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Nav Kapur: research making a difference to real lives
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Profile Nav Kapur: research making a difference to real lives
Gunjit Bandesha
It is reassuring to hear that one of the top clinical researchers on suicide prevention in the UK does not shy away from continuous evaluation. Nav Kapur, professor of psychiatry and population health (University of Manchester, Manchester, UK), fired by an internal drive, is always asking himself whether he is doing enough, and if he could be doing better. This is good news for mental health services and for people who access and use of these services. Kapur was born in the East End of London—“not the most pleasant of environments”, he says with some hesitancy, and a “real contrast to the leafy suburban area in south Manchester where my kids are growing up”. He describes himself as a nerdy teenager. “I know it’s a cliché, but I really did want to be an astronaut”, he says, “because my birthday coincided with Neil Armstrong’s trip to the moon, and I felt tied to celestial spheres in a way I can’t really explain”. Kapur did explain how he was turned off studying medicine because his respected older brother, a general practitioner, had trodden that path before him. However, aged 17 he felt he had an important decision to make—“should I go for sociable science or pure science; medicine or astrophysics? And the more human side of me won. I then chose psychiatry because I felt my communication skills were an asset and this was where they could be applied in the most positive way”. Kapur has carved his own path; after training as a psychiatrist in Leeds and Manchester, UK, he was lecturer, senior lecturer, and reader in psychiatry at Manchester University, before taking up his current post in 2008. “I often get teased for not moving very far”, Kapur says, “but I have moved from London, to Leeds, to Manchester— all very big life changes!” Academia had its charms— offering a self-disciplined work structure and the space to cultivate ideas from thoughts—but Kapur was somewhat “suspicious” of academics (the finer details of which were not forthcoming). He casually implies that it was a phone call, first offering a research post on self-harm, and then another call offering a part-time lecturer post, that determined which path he followed. “Suicide research was not a conscious decision either”, Kapur adds, “Louis Appleby needed someone to help run his academic unit for a while, and despite an earlier published ‘spat’ with him in the Psychiatric Bulletin, our first conversation was about our kids and holidays, and that was that”. Kapur joined the world-leading research unit at the University of Manchester. He was officially an academic. Kapur works on a local and national level, researching the aetiology, treatment, and prevention of suicidal behaviour. His university centre is unique in that it focuses on suicide prevention in health service settings. Leading the suicide research programme of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Kapur explains that the registry captures data from people who 814
have died by suicide within 12 months of contact with mental health services. “We are not forgetting people who don’t seek help, but a focus on those who do helps to tell us what safety measures are needed in mental health services. It also can shed light on what works and what doesn’t. Our research is very much focused on clinical practice. If we ask ourselves whether our research has made a difference, the answer is yes it has.” One important point that Kapur raises is that policy and new initiatives are no quick fix; “the best policies will not make a difference in a dysfunctional organisation—a stable workforce and organisational systemic change, the wider drivers of safety, are also part of the solution”, Kapur says. “We also need to communicate our findings, not only publish them.” As the Chair of NICE expert groups, who developed guidelines and quality standards for self-harm, Kapur feels engaged and motivated; “I suddenly found out I was quite good at chairing meetings and steering guidelines”, he says with a self-effacing laugh, “and actually applying research to make a difference.” However, doctors are given a mountain of guidelines, which are only useful if they are incorporated into patient care. “We have to ask what we can learn from our data”, Kapur says. The Manchester Self-Harm (MaSH) project can track individuals who present to hospital with self-harm. “By following people up, we can determine who has died, and from this we have learned that there is a 30–50-times increase in the risk of suicide in the year following the hospital visit. The greatest risk is soon after presentation, so if we are going to provide help and treatment we need to do this quickly. ” National Institute for Health Research (NIHR) Programme Grants have enabled Kapur’s collaboration with world-renowned experts in Bristol and Oxford to develop intervention and prevention strategies for self-harm and suicidal behaviour. From the research he has concluded that “risk prediction is a bit of a fallacy. If we use risk scales, we should use them as an adjunct to assessment or a change measure. We can’t use them to decide who does and doesn’t get treatment.” Kapur’s charm derives not just from his genial and sociable nature, but also from a healthy element of self-doubt, despite his successes. Concerned that he might not have been interesting enough, he jokingly pointed out that his “former eclectic range of interests” have somewhat dwindled with work and family commitments. He is proud of the way he has juggled a “reasonable academic career” with his family life, and he also reads, dabbles in the kitchen, and collects new experiences by “travelling as far away as I can”. However, so far, he has always come back to earth, to Manchester specifically, where he is much needed.
Jules Morgan www.thelancet.com/psychiatry Vol 3 September 2016
Profile Nav Kapur: research making a difference to real lives
Gunjit Bandesha
It is reassuring to hear that one of the top clinical researchers on suicide prevention in the UK does not shy away from continuous evaluation. Nav Kapur, professor of psychiatry and population health (University of Manchester, Manchester, UK), fired by an internal drive, is always asking himself whether he is doing enough, and if he could be doing better. This is good news for mental health services and for people who access and use of these services. Kapur was born in the East End of London—“not the most pleasant of environments”, he says with some hesitancy, and a “real contrast to the leafy suburban area in south Manchester where my kids are growing up”. He describes himself as a nerdy teenager. “I know it’s a cliché, but I really did want to be an astronaut”, he says, “because my birthday coincided with Neil Armstrong’s trip to the moon, and I felt tied to celestial spheres in a way I can’t really explain”. Kapur did explain how he was turned off studying medicine because his respected older brother, a general practitioner, had trodden that path before him. However, aged 17 he felt he had an important decision to make—“should I go for sociable science or pure science; medicine or astrophysics? And the more human side of me won. I then chose psychiatry because I felt my communication skills were an asset and this was where they could be applied in the most positive way”. Kapur has carved his own path; after training as a psychiatrist in Leeds and Manchester, UK, he was lecturer, senior lecturer, and reader in psychiatry at Manchester University, before taking up his current post in 2008. “I often get teased for not moving very far”, Kapur says, “but I have moved from London, to Leeds, to Manchester— all very big life changes!” Academia had its charms— offering a self-disciplined work structure and the space to cultivate ideas from thoughts—but Kapur was somewhat “suspicious” of academics (the finer details of which were not forthcoming). He casually implies that it was a phone call, first offering a research post on self-harm, and then another call offering a part-time lecturer post, that determined which path he followed. “Suicide research was not a conscious decision either”, Kapur adds, “Louis Appleby needed someone to help run his academic unit for a while, and despite an earlier published ‘spat’ with him in the Psychiatric Bulletin, our first conversation was about our kids and holidays, and that was that”. Kapur joined the world-leading research unit at the University of Manchester. He was officially an academic. Kapur works on a local and national level, researching the aetiology, treatment, and prevention of suicidal behaviour. His university centre is unique in that it focuses on suicide prevention in health service settings. Leading the suicide research programme of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Kapur explains that the registry captures data from people who 814
have died by suicide within 12 months of contact with mental health services. “We are not forgetting people who don’t seek help, but a focus on those who do helps to tell us what safety measures are needed in mental health services. It also can shed light on what works and what doesn’t. Our research is very much focused on clinical practice. If we ask ourselves whether our research has made a difference, the answer is yes it has.” One important point that Kapur raises is that policy and new initiatives are no quick fix; “the best policies will not make a difference in a dysfunctional organisation—a stable workforce and organisational systemic change, the wider drivers of safety, are also part of the solution”, Kapur says. “We also need to communicate our findings, not only publish them.” As the Chair of NICE expert groups, who developed guidelines and quality standards for self-harm, Kapur feels engaged and motivated; “I suddenly found out I was quite good at chairing meetings and steering guidelines”, he says with a self-effacing laugh, “and actually applying research to make a difference.” However, doctors are given a mountain of guidelines, which are only useful if they are incorporated into patient care. “We have to ask what we can learn from our data”, Kapur says. The Manchester Self-Harm (MaSH) project can track individuals who present to hospital with self-harm. “By following people up, we can determine who has died, and from this we have learned that there is a 30–50-times increase in the risk of suicide in the year following the hospital visit. The greatest risk is soon after presentation, so if we are going to provide help and treatment we need to do this quickly. ” National Institute for Health Research (NIHR) Programme Grants have enabled Kapur’s collaboration with world-renowned experts in Bristol and Oxford to develop intervention and prevention strategies for self-harm and suicidal behaviour. From the research he has concluded that “risk prediction is a bit of a fallacy. If we use risk scales, we should use them as an adjunct to assessment or a change measure. We can’t use them to decide who does and doesn’t get treatment.” Kapur’s charm derives not just from his genial and sociable nature, but also from a healthy element of self-doubt, despite his successes. Concerned that he might not have been interesting enough, he jokingly pointed out that his “former eclectic range of interests” have somewhat dwindled with work and family commitments. He is proud of the way he has juggled a “reasonable academic career” with his family life, and he also reads, dabbles in the kitchen, and collects new experiences by “travelling as far away as I can”. However, so far, he has always come back to earth, to Manchester specifically, where he is much needed.
Jules Morgan www.thelancet.com/psychiatry Vol 3 September 2016