Project details

Summary

What is the study about?

Severe mental ill health (SMI) including depression, psychosis, and bipolar disorder affects around 1% of the population. People with SMI often have problems with their teeth and gums. They are more likely to have missing, filled, and decayed teeth than people without SMI. Having poor oral health impacts a lot of everyday activities like eating, speaking and smiling. It can affect how patients see themselves and their mental health.

Dentists can treat many early teeth and gum problems. However, very few people with SMI attend regular dental appointments. Instead, they are more likely to seek help when in crisis and invasive treatments are the only option. Accessing a dentist for people with SMI can be difficult for lots of reasons. People can feel helpless, fearful, or demotivated about attending. They can have difficulty booking, planning, and getting to appointments. They may struggle to pay for or access free dental care. Unfortunately, existing dental initiatives have not addressed the barriers facing this group and do not help people with SMI to attend the dentist.

We want to help people with SMI to access dental care. We will use mental health support workers who are already working in the NHS. They will link people receiving care from mental health teams with dental services. The support workers will help people to book, plan, and attend regular dental appointments. They will support patients to apply for financial support. People call this type of support link work. Research has indicated that link work can increase dental visits in people who might not normally attend. Mental health support workers already do link work for other appointments. Link work has been used to help other vulnerable groups of people (e.g. children) around dental care. However, this will be the first use of link work to help people with SMI to attend the dentist.

What are you trying to find out?

The study aims to test a new intervention for supporting people with mental health difficulties to see a dentist. We call this a link work intervention. It involves a support worker offering support around finding and attending a dentist. We want to explore whether a link work intervention can help people to attend a dental appointment (e.g. a check-up, treatment).

We are planning to recruit 480  people to take part in this study.  

Who is it for?

To take part you need to:  

• Be aged 18 years or older
• Be receiving care from a community mental health team (CMHT) or early intervention for psychosis service (EIS) at the point of referral into the study  
• Have not attended a dentist in the past three years (this does not include visits to an emergency dental hospital or A&E)
• Be able to provide informed consent
• Not currently be enrolled in another dental research trial

You will not be able to take part if you are currently an inpatient on a mental health ward or if you have immediate plans to harm yourself or others.   

What does taking part involve?

You can find out more information about taking part in this study by downloading the key documents at the top of this page. 

You would be in the study for around 9-10 months.   

1. Consent: A researcher would explain the study in more detail and answer any questions. They would then ask you to fill in a consent form. 

2. Assessment: The researcher would ask you to complete some questionnaires and interviews (no longer than 75 mins). 

3. Allocation to a group: You will be randomly assigned to one of two groups: 

1. Control Group: You will receive treatment as usual from your mental health team. However, you will not receive any additional intervention (e.g. link work) as part of the research study. This would not stop you from seeking additional  support or seeing a dentist outside of the trial.
2. Intervention Group: You will receive treatment as usual from your mental health team, plus the link work intervention. You will be assigned a support worker for nine months. Their job will be to help you to find a dentist and attend any  appointments. They will help you to apply for financial support around dental appointments (if eligible) and offer practical assistance (e.g. go with you). They can help you to make sense of information around dental visits and provide support if you are feeling anxious about attending. Each appointment (up to six in total) with the support worker will usually take 15-75 minutes.   

4. Follow-up assessment: After nine months, y ou will complet e the same questionnaires that you did at the start of the study. This will help us to see whether anything has changed over time (Up to 60 mins). 

5. Optional interviews: If you received the link work intervention, there is the option of completing one or two 60-minute interviews about how you found it. 

Why is it important? 

By taking part, you would be helping to develop new ways of supporting people with mental health difficulties to access a dentist. This may help other people in the future. Past participants in this kind of research have sometimes found this to be a positive experience.    

How can I find out more?

You can find out more information about taking part in this study by downloading the key documents at the top of this page. 

If you are interested in taking part in the study, or if you have questions for the research team, click the button below to email us:

Email the research team