New research centres to improve the lives of people with severe mental illness

The need for improved care and new treatment methods for people with severe mental illness is substantial. Today, knowledge about which interventions work best for those with the most severe conditions is limited, as is knowledge about which preventive measures are most effective. There are too few studies involving patients receiving inpatient care, those who frequently return to emergency departments, or those subject to compulsory care.

Psychotic disorders, bipolar disorder, eating disorders, self-harm, depression, anxiety disorders, personality disorders and suicidal conditions are examples of diagnoses defined as severe mental illness.

Three new research centres in Lund, Uppsala and Stockholm

Over the next ten years, Forte is funding three newly established research centres for severe mental illness with a total of SEK 240 million. The centres will develop better and more precise methods, treatments and interventions to support people living with, or at risk of developing, severe mental illness and syndromes, as well as clarify the content and goals of care.

Focus on prevention and early intervention in Uppsala

Simon Cervenka, who leads the research at the new Uppsala Centre for Preventive Psychiatry, emphasises the importance of prioritising and investing in early interventions for people at high risk of developing severe mental illness.

– This group often has poorer life opportunities. They experience difficulties in working, studying, maintaining social relationships, and they have poorer access to somatic healthcare. Achieving more equal mental health in Sweden is a matter of justice, says Simon.

The Centre for Preventive Psychiatry will take a multidisciplinary approach to develop and evaluate methods for identifying risk and preventing severe mental illness and conditions, including suicide. The aim is to reassess core concepts within mental health, develop and validate models for risk assessment, and co-create preventive interventions and care pathways.

– This is about a shift in where we place our efforts. We want to generate evidence for new preventive care models — models that become part of systems, guidelines and how care is structured, in order to influence decision-makers, healthcare organisation and societal structures. But first we need to demonstrate that they work, what should be done, and that it is ethically defensible, says Simon.

Investment in better person-centred support at Lund University

Ulrika Bejerholm, who leads the ReLife Centre for Mental Health and Recovery at Lund University, also stresses that this is a particularly vulnerable group of people with complex needs.

– They often receive fragmented interventions — not only from psychiatry, but also from primary care, social services and employment support. To truly meet their needs, we need to work in a more coordinated way and focus on the whole person. That is how we can identify underlying problems and factors that contribute to or exacerbate mental ill health, says Ulrika.

To identify an individual’s actual needs, it is not only important to identify problems and barriers, but also to highlight the resources and strengths that a person possesses, Ulrika explains.

– That allows us to better understand the underlying causes of mental ill health and create more targeted solutions that promote recovery for the individual.

ReLife is an integrated part of the leadership and operations of Region Skåne and Region Kronoberg. The centre will also engage in dialogue with national and international reference groups and user organisations to prioritise the right research questions and projects. The ambition is to combine scientific knowledge, experiential knowledge and real-world practice to contribute to more effective, equitable and inclusive mental health systems nationally and internationally.

– We take a life-course perspective and are very curious about how severe mental illness is experienced. During the first years, we will make a major effort to listen to people’s lived experiences of severe mental illness. We will map life situations as well as care pathways and identify critical points that we can then focus on to create change, says Ulrika.

Improving care and recovery for those most severely affected

The Centre for Applied Psychiatric Research and Innovation (CAPRI) at Karolinska Institutet is the third centre to receive funding from Forte for a ten-year period. Here, researchers will work together with patients, their relatives, clinicians and social services to co-create, test and implement solutions based on individual needs.

– We focus on the most severely ill patients — those in inpatient wards, those who come to emergency departments, or who receive various forms of intensive outpatient care. It is about closing knowledge gaps in these settings, says Christian Rück, who leads the research at CAPRI and is a senior consultant and professor of psychiatry at Karolinska Institutet. 

The new knowledge generated will improve inpatient care, reduce self-harm and coercive measures, and strengthen people’s recovery and participation in society.

– We want to build the psychiatric inpatient ward of the future. Together with Region Stockholm, we will develop a prototype where our findings can be applied. There needs to be stronger evidence for this patient group so that they receive better care and a better care trajectory — enabling both them and their relatives to function better, says Christian.

Co-creation as a guiding principle

All three centres work with co-creative research. CAPRI, for example, has initiated collaboration with the National Collaboration for Mental Health (NSPH) and with Urban Markström at Umeå University, an expert in co-creation.

– We work with co-creation ‘from start to finish’ in our studies — not just as a label on an individual project, says Christian.

ReLife-Centre at Lund Universitey has long involved staff, patients and user organisations in its collaboration with Region Skåne, allowing them to help formulate research questions based on real needs.

– At ReLife, we also employ people with severe mental illness directly in the research group. We hope that several of them will be able to become researchers themselves in the future, says Ulrika. 

It’s about life

Forte and 26 other government agencies are involved in the national strategy for mental health and suicide prevention entitled "It’s about life" (in Swedish: Det handlar om livet), which runs from 2025 to 2034, in parallel with the research period of the centres. The strategy provides a unified framework with overarching goals and seven sub-goals. All three centres will, in different ways, contribute to achieving the strategy’s goals and objectives.

– Our centre particularly addresses the strategy’s priorities regarding preventive interventions, strengthened suicide prevention efforts, and knowledge development and collaboration between healthcare and other societal actors,” says Simon Cervenka, at Uppsala Centre for Preventive Psychiatry.

Frida Alicedotter-Bartonek, Research Officer at Forte, has been involved in designing the call for centre grants and works with Forte’s national programme for mental health, which funds the initiative.

– We are very pleased with how each centre addresses society’s knowledge needs. They are genuinely committed to improving the situation for those who are most severely affected and involve practitioners, user organisations and people with severe psychiatric conditions in meaningful ways. These are individuals who are rarely heard and whose care is not sufficiently researched. At Forte, we look forward to following the centres’ work, how they integrate the national strategy for mental health and suicide prevention into their research, and to highlighting their research results,” says Frida Alicedotter-Bartonek.