Project Background: The transition from adolescence to young adulthood is a critical period characterized by significant psychological, social, and biological changes. Mental health issues often emerge during this time, necessitating timely and appropriate psychiatric interventions. However, high rejection rates of referrals to psychiatric services can lead to adverse outcomes. A precursor to this project was a prior NFR funded initiative on health care services under pressure and consequences for patient flows, efficiency, and patient safety. 

Project Scope: This research aims to investigate the impact of rejected referrals to psychiatry on adolescents and young adults, focusing on outcomes such as suicide rates and the use of health services. The research will help to provide evidence that will contribute to improved decisions in health policy and health care. The research goals will be achieved by applying cutting edge methods for observational data to answer some of the most pressing questions in health service delivery.

Research Questions: The research often sparks lively debates because we ask questions that affect us all. For example, does the distance to a hospital affect birth outcomes? What happens to patients’ health after a GP quits practice? 

Research Topics: The following are main research topics of this project

1. Health Services Trajectories: Examine the trajectories of health service usage before and after the rejection of psychiatric referrals.
2. Suicide Risk Comparison: Compare the risk of suicide among those whose referrals were rejected to those accepted for psychiatric care and the general population. 

Project Aim: This research study aims to determine if patients experiencing rejections have a substantially different mortality risk compared to those accepted for treatment. Timing of Rejections as a Trigger: Investigate whether the timing of rejection notes acts as a trigger for suicide risk or self-harm. Using a case crossover design, where the patient serves as their own control, we can explore if rejection notes are associated with self-harm incidents.

Main research field: Health services

Keywords: Mental health, referral, psychiatric services, outcome, suicide, health service use, adolescents

Supervisor and Co-Supervisor: Supervisor: Prof. Ottar Bjerkeset (ottar.bjerkeset@nord.no), Co-supervisor: Professor Johan Håkon Bjørngaard

Research group: Epidemiology, health services and population based studies

Faculty: Faculty of Nursing and Health Sciences

Main supervisor: Prof. Ottar Bjerkeset has adviced PhD students the last 15 years, mainly epidemiological research in various areas of mental health, psychosomatic medicine and health services – especially in adolescents. Many of the projects use data from the Trøndelag Health Study, Norway (http://www.ntnu.edu/hunt) and national health registers. At Nord university, Prof. Bjerkeset leads the research group "Epidemiology, health services and population based studies". Publication record of Bjerkseset can be found here Publications: https://scholar.google.fr/citations?hl=no&user=y0xRsMkAAAAJ 

Co-supervisor: Professor Johan Håkon Bjørngaard, a distinguished professor in health services research, serves as the project leader for Regforsk. He has long experience with supervision of PhD candidates in this field. Publications: https://scholar.google.co.uk/citations?user=UVfbaekAAAAJ&hl=en.

Supervisors: Both Bjerkeset and Bjørngaard are affiliated with Nord university and NTNU, and have collaborated for several years at Regforsk. At the moment 10+ PhD candidates and 10+ reserachers on post.doc/professorate level are engaged in Regforsk studies. Regforsk: https://www.ntnu.edu/ism/research/regforsk#/view/publications.

Research infrastructure and facilities: The researcher will work at Nord University. The researcher will also have an opportunity to be engaged with Regforsk. 

Regforsk: It is a strong research community specialized on healthcare services at NTNU (Norwegian University of Science and Technology), using a complete and comprehensive linkage of national health registry data. Regforsk was formally established in 2019 with the support of the Research Council of Norway (NFR) funded project titled “Improved Decisions with Causal Inference in Health”. This is known as "Regforsk," a name that directly conveys our specialization in registry-based healthcare research. Included in this platform/infrastructure are: Primary care and specialist health service use, pensions and disability, educational level, birth and mortality data, and some of Norway's largest population studies: HUNT - Trøndelag Health Study - NTNU, and The Tromsø Study | UiT). These population studies cover decades of extensive data collection, across a wide range of health and social demographic data. In sum, the available data in this project will provide unique possibilities for cutting edge methodological designs and novel findings.

Who Can Apply? Eligibility Criteria: MSCA European Postdoctoral Fellowships are awarded for a duration of 12-30 months (12-24 months of Research + 6 months of additional placement in non-academic sector) to researchers of any nationality who:

• Are in possession of a doctoral degree.
• Have a maximum of 8 years full-time equivalent (FTE) experience in research after their doctoral degree.
• Comply with the MSCA mobility rule, i.e., have not resided or carried out their main activity (work, studies, etc.) in Norway for more than 12 months in the 36 months immediately prior to the call deadline.
• Have identified a supervisor at Nord University willing to host and supervise them.

If awarded, the Postdoctoral Fellowship grant covers salary, mobility allowance, family allowance (if eligible), and other allowances (if eligible) for the research fellow. The grant also covers research costs and overheads for Nord University.

How To Apply: If you are interested in this Expression of Interest (EoI), please first carefully review the eligibility criteria outlined above. If you meet these requirements, kindly submit the following documents to ottar.bjerkeset@nord.no, bent.m.strandas@nord.no, and umair.n.mughal@nord.no:

• Eligibility Information:
  • Date of PhD degree award
  • Full-time research equivalent experience after PhD
  • Period of residence in Norway (if any)
• Research CV:
  • Comprehensive CV including a complete list of publications, projects, and relevant research expertise.
• Motivation Letter:
  • Describe your interest in collaborating with the relevant professor and research group.
  • Clearly outline your research and career goals.
  • Demonstrate how your research complements with the proposed EoI and those of the targeted research group.

How the MSCA PF Process Works: After reviewing your submitted documents, we will contact shortlisted candidates for an interview. Selected candidates will collaborate with us to prepare a full MSCA Postdoctoral Fellowship (PF) application for submission under the Horizon Europe Programme, with a deadline in September.

We will provide comprehensive support throughout this process, including:

• Assistance in refining and focusing your research topic
• Participation in the MSCA MasterClass
• Professional reviews and feedback on your application
• Other necessary guidance to ensure submission of a high-quality application

Please note that MSCA PF is highly competitive, bringing together some of the best research talent globally. While funding success is not guaranteed, participating in the application process provides valuable experience and insights into your own research and proposal writing skills, as well as fostering close collaboration with your supervisor and research group.