical and emotional safety to staff and avoid re-traumatisation6.

[Ukraine Health Summit 2023 – IGHI Centre for Health Policy Banner]

Family support

Mental health needs vary significantly across different population groups. People with pre-existing mental health conditions may have deteriorated during the war, both due to the direct impact of the conflict and to the decrease in access to care. Additional groups that require mental health services include active military personnel and their families, veterans and their families, bereaved families, children exposed to war, and relocated/displaced families. An individual may be part of several of these groups at once.

There is an opportunity to leverage digital mental health interventions to support families. A scoping review7.identified 36 studies of these interventions, the majority of which targeted young people and parents/carers. These were self-guided, potentially improving access to psychological support without increasing demand on limited clinical services. Most of the interventions tested were associated with improved psychopathology.

Mental wellbeing is strongly associated with a person’s basic needs being met. This is even more the case in a post-conflict setting. One study that looked at the use of healthcare and community-based services in war-affected regions of Croatia found that, although a variety of services were put in place to help the affected population, only the solution of housing (accommodation support) significantly predicted traumatic stress recovery8.

The importance of safety and stability for the affected populations cannot be overstated, as these are crucial to people’s mental well-being. For some specific populations, a key factor in mental health recovery will the passage of time and the return to a safe and predictable routine.

Government leadership, well supported frontline mental health workers and a focus on wider societal support will create the conditions for successful mental health service in post-conflict Ukraine.

References

1. World Health Organization. (2022, December). Scaling-up mental health and psychosocial services in war-affected regions: best practices from Ukraine. Retrieved from https://www.who.int/news-room/feature-stories/detail/scaling-up-mental-health-and-psychosocial-services-in-war-affected-regions–best-practices-from-ukraine#:~:text=In%20applying%20these%20estimates%20to,have%20a%20mental%20health%20condition (Accessed 2023/07/28)

2. Euronews. (2023, February). War in Ukraine having a devastating impact on people’s mental health. Retrieved from https://www.euronews.com/2023/02/20/war-in-ukraine-having-a-devastating-impact-on-peoples-mental-health (Accessed 2023/07/28)

3. World Health Organization. (2020, July). Ukraine WHO Special Initiative for Mental Health Situational Assessment.Retrieved from https://cdn.who.int/media/docs/default-source/mental-health/who-special-initiative-country-report—ukraine—2020.pdf?sfvrsn=ad137e9_4 (Accessed 2023/07/28)

4. World Health Organization. (2022, December). Ukrainian Prioritized Multisectoral Mental Health and Psychosocial Support Actions During and After the War: Operational Roadmap. Retrieved from https://reliefweb.int/report/ukraine/ukrainian-prioritized-multisectoral-mental-health-and-psychosocial-support-actions-during-and-after-war-operational-roadmap-enuk (Accessed 2023/07/28)

5. Jarrett, C. (2008, January). When therapy causes harm. The Psychologist. Retrieved from https://www.bps.org.uk/psychologist/when-therapy-causes-harm (Accessed 2023/07/28)

6. Office for Victims of Crime Training & Technical Assistance Center (not dated). Building trauma-informed organizations. Retrieved from https://www.ovcttac.gov/views/TrainingMaterials/NVAA/ASI/index.cfm?nm=nvaa&ns=asi&nt=sgo&nf=btio (Accessed 2023/07/28)

7. Danese et al. Digital mental health interventions for children and adolescents affected by war: a scoping review. The Global Resources for War-affected youth (GROW) Network. Currently under review at JAACAP.

8. Francisković T, Tovilović Z, Suković Z, Stevanović A, Ajduković D, Kraljević R, Bogić M, Priebe S. Health care and community-based interventions for war-traumatized people in Croatia: community-based study of service use and mental health. Croat Med J. 2008 Aug;49(4):483-90. doi: 10.3325/cmj.2008.4.483. PMID: 18716995; PMCID: PMC2525834. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2525834/ (Accessed 2023/07/28)

COP28: Centring Mental Health in the Health Response to Climate Change

Join us on this journey as we recap the highlights of COP28 in the UAE. The Climate Cares Centre team shed light on the profound interconnections between mental health and climate change, and the critical window for shifting from a vicious to a virtuous cycle, enabling people and the planet to thrive. 

The 28th UN Climate Change Conference (COP28) was a turning point for the centring of human health in climate negotiations. Political leaders began to acknowledge climate change as a health emergency, including at COP’s first ‘Health Day’, where more than 140 countries made a historic commitment to the UAE Declaration on Climate and Health, and one billion USD in finance commitments were pledged for climate and health.

This progress follows years of advocacy by the climate and health community, who have worked tirelessly to put people and health at the centre of the multilateral climate processes. The health community collectively used its trusted voice to achieve recognition of the fact that in negotiating the amount of fossil fuels that can be dug up and burned, what is ultimately being negotiated is how many people will lose their lives, their health, their land, and their livelihoods. The 7 trillion USD given in fossil fuel subsidies in 2022 alone is also subsidizing air pollution and the premature deaths of more than 8 million people. It is additionally subsidising the increased intensity of a changing climate and all the associated hazards, which is recognised by the World Health Organisation (WHO) as the greatest threat to human health. And it is not only physical health that is on the line.

COP28 also saw growing recognition of the deep interconnections between climate change, mental health and well-being. Starting with the first-ever mental health event at a COP in Glasgow, the Climate Cares Centre has been part of international efforts to bring attention to the psychological stressors and traumas of the climate crisis. At every COP, we highlighted how climate impacts are raising the risk of people dying by suicide, new cases and worsened symptoms of mental health problems, and reduced well-being through more distress, stress, and negative sentiment in the population. The extra mental health burden from extreme weather events, air pollution, and lack of access to green space has been estimated at 537 billion USD every year by 2050. The mental health toll of the climate crisis is reducing the capacity of individuals, communities, and systems to take action to prevent and adapt to the increasing climate hazards they face.

From a vicious to a virtuous cycle, the opportunity for action should not yet be missed. Climate action is an opportunity multiplier for creating the conditions that foster good mental health such as more connected and equal societies, clean air, and access to green spaces, while good mental health and psychological resilience can be an enabler of sustained climate action.

[Climate Cares Centre Delegation: Nienke Meinsma, Dr Omnia el Omrani, Dr Emma Lawrance, Jessica Newberry Le Vay]

Recognizing the climate-mental health nexus

Out of the many “firsts” for health at COP was a COP Presidency-led dialogue on mental health and climate change, hosted at the COP28 Youth Climate Champion Pavilion. The Climate Cares Centre supported the organisation by the co-hosts of Wellcome and the Health Working Group of the official Children and Youth Constituency.

[Jessica Newberry Le Vay speaking at the COP28 Youth Climate Champion event on Mental Health and Climate Change]
Dr Emma Lawrance set the stage for the open discussion by summarising the current evidence exploring the multiple pathways by which climate change interacts with mental health. Jessica Newberry Le Vay also presented highlights of the youth perspectives gathered by the Wellcome-funded Connecting Climate Minds (CCM) dialogues on climate-related mental health consequences. Further efforts were shared including the COP² Roadmap for Care and Change to build psychological resilience, the UNICEF Climate-Changed Child Report, and the upcoming Youth Mental Health toolkit by the African Union Youth Envoy on emerging issues affecting mental health in Africa including climate change, in a packed room of diverse young people – standing room only!

Participants also shared the overlooked impacts of climate change on the mental health of people with disabilities including social isolation and increased vulnerability during climate-related disasters. A powerful question came from one of the COP28 youth delegates, who spoke of the need to understand how people with disabilities are affected in particular in the climate crisis, and what these risks and burdens do to their mental health. She noted, “Mental health is often overlooked, but we often become stressed in our minds, and then sick in our bodies.”

session participants at the Youth Climate Champion Pavilion
[Session participants at the Youth Climate Champion Pavilion]
 

Introducing Connecting Climate Minds at COP

One of the Climate Cares Centre’s flagship initiatives is Connecting Climate Minds (CCM), a global Wellcome-funded project that aims to develop an aligned and inclusive agenda for research and action on climate change and mental health that is grounded in the needs of those with lived experience of mental health challenges in the context of climate change. Over the last year, the CCM project has developed communities of practice in climate change and mental health around the world, including diverse expertise including that of lived experience.

[Connecting Climate Minds team]

The second day at COP28 had us brimming with enthusiasm as we held the first official in-person Connecting Climate Minds (CCM) as a UNFCCC side event. We focused on the methodology by which the seven regional communities have developed research and action priorities for climate-mental health nexus. We also highlighted the priority themes that emerged from the eighteen virtual and in-person dialogues across Peru, Nigeria, India, and Cameroon with indigenous communities, smallholder farmers, and young people. Professor Sir David Nabarro chaired a lively discussion with remarks by exceptional representatives from the CCM global team and youth ambassadors, Wellcome, the International Federation of Red Cross and Red Crescent Societies and the International Federation of Medical Students Association.

Dr. Britt Wray presenting findings from the lived experience expert dialogues that Connecting Climate Minds has been hosting with youth, Indigenous populations and smallholder farmers
[Dr. Britt Wray presenting findings on behalf of Connecting Climate Minds Lived Experience Working Group]
Dr. Britt Wray, Director of CIRCLE at Stanford Psychiatry shared “The CCM dialogues surfaced the fact that many young people are typically looked to as the beacon of hope for climate action by older generations and powerholders, but this puts a deeply unfair burden on their shoulders for fixing a crisis that they did not create. Youth participants also told us that they want and need safe collective spaces where they can find legitimization and support for their frustrations and grievances. Several audience members shared that this portrait of youth activist mental health aligned with their experience and helped them feel validated and resourced. Sometimes, just a little bit of information can go a long way in terms of providing psychosocial support that can make a difference in the lives of individuals. COP28 was an unexpected venue to do just that.”

Later that day, Jess presented the work and process led by the CCM team to develop a youth-led agenda for research and action in climate change and mental health level based on the insights and expertise of the 150+ young participants. Jess highlighted “Critically, young people want and need to be at the heart of research to better understand and respond to the impacts of climate change on their mental health. We also heard many young people share the need to integrate mental health into climate education, which is one of the Climate Cares Centre’s areas of focus for 2024”.

[Jessica Newberry Le Vay presenting the findings of the CCM youth dialogues at COP28 Children and Youth Pavilion]

Insights and hopes of young people

The second week of COP began with Youth, Children, Education, and Skills Day, which aimed to bring the perspectives and actions led by young people to the centre of climate diplomacy. Not only are young people among the most vulnerable when it comes to the intersecting risks of climate change for mental health, but they also have important perspectives on actions that can foster both psychological and climate resilience. Thus, involving young people in decision-making around climate action is a critical pathway for supporting their mental health and well-being in the context of climate change.

[Dr. Emma Lawrance speaking at a joint mental health event at the WHO Pavilion organised by the Climate Cares Centre and the United Nations University]
That is why we co-organized a panel discussion with the United Nations University (UNU-CRIS and UNU-Merit) to discuss the impacts of climate change on the mental health and well-being of young people and the opportunities to build resilience. “From COP28’s groundbreaking focus on climate and health to the vital recognition of the climate-mental health nexus in academic, media, and policy discourses, we’re on the promising pathway toward transforming advocacy into action. The coming together of climate and health professionals on the sidelines of COP28 reflected the importance of stakeholders coming together to shape the future of climate and health research and collective activities.” says Prof. Dr. Nidhi Nagabhatla, Program Lead- Nature, Climate and Health, UNU CRIS.

In addition, we had the opportunity to speak at the Entertainment and Culture Pavilion demonstrating the impacts of climate change on livelihood and culture leading to ecological grief as a reaction to threatened and realized loss. Conversely, the connection of many young people to culture, land, and communities has been strengthened by their engagement in collective climate action. Omnia El Omrani shared that: “As the COP27 President Youth Envoy, I saw the exceptional ability of youth to communicate the urgency of climate action in ways that resonate with communities and build agency through the lens of culture and arts, bridging the gap between science and lived experiences.”

[Dr. Omnia El Omrani at the COP28 launch of the first ever Youth Stocktake, a comprehensive analysis of youth involvement in the COP process]

Elevating the political profile of mental health

At COP28, our team focused on making the case for mental health as a priority action in the health response to climate change. We were inspired to see that the climate and mental health intersection was integrated in the first section of the UAE Climate and Health Declaration on common objectives: “Promoting a comprehensive response to address the impacts of climate change on health, including, for example, mental health and psychosocial wellbeing, loss of traditional medicinal knowledge, loss of livelihoods and culture, and climate-induced displacement and migration.”

[Climate and Health Ministerial led by WHO Director-General Tedros Adhanom Ghebreyesus]
Furthermore, the climate and health ministerial session, co-moderated by Dr. Maria Neira, WHO, Dr. Githinji Gitahi, Amref Health Africa, and Climate Care’s Dr Omnia El Omrani, saw 50 Ministers of Health and senior health delegates come to COP for the first time. They were provided the space to showcase progress made on climate and health by their countries, alongside their country priorities, needs, and opportunities for action and continued collaboration. We witnessed only fourteen mentions of mental health in the statements delivered by the UAE, Canada, Philippines, Senegal, Vanuatu, the European Commission, and others – as tracked by United for Global Mental Health. “The importance of people’s mental health and emotional resilience in the climate emergency is increasingly recognized: the massive positive impact of investing in the mental well-being and resilience of societies may be less well appreciated,” said Professor Sir David Nabarro, Co-Director, IGHI.

 

On the last day, the COP28 Global Stocktake outcome was adopted and included the first-ever mention of transitioning away from fossil fuels, and several country delegates used their final interventions following the text adoption to acknowledge that, for them, COP28 negotiations had represented a step forward in being more “heart-centred”. Such mention can be a springboard for the development of concrete targets with the finance needed and the means of implementation to equitably phase out fossil fuels aligning with what the science says is urgently needed to protect people from the worst consequences of climate change on their health and well-being. Dr. Emma Lawrance shared her reflections with The Guardian: “The COP negotiations are ultimately negotiating human health and wellbeing – mental and physical. Unless developed countries lead the way in delivering emission cuts and the fair funding structures other countries need to act, the cost of inaction will be lives and quality of life.”

[Adoption of the GST during the final plenary]

What’s next?

Despite the progress made on the recognition of mental health in the context of climate negotiations, the awareness and prioritization of the climate-mental health nexus remains more concentrated on climate anxiety in young people. It was also evident that research and action remained disconnected, with successful interventions being quietly implemented but not widely identified and elevated at COP. Climate and mental health policies and practices continued to operate siloed, missing opportunities for co-beneficial cost-effective action. This could be attributed to the under-researched complexity of the interactions between climate and mental health leading to the inadequate consideration of all mental health impacts and actions across climate discussions and vice versa. Nienke Meinsma noted: “It was great to see mental health prominently featured on the Health Day and throughout COP. However, we need to see concrete commitments to research, policy, and funding for climate and mental health as to safeguard the mental health of the most affected communities by the climate crisis.”

 

This presents a significant opportunity for future COPs to increase the awareness and deep understanding of the overlooked climate-related mental health presentations, economic outcomes, and interventions that respond to them such as post-traumatic stress disorders due to extreme weather events, suicide due to increased traumas and livelihood impacts (e.g. crop failure), and physical heat stress risks for people with pre-existing mental health challenges (e.g. psychotropic medication side effects in extreme heat impairing ability to regulate temperature).

 

To effectively address this, funding institutions such as multilateral development banks and philanthropic foundations could fund research and research capacity building/awareness raising to better understand and address the linkages between climate and mental health. The research findings could provide policymakers with scientific data and indicators to integrate mental health into climate policy and vice versa.

 

Thus, on 19-21 March 2024, we will come together in person in Barbados to finalize the Connecting Climate Minds Global Research and Action Agenda on climate change and mental health, celebrate the communities that have been built and the past year’s tremendous work and discuss how the agenda can be translated into policy and practice. You can sign up to join us virtually here.

 

 

 

 

 

 

Climate Change and Mental Health: Insights from Connecting Climate Minds’ First Regional Dialogues 

Villagers pray for their family members at a flooded public cemetery due to rising sea levels. Often, residents live with the seawater, as homes are commonly flooded. Sayung subdistrict, Demak, Central Java, Indonesia.
Photo credit: Aji Styawan / Getty Images Climate Visuals Grant recipient

 

As climate change continues to reshape our world, it’s not just landscapes that are transforming; the mental health of communities worldwide is also on the line. Over the past month, Connecting Climate Minds has been uniting global experts, researchers, and stakeholders in the diverse fields relevant to climate change and/or mental health from across the world. These discussions transcend borders, bringing together experts from seven regions of the world: Latin America and the Caribbean; Sub-Saharan Africa; Northern Africa and Western Asia; Central and South-Eastern Asia; Eastern and South-Eastern Asia; Oceania; and Europe and North America. The current field of mental health and climate change are disconnected and siloed, which reflects an urgent need to align research and action at the intersection of these two fields. The Connecting Climate Minds’ project aims to address this gap, with the goal of creating an actionable research agenda informed by lived experiences, while also connecting communities of practice across the globe. This agenda will capture the vast diversity of regions and groups of people that are affected by the climate crisis, allowing for an inclusive and comprehensive outline for future researchers, with investment and action from policymakers and relevant stakeholders.

The current field of mental health and climate change are disconnected and siloed, which reflects an urgent need to align research and action at the intersection of these two fields.

 

The first dialogues proved to be a stunning success, with a total of 288 attendees representing 42 different countries across the world. This impressive turnout reflects the pressing need for collaborative efforts to address climate change and the enthusiasm among experts to contribute their knowledge and skills to this global challenge. Each dialogue kicked off with a dynamic plenary session followed by breakout rooms, where lived experiences and on-ground stories were shared from attendees. The breakout rooms consisted of a variety of different perspectives, including medical practitioners, public health and psychology researchers, climate experts, economists, anthropologists, clinical professionals, disaster management personnel, and beyond. A few groups represented at the dialogue include the president of the Jordanian Association of Psychiatrists, United Nation Youth Delegates, and senior leaders within the World Health Organization (WHO).

Attendees shared personal stories and experiences related to climate change, underscoring the real-world impacts of the crisis on individuals and communities. One attendee from Afghanistan shared, “People lose their assets, their livestock, and people are getting injured, killed, especially when flash floods occur at night. Just recently, a few months back, there were flash floods in nine or ten provinces. We had around 20, 29 people dead, and then more than a hundred injured. That caused a huge level of anxiety in the households that lost their relatives.”  Another attendee from South Africa shared,  “We are all impacted by climate change. And people with money have insurance and can survive. But the rest of the population loses everything.” These lived experiences served as a powerful reminder of the urgency of the interplay between climate change and mental health. From the diverse array of perspectives shared, a rich tapestry of themes and discussions emerged from the breakout sessions.

Some of the notable themes include:

  • Socioemotional stress: With extreme weather changes, people may be prevented from seeing their family members and friends, and children may not be able to go to school. Increased social isolation leads to detrimental effects on mental health and wellbeing.
  • Economic impacts: Temperature and drought affects farmers, as well as the physical and cognitive demand of workers. In the long term, changes in the environment have led to significant food insecurity amongst communities.
  • Community Resilience: There is a pressing need to provide culturally-sensitive and accessible psychosocial support for people who have suffered disasters or other impacts from climate change. Long-term support is necessary to build community resilience in the face of environmental change and disaster.
  • Context-Specific Research: Each region has different needs and varied mechanisms by which climate change affects mental health. Thus, research priorities are not a “one size fits all” solution–instead, it should be context specific and informed by lived experiences.

 

The first Connecting Climate Minds dialogue is only the start of the collective effort to align research and action at the intersection of climate change and mental health. Participants at the dialogues expressed their gratitude for the opportunity to have their stories heard and collaborate with experts from different disciplines. 

One attendee noted, “I had the opportunity to unburden my heart. Many thanks for creating this space to inspire change and action.” 

 

Looking ahead, there are one more dialogues scheduled in the coming months for each of the seven global regions. The aims of the first dialogues were to create knowledge through research, and to foster evidence-based policy and action. Attendees will continue to work together to refine the research priorities that have been identified from these dialogues. Through collaboration, each region will build an inclusive research agenda and actionable plan aimed at addressing the nexus of mental health and climate change within their respective communities. Furthermore, pre- and post-dialogue surveys will be conducted to gather insights from attendees, such as their perception of themes identified in the dialogues and their views on what criteria can be used to prioritize future research.

It’s safe to say that the first Connecting Climate Minds Regional Dialogue represents a significant step forward in the global effort to combat climate change through knowledge- sharing, collaboration, and structured discussion. As we move forward, the goal remains clear: to work together, across disciplines and generations, to build an equitable research framework in the face of climate change for the people of our planet.

 

Connecting Climate Minds is funded by Wellcome and delivered through Imperial Projects.

Our global project team brings together experts across Imperial College London, the Red Cross Red Crescent Climate Centre, the Climate Mental Health Network, SustyVibes, Force of Nature, St Luke’s Medical Center, The Planetary Health Alliance, Jordan Health Aid Society International, BRAC James P Grant School of Public Health (JPGSPH), Queensland Centre for Mental Health Research (QCMHR), The University of Queensland (UQ), the University of the West Indies and Claretian University of Nigeria.

Breaking barriers — My path to becoming the Julia Anderson Change Lab Behavioural Science Trainee

In our blog series, we present the captivating stories of the fourth cohort of Julia Anderson trainees. As an impactful initiative at the Institute of Global Health Innovation (IGHI), the Julia Anderson Training Programme (JATP) provides people with little or no prior work experience with paid work experience. Last week, Beatrice shared her unique journey as the Helix Centre Trainee. Today, we have the pleasure of introducing you to the last trainee, CJ, the Change Lab Behavioural Science Trainee, determined to pursue her dream of becoming a clinical psychologist.

Discovering my true colours

My name is Calea-Jay, but you can call me ‘CJ’—that’s what my friends and family call me. Growing up in the lively neighbourhood of Peckham in southeast London has shaped me in so many ways. I’m an INTJ-T personality type, which means I tend to approach things with an analytical and strategic mindset.

When I was younger

Life hasn’t always been a smooth ride for me. I’m open about my experiences with EUPD (Emotionally Unstable Personality Disorder), also known as BPD, which has presented its share of challenges. This means I feel intense emotional fluctuations, moments of fear, and insecurity. But it’s also taught me resilience and the importance of personal growth. Another thing that makes me who I am is my dyslexia, which has shaped my journey and helped me understand the world from a unique perspective. Plus, I’m proud to be part of the LGBTQ+ community, which has been an essential aspect of my identity.

In my downtime, I’m all about manga, anime, and music. I’ve got a soft spot for K-Pop, Dancehall, and RnB. I love experimenting with different cuisines in the kitchen ­- Caribbean and Japanese foods are my absolute favourites!

My trip to Jamaica, where my family is from

Paving my path one step at a time

My experiences at the University of Brighton have been instrumental in shaping who I am today. Currently going into my third year, I am pursuing a BA Hons in Psychology and Criminology. This multidisciplinary programme has allowed me to explore the complexities of human behaviour and delve into the intriguing world of criminology.

In addition to my studies, I find immense fulfilment in giving back to the community through volunteering. I am actively involved with Pathway to Health, a charity clinic in Brighton. At this clinic, we provide alternative therapy through ear acupuncture and mental health support for individuals dealing with drug and alcohol misuse. These interactions have been deeply rewarding and enriching for both me and those I support.

As I combine my academic pursuits with my volunteer work and university engagements, I was excited to embark on the Julia Anderson Training Programme at IGHI. The programme’s focus on health and innovation resonates deeply with my aspirations, and this experience is really shaping my journey moving forward.

Embracing opportunities: my application journey towards the JATP

When I discovered the Julia Anderson Training Programme (JATP) at IGHI, it seemed tailor-made to my interests, aspirations and passion to make a difference in the field of clinical psychology and behavioural science. While I had a strong understanding of Imperial College’s reputation, getting to know the IGHI’s work made me even more enticed to join their team and I was motivated by the opportunity to be part of meaningful projects that could truly impact global health.

Finding a first job in the fields of clinical psychology and behavioural science, where experience is often required, can be difficult. However, the JATP offers a chance for individuals with little to no experience to work alongside seasoned professionals on projects aimed at improving global health. Access to training and mentoring, along with networking opportunities, gives trainees like me the chance to expand our skills, learn from different perspectives, and nurture our passion for research and behavioural science.

As someone with no prior experience in professional roles, the application and interview experience were both exhilarating and nerve-wracking. But, the recruitment process of the JATP is very impressive, particularly the decision to anonymise applicants and their educational institutions. This approach ensured an unbiased evaluation, providing everyone with a fair chance at the roles.

Making a difference through behavioural science

As a Change Lab Behavioural Science Trainee, my primary focus is to support my team in implementing behavioural intervention projects aimed at improving global health. My responsibilities span a wide range of tasks, including conducting literature reviews, analysing data, conducting interviews, and preparing co-design workshops. Additionally, I collaborate with various companies and the NHS to foster partnerships that enhance the impact of our initiatives.

 

“My work experience so far with the Change Lab at IGHI has been immensely fulfilling. I enjoy every aspect, from collaborating with like-minded individuals to engaging in behavioural intervention projects. The supportive and encouraging environment within the team has been invaluable, allowing me to grow both personally and professionally.” — CJ

 

One of the current projects I’m engaged in is “Digital Consent for Surgery” in partnership with Concentric and Behavioural Intervention. Currently, the adoption of digital consent forms is low, despite their known benefits. Our aim at the Change Lab is to better understand the barriers to adopt and design interventions that improve usage. One such intervention involves implementing an electronic ‘pop-up’ reminder for surgeons during patient consultations, or a league table system that allows them to compare their performance with colleagues, utilising the gamification approach.

My work experience so far with the Change Lab at IGHI has been immensely fulfilling. I enjoy every aspect, from collaborating with like-minded individuals to engaging in behavioural intervention projects. The supportive and encouraging environment within the team has been invaluable, allowing me to grow both personally and professionally.

In the future, I am planning to compete a Master’s in Psychology and Neuroscience of Mental Health  and I plan on becoming a clinical psychologist — which I’m sure will be a fulfilling journey filled with self-discovery.

This blog series has been written by Rao Fu, Julia Anderson Programme Operations Trainee. Join us as we delve into the extraordinary stories of our fourth cohort trainees of the Julia Anderson Programme at IGHI! The last two trainees’ stories can be accessed at:

Find out more about the Julia Anderson Training Programme.

Designing inclusive healthcare – my experience as the Julia Anderson Helix Trainee

In our blog series, we present the captivating stories of the fourth cohort of Julia Anderson trainees. As an impactful initiative at the Institute of Global Health Innovation (IGHI), the Julia Anderson Training Programme (JATP) provides people with little or no prior work experience with paid work experience. Last week Rao shared her story as the Programme Operations Trainee. Today, we will introduce you to Beatrice, the Julia Anderson Helix Centre Trainee, whose passion for making healthcare more accessible and inclusive has led her on an incredible journey.

Getting to know me

My name is Beatrice, a trilingual girl from Hong Kong who can speak English, Cantonese and Mandarin fluently. Despite growing up surrounded by skyscrapers, I have always felt a deep connection with nature and developed a strong love for outdoor activities such as hiking, snorkelling, kayaking, and cycling. Traveling is my passion, and I’m always on the lookout for budget holidays that allow me to immerse myself in local culture and cuisine.

children running outdoors
A cherished outdoor moment from my childhood

In my spare time, I am the secretary of the University of Bath Mahjong club, where I indulge in the fascinating world of this tile-based strategy game popular in many Asian countries. Playing Mahjong with my friends brings immense joy, and there’s nothing better than winning a round and earning a well-deserved dinner treat!  

 

Me in Venice, Italy

Pursuing my Passion

My journey has led me to the University of Bath, where I am currently pursuing a BSc in Psychology as a third-year student. Bath’s enriching academic environment has shaped my understanding of human behaviour and nurtured my passion for making a positive impact in the field of mental health.

Beyond the classroom, I actively engage in extracurricular activities that have broadened my horizons and allowed me to give back to the community. One of the most rewarding experiences has been volunteering at Shout, an online text-based crisis hotline. Though I’ve only completed a few shifts, the opportunity to provide support and be there for individuals in their darkest moments has been deeply fulfilling. It has reinforced my commitment to advocating for mental health and the importance of accessible support systems.

As I continue my academic journey, I strive to integrate my psychological knowledge with real-world experiences. By participating in university societies and volunteering, I enjoy working with people from diverse backgrounds. I am now further developing my skills through the Julia Anderson Training Programme at IGHI.

My application journey 

Discovering the Julia Anderson Training Programme (JATP) was a serendipitous moment as I stumbled upon it while browsing through my university’s career page. Intrigued by the programme’s description, it didn’t take long for me to realise that this was an opportunity I couldn’t let pass.

What was it that attracted me to apply for the Julia Anderson Helix Centre Trainee role? It was a perfect alignment of my values and interests. The project’s focus on addressing health inequities resonated deeply with me and I was excited by the thought of being able to contribute to a meaningful project that aimed to make a positive impact in healthcare. Moreover, the JATP encompassed both my existing research skills and my desire to learn new skills, such as design, and so it felt like the ideal platform for both personal and professional growth.

Despite applying during my final exams, I managed my time effectively and performed well throughout the process. One aspect that I am particularly proud of is my “proudest achievement” presentation during the second-round interview. Unlike traditional interviews, the Julia Anderson Training Programme prefers understanding applicants better by using a strength-based way instead of a standardised CV. In a creative twist, I presented my story of ‘Moving to a New Country’ to the panel in a storybook format, allowing my personality and creativity to shine through. It was a memorable experience that showcased my unique approach to storytelling.

drawing depicting Hong Kong with the text 'Our story begins in Hong Kong... and for our protagnist this was home.
My presentation slides of the proudest achievement: ‘Moving to a New Country’

Embracing captivating projects

As a Julia Anderson Helix Centre Trainee in the Design Strategy team, I’m thrilled to work on two exciting projects: one focuses on outpatient appointments and the other involves improving patient and public involvement and engagement (PPIE) within research.

In the outpatient project, I get to come up with cool ideas to make it easier for people to go to their hospital appointments. We want to understand why some people miss their appointments and find ways to help them attend. It’s all about making sure everyone can access healthcare when they need it. As part of the project, I listen to researchers and collaborate on creating a resource hub aimed at assisting IGHI researchers in enhancing patient and public involvement and engagement (PPIE).

Working on these projects is very rewarding, I learn new things every day and feel so engaged in my work. It’s amazing how my ideas and designs have the potential to make a real difference in people’s lives and healthcare. The team I work with is fantastic! They welcomed me warmly and always encourage me to do my best. I feel valued and inspired to push my creativity and skills even further.

 

“Being a Julia Anderson Helix Centre Trainee at IGHI is a dream come true. I get to be part of making healthcare better for everyone. Every day is a new opportunity to learn, grow, and make a positive impact on people’s lives.” — Beatrice

 

Besides my main projects, I also get to help out with other cool things in the Design Strategy team and the Helix Centre. From writing about our work to coming up with new ideas, there’s always something exciting to do! Being a Julia Anderson Helix Centre Trainee at IGHI is a dream come true. I get to be part of making healthcare better for everyone. Every day is a new opportunity to learn, grow, and make a positive impact on people’s lives.

Navigating the path ahead

My future career path is still taking shape, and I am excited about the possibilities that lie ahead. This programme serves as a catalyst for gaining valuable insights into potential career paths and the type of work environment where I can thrive.

Currently, I am considering career paths that merge my interests in behavioural science and clinical psychology. These fields offer opportunities to delve deeper into understanding human behaviour, addressing mental health challenges, and making a positive impact on individuals’ lives. Cultural contexts play a crucial role in my aspirations, as I am keen on exploring how research and design can be tailored to diverse cultural backgrounds, ensuring inclusivity and effectiveness.

While my interests primarily lie in these areas, I remain open-minded and curious, considering a wide range of possibilities. The JATP provides me with a unique vantage point to explore various career paths within the realm of global health innovation. It offers exposure to cross-disciplinary collaboration and the chance to work alongside experts from different fields, broadening my horizons and inspiring me to think beyond conventional boundaries.

This blog series has been written by Rao Fu, Julia Anderson Programe Operations Trainee. Join us as we delve into the extraordinary stories of our fourth cohort trainees of the Julia Anderson Programme at IGHI! Stay tuned for more captivating journeys and inspiration from the trainees’ unique perspectives.

The last trainee’ s blog post can be accessed at:

Find out more about the Julia Anderson Training Programme.

Embracing change – My journey of self-discovery as the Julia Anderson Programme Operations Trainee

In our blog series, we present the captivating stories of the fourth cohort of Julia Anderson trainees. As an impactful initiative at the Institute of Global Health Innovation (IGHI), the Julia Anderson Training Programme (JATP) provides people with little or no prior work experience with paid work experience.

For the first blog post of this series, we will share Rao’s story as the Programme Operations Trainee at IGHI, whose journey is about self-discovery and growth, transforming uncertainties into opportunities.

 

Rao Fu

 

About me: A Positive Lover of Life

I’m Rao, a non-typical Virgo with an ENFJ MBTI personality. Coming from Shijiazhuang, a vibrant city in Northern China known by its English nickname of ‘Rock Hometown,’ I’ve been lucky to grow up in a warm family with lots of support and love. My parents, who run two kindergartens catering to ages 3-7 in our hometown, have been my pillars of strength throughout my life. Despite their busy schedules, they never missed a single moment of my growth and always embraced positive parenting to encourage me to pursue my aspirations. The soulful melodies of Flamenco Guitar are my favourite, inspired by my dear dad who is crazy about flamenco. With my camera in hand, I love capturing fleeting moments and sharing my unique perspective with the world. Additionally, making deep connections with diverse people is also something I enjoy. As an active listener, I am inspired by others and love learning different perspectives.

Rao (right) with her mum (middle) and little sister (left), at Beijing Capital International Airport, China, August 2021

My Background as a Former Educator

I studied Preschool Education for my undergraduate degree and achieved a teaching qualification as an Early Years Teacher in China. With a longing for engaging with diverse cultures and wanting to study in the UK, I took the leap in 2019 to study for a Master’s degree in Educational Leadership and Policy at the University of Bristol. After a gap year in China, I flew back to the UK in the summer of 2021 to study the PGCE Primary Programme at UCL and explore the teacher training journey in the UK.

When my other classmates were busy submitting applications and preparing countless interviews to get into teaching, I made a surprising decision – not to be a primary teacher. Well, surprising to some, but clear to me: I was still exploring my other strong interests in other areas to better understand myself and wasn’t prepared to start a long-term career path as a teacher. So, how did I end up as Julia Anderson Programme Operations Trainee at IGHI?

My Application Journey towards the Julia Anderson Training Programme

Having noticed the Julia Anderson Training Programme Operations Trainee opportunity advertised on my university’s career website, I started researching the programme in more detail. I spent many hours looking through the website of IGHI and the JATP and decided that I wanted to be a part of the programme.

As an international graduate with little experience in the UK’s job market, I have gone through difficulties and setbacks in finding a job in the past year. Unlike other graduate schemes, not only does the JATP have a more inclusive, equitable and accessible recruiting system, they also have a strong commitment to supporting individuals in their early career development. For example, using an anonymous application form with three questions instead of uploading a CV helps to remove any potential bias. They also organise informative webinars for prospective applicants and shortlisted candidates. The recruitment team of JATP is also very helpful during the application process. If I had any questions, they always got back to me with helpful answers and advice.

You might be wondering, what attracted me to apply specifically for the Programme Operations role, since it’s not directly related to my studies. You might have guessed somehow – the first reason is the versatility of the role. As a recent international graduate without any extensive experience outside of teaching and education, I knew a career change wouldn’t be easy. At interviews, I was always asked “Why do you want to change careers?” And the only answer I could come up with was “I am not sure…”, so I knew I had to find a work experience that would allow me to engage in various tasks and expand my skillset.

“Perhaps it is only a small initiative for some, however, for a graduate who is struggling to get a first work experience in the UK, it has reignited my passion for the future, bringing me hope, courage and confidence to continue the pursuit of my aspirations.” — Rao

 

At the same time, I was also eager to kickstart my future in the UK and saw this opportunity as the perfect bridge to help me transition into new career paths. The trainee role would bring me hands-on experience and equip me with a wide range of skills in my interested areas (such as working in an office setting). More importantly, by working with such a multi-disciplinary team with professionals from diverse backgrounds, I could build and develop my networking connections, which would be a very valuable experience for me.

For most people, preparing the application and interview for their dream job is a nerve-wrecking process, and I feel the same. At the beginning, I didn’t put too many expectations on acing this role; instead, I spent my time trying to complete every task to the best of my ability. I focused on the process rather than the result. Therefore, when I received the call to offer me the role, I was completely surprised and couldn’t believe that I was going to embark on this journey.

Thriving in a Dynamic Role

As the Operations Trainee, there are a variety of tasks I will work on during my time at IGHI, and the blog post you are reading at the moment is one of them – as I am planning, writing and promoting a blog series for the JATP myself! In the following weeks, I will mainly be focusing on marketing the JATP, helping to recruit the next cohort and engaging in lots of other tasks related to the programme. I enjoy the work as every day is different. More importantly, I feel very lucky to have an incredibly supportive line manager, Sophie, who cares for me and is always there to offer help. Also, meeting and working with the other two trainees, Beatrice and CJ, has added much joy to my daily life. Overall, every colleague I meet and work with at IGHI has made my day.

I feel very lucky and grateful that I came across the Julia Anderson Training Programme at one of the most uncertain stages of my life. Perhaps it is only a small initiative for some, however, for a graduate who is struggling to get a first work experience in the UK, it has reignited my passion for the future, bringing me hope, courage and confidence to continue the pursuit of my aspirations.

Rao (the right) with the other two Julia Anderson Trainees of the fourth cohort, Beatrice (the left) and CJ (the middle left), as well as her line manager, Sophie (the middle right)
Rao (the right) with the other two Julia Anderson Trainees of the fourth cohort, Beatrice (the left) and CJ (the middle left), as well as her line manager, Sophie (the middle right)

Looking forwards

I have been asked many times why I decided to change career direction after having studied education for many years. On top of that, I often get asked what my future career aspirations are. Truth be told… I can’t give a straight answer and it is something I am lucky enough to explore as part of the training programme. I have many interests, and this role gives me the opportunity to develop these further.

When I was 18, standing at the crossroad of my life for the first time and thinking about which subject I was going to learn at university, I was unsure about my next step. Now, in my mid-twenties, I am at another turning point in my life. I have realised that a brilliant career path is not the destination, but a life-long journey where I can continuously improve myself. It’s all about ourselves – what kind of person do we want to be in the future and to achieve it, how can we get there?

 

This is the first of an exciting blog series where we’ll be sharing the unique stories of other Julia Anderson Programme trainees. Next week, get ready to be inspired by Beatrice’s extraordinary journey towards becoming the Julia Anderson Helix Centre Trainee. Stay tuned for more captivating stories as the series continues! 

Find out more about the Julia Anderson Training Programme (JATP).

 

Design Dash: Accelerating innovation in NHS screening programmes

On your marks, get set… Our MSc Healthcare and Design students take part in a Design Dash, a rapid design process to solve a real-world healthcare challenge. We spoke to two students, Aoife McGrath and Jasmine Banerjee, about the process.

A design dash is a rapid, collaborative method for conceiving tangible healthcare innovations. Our Helix Centre teaches and assesses the Design Dash module on the MSc Healthcare and Design course that is aimed at healthcare professionals and designers and co-run by Imperial College London and the Royal College of Art. The students work with Helix Centre’s researchers, designers and public engagement experts on a live rapid design project to prototype a solution to an identified challenge.

This year, the Design Dash focused on NHS screening programmes for cancer, which are important for both patients and the NHS, as detecting cancer early gives people a better chance of responding to treatment and therefore recovering from their illness.

The module starts with an action-packed week running through the Design Dash process, offering a chance to explore a new brief in an intense, collaborative and open-minded way. With an initial focus on bowel cancer screenings, the students were taken through the process of framing and dissecting briefs and understanding patients’ experiences. After the group projects, the individual assignment for the module was to create a project to increasing the uptake of breast or cervical screening.

While the end products of the Design Dash are only prototypes, by applying real-world design techniques that Helix Centre uses, the students gain knowledge that will stay with them throughout their careers.

Jasmine Banerjee, Product Designer and student on the Healthcare and Design MSc programme

I’ve come straight onto this master’s from doing an undergraduate in product design. I have a keen interest in medical technology and focused on this for all my undergraduate self-led projects.

The Design Dash week was fantastic, well organised and the content was brilliant. It was set up really well to teach us about important considerations for any design project, particularly for the students from a non-design background, such as by creating ‘how might we’ questions to help guide your research.

For my assignment, I chose breast screening as I had a whole range of expert patients that I could think to talk to. I also spoke to a GP who gave their interpretation of why there was low uptake and which patients they have to chase up to attend screenings. I was aware that people from ethnic minorities were less likely to attend screenings, and I wanted to consider how to approach these women. Based upon insights from my interviews with patients and my secondary research, the main barriers I identified were access to information, knowledge of what to expect and knowledge of their local unit.

“The main barriers I identified were access to information, knowledge of what to expect and knowledge of their local unit”

How might we make it easier for people to learn about the importance of screenings despite time constraints?

People often say they don’t have time to go to their screenings or have time to learn about it. So I thought, when is the time in a person’s life when they are ‘wasting time’ but have no other option? When they’re on public transport! I started looking at statistics about how long people spend on the tube during the commute and thought that using the London Underground was a good way of targeting every demographic.

I developed the ‘Boob Tube’, which is based on the London Underground, but the idea is for each tube line to be sponsored by, or working in partnership with, a breast cancer charity such as CoppaFeel!. Each carriage is filled with child friendly and religiously sensitive infographics, containing information on breast screening, what it is, what to expect, how to prepare for it, and why it’s important.

Mock-up image of inside an underground tube carriage, with signage for breast cancer awareness and 'Boob tube' branding.

How might we prevent patients feeling uncomfortable with the level of nudity?

Boob tube top with 'Boob Tube' logo

Alongside this, a lot of the people I interviewed said they felt discomfort with the level of nudity in front of healthcare professionals. So, I designed a boob tube top, with the ‘Boob Tube’ logo, which you can whip down and back up in-between each scan.

Breast cancer is one of the most common cancers, and screenings are an important way to protect yourself, but also in a secondary way, to protect your friends and family who care for you. They are there to provide you with reassurance and give you the best chance.”

Aoife McGrath is a senior microbiologist and student on the Healthcare and Design MSc programme

Aoife McGrath

“I currently work as a Senior Microbiologist, on the development of consumer healthcare products.

The Design Dash was like a R&D sprint, from the early stage of understanding what the problem is, to creating final prototypes, all the while focusing on human-centred design. During the week, we spoke with people who had experience of bowel cancer screening, to first hand understand the concerns and feelings about the process. Getting those patients, users and experts involved from the beginning of the design process is hugely important and a key learning for designing in healthcare – you have to design with people at either end of the bell curve; you can’t just design for an average person.

“Getting patients, users and experts involved from the beginning of the design process is hugely important and a key learning for designing in healthcare”

 

For my own Design Dash research project, I chose to explore cervical screening, as I’m in the screening age bracket, so have first-hand experience and felt it would be easier to reach out to others. I created and shared an anonymous questionnaire, in addition to reaching out to my peers who were comfortable to speak on the subject, which enabled me to gather feedback about people’s experience with cervical screening.

A main theme identified through my research and interviews was a lack of education, people don’t fully understand why cervical screening is required or beneficial. More than one of the women I spoke to said ‘no one ever told us about this in school, we didn’t learn anything about it until I received the appointment letter in the post. Why are we not taught about this?’

There was also an issue of time, with NHS appointments typically being scheduled through the working day, resulting in people taking time off work. The subject of cervical screening or smear testing is rarely discussed, it’s a very personal topic and people don’t really talk about it. Thinking about this, other items such as sanitary products, tampons and contraception are readily available with less discomfort, but targeting the same area. Therefore, with my design, I tried to look at different aspects where I could improve three things – education, time and emotions.

How might we combine cervical screening awareness with sanitary products that are readily available, and something people are more comfortable with?

My design idea was to combine cervical screening swab samples with sanitary products. The idea would help educate people, making them more aware of cervical screening, and also reducing the time it takes to currently attend a screening appointment. During the COVID-19 pandemic, we were all doing our own swab sampling – to detect the virus. The cervical screening test used to detect the human papilloma virus, which can potentially lead to cancer, so why couldn’t we do cervical screening tests at home?

 

I read about the ‘small c’ campaign – YouScreen, where they have piloted a study of 30,000 women in North London, to assess if they could sample at home. 99% of those women were able to successfully and collect their own cervical sample, which was brilliant. The idea is you use a normal swab and then send it off to a lab like you would for a PCR COVID test. However, I thought, the swab might be a bit awkward, so how can we make this easier? So, my idea is to use the tampon applicator to help people take the sample. A tampon is something that is part of everyday life, therefore more comfortable and perhaps doesn’t seem as foreign as a swab.

My design also raises awareness of cervical cancer, having information about the importance of the screening on the packaging, with links of how to collect a sample with the special tampon applicator. Creating a rapid screening test, like COVID lateral flow tests, would simplify this further and anytime you buy a pack of tampons you can check from the comfort of your own home. A rapid cervical screening test is not yet available, but it is feasible to get there.

How might we use this design help people and healthcare systems?

Potentially this could take a burden off the NHS by reducing the amount of cervical screening tests the NHS needs to do. While also enabling the positive results to be detected sooner.  It’s estimated that there has been a 70% reduction in cervical cancers from screening, but 83% of deaths could be prevented if everyone attended regularly. It’s a hugely important test to save lives, to empower women and people with a cervix to take control of their own health.

“It’s estimated that there has been a 70% reduction in cervical cancers from screening, but 83% of deaths could be prevented if everyone attended regularly.”

 

The Healthcare and Design course works directly with the NHS, and it’s a pivotal time to design efficient, frugal, clever solutions to help healthcare systems. Providing solutions to screenings, which prevents people from needing treatment, would be a huge help for people, but also healthcare systems in the UK and globally.”

Study our MSc in Healthcare and Design

Do you want to join us and use design thinking to solve problems in healthcare? Our MSc in Healthcare and Design is now open for applications, offering a hybrid teaching model so that you can learn flexibly at your own pace. Find out more about this course and how to apply on our website.

Keeping OnTrack with stroke rehabilitation

The Helix Centre, part of the Institute of Global Health Innovation, is helping stroke patients to manage their recovery and increase their independence, with a wearable tool that provides support for the rehabilitation of their arm and hand.

Sana talks to the Helix Centre’s Clare McCrudden about the OnTrack technology
Sana talks to the Helix Centre’s Clare McCrudden about the OnTrack technology

OnTrack Rehab is a platform that combines tracking of arm movements through a smart watch with personalised virtual coaching and dedicated clinical support. The system allows stroke patients to convert every-day activities into productive rehabilitation, and stroke therapists to monitor and help guide the patients’ progress. The development of the platform has been led by a multidisciplinary team at Helix including Gianpaolo Fusari (Project Lead) and Clare McCrudden (Engagement Lead). Gianpaolo and Clare recently ran a data collection experiment involving 20 stroke survivors to improve the software behind OnTrack.

Sana, a stroke survivor, volunteered to participate in this experiment, and met with us to describe her experience. Senior Occupational Therapist Simone Welch works in the stroke team at Charing Cross Hospital (Imperial College Healthcare NHS Trust), and chatted with us about the medical support for stroke survivors.

 

Experiencing stroke

In 2021, Sana experienced weakness in her left side following a medical procedure, and ultimately was diagnosed with a stroke. “I felt lucky in my stroke – though not lucky to have a stroke! – because stroke outcomes could be more significant.”

Sana’s physical symptoms such as some limited arm movement required ongoing management and rehabilitation as well as sensory-based issues, like those of many stroke survivors. But it can be difficult for those who’ve had a stroke to know what to expect. Sana described that support came not only from her medical team, but beyond – reading information on the internet to understand her issue, and the information provided by medical charities.

Sana is fitted with sensor technology to track her movements in order to improve the software embedded in the OnTrack system.
Sana is fitted with sensor technology to track her movements in order to improve the software embedded in the OnTrack system.

During a visit to hospital, an NHS physio checked that Sana could do simple everyday tasks, like brush her hair. But at home, it was more challenging to engage with the ongoing exercises.

Sana felt that the support and rehab she needed wasn’t as easy to see as most of her impairments were more hidden and not so obvious. “I am grateful that it could have been worse but if I had something more significant and visible then people would be taking me more seriously.” So when the Stroke Association sent a physiotherapist to her house for assessment and gave her exercises it was the beginning of better support.

“When it’s painful you just don’t want to do [the exercises],” Sana said. With the difficulty of engaging with exercises, plus limited face-to-face support during the pandemic and the lack of services tailored for younger people who’ve had a stroke, tailored support is needed.

As a young person surviving a stroke, Sana wanted to see support that would allow for variabilities in age and outcome, rather than a ‘one size fits all’ approach.  So the invitation to participate in OnTrack’s stroke rehabilitation was appealing. Sana felt that by participating in the research, her experience was able to help others, especially when those people did not fit the ‘usual’ stroke survivor’s demographic.

One aspect of OnTrack that Sana liked was the idea of “meaningful movements”. Physiotherapy rehabilitation requires hundreds of specific or purposeful movements each day, which felt unattainable. But with the smart-watch style device, Sana describes feeling more able to achieve goals – through every-day tasks such as brushing hair and doing dishes – which count as meaningful arm movements for rehab.

“This would have been useful to me;  I need to engage with something interactive,” Sana said. That’s where the app helps – measuring activity and giving motivation/feedback reinforced through different channels within the watch and app, and through the support provided by therapists.

Image of a phone screen held in hands, that says "Activity" anbd has figures of
OnTrack app interface which records movement

Sana’s message to survivors: “It does get better.”  Sana recommends to engage with the exercises, and found YouTube videos and stroke support charities helpful in her recovery.

Stroke therapy

Woman stands in front of hospital entrance
Simone Welch

Simone first saw the OnTrack technology in its very early stages – when in-person service provision was really limited during the pandemic. “[It] provided an intervention that allowed [stroke survivors] to continue with the upper limb recovery”, said Simone, as well as to participate in research.

Within 24 hours of being admitted to the HyperAcute stroke unit where Simone works, the patient will be referred for a therapy assessment – be it speech, physical or occupational therapy. But the rehab certainly doesn’t end there. Where some boroughs have intensive community stroke therapy available, including at the patient’s own home, the vast majority of rehab happens when the patient is on their own. “There is a concept called self-management which is really, really important,” where patients take on responsibility for their progress and their rehabilitation.

Simone wants her patients to be able to be discharged and return home. And the app would really support them to be able to track how they’re doing with their arm and hand recovery when not in hospital. When stroke patients like Sana have an arm weakness, OnTrack Rehab can send reminders, and help them to focus on what they need to achieve. “So it’s a bit like a step counter for the arm,” explains Simone.

As any movement of the arm – actual exercises or using your arm to wash your face or to feed yourself – is beneficial, tracking with OnTrack is a really positive solution.

Keeping on track

There’s plenty of hope about what OnTrack could help with. Simone said: “I think it would help guide conversations between therapist and patient on how they can do more outside of their sessions.” Plus, it gives data that therapists can go through with their patient to support them to reach their goals.

“There’s a lot you can do to support someone’s overall quality of life and their well-being”, says Simone. The app could prompt therapists to ask: “I can see you were really active at this time of the day, but not so much here – what was happening?” This is particularly important when therapists may only see their patient for an hour, as the app allows you to know what’s happening in the other 23 hours of the day.

A smart watch on a wrist with a message that says "Well done! You have reached your daily goal"
OnTrack smart watch

For OnTrack Rehab, Clare and Gianpaolo are working to evaluate the device and its impact with more people and this year a new clinical trial will begin.

Gianpaolo said: “The data and insights that we gathered with the collaboration of Sana and other stroke survivors during Phase 1 has helped us to improve the OnTrack experience as a whole.  One big change that we can’t wait to test during Phase 2 is the inclusion of smarter prompts delivered directly to the patient’s wrist, hopefully we will be able to see how these tailored messages motivate people to increase the use of their arm in more varied activities.”

“We are delighted to have members of the research study as part of a wider group of stroke survivors and carers guide us through the next phase of OnTrack Rehab, piloting it in the NHS. We expect to be able to enhance the both patient and carer’s experience, and also embed new co-designed features to keep users motivated and supported.” said Clare

Find out more about OnTrack and the user-centred designs created by the Helix Centre.

Fightin’ Thru – Mental Health is worth fighting for

young people in a boxing gym
Image credit: Jonathan Turton, Instagram @jftfilm

For many young men, opening up about mental health can feel daunting, with many feeling restricted by barriers such as stigma or fear. Those who identify as Black or minority ethnic are also more likely to experience racism, poverty and poorer educational outcomes than those who identify as White. These young people are also less likely to seek help through traditional mental health services.

To tackle this, the Institute of Global Health Innovation (IGHI) teamed up with The Mind Map, a Liverpool-based mental health organisation, and Golden Gloves Amateur Boxing Club in Toxteth, Liverpool, to form Fightin’ Thru. Fightin’ Thru is a boxing-themed campaign using innovative, creative and non-traditional mediums to raise awareness and encourage opening up about mental health in minoritised young men. We sat down with Ste Turton, a journalist for The Mind Map, and Badra Toure, a young boxer at Golden Gloves, to discuss the project.

Research conducted by Dr Lindsay Dewa, Advanced Research Fellow in Mental Health at IGHI highlighted that young men, particularly those who identify as Black or minority ethnic, were a vulnerable group when it came to mental health difficulties. Based upon these findings, Lindsay, and Ste, who had worked together previously, wanted to run an awareness project involving the young people who live in these communities, with Ste suggesting boxing as the focus. They received funding from The National Lottery Community Fund to run the new project.

30% of 16–24-year-olds experienced ‘poor mental health’ in 2020
 (cCopeY, Imperial College London)

 

The project started in 2020, with posters placed in the Golden Gloves to recruit three young men aged 16-18 as the gym’s main collaborators. After an overwhelmingly positive application response, Badra, along with Mahbub (Mabz) Rahman, Jay Bushell and later addition Rio Clay Pierre, were selected as stand-out candidates to be paid for their work in planning and running sessions. They were joined by Head Coach Wayne Smith and the gym’s highest-ranked professional Marcel Braithwaite on brainstorming sessions. Pre-pandemic visions for the project included a fight night and interviews with high-profile boxers to break down the stigma surrounding mental health. However, when the COVID-19 pandemic and national lockdowns hit, plans were turned on their head, at a time when the need for mental health support due to the strains of the pandemic were only increasing.

COVID-19 moved the conversations from the boxing gym to Zoom. But despite the project going virtual, the regular calls offered a valuable touch point for those involved, with Badra saying that the group enabled him to connect with the other young men involved in the project at a time where in-person connections were not possible.

Throughout the pandemic, Fightin’ Thru provided free counselling for the young boxing club members, alongside online workshops and coaching sessions covering topics such as sleep, motivation, and resilience. Coaches at the Golden Gloves also attended Mental Health First Aid courses, run by The Mind Map, to learn how to spot the signs and symptoms of mental ill health and support the young people in a non-judgmental way.

The project also highlighted influential boxers who openly spoke about their experiences of mental health, demonstrating a broader shift in the perceptions of mental health and sport. In our conversation, Ste told us he had been moved by one of the sport’s bright young fighters Ryan Garcia talking openly about his personal battles. Following the biggest win of his career in 2021, Garcia suffered severe lows, which he discussed publicly in an attempt to improve the conversation between young men around mental health.

“Everything came crashing down on me. I was lost in my head; it was like being in a maze and I didn’t know where to go.”

“I now have people telling me that by opening up, I’d saved their lives. That right there is worth all the pain I went through. If a kid got out of a dark place because of my story, that’s worth more than I could ever do in the ring.”

As well as Instagram live sessions with sport psychologist Phil Steele and European Champion Zelfa Barrett, The Fightin Thru’ team produced a short film last year, featuring many of the young people involved in the project. Ste said:

“The film shows how diverse the Golden Gloves is, the great community work going on, and the great platform it can be to get the message of good mental health across to young men, from all walks of life and all communities.”

Badra hopes that the project has given people who are struggling a place to go. Badra said:

“I’ve never really heard about people discussing [mental health] in my groups. Projects like Fightin’ Thru help break down this stigma because it’s a space where you can talk to others, and where people will listen and give you advice.”

Ste and Badra hope the project has demonstrated how important boxing and community centres are to keep young people occupied, by giving them a place, a platform, and discipline. Lindsay hopes this is the start of using different and creative medias to increase awareness of the importance of good mental health in minoritised groups.

You can follow the project on Instagram @Fightinthru, which celebrates members of their community, teaching the young boxers that good mental health is as important as their physical fitness, and encouraging them to seek help when needed.

 

The cost of caring: How to support wellbeing in climate careers

Dr Emma Lawrance, Lead Policy Fellow for Mental Health, IGHI and Jessica Newberry Le Vay, Junior Policy Fellow in Climate Change and Health are part of Climate Cares.

Former COP President Alok Sharma speaks at COP27
Former COP President Alok Sharma speaks at COP27
(Credit: Rory Arnold / No 10 Downing Street)

In November 2022, we brought discussions about the interconnections between climate change and mental health and wellbeing to COP27 in Sharm el-Sheikh in Egypt – at the 27th United Nations Climate Change Conference. This was only the second time that mental health has been a focus of COP events, with our COP26 Resilience Hub event the first, and overdue. We built new relationships with others who work in the climate change and mental health space, fostering community and collaboration. We published papers bringing together voices from all corners of the globe. And we were exhausted! But we pitched for funding to do more, and have big plans for 2023 to deliver on our vision to better understand and support mental health and wellbeing in the climate crisis.
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