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A new clinic at North London NHS Foundation Trust (NLFT) is helping people with difficult-to-treat depression and bipolar disorder access specialist expertise while bringing research directly into patient care. 

Funded by the Mental Health Translational Research Collaborative Mission, the MoRe (Mood Research) Clinic combines clinical assessment with research, so patients can benefit from the latest evidence while helping shape future treatments.  

By working closely with GPs and specialist services, the clinic aims to bridge a recognised gap in care for people living with complex mood disorders. 

“There are lots of people in primary care who remain unwell but do not quite reach the criteria to be seen in secondary care. These are the people we’re trying to reach,” says Professor Quentin Huys, who leads the clinic.  

The clinic accepts referrals for people experiencing difficult-to-treat depression, also known as treatment-resistant depression (TRD), who have tried at least two evidence-based treatments for their current depressive episode — such as antidepressants or psychological therapy — without experiencing significant improvement. It also accepts referrals for people living with bipolar disorder. 

Prof Joseph Hayes, consultant at the clinic, says “People can spend years living with symptoms despite trying multiple treatments. Our aim is to provide fresh clinical expertise at a point where many patients feel they’ve run out of options.” 

The need for services like the MoRe Clinic is growing.  

Around one in six people in the UK experience common mental health problems such as depression, with most receiving treatment through their GP.  

However, research suggests that up to 80 per cent of people with depression and mood disorders never access secondary mental health services, where more specialist advice and treatment are available.  

While definitions vary, studies also indicate that difficult-to treat depression is common, with one study published in World Psychiatry  finding that approximately 50 per cent of participants do not respond to first, or second-line antidepressant treatments. 

The clinic reflects the NHS’s ambition to provide more personalised care closer to home, intervening earlier to improve outcomes, and prevent people from falling through the gap between primary and specialist mental health services.  

It also supports closer collaboration between clinical care and research, ensuring patients can benefit from the latest evidence and emerging treatments.  

“Too many people with treatment-resistant depression continue to experience significant symptoms despite receiving treatment, yet they may not meet the threshold for ongoing secondary care. The MoRe Clinic helps bridge that gap by providing specialist assessment and evidence-based recommendations, while working closely with GPs and mental health services to ensure patients receive the most appropriate care,” says Dr Cristina Bizzotto, a psychiatrist at the clinic. 

Patients referred to the MoRe Clinic receive a comprehensive psychiatric assessment alongside a detailed review of their current and previous treatments. Following the assessment, the team provides personalised recommendations to the patient, their GP and, where appropriate, their psychiatrist. These recommendations may include changes to medication, alternative treatments or referral to specialist services. 

Charlotte Mair, Clinical Research Assistant at the clinic says: “It gives patients who have struggled to access secondary care, and have been living with depression for years, without anything really helping, the opportunity to be assessed by psychiatrists with specialist expertise in mood disorders, and treatment-resistant depression and bipolar disorder.”  

Alongside its clinical work, the clinic has a strong focus on research. 

“We run research studies evaluating promising new treatments, as well as trials comparing existing medications. Eligible patients have the opportunity to take part in this research, helping to advance our understanding of mood disorders while also gaining access to innovative treatments that may not yet be widely available,” says Charlotte. 

“Research is embedded within everything we do. By integrating research with routine clinical care, we’re able to generate new evidence while giving patients the opportunity to contribute to the development of future treatments for depression and bipolar disorder,” says Prof Quentin Huys. 

GPs can refer eligible patients to the MoRe Clinic using the referral form available on the NLFT website. Patients can also self-refer by completing this form. 

For people who have spent years trying different treatments without finding relief, the MoRe Clinic offers another opportunity to access specialist advice and explore new treatment options. As the service grows, the team hopes it will help ensure fewer people fall through the gap between primary and specialist mental health care. 

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Note to the editors: The MH-TRC brings together leading investigators in experimental medicine and early-stage mental health research from across the UK to accelerate discoveries into clinical practice.