My Story

I believe that life becomes a dark place for everyone at least once in their life, it is my hope that this preventative evidence based initiative will allow a light to be shun on the darkness and help those that would otherwise remain lost in the dark.

The purpose of this grant is three-fold:

• Help develop mental health at a decentralised level
• Provide much needed service to the global community
• Create affordable care for those who need it the most.
• Further mental health research leveraging principles of decentralized scientific research

Conal has a diverse background in mental health that spans over a decade. Clinically Conal has treated a wide variety of mental health problems and currently runs an Anxiety, OCD and Depression clinic using Cognitive Behavioural Therapy as his main approach in a major maternity Hospital in Dublin, Ireland.

Conal has worked in University of Trinity College Dublin in the Department of CBT developing an Online Teaching Tool to teach therapists how to learn CBT skills, here he familiarized himself with fundamental educational and learning theories as well as an in depth knowledge of CBT. He is a visiting lecturer on the Postgraduate CBT program there.

Outside of clinical work and formal research Conal is completing his Doctorate in Psychotherapy where his main area of focus is mood disorders (Anxiety disorders and OCD) and developing fresh theory into the aetiology and integrative understanding of these disorders.

Problem

Mental health problems affect 1 in 3 people globally, and the rate of these conditions is increasing.

Unfortunately, greater than 40% of individuals do not benefit from selective serotonin re-uptake inhibitors (SSRIs), commonly called ‘antidepressants’, which are the most commonly prescribed medication for mental health issues. Recent data suggests that these medications may not have the utility once thought.

The alternative option to medication is psychotherapy- Cognitive Behavioural Therapy being the therapy of choice due to its high level of evidence based clinical trials., However there are a number of problems that exist, even with therapy. Firstly, it is often expensive and time consuming. Secondly, there are too few therapists to meet the growing need for the delivery of high quality therapy to individuals that are suffering. . At present, the alternative option outside of private therapy and medication is to attend Adult Mental Health Services nationally. Due to an excessive demand on public services, individuals must be deemed ‘severely unwell” to get help, at which point the interventions are reparative at best.

So with that in mind- what do you do if you are struggling with day to day tasks, relationships, employment, negative thinking, regulating emotions, managing stress? Many people get lost in the barren untherapeutic ‘no mans land’. Not unwell enough to access public services but not enough money to afford private therapy. Their options at present are to wait until things capitulate to a point where they are deemed “unwell enough" to be treated by the public service or suffer potential financial hardship trying to afford private therapy. This leaves them with no access to treatment options and their problems can deteriorate, impacting their quality of life, capacity to work, relationships, and social integration. Moreover, it increases the likelihood of suicide, which has lasting impacts on families.

A suboptimal temporary solution is medication, but it is not a long-term fix. Psychotherapy offers people the option to learn life skills in order to manage stress, improve relationship quality and live a more optimal and fulfilling life. However, due to the high cost of attending therapy, many individuals cannot afford it, leading to a higher reliance on medication.

Solution

To address the issue of the lack of affordable therapy, we propose to roll out decentralized, low-cost, prevention-focused programs for mental health.

These programs will involve preventative interventions such as:

• Psychoeducation

• Developing cognitive-behavioral therapy (CBT) skills

• Emotional management

• Cognitive restructuring

• Relapse prevention

• Formalized psychotherapeutic interventions

Instead of providing one-on-one therapy, the focus will be on providing education in therapy for a broader reach. The programs will be available online regularly, making them accessible to more individuals at a lower cost in order to reduce barriers to entry and ensuring everyone is able to avail of high quality, evidence based psychotherapy.

These evidence-based programs will ensure that people from all backgrounds can still access high-quality therapy and receive the help they need to prevent their symptoms from worsening The social value of these programs is that they offer a lifeline to individuals who would otherwise not be able to afford therapy, providing them with the tools to improve their mental health and well-being.

Our Proposal

We propose the development of a suite of evidence-based interventions that will focus on treating anxiety disorders, depression, and OCD. These interventions will be delivered in a 5-8 week program format, with each week dedicated to a specific topic.

The program is built using established learning theories in order to scaffold each week so that skills learned in one week are refined and improved upon in the next, promoting a process of consistent development.

The program will begin by providing participants with an understanding of mental health disorders generally (i.e. Depression,Social Anxiety, Low Self Esteem), how they develop and why they suffer from it. We will then introduce a variety of cognitive distortions that are prevalent in the majority of mental health presentations. Following this, the clinical model of specific disorders and how suboptimal behaviors perpetuate the problem. Next, we will help participants understand the connection between their thoughts, emotions, and behavior and introduce cognitive interventions to rationalize and restructure dysfunctional thoughts. Psychoeducation around cognitive distortions, such as catastrophization, mind-reading, jumping to conclusions will be an important aspect of the program. In order to maximize engagement and knowledge development the program will use clinical vignettes to illustrate these difficulties and allow participants to see how it works in from a third person perspective making the experience easier to analyze.

Throughout the program, participants will learn emotional regulation techniques and behavioral modification strategies to help them manage their symptoms. We will also provide them with an understanding of relationship dynamics and how to improve their relationships. Integrating reflective practice into daily life will be encouraged to help participants better understand their triggers and develop relapse prevention strategies. Reflective practice will differ each week and be specific to the module in turn allowing participants to practice the theory they have learned, reflect on their practice and refine the approach moving forward.

Overall, our suite of interventions will focus on providing participants with a comprehensive understanding of their disorder and the tools they need to develop insight, recognise triggers, broaden perspective and manage their symptoms. The program will be delivered online which will help to firstly overcome geographical limitations secondly, increase the number of individuals that can participate and most importantly make this preventative initiative affordable to those in society that need it most., a lower cost. We are confident that this evidence-based program will have a significant impact on the mental health and well-being of participants and are excited to bring this proposal to life.

The goal is to build out this program and run multiple initiatives throughout 2023. The output of these initiatives will be condensed into content that can be shared with the global community of folks interested in mental heatlh.

DeSci & Mental Health

How can decentralised science help? Decentralized science is a rapidly growing movement that aims to democratize the scientific process by giving more power to individual researchers and communities. In the field of mental health, this approach could have profound implications. By allowing researchers and mental health professionals to work collaboratively in a decentralized environment, the field could become more responsive to the needs and concerns of individuals with mental health conditions. Decentralization could also help to break down traditional power structures in the field, enabling a more equitable distribution of resources and a more diverse range of perspectives. Ultimately, the goal of decentralized science in mental health is to foster a more dynamic and inclusive research environment, one that is better equipped to address the complex challenges facing individuals with mental health conditions.

What would we do with a grant?

Any grant funds would be particularly helpful in funding the following activities to take place in 2023 and lay the foundations for further growth beyond:

• Funding the development of the suite of separate interventions for anxiety disorders, depression, and OCD

• Providing free sessions for participants to increase accessibility and reach

• Investing in advertising and marketing to ensure the program is promoted widely

• Paying staff to deliver the program and provide support to participants

• Producing high-quality content, including videos and easily accessible materials

• Making the programs available on-demand, for 8 consecutive weeks, to enable participants to complete it at their own pace

• Incorporating interactive features such as asking questions and providing different scenarios for participants to learn from

• Developing worksheets and intra-session educational tasks to help participants learn and apply the interventions more effectively.