Epidemiological study of self-harm and suicide among people diagnosed with mental disorders that are commonly treated in primary care

The epidemiology of self-harm and suicide has not been extensively studied among registered primary care patients, as much of the existing empirical evidence has been generated from datasets derived from inpatient psychiatric units or general hospital emergency departments. The majority of people diagnosed with a mental disorder, including conditions such as depression, anxiety disorders and eating disorders, are never referred to or treated by specialist mental health services. Thus, investigation of a nationally representative primary care patient cohort, with linkage to additional routinely collected clinical datasets and national mortality records, provides a unique platform for investigating people diagnosed with ‘mild to moderate’ mental health problems, their clinical management across healthcare sectors, and their subsequent risks of nonfatal and fatal suicidality and other causes of premature death.

The novelty of this project lies with its utilisation of the full linkage potential of the Clinical Practice Research Datalink (CPRD). In recent years, clinical records from a majority of CPRD general practices in England have been routinely linked to Hospital Episode Statistics (HES) records and to Office for National Statistics (ONS) mortality records. During 2017, linkage to the Mental Health and Learning Disability Data Set (MHLDDS) will become available to academic researchers for the first time. This exciting new linkage opportunity will provide information on outpatient contacts and specialist community care. Epidemiological studies of this nature enable researchers to generate multiple peer reviewed academic papers over a relatively short period of study, and the translational evidence generated could also interest influential national bodies such as the Royal Colleges (of General Practitioners and of Psychiatrists) and the National Institute for Health and Care Excellence (NICE). This PhD studentship provides an excellent opportunity to conduct multidisciplinary research in two world-leading centres for research into suicidal behaviour and epidemiology conducted using large routinely collected data sources.

Excellent specialised training for examining large routinely collected datasets will be provided. Supervisors Webb and Ashcroft have jointly conducted many CPRD-based studies, and their teams of postdoctoral researchers and PhD students in the Centres for Mental Health & Safety and Pharmacoepidemiology & Drug Safety will provide additional ad hoc advice and support. The successful candidate would also attend epidemiological/statistical courses at the University, including modules from the online Masters in Public Health, as well as short courses in the Faculty of Biology Medicine and Health (e.g. course run by Dr Mark Lunt - Division of Musculoskeletal & Dermatological Sciences) and in the Faculty of Humanities (i.e. courses hosted by the Cathie Marsh Institute for Social Research). The successful candidate would be expected to regularly attend meetings of the CPRD User Group and Pharmacoepidemiology Journal Club. Funding for attending external courses and/or presenting research findings at conferences will also be available.

Applicants are expected to hold, or about to obtain, a minimum upper second class undergraduate degree (or equivalent) in a health sciences, statistical or social sciences subject; a relevant masters degree in one of these disciplines is also desirable. For information on how to apply for this project, please visit the Faculty of Biology, Medicine and Health Doctoral Academy website (https://www.bmh.manchester.ac.uk/study/research/apply/). Informal enquiries may be made directly to the primary supervisor.