Q & A PhD student Rachel Pearson, UCL GOS Institute of Child Health

What influenced your decision to work in mental health and what inspires you most working in this field?

I’m not sure I ever made a conscious decision to research mental health but throughout my career almost all my projects have involved mental health. Its always been an important area for me: I was a mental health service user in my late teens and women in two generations of my family were diagnosed with serious mental illness in their 20s. Learning about my relative’s experiences with mental health care and trying to access and navigate mental health services myself has really driven my interest in research to understand barriers to healthcare and inequalities in healthcare access and outcomes.

I’m most inspired by the many patient groups set up to support mental health service users to engage with research, through public engagement activities, as stakeholders, and as study participants. I’ve learnt so much from speaking with service users about my current research project and their feedback has helped our study team to strengthen our objectives. A key lesson I’ll take away from my current project is the importance and value of involving service users and the public in research from the very beginning.

Can you very briefly tell us about your journey into mental health research? 

During my undergraduate degree in Maths, I spent a year working in clinical trial data analysis: the first study I worked on was for a drug to treat serious mental illness. I then went on to do an MSc in medical statistics where my summer project explored the associations between intimate partner violence and depression, anxiety and PTSD in refugee camps. Afterwards, I joined NHS England working to evaluate the impact of integrated care teams (i.e. joining up care across primary, community, mental health and social care) on health service use among people with comorbidities. I joined UCL in 2018 as a research assistant to work alongside Prof Ruth Gilbert, Dr Linda Wijlaars and colleagues at Lancaster University on my current project: understanding the healthcare needs of women whose children are involved in care proceedings.

Can you tell us about your research involving the health and wellbeing of women who have become involved in care proceedings and have children placed into out-of-home care?

Many women involved in care proceedings (i.e. court proceedings concerning whether or not to place a child into care) in England experience healthcare need related to drug or alcohol use, domestic violence and abuse, long-term physical conditions, or mental health problems. However, little is known about whether this healthcare need is adequately addressed by services before, during and after court involvement.

This project involves linking family court data on care proceedings with data on health service use to establish new, pseudonymised linked data sets for research. For example, we have linked data on over 2000 women involved in care proceedings in South London boroughs served by the South London and Maudsley NHS trust to their mental health service user records. We will use these new data sets to better understand the healthcare needs and health service use of women involved in care proceedings in England. A key aim is to identify opportunities for healthcare family courts and children’s social care to better respond to women’s healthcare needs before, during and after court involvement. Crucially, this project will contribute evidence that could be used by policy makers, service planners, and practitioners to develop strategies to improve maternal health and wellbeing before pregnancy and birth and potentially reduce the risks of child maltreatment and involvement in care proceeding.

What has been the impact of your research? 

As this research is still ongoing, we are yet to see the impact of this work. However, part of this research involves establishing a linked data set between mental health records and public family court data which can be used by other researchers. We hope that by establishing this as a research database (rather than a data set only to be used for one particular project/team) these data will generate a multitude of evidence on the relationships between maternal mental health and care proceedings, increasing the potential impact of this project.

What’s next for your research in this field? 

We’re currently applying to link data on hospital use in England (Hospital Episode Statistics) for over 100,000 women involved in care proceedings between 2007 and 2019. This linked data set will be used to explore the long-term health outcomes among women involved in care proceedings and whose children enter out-of-home care to inform services that provide post- care proceeding support to parents.