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Examining the causes of health & social inequalities in major psychiatric disorders: causal inference methods in epidemiology applied to longitudinal data

Mental Health Research UK PhD Scholarship 2023 – Health Inequalities and Mental Illness, University College London

Supervisors: Professor James Kirkbride and Dr Jen Dykxhoorn


Lay Summary: Severe mental illnesses (SMI) such as schizophrenia, bipolar disorder and major depressive disorders are more common in some groups of people, including those who live in urban areas, those who experience poverty, or several migrants and minority ethnic groups. These links have been explored in previous research, but we still do not know whether social factors cause SMI.


This PhD project will use new methods to explore whether social factors cause SMI. We will work closely with people with lived experience to shape the research questions and interpret the evidence.


We will use data from the whole population of Sweden (over 10 million people) to identify the main social causes of SMI. The high-quality data from Sweden is a rich resource, which can fill gaps in existing evidence. Research based on Scandinavian registers has been a powerful tool for understanding mental illnesses in the UK and the Global North. The research from this PhD will also be used to make predictions about future need for SMI care in Sweden, based on a similar approach that was developed and used in England.


Broadly, this PhD will identify social factors which cause SMI and lead to inequalities across the population. This research can shape public health policies, help design effective ways to prevent SMI, and improve mental health services in areas where they are most needed.  


Aim: Utilise both traditional and novel causal inference methods in epidemiology to examine the mechanisms driving inequalities in SMI across place and migrant status. Our project objectives are: 

1. To determine whether exposure to social inequalities including deprivation, adverse childhood experiences, urbanisation, and poverty is causally-related to risk of psychotic disorders, bipolar disorder, and major depressive disorders.

2. To determine whether exposure to migrant status – including by generation and refugee status is causally-related to these severe mental illness outcomes. 


3. To develop and apply novel simulation approaches to investigate the causal mechanisms that may predict severe mental illness risk in people exposed to identified social determinants.


4. To develop an online tool to predict need for mental health services and inform public health planning.

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