Mary-Ellen Lynall: Translating new advances in neuroscience into psychiatric care

lynall_smallThe popular press and scientific journals are littered with exciting advances in basic and clinical neuroscience. But what does this mean for psychiatry, and for psychiatric training?

Current trainees will one day prescribe new and better treatments that have grown out of a deeper understanding of brain function (or if not, I’ll be deeply concerned). But how do we ensure that trainees are well versed in the neuroscience underpinning these treatments? How can trainees be expected to explain the complex neurobiology of conditions such as depression, addiction, and psychosis to patients in an understandable way?

Improved understanding of the neuroscience behind psychiatric disease has developed recently and is continually evolving. It is essential that medical trainees learn about this important area, which will be a central part of providing good care.

We cannot expect the skills and knowledge to trickle down through the medical hierarchy.

The Royal College of Psychiatrists, the Wellcome Trust, and the Gatsby Foundation have teamed up to address this challenge. Over the next two years—with input from trainees, trainers, and the public —the newly formed Neuroscience Project will develop not only a new neuroscience curriculum, but also a plan for its dissemination, using multimedia learning technology to make the information relevant and accessible to trainees.

In the US, a similar process of curriculum review, driven by advances in neuroscience, is already well underway. The same arguments for reform are holding sway on both sides of the Atlantic: psychiatric practice and research must be at the forefront of neuroscience, not playing catch-up. And in order to attract the best junior doctors, psychiatry should reinforce its unique selling points: the combination of neuroscientific rigour with a holistic approach. The emerging opportunity to apply advances in neuroscience for patients’ benefit is what first attracted me to the profession; I came to medicine after a degree in neuroscience.

Ultimately, the aim of these reforms is to improve patient care. Tomorrow’s psychiatric trainee might show a video of a functional MRI scan to explain the malfunctioning circuitry in depression, or use a diagram of the basal ganglia to explain the challenges of overcoming an addiction. For patients, carers, and families, being able to see and understand the physical changes underlying mental disorder and recovery could help to combat the stigma around mental health.

The success of this project depends on your input. Read about the project as it evolves on our website.

Our curriculum may need to change, but the underlying principle endures: as psychiatrists we integrate the physical, psychological, and social into everything that we do.

Mary-Ellen Lynall is an academic clinical fellow in psychiatry at the University of Cambridge and a member of the Gatsby/Wellcome Neuroscience Commission.

Competing interests: M-E L receives a grant for scientific research into the role of B cells in psychiatric disease from Addenbrooke’s Hospital Charitable Trust.

  • David_Colquhoun

    Nobody would be more delighted than I if what you say were true. But I fear it is closer to hype than reality. In the end, the false hope engendered by exaggeration of what’s understood about the brain harms patients, and it harms neuroscience. Take a look at http://www.healthnewsreview.org/toolkit/tips-for-understanding-studies/biohype-bibliography/#.V_-66MeGRuc.twitter

  • sinope

    You said: “For patients, carers, and families, being able to see and understand the physical changes underlying mental disorder and recovery could help to combat the stigma around mental health.”

    Are you sure about that? Imagine for a moment that you are the patient. Your whole life has gone haywire, you are desperately struggling to make sense of your world, your inner self, your very soul. Now imagine being taken into a room and shown an image of your brain on a screen. The doctor points out which bits of the image are abnormal – this is proof that you are not like other people, that your brain is defective, you have an “underlying mental disorder.”
    Does that help you feel less stigmatised?

  • Adam

    I’m not anti-neuroscience as one strand of mental health research, but Goldacre’s (2010) summary of the evidence on social attitudes suggests that stigma might not be one of the areas that will be aided by this discipline eventually winning out (or continuing to claim to) over the social sciences. It seems that the public think faulty brains are more dangerous and unpredictable than people caught up in stressful psychosocial situations. I just think this needs bearing in the minds of biopsychiatric thinkers who advocate the (admittedly attractive) “mental illness is an illness like any other” line.

    https://www.theguardian.com/commentisfree/2010/oct/09/ben-goldacre-bad-science-adhd-stigma

    I wish the writer all the best in their research.

  • Duncan Double