Each commissioned team will review the evidence for one active ingredient. The active ingredients are diverse and cover the range of options, from improving gut microbiome function to increasing financial resources via cash transfer, from the use of antidepressants to increased self-compassion.
Our team will look at the effects of SSRIs in young people. SSRIs are used in this age group and are effective compared to placebo, though effects are relatively modest and concerns about the long term effects on the developing brain remain. During this commission, we will be reviewing the available evidence to present an insight analysis into what the evidence says about how, when and why SSRIs may be effective.
We will be meeting regularly with the other commissioned research teams to share learning and start to explore how the different active ingredients relate to each other.
Key to our success in the application process was our inclusion of the vital perspective of those with lived experience of mental health difficulties as part of our advisors.
In time, Wellcome wants to work with the mental health science community to refine and review these initial active ingredients to a core foundational set that we know work for the most young people, in the most contexts, globally. This set will underpin Wellcome’s work on advancing mental health science. For the first five years of the programme, it is committing £200m to finding the next generation of treatments and approaches for anxiety and depression in young people aged 14-24.
Wellcome believes it is vital we find the next generation of treatments and approaches that help young people with anxiety and depression worldwide. Anxiety and depression are holding millions of people back in life, generally starting in youth. Yet we still know too little about what works for whom, in what contexts, and why, in terms of either prevention or intervention.
To undertake iteration and innovation, Wellcome wants to identify what the ‘active ingredients’ are for the many treatments, therapies and social tools which already help young people through this commission. What are the facets of talking therapies which make them work for certain people? What are the physiological elements which enable people to self-manage their anxiety and depression? What are the social factors which allow people to escape from loneliness?
In some fields, the active ingredients of successful interventions are relatively clear cut. For example, two key interventions offered for the treatment of cancer are surgery or chemotherapy, and science has found the active ingredient of both is the destruction of cancer cells.
Founding the future of mental health science
Through this commission, our team are founding members of the community advancing mental health science that Wellcome are building. Together, we are collectively focused on looking at the issue through a new lens: that of the ‘active ingredients’ of interventions that work.
Professor Miranda Wolpert, Head of the Mental Health Priority Area at Wellcome, says:
“We are delighted to be working with such a wonderful range of researchers worldwide to study which aspects of interventions really make a difference in preventing and treating youth anxiety and depression. We see this commission into reviewing the evidence for active ingredients of interventions as the crucial first step in finding the next generation of treatments and approaches for tackling youth anxiety and depression across the world.”
Grace Gatera, a Lived Experience Mental Health Advocate living in Kigali, was part of the application review team. She says:
“The successful proposals have really touched something in me, as they make lived experience a priority in research and are focused on the end user. I’m looking forward to the work the teams are going to do that pave the way for a future of affordable, accessible mental health care for all young people worldwide, including those from low resource settings”.
We are delighted to be part of this insight review and start to address this really important area for adolescent mental health. SSRIs are widely prescribed across ages and yet there is little scientific work exploring how they work in young people and the effects underlying both the therapeutic and unwanted effects of treatment. - Professor Catherine Harmer, team lead, Department of Psychiatry, University of Oxford.
The commission begins today and we will report our findings in October 2020.