Towards a mental health super science

Imagine a world in which no one is held back by mental health problems. That's the vision of Professor Miranda Wolpert MBE, Head of the Mental Health Priority Area at the Wellcome Trust. With £200million to spend over five years, Wolpert and her team are taking a radical new approach to addressing anxiety and depression in 14- to 24-year-olds.

Last year Wolpert concluded from a brief survey that the mental health conversation was best framed around supporting recovery and the achievement of goals, rather than achieving a 'cure' to mental health problems. While the term 'cure' represented hope and ambition for some, for others it increased stigma and took focus away from finding ways to live with anxiety and depression.

With this ambition of 'no one held back' in mind, Wolpert is less interested in debates about the causes or definitions of anxiety and depression, and is more focused on solutions. What are the 'active ingredients' of approaches that help those affected by anxiety and depression? There are possible active ingredients in four distinct categories that Wolpert says the field sometimes confuses: prevention, treatment, stopping relapse and managing ongoing difficulties. 

Funded teams are currently reviewing the evidence for 26 different active ingredients. These range from the biological (such as better gut microbiome function), to the behavioural, to relationships, to societal (including cash transfer and engagement with theatre). The aim is to identify the 'best bets' – the most promising active ingredients for Wellcome to focus on. While the scientists working on these active ingredients come from traditionally siloed fields, such as brain science, developmental science, and data science, Wolpert is passionate about creating a wider community around mental health science – what she calls a super science. 

Part of this new super science, in Wolpert's view, includes widening our very definition of science to incorporate economics, anthropology, humanities, and social science – in short, anything that looks rigorously at evidence. Wolpert likes the British Academy's new acronym SHAPE, for 'Social science, Humanities & the Arts for People & the Economy', which they describe as 'a new collective name for those subjects that help us understand ourselves, others and the human world around us'.

Wolpert warned us to beware the jingle-jangle fallacies. The jingle fallacy is the assumption that two things are the same because we use the same word to describe them, and the jangle fallacy is the assumption that two things are different because we use different words to describe them. Wolpert said mental health science is currently full of these fallacies, pointing again to the need for siloed groups to work together and share knowledge.

Creating this super science community involves drawing on people who have experienced anxiety or depression. Wolpert endeavours to have people with lived experience at the heart of this work, and Wellcome has created a network of experts with lived experience who are advising throughout the process. The work is also inclusive in explicitly aiming to feature non-WEIRD research, and taking a global approach with a particular interest in low and middle income areas.

This is only year one of a ten-year programme, and Wolpert is optimistic. Quoting Maya Angelou, Wolpert said, 'I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel'. Wolpert hoped she had made the audience feel optimistic, and invited everyone to join her on this journey (via open discussion on Twitter and LinkedIn) to achieve a new vision in addressing mental health problems in young people.

- See also Professor Miranda Wolpert in conversation with Dr Tony Rousmaniere, 'talking failure in therapy and beyond'.

More reports from the online 2020 Conference will appear here, and in the September print edition.