Q&A | Professor Ian Goodyer OBE on the UK’s mental health crisis

Ian Goodyer (1990), Professor of Child and Adolescent Psychiatry, University of Cambridge, was made an OBE for his services to Psychiatry Research this year. Here, Ian gives his take on the mental health crisis currently facing the UK, and explains what his role at the University entails

Hello Ian. Please tell us, in a nutshell, who you are and what you do.
I am a Child and Adolescent Psychiatrist based at the University of Cambridge, pursuing research into the connections between human development and psychopathology. My studies are centered on adolescents in the community as well as current patients.

‘Currently mental illnesses emerging in the youth population remain undetected and untreated in around 80% of cases’

‘Of 1.2 million children and adolescents who may have benefited from mental health assessment and possibly treatment, only around 150,000 were even referred’

Give us your take on the mental health crisis currently facing the UK.
Currently mental illnesses emerging in the youth population remain undetected and untreated in around 80% of cases. Existing services in the NHS have been reduced substantially since 2008 and especially between 2010 and 2014. Of 1.2 million children and adolescents who may have benefited from mental health assessment and possibly treatment, only around 150,000 were even referred. Untreated mental illness in childhood and adolescence has been estimated to cost the UK economy around £8 billion over a working lifecourse. It is time that mental illnesses and mental health were taken seriously by governments. This is beginning to happen and I hope that the continued support of the public will ensure that the mentally ill child and adolescent gets a much better opportunity for prevention, early detection and treatment in the future.

What must be done to improve matters in the forthcoming decade?
A mental health service that has sufficient volume of practitioners that are linked from schools through to hospitals is required, breaking down the existing barriers that exist between organisations such as local authorities and NHS trusts. Research into developing and emerging mental illness and their neural basis should be substantially increased, and new treatments and interventions should be sought for the severely mentally ill, as current therapeutic approaches are only working in some 65% of cases, leaving many depressed and psychotic young people with no effective therapy and a future likely to consist of recurrent mental illness and increasing personal and social impairments.

Wolfson College, Cambridge, where Ian is a Fellow

What does an average day look like for you as a Professor at the University of Cambridge?
Most days involve contact with the research group and considering project design, data analysis and writing of papers. Like all clinical professors there are responsibilities to treat patients, teach clinical students and postgraduate trainees in psychiatry as well as research students at Master’s and Doctoral level.

‘I cannot thank Cambridge enough for the opportunities that have been presented to me over the past 30 years’

And what have been your top achievements in the past few years?
We revealed a biomarker of morning cortisol hypersecretion that if present in adolescent males increases the liability for major depression by 15 fold. This maker is also associated with mnemonic impairments in both sexes that are also associated with major depression. We concluded that there is a corticoid-mediated mnemonic impairment in some adolescents that is one of a likely multiplicity of pathways that result in depressive disorders.
Concurrently in our therapeutic randomised controlled trials of treatment for depression we have developed a new brief psychosocial treatment that is as effective as current alternatives but cheaper and more easily implementable in routine mental health services.
Finally, our group has demonstrated differences in the structure of the brain in adolescents with antisocial behaviour. Further, we showed difference in neural structure existed between children and adolescents with the same antisocial behaviour characteristics, and confirmed our prior hypothesis that there is likely to be a neurobiological vulnerability in some boys that increases the liability of antisocial behaviour.

Lastly, please tell us about your time lecturing at St John’s College earlier in your career.
I was not a Cambridge undergraduate but became a member of St John’s when appointed to a University lecture post back in 1987. I found the support of colleagues in the College and in the University a key element in the emergence of my better ideas and scientific projects. I become a Professorial Fellow at Wolfson College in 1992, retaining close ties with my Johnian colleagues for many years after this. I cannot thank Cambridge enough for the opportunities that have been presented to me over the past 30 years. The available scholarship and collaboration through our collegiate and departmental system has been the foundation for the work my group has been able to conduct over this time.

To read more of Ian’s writings on mental health in young people, see cam.ac.uk/people/ian-goodyer

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