Welcome to a bumper autumn issue of Mental Elf Monthly, covering August, September and October. The newsletter took a summer break but the blogs kept coming, with nearly 50 published since our last issue. Many of this season's most discussed blogs ask how treatment can fit better around the person receiving it. Can people who have taken clozapine for years safely have fewer blood tests? Could a tool that asks which side effects you most want to avoid help more people stay on antidepressants? And when someone living with psychosis mentions social media, what should we ask them about, if not hours spent online?
Elsewhere in our Top 12: brief EMDR for people diagnosed with 'personality disorders', Australia's social media age limit, teenage exam pressures, models for predicting suicide risk, what patients and carers want measured in physical health research, weight-loss drugs and depression, the ODDESSI trial of Open Dialogue, and how to audit AI chatbots for safety.
And don't miss our free webinar on Tuesday 24 November, where the NIHR Policy Research Unit for Mental Health shares what it has learned about Early Support Hubs and other new community services for young people. Free tickets below.
π Our most popular blogs this autumn
1. Clozapine monitoring: can long-term users safely test less often?
Regular blood tests are one reason clozapine is underused, even though it can help people whose schizophrenia hasn't responded to other treatments. This UK study of 1,025 long-term patients on 12-weekly monitoring is encouraging, and the blog looks at what fewer tests could mean for safety and support.
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2. Can brief EMDR (eye movement desensitisation and reprocessing) help people with complex emotional needs?
Ten sessions of EMDR reduced symptoms more than a waiting list in adults diagnosed with 'personality disorders', even when they didn't have post-traumatic stress disorder. The blog asks what a waiting-list comparison can tell us, and how brief EMDR might do against established therapies.
π€ Read the BLOG by Lisa Lloydβ
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3. The PETRUSHKA tool: matching antidepressants to people's needs and preferences
Many people stop antidepressants early because of side effects. In this trial, people named the side effects they most wanted to avoid, and the PETRUSHKA tool weighed that against predictions of what might suit them. More people stuck with their treatment through the difficult first weeks.
π€ Read the BLOG by Oonagh Colemanβ
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4. Did Australia's social media age limit change teenage behaviour?
Three months after Australia banned under-16s from social media, most of the teenagers in this BMJ study were still logging in. Many came across an age check, but it didn't stop them. With the UK debating the same policy, this is one to read before forming a view.
π€ Read the BLOG by Linda Kayeβ
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5. Social media and psychosis: friend, foe, or something in between?
A systematic review of 14 studies found no link between social media use and more severe paranoia or hallucinations in people with psychosis, though the evidence is small and mostly cross-sectional. In clinic, it may help more to ask who people talk to online, whether it leaves them feeling closer to others, and whether it keeps them up at night.
π€ Read the BLOG by Gabriel Tiraboschiβ
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6. The income, mental health and physical health triangle, unpacked
This Danish cohort study of 5.3 million people looked at what happens when someone has both a low income and a mental illness. The impact was greatest for people carrying both, which raises a practical question for services: does income support sit anywhere near your mental health pathways?
π€ Read the BLOG by Drew Meehanβ
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7. Does academic pressure harm young people's mental health?
In this study of the ALSPAC cohort, academic pressure at age 15 was associated with more depressive symptoms, and slightly higher odds of self-harm, right through to early adulthood. It can't prove cause and effect, but it gives schools and exam boards one more reason to think about how assessment is designed.
π€ Read the BLOG by a group of UCL MSc studentsβ
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8. Is there a better way to predict suicide risk? Findings from a systematic review on prediction models for self-harm and suicide
A common view in suicide prevention is that individual risk can't be predicted. This systematic review found that statistical models did better than chance at predicting suicide and self-harm, but only a small fraction were presented in a form a clinician could actually use.
π€ Read the BLOG by Laura Melzerβ
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9. Where do we go from here? Research priorities for metabolic interventions in severe mental illness
Research on physical health interventions for people with severe mental illness usually measures weight, blood pressure and blood glucose. When patients and carers helped set the research agenda in this James Lind Alliance priority-setting partnership, they also wanted to know whether people feel better and function well.
π€ Read the BLOG by Kirsten Lawsonβ
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10. Are GLP-1 receptor agonists linked to better mental health?
This Swedish study of 95,490 people with depression or anxiety who were taking diabetes medicines found semaglutide, and to a lesser extent liraglutide, linked to a lower risk of their mental illness getting worse. Other drugs in the same group were not, and the authors call for a trial before anyone changes practice.
π€ Read the BLOG by Alexandra Allamβ
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11. Beyond relapse: what does the ODDESSI trial tell us about Open Dialogue?
ODDESSI, the first randomised controlled trial of Open Dialogue, didn't reduce relapse, its primary outcome, despite some very positive coverage. The blog asks whether a relapse measure from first-episode psychosis research was the right test in a trial where depression was the most common diagnosis, and why that can't be decided after the results are in.
π€ Read the BLOG by Diamantis Toutountzidisβ
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12. Can we audit AI chatbots for mental health safety?
More people are turning to AI chatbots for mental health support. This Nature Medicine study simulated 810 conversations between users with mental health vulnerabilities and nine chatbots, and found that risk grew as conversations went on. The blog asks how far this kind of audit gets us towards safer chatbots.
π€ Read the BLOG by Robert Meadowsβ
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Free Webinar 24th Nov 2026: Early support for young people's mental health: - what does the evidence say?
England is building a new front door to mental health support for young people. Early Support Hubs are open across the country, Mental Health Support Teams are in schools, and fifty Young Futures Hubs are promised by 2029. The evidence about what works in these services has only just started to arrive.
The NIHR Policy Research Unit for Mental Health has been studying what happens inside these services, talking to young people, frontline staff and the managers who run them. On Tuesday 24 November (9:30 to 12:30) we're hosting a free online event where that research meets the people making decisions about it.
Prof Sonia Johnson from UCL chairs, with talks from Andrew Sutcliffe on policy, Kylee Trevillion, Jessica Griffiths, Jordan Thompson, Alessandro Dorata and Andrew Grundy from the PRU research team, Prof Pasco Fearon and Prof Essi Viding on early intervention in schools, and Prof Ulrike Schmidt on early intervention for eating disorders. Each session stands alone, so you can join for the part that matters most to you.
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Missed our TMS webinar? Watch the recording
In July we brought together researchers, clinicians, people with lived experience, policymakers and commissioners to ask why transcranial magnetic stimulation (TMS) is still hard to get on the NHS. It's a safe and effective treatment for difficult to treat depression, it was invented in the UK, and the evidence suggests it could save money. The full recording is now on our YouTube channel.
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