When you speak to experts in mental health research, they all say a similar thing. Over the next few decades, the way we diagnose and treat mental health conditions will be completely transformed.  

“We are at an exciting inflection point in how we categorise and treat these conditions,” says Professor Husseini Manji, co-chair of the UK government’s Mental Health Mission.  

“We’re going to improve the lives of the millions of people in the UK who are suffering from these disorders.”  

“Today, many patients don’t respond to existing treatments. For example, 60 per cent of depressed patients don’t respond to the first antidepressant they’re prescribed. We’re not meeting their needs. But with access to data, we can change that.  

“Often in trying to treat mental health problems, you’re using trial and error to prescribe,” says Professor Ann John, Director of Data Mind, the UK’s mental health data hub. “But in the ideal world, we’ll get closer to knowing what will work for a particular person.” 

As the UK’s largest health research programme, Our Future Health has the data that Husseini and Ann believe can revolutionise the way we diagnose and treat mental health conditions.   

What causes mental health conditions? 

Put simply, there’s a lot we don’t yet know about the risk factors for mental health conditions.  

“Think of heart attack,” says Dr Kirstin Purves, Head of Experimentation and Insights at Our Future Health, who has a PhD in statistical genetics and psychology. “We know why having high cholesterol is a risk factor: it narrows the arteries, which constricts blood flow, so the heart has to work harder. But we don’t yet have that kind of knowledge for mental health. For example, we know that being a woman is a risk factor for developing anxiety, but we don’t know exactly why.”  

The genetic basis of mental health conditions is complex. “There is no one gene for depression or for anxiety,” says Kirstin. “Rather there are a lot of parts of your DNA that are linked to experiencing a mental health condition.  

“Also, there’s no simple cause and effect between having genetic risk factors and developing a mental health condition. Whether you do is influenced by your DNA but also things like your sex, gender, age, your life experience and the environment around you, and the interactions between all those things.” 

Husseini says that both nature and nurture play a role. “If someone has many of the genes that put them at risk for developing illness, then it will take very little life stress to trigger an episode. If someone has only a few of these genes, it may require much more life stress to trigger an episode.”   

This is where the millions of people who are signing up for Our Future Health will really make a difference. “Our Future Health’s data can play a crucial role by providing a large, diverse dataset that can help us understand the interaction of lifestyle and genes in mental health conditions,” says Husseini.    

Here, the large number of people taking part is important, because it will give researchers the statistical power to be sure that any pattern they find does exist. But the incredible detail of the data is just as crucial. For example, our volunteers share their health records with us, so researchers can study people who have existing conditions, or who go on to develop conditions. It should supercharge the ability to better understand how and why mental health problems begin.  

“Our Future Health will help identify groups of people who may be at risk of mental health conditions before they have even developed them,” says Husseini. “Based on people’s risk profiles, researchers could ask those at risk to take part in further studies, to discover new ways to reduce that risk.”

Better diagnosis of mental health conditions

Data from Our Future Health will also lead to more precise diagnosis of mental health conditions, and more targeted treatments.   

“There’s been a huge change in how we view diagnosis in recent years,” says Ann. “We’ve seen a rise in the importance of transdiagnostic symptoms, of the symptoms important to patients rather than making a diagnosis. The idea that someone has just one diagnosis is long gone”. For example, half of people with depression have been diagnosed with another mental health condition, such as generalized anxiety disorder.    

A lot of mental health conditions have overlapping symptoms. One example is anhedonia, a loss of pleasure, drive and motivation. “Depressed mood, anxiety symptoms, sleep problems, difficulty with concentration, can all be seen in many people who may have different diagnoses,” says Husseini.  

Familiar psychiatric labels, for example ‘depression’, ‘anxiety’, or ‘bipolar disorder’, are likely to adapt over time. “Traditional diagnostic categories often do not reflect underlying biology,” says Husseini.  “Neuroscience has shown that symptoms traditionally grouped under single diagnostic categories often have different underlying mechanisms,” he says.  

Genetic analysis tells a similar story. “For example, there are many combinations of symptoms that meet the criteria of depression,” says Kirstin. “People diagnosed with depression may have something in common genetically – but will also likely have differences. There are still a lot of individual differences that we don’t understand.” 

More precise treatments for everyone

Our data should also supercharge an improvement in the treatments available for mental health conditions. 

“Currently, if someone goes to the GP with symptoms of depression, the GP will give them a medicine,” says Sir Munir Pirmohamed, NHS Chair of Pharmacogenetics at the University of Liverpool. “There’s often a three-month wait to see if the patient improves on that medicine. If they don’t improve, they stop that one medicine and start another one. Some people can go through four medicines in 12 months and don’t improve at all.” 

As diagnosis becomes more precise, it will lead to more precise, tailored prescriptions. “Our Future Health will likely help us to refine our understanding of individual genetic differences in depression and anxiety,” says Kirstin. “Once we know more about this, and understand how underlying biology relates to symptoms, we will be able to give people the right treatment sooner in their journey.”  

“We need to move away from the basis of one dose fits all, or one drug fits all, and move to a much more personalised way of treating people,” Munir agrees. “Our Future Health is a fantastic opportunity to develop personalised or precision medicine, tailoring treatment to someone’s disease, to their individual genes and other factors, so that they get the best responses and the best outcomes.” 

“You could compare the change to how antibiotics have evolved. We once treated all infections with broad-spectrum antibiotics,” says Husseini “Now we identify specific pathogens and tailor treatments to them. Similarly, in mental health we are moving towards identifying specific biological markers and tailoring treatments to individual patient profiles, improving outcomes.”  

Looking to the future

Ultimately, our experts hope that a better understanding of mental ill health will help take away some of the stigma associated with the conditions. “Once you have the science that shows someone was seriously ill and they become well after treatment, that starts to reduce the stigma,” says Husseini.   

And if that isn’t enough of a motivator, consider this: taking part in ground-breaking research on mental health could be positive for you on a personal level. “I encourage everyone to participate in research,” says Ann. “There’s some evidence that it really helps people to feel that they’re part of the solution.”