[Mental health: an identification of new directions walking in Archie Cochrane footsteps].
New borders and promising new directions in scientific fields are often difficult to identify and define. This paper attempts to it so in relation to recent developments and new research evidence in mental health, recognizing that this exercise may be biased by many factors, including: the author's own perspective, professional background and research training and the always present dialectic between the analysis of the past and the attraction of the future. A good starting point is the ground-breaking work by Sir Archibald Cochrane. He recommended to adopt a rigorous and continuous evaluation of clinical practice and protocols, promoting well designed clinical research and the use of scientific methods. This evidence-based approach should also be used in mental health. High quality research, continuous education and good clinical practice, incorporating the results of scientific experiments and observations, represent the approach that ensures an improvement in care provision and patient satisfaction. Currently, mental health care is still too "opinion oriented", due to the over emphasis placed on personal experience and traditional approaches by many psychiatrists. In this paper some of the most promising recent results in psychosocial research, psychopharmacological studies and genetics, as well as in neuroimaging studies, are briefly summarised. From a pragmatic point of view, it is possible to achieve a significant improvement in the quality of mental health care if the following procedure is followed: firstly, to start from solid evidence; secondly, to promote the wide implementation of evidence-based research into every day practice; thirdly, to ensure that administrators and policy makers incorporate the available scientific evidence in the planning and evaluating services and mental health systems of care. The integration between research, education and practice remains the hardest border to cross, yet the achievement of it holds the greatest promise for better mental health care in the future.
Tansella
Michele
M
Sezione di Psichiatria e Psicologia Clinica e WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation.
D035843:Biomedical Research; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002986:Clinical Trials as Topic; D019317:Evidence-Based Medicine; D006801:Humans; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D008603:Mental Health; D017060:Patient Satisfaction; D011570:Psychiatry / Q000639:trends*; D014057:Tomography, X-Ray Computed