Welcome to our May newsletter! This month's top blogs share a common thread: the gap between what we hope for and what the evidence actually shows. Joël Zwiep covers an exciting proof-of-concept trial testing whether targeting inflammation can ease depression in the third of patients who show raised C-reactive protein (CRP). A single dose of tocilizumab safely cleared inflammation, with trends favouring the drug for fatigue and depression severity. The mechanism held, and the path forward is clear: bigger trials, longer follow-up, and using baseline CRP to identify who's most likely to respond. This is precision psychiatry beginning to find its feet.

Matt Butler offers a more sobering read on the EPISODE trial of psilocybin-assisted therapy for difficult-to-treat depression: no benefit over placebo at six weeks, considerable unblinding, and a serious adverse event that deserves attention. A careful piece of evidence in a field that badly needs it.

Then there's the implementation problem. Gavin Tucker reports on the third Lancet Psychiatry Physical Health Commission, which argues that we already have the evidence that lifestyle interventions extend lives for people with severe mental illness. The question is why we still aren't delivering them. Emma Wallace covers a Danish cohort study showing homelessness is an independent driver of suicide risk, even after accounting for psychiatric disorders. For women currently homeless, the risk is eight times higher than the general population. Housing is suicide prevention.

Finally, Emma Sullivan reviews a large UK Biobank study using accelerometers to map how sleep changes across later life. If you work in mental health, the normative reference data is worth bookmarking.

As always, click through to read the blogs and join the conversation on LinkedIn.

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📈 Top 5 blogs this month

1. Targeting inflammation in depression: a proof-of-concept worth following

About a third of people with depression show low-grade inflammation, often alongside fatigue, oversleeping, and low energy. A new proof-of-concept RCT tested whether a single dose of tocilizumab, an anti-inflammatory drug that blocks IL-6 signalling, could ease depressive symptoms in this group. The infusion safely cleared inflammation. Trends favoured the drug for fatigue and depression severity, but weren't statistically significant. Promising mechanism. Next up: bigger trials, longer follow-up, and using baseline CRP to identify who's most likely to respond.

🤓 Read the BLOG by Joël Zwiep​

🗣️ Join the LinkedIn CONVERSATION​

2. Lifestyle interventions for severe mental illness: time to deliver

People with severe mental illness die up to 20 years sooner than the general population. The third Lancet Psychiatry Physical Health Commission focuses on the implementation gap. We have the evidence that lifestyle interventions work. So why aren't we delivering them? Ground interventions in one motivational theory. Involve specialist dieticians and exercise practitioners. Confront staff scepticism that quietly undermines patient progress. Evidence means nothing if we don't implement it.

🤓 Read the BLOG by Gavin Tucker​

🗣️ Join the LinkedIn CONVERSATION​

3. Psilocybin-assisted therapy for difficult-to-treat depression: underwhelming, but still vital?

Psychedelics were once (very recently) held up as a "new panacea". Psychological antibiotics that would revolutionise psychiatry. Then came the naysayers, and the methodological reckoning. The EPISODE trial is the latest piece of well-designed evidence, and it is part of that reckoning. The results are sobering. No significant six-week benefit over placebo on the primary outcome, considerable functional unblinding, and a serious adverse event worth taking seriously.

🤓 Read the BLOG by Matt Butler​

🗣️ Join the LinkedIn CONVERSATION​

4. Suicide prevention must address homelessness, not just mental health

People experiencing homelessness are two to four times more likely to die by suicide than the general population. For women currently homeless, that rises to eight times higher. A large population cohort study from Denmark shows this risk holds even after accounting for psychiatric disorders. Homelessness is an independent driver of suicide and self-harm risk. For suicide prevention, addressing housing is not optional.

🤓 Read the BLOG by Emma Wallace​

🗣️ Join the LinkedIn CONVERSATION​

5. How sleep changes across later life, and what it means for mental health

If you work in mental health, this large-scale study is worth your attention. Researchers used wrist accelerometers to track sleep in over 77,000 UK Biobank participants aged 44-82, producing normative reference data for sleep duration, timing and daily activity across age and sex groups. Key findings: men slept around 17 minutes less than women before 60; under-60s gained nearly 50 minutes of extra sleep at weekends; and recent depressive symptoms were associated with lower daily wake activity and later sleep onset. Objective and self-reported sleep measures told meaningfully different stories.

🤓 Read the BLOG by Emma Sullivan​

🗣️ Join the LinkedIn CONVERSATION​

Student Mental Health focus with new Nurture-U podcast series and webinar

After the success of our ReSET podcast and webinar aimed at secondary schools, we're now delighted to be focusing on what universities can do to improve student mental health.

Episodes 1-2 of our four-part Nurture-U podcast are out already with two more to follow before June 10th. Listen to them wherever you get your podcasts: YouTube, Spotify, Apple etc.

Join our webinar at 11am BST on Monday 15th June to explore the latest student wellbeing evidence from Nurture-U, and what it means for universities. Over five years, Nurture-U surveyed 14,000 students across five universities, tested interventions including a mental health literacy course and digital tools for anxiety and depression, and developed a whole-university framework for creating compassionate campuses.

In four short talks, the research team will present their key findings. A panel of experts will then reflect on what this means for higher education in practice: the barriers to implementation, the role of institutional leadership, and what universities should be doing differently.

🎟️ Get your free ticket now 🎟️

Teens, screens and a hill of beans? The gap between the headline you want and the headline you get

If you're interested in youth mental health and the role of social media, smartphones, gaming and digital technology, Mental Elf Founder André Tomlin has written up what he learned from two days with 30 researchers at the inaugural Huo Family Foundation Science Programme.

It's a look at where the science is heading, why "screen time" is the wrong unit of measurement, why gaming matters more than we think, and how researchers and policymakers can talk about all of this without falling into the usual headline traps.

​Teens, screens and a hill of beans? Read the article now.

🌳🌤️🍄 Commission The Mental Elf to share your research

We help researchers share evidence through social media, podcasts, videos, webinars and more. Right now we're working with research groups across the country to disseminate their new research and maximise their reach and impact.

You can commission our expert team or write us into your next grant application as your dissemination partner.

🎗️ Contact us now and get yourself some #ElfHelp.

🔗 elfi.sh/help​

📧 andre.tomlin@nationalelfservice.net​

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