The days that Associate Professor James Scott savours most are the ones where he can see his research making a real difference to people’s lives.
The 49-year-old keeps many balls in the air, splitting his time between mental health research – striving to find both the causes and the cure for mental illness – and clinical work to provide treatment and care for people suffering poor mental health.
This week Associate Professor Scott, a principal researcher at the Queensland Centre for Mental Health Research at West Moreton Health, was named the winner of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Senior Research Award.
The prestigious award, established in 1978, recognises the person who has made the most significant contribution to psychiatric research in Australia and New Zealand over the past five years.
In that time Prof Scott has made great strides in four key areas of mental health research including epidemiology and bullying, neuro-immunology, maltreatment of children and clinical trials.
His recent work has led to significant developments in the potential screening and successful treatment options for people suffering psychosis, and has also helped put bullying on the world stage.
But Prof Scott said the true measure of success was not in awards or even research gains, but in the implementation of study and the difference it made.
“The things that influence our programme of research are very much the things that I see in my clinical practice,” Prof Scott said.
“Over the years I have seen so much childhood maltreatment, I have seen so much bullying and I have seen so many people with psychosis who are not getting better.
“So when I see something that could make a difference to a person’s health I think we have to grab it and explore it and see what is going on.”
It was only weeks after reading an article about auto-immune encephalitis and its link to psychosis that Professor Scott met with specialists from other areas of medicine to conduct one of his most important studies to date.
“I had been referred to a young man who had been unwell with psychosis for six or seven years. He had seen a number of other clinicians and I was giving a fourth opinion,” Prof Scott said.
“I had been reading about auto-immune encephalitis only a few weeks before he had come in. He was so unwell and I said to his mum ‘I don’t think there is much I can do to help your son but let’s check for this condition’, and sure enough he came back as positive for this auto-immune illness.
“He was treated with immunotherapy and got better. It was something I had never seen, it was miraculous.”
Earlier this year Prof Scott presented findings to the Schizophrenia International Research Society in Italy showing that up to five per cent of people admitted to hospital for their first episode of psychosis have an auto-immune illness where their body is producing antibodies that attack the brain and cause a psychosis.
“Traditionally we thought psychosis has been due to a change in the dopamine system but we are finding that for a small percentage of people with psychosis it is actually an autoimmune illness that requires immunotherapy rather than antipsychotic treatment.
“Knowing this means there is huge potential to open up new opportunities for really effective treatment for this group of people that targets their auto-immune illness, not schizophrenia.”
“When we treat these people with immunotherapy rather than psychiatric medication, they get better.
“When you see the difference in someone it is just life-changing. I have seen a few people with this autoimmune encephalitis who were misdiagnosed with psychosis. They are back working, fully recovered, it’s just lovely.
“If we had not identified this I think they would still be having psychosis.
“Ultimately as a health professional that is why you go to work – to make a difference to people.”
Professor Scott said his research was spurred by his interactions with patients and their families and only possible due to the support of his fellow researchers.
“You do nothing in isolation,” Prof Scott said.
“You are leveraging on what other people have found.
“I feel very strongly that I’m winning this award as the result of the work that everyone else has done – it’s what we have done together.”
Professor Scott said he hoped the award would help persuade greater uptake of the knowledge found in research.
“It’s nice to get recognition but I don’t see it as a highlight,” Prof Scott said.
“A highlight for me would be if we were able to successfully identify this five per cent of people with psychosis who would benefit from immunotherapy, and they received it and they got better.
“If I left my research career seeing that happen, that would be a highlight.
“If we could get programs in schools that could meaningfully reduce bullying, that would be a highlight. These are the sort of things that I think most people who stick at research are hoping to see – change.”