PsySTAR Programme (Psychiatry: Scottish Training in Academic Research Programme)

Psychiatry took itself off from the rest of medicine about 100 years ago and the management of people with psychiatric disorders has suffered as a consequence. Advances in psychiatry have not kept pace with increasingly rapid developments in diagnostics and therapeutics, even in a discipline like neurology which also deals with the complexity of the brain. Neuroscience, the science of the brain, has now advanced to the point where we can model aspects of psychiatric disorders in cells, animals and even computers and thereby develop new treatments to improve the lot of psychiatric patients. Similarly, there are several, novel behavioural and psychosocial interventions which are ripe for application in the treatment and prevention of mental health problems.

The time has therefore come to bring psychiatry and especially the training of academic psychiatrists back into the rest of medicine, including the behavioural and public health sciences, to realise the opportunities presented by biomedicine and cognitive neuroscience. To do so however, the discipline as a whole needs to move away from the isolation of departments of psychiatry and towards truly interdisciplinary research. In particular, the next generation of academic psychiatrists need to be familiar with cutting edge neurobiological and psychosocial research techniques which can develop new treatments and the clinical trial methods to test whether they work. Our PsySTAR trainees will receive concentrated teaching in each of these before selecting a PhD with one or more world leading scientists, with careful mentoring and guiding so that they choose the right PhD for them. The PhD will be done with one or more world leading scientists, with mentoring from an internationally renowned academic psychiatrist. PsySTAR trainees will therefore be placed in labs where many other scientists and doctors from many specialties are working together. This will have the added value of critical mass and peer-to-peer support, and reinforce the integration of research and clinical training.

The obvious question, however, is why should this training be based in Scotland? The answer is that we offer a training environment with world class expertise in the relevant fields; that we have already moved away from departments of psychiatry and towards interdisciplinary research centres and collaborative groupings; and that we already have several such training schemes (for translational medicine, pharmacology, pathology, brain imaging and the basic sciences) as well as mature NHS, academic and industry partnerships in our uniquely co-operative environment. It is worth noting that there are currently at least 15 clinical academics in England and Wales who undertook basic and/or higher psychiatry training in one or more sites in Scotland and now occupy senior positions across, for example, the Universities of Cambridge and Cardiff, and the Institute of Psychiatry, including indeed many of the Professors of Psychiatry in Oxford. We have therefore a very well established track record of training to the benefit of British psychiatry and indeed medical research as a whole.

British academic psychiatry needs a new approach. Unparalleled advances in the rest of medicine have supplied research tools that have vast untapped potential to improve the management of psychiatric disorders. The overarching goal of the PsySTAR PhD fellowship programme is to get the next generation of academic psychiatrists to engage with the relevant aspects of basic science and medicine, and thus foster a cadre of psychiatric researchers focused on developing innovative treatments through cutting edge approaches in stem cell biology, epigenetics, developmental programming, animal and computational models, and novel behavioural and psychosocial interventions for treatment and prevention.

We propose an innovative mental health clinical research training PhD programme based on the outstanding basic-to-clinical translational research environment and the existing excellence in clinical training in Scotland. PsySTAR brings together leading researchers and centres of excellence in psychiatric genetics, behavioural and clinical neuroscience, brain imaging, epidemiology, biomedicine, the quantitative sciences, social and public health sciences and clinical trial methodology. Trainees will receive concentrated teaching in each of these, with careful mentoring and guidance towards PhD supervisor and project selection, integrated into their first year of specialist training. The PhD will be taken with one or more scientists, often in different locations, with mentoring from an academic psychiatrist, all from units rated world leading/internationally excellent in RAE2008. We will manage the cohort, alongside those in similar clinical PhD schemes, to maximise the added value of critical mass and peer support.

We have in Scotland many more trainees applying to psychiatry training schemes than in the rest of the UK, a proven track record of academic training, a well established collaborative research infrastructure and mature NHS and industrypartnerships.

Clinical psychiatrists and indeed mental health workers as a whole in the UK and beyond will also benefit from the immediate work of the PsySTAR trainees themselves and over the course of the next generation both in terms of the research they do and the trainees they go on to supervise. As scientific knowledge increases and practical applications are seen to benefit patients, the field as a whole will benefit from renewed optimism, with an increased standing amongst the rest of medicine and in society generally, and a greater interest amongst young doctors in clinical and research training in psychiatry.

The broad range of relevant research skills available to PsySTAR trainees, and our focus on translational neuroscience in its broadest sense - from both mouse to man and from bench to bedside - will have a number of wider benefits. As new treatments are developed and established, the UK's expertise in translational neuroscience will be reinforced, patients and their relatives and carers will benefit from novel therapeutic approaches, industry will have the opportunity to exploit these and related initiatives for commercial gain, mental health policy leaders will benefit from an increased range of evidence based interventions, educational and cultural organisations will have renewed opportunities for the dissemination of scientific information of wide interest to the public, and society as a whole should benefit from the direct and indirect impact upon the nations mental health.

To make the most of these opportunities, PsySTAR will have a vigorous public engagement and public lecture programme, as do all the participating PsySTAR universities and research centres. Most support Café Scientifique (http://cafescientifique.org), as shall we. Opportunities also arise for public engagement through Edinburgh's International Science Festival (www.sciencefestival.co.uk), and from this year through a 'Neuroscience stream' at the Edinburgh International Film Festival. Many of the investigators within PsySTAR work regularly with the Science Media Centre (www.sciencemediacentre.org/) in London, engaging with mainstream media to demystify science and transmit a clear message about societal benefits. Our programme will particularly emphasise the benefits to society of a modern forward looking science based psychiatry training programme that will deliver high quality academics and in turn novel therapies and therapeutics. Several PsySTAR scientists are actively engaged with the Scottish Parliament in promoting disease-specific and broader health-related issues to prioritisation in the public portfolio, such as rational antidepressant prescribing targets and the promotion of evidence-based health policy.

We shall also participate enthusiastically in highly relevant initiatives in life sciences including:
1. Beltane 'Beacon for Public Engagement' in Scotland (www.rcuk.ac.uk/sis/beacons.htm), which is supported by the UK Funding Councils, together with the Wellcome Trust, to encourage citizen participation and understanding of research relevant to public policy, bringing together researchers in medicine and the sciences and engineering with those in social sciences, arts and humanities to ensure breakthroughs in technology, medicines and treatments are described in a human context that relates to health and the environment we live in.
2. ESRC Innogen Centre (www.innogen.ac.uk), which merges interdisciplinary teams of social, natural and medical scientists to understand genomics and life science innovation and its better governance - in industry and research, globally and in everyday life, focusing on how rapid changes in life science can address global health needs. Over the next 5 years ESRC will invest a further £5million to address new research areas: including tissue engineering, systems/synthetic biology, translational medicine and health, with the aim that society maintains its understanding and control of new science.