NIHR Global Health Research Group: Improving Outcomes in Mental and Physical Multimorbidity and Developing Research Capacity (IMPACT) in South Asia at the University of York
A team at the University of York is building a research network across South Asia to tackle the common but neglected problem of people living with both mental and physical long-term illnesses at the same time. This matters because in low- and middle-income countries, conditions like depression and diabetes or heart disease frequently occur together, yet healthcare systems are designed to treat them separately. Patients often fall through the cracks, receiving fragmented care that addresses neither condition well. The IMPACT group will train local researchers, run studies on how to deliver integrated care, and strengthen the evidence base for treatments that work in these settings. If successful, the programme could shift how health services in South Asia are organised, moving from single-disease clinics to models that treat the whole person. This would not change everyday life overnight, but it could quietly reshape primary care systems, making them more efficient and reducing the long-term burden on hospitals. The group also aims to leave behind a lasting research infrastructure, so local teams can continue generating evidence long after the grant ends.
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STRATEGIC ALIGNMENT: Our proposal aligns closely with the vision of the University of York (UoY) Research Strategy (2015-20) - to deliver world-leading excellent research with life-changing impact, taking a global perspective and interdisciplinary approach. ‘Health and Wellbeing’ and ‘Justice and Equality’ are prioritised UoY research themes which resonate with our proposal. In recent years, York has prioritised mental health and international development, with significant investment (posts, research office support, funding), including on-going work to establish a Centre of Excellence for Mental Health Research (https://www.york.ac.uk/research/themes/health-and-wellbeing/mentalhealth/) and approval of a new Centre for Global Sustainable Development. York also has an ambitious and ethical engagement with the Global Challenges Research Fund, aiming to leave a legacy for our partners in the global South, for UK research and for the University. ENVIRONMENT: York is recognised for having created “an environment that is conducive to producing research of world-leading quality, in terms of its vitality and sustainability”. In the 2014 Research Excellence Framework, York was rated joint top in the UK for research environment in Unit of Assessment 2. York’s Research Office provides specialist operational support, recognising the complexities of research in LMICs, including guidance on codes of good practice on ethics, study design and data management and provides excellent infrastructure for research study management in LMICs. York’s International Development Network (IDN) (york.ac.uk/idn) provides a vehicle to access extended networks of expertise in the delivery of research programmes in partnership with ODA recipient countries. There is also a rapidly expanding hub of global health expertise e.g. public health (Kamran Siddiqi), health economics (Marc Suhrcke) and econometrics (Rowena Jacobs), social policy (Martin Webber); history of medicine (Sanjoy Bhattacharya), infectious diseases (Paul Kaye) and inequalities (Kate Pickett). Mental health research is the largest clinical-thematic grouping at York with a strong track record for attracting research funding (current portfolio £25 million), leading collaborations and delivering nationally and internationally important research, with high impact (e.g., leading the mental health comorbidities theme for the Yorkshire and Humber NIHR CLAHRC and programmes on self management of long-term conditions in severe mental illness (DIAMONDS); pharmacy-based interventions for alcohol problems; smoking cessation in SMI (SCIMITAR) and integrated care for depression in older people (CASPER), funded by NIHR Programme, HS&DR & HTA grants and research charity funding. Mental health research at York is co-located with other internationally excellent research groups, with expertise covering the full range of disciplines needed to support the proposed IMPACT programme, including i) Mental Health and Global Health Economics teams in the Centre for Health Economics (CHE), which produces policy relevant research; ii) the Centre for Reviews and Dissemination (CRD) and the Cochrane Common Mental Disorders Group, a partner of Cochrane Global Mental Health, with expertise in evidence synthesis and knowledge mobilisation (http://globalmentalhealth.cochrane.org); iii) The UKCRC registered York Trials Unit (YTU), with an international reputation for large high quality trials in mental health and in LMICs (https://www.york.ac.uk/healthsciences/research/trials/) and in using innovative methods, including ‘trials within cohorts’ (TwiCs). YTU is part of an international TwiC consortium, has the largest number of TwiCs nationally and advises/supports other groups on this approach. York also hosts world-class research programmes addressing health risk behaviours and interventions delivered by lay-health workers in the UK and in LMICs.[1-7] The IMPACT Group’s ambition to apply an
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