We are delighted to announce Natasha Chilman as one of our Data Impact Fellows for 2023. In this post Natasha shares a bit about her background, her current work and research and what she hopes to get out of the Fellows scheme.
About me and my background
I previously worked in mental health crisis houses for the charity Rethink Mental Illness, where I often worked with people experiencing housing insecurity and homelessness. I then completed my MSc in Clinical Mental Health Sciences at University College London, before crossing the Thames to King’s College London to work as a research assistant using electronic health record data. I really enjoyed working with large-scale datasets and started to pursue a career in research.
I started my PhD at the Institute of Psychiatry, Psychology and Neuroscience (King’s College London) in October 2020, in collaboration with Rethink Mental Illness.
My PhD is funded by the Economic and Social Research Council (ESRC) London Interdisciplinary Social Science Doctoral Training Partnership (LISS-DTP). I am affiliated with the ESRC Centre for Society and Mental Health, and I also use King’s Centre for Military Health Research systems.
Following my experience working in crisis houses, I am interested in better understanding health inequities for people who have previously experienced homelessness.
My research
My current PhD research aims to improve our understanding of multimorbidity with mental health conditions for people who have experienced homelessness.
Homelessness can encompass many different types of experiences, for example rough sleeping, temporary accommodation, and sofa surfing. We know that people who experience homelessness also experience severe health inequalities across mental health conditions, physical health conditions, and addictions.
However, previous research looking at multimorbidity (defined as the co-occurrence of multiple health conditions) and homelessness have largely focused on people who are currently rough sleeping, predominantly male, and who are accessing specialist homelessness services. This limits our understanding of multimorbidity and can exclude people who have experienced other types of homelessness.
Addressing this gap is important to inform integrated healthcare support for people who have experienced homelessness, as recently recommended by the 2022 National Institute for Clinical Excellence guidelines.
My PhD research aims to better understand this issue using a combination of quantitative and qualitative methods. I have been working with Experts by Experience at the charities Rethink Mental Illness and Pathway throughout this research project.
This means the research questions, protocol, analysis, and interpretations are informed and enriched by people who have lived experience of homelessness.
My quantitative study aims to assess the prevalence of multimorbidity with mental health for people who have experienced homelessness, using data from the 2007 and 2014 Adult Psychiatric Morbidity Surveys (APMS). The APMS is a survey of adults living in private households in England and is held on the UK Data Service for access with a Special Licence from NHS Digital. Respondents were asked if they had ever experienced homelessness, and how long ago they were last homeless. Structured, validated scales were used to assess for mental health conditions, physical health conditions, and substance use.
This dataset provides a rare opportunity to understand the heath of people who have previously experienced homelessness but are now living in private households, in a nationally representative sample.
I presented some preliminary results from my analysis at the 2022 Health Studies User Conference. These findings thus far illustrate severe inequities in multimorbidity for people who are formerly homeless. You can watch a recording of my talk in the first 10 minutes of this video:
My qualitative study aims to better understand people’s experiences of their health conditions and homelessness.
To do this I am speaking with people who are using or work in Rethink Mental Illness services in one-to-one interviews. Rethink Mental Illness is a nationwide charity which provides a variety of community and supported accommodation services. In these interviews I have asked people to tell me their story about health and homelessness. This study will provide actionable directions for integrated healthcare from people who have experienced homelessness. I am in the middle of this project currently (watch this space!) and am incredibly grateful to participants who have shared their experiences with me for this project.
Lastly, as part of my PhD programme, I recently completed an internship in the Evidence & Impact team at Rethink Mental Illness. I worked with community mental health services to pilot outcome measurement tools, which provided actional learnings for best practice and wider implementation. I also led an evidence review of interventions to support carers of people severely affected by mental illness.
Working between services and research in this internship was a great opportunity to develop my skills translating research into impact.
My future plans
I am currently completing and writing up my quantitative and qualitative PhD study results. Being a UK Data Service Impact Fellow is an exciting opportunity to share findings from my research more widely with healthcare practitioners, managers, commissioners, and researchers. I plan to use the funding to present at national and international conferences and stakeholder events. The scheme is also a great chance to meet fellow researchers from a range of disciplines using UK Data Service datasets to investigate health and social inequality. I look forward to sharing more about my research on this blog, thank you for having me!
Follow Natasha on Twitter: @NatashaChilman