Project Area: Health policy and systems research
Project Summary
BACKGROUND:
Depression is a common comorbidity in cancer, affecting up to 30% of patients, with around 10% meeting criteria for major depression. Untreated depression is associated with poorer adherence to cancer treatment, increased symptom burden, reduced quality of life (QOL), and higher healthcare utilisation, generating significant economic and societal costs. Despite international consensus on integrating psychosocial care into routine oncology practice, systematic identification and management of depression remain inconsistent internationally and in Ireland. UK research highlighted this gap, with 73% of patients with cancer and major depression receiving no potentially effective depression treatment.
This doctoral research addresses these gaps by evaluating the acceptability, feasibility, and economic impact of implementing an evidence-based collaborative care model—SMaRT Oncology—within Irish oncology services. Collaborative care is a structured, team-based approach integrating mental health into routine cancer care and is the only intervention with a robust evidence-base. Models like SMaRT Oncology have demonstrated clinical effectiveness and cost-efficiency, but their applicability in Ireland is unknown.
OBJECTIVES:
1) Identify barriers and facilitators to implementing collaborative care and assess acceptability and feasibility using the Consolidated Framework for Implementation Research (CFIR).
2) Estimate the cost-effectiveness of SMaRT Oncology compared to usual care through model-based economic evaluation from the Health Service Executive (HSE) perspective, expressed as incremental cost per clinically significant depression reduction and quality-adjusted life years (QALYs).
3) Adapt SMaRT Oncology for cultural and operational fit within Irish healthcare through Collective Intelligence co-design workshops with patients, families, clinicians, managers and policymakers.
4) Co-create implementation recommendations to support scalable integration into oncology services.
METHODS:
A mixed-methods design will be employed across four interlinked work packages: qualitative evidence synthesis, key informant interviews, economic modelling, and participatory co-design workshops. Guided by the ADAPT framework, the project emphasises meaningful Patient and Public Involvement (PPI) throughout. National and international placements will strengthen implementation insights and capacity building: with the NCCP Cancer Survivorship team for policy exposure and at Oxford Cancer Centre for practical experience in collaborative care integration.
IMPACT:
Findings will inform national strategies, including the National Cancer Strategy, supporting greater integration of mental health care in oncology. By assessing feasibility and cost-effectiveness, this research will lay the foundation for scalable psycho-oncology services in Ireland, enhancing patient QOL and advancing global knowledge on collaborative care adaptation. The Scholar will gain expertise in evidence synthesis, mixed-methods research, implementation science, health economics, and participatory research, positioning them as a future leader in health services research.
Skills Required
(If applying for this project you will be asked to outline how you meet the skills required below)
Essential
- A degree in a relevant discipline (e.g., health economics, psychology, social science, allied health).
- Strong quantitative research skills and statistical analysis using Stata.
- Strong qualitative research skills, including experience in conducting interviews and thematic or framework analysis.
- Competence in evidence synthesis methods (e.g., systematic or scoping reviews).
- Ability to work independently and collaboratively within multidisciplinary teams.
- Excellent communication and interpersonal skills for key informant and interest-holder engagement and PPI activities.
- Strong organisational and project management skills.
- Experience in participant recruitment and ethical research conduct.
Desirable:
- Understanding of cost-effectiveness analysis and health economic modelling
- Evidence of scholarly output, ideally peer-reviewed publications.
- Experience in engaged research and/or PPI in research.
- Familiarity with NVivo for qualitative data analysis.
- Knowledge of health services research and implementation science frameworks (e.g., CFIR, ADAPT).
These skills will enable the Scholar to successfully execute the mixed-methods design, engage with diverse interest-holders, and produce high-quality outputs that inform policy and practice.
Supervisory team:
Dr Maria Pertl, PI/Primary Supervsior
Lecturer, Department of Health Psychology, RCSI University of Medicine and Health Sciences
Dr Paul Hanly, Lecturer in Economics, Department of Economics, Cork University Business School, University College Cork.
Dr Luke Solomons, Consultant in Psychological Medicine, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital and Honorary Senior Clinical Lecturer, Department of Psychiatry, University of Oxford.
Prof Frank Doyle, Associate Professor, Department of Health Psychology, School of Population Health, RCSI University of Medicine and Health Sciences.
The supervisory team brings extensive, complementary expertise to ensure comprehensive guidance throughout the project.
Dr Maria Pertl is a Chartered Health Psychologist, Principal Investigator, and Lecturer in RCSI’s School of Population Health and has a strong track record in evidence-synthesis, mixed-methods and psycho-oncology research. Dr Pertl’s research explores the psychological and social impact of chronic health conditions on patients, their families, and caregivers. A central focus of her work is psycho-oncology, with particular interest in identifying effective interventions to support individuals living with and beyond cancer. Her research addresses the challenges associated with cancer-related fatigue, depression, and anxiety, aiming to improve quality of life and psychological wellbeing among people who have received a cancer diagnosis.
Dr Pertl has authored more than 30 peer‑reviewed publications (Scopus H‑Index 13), and has supervised PhD, Masters, and undergraduate students, and interdisciplinary research teams. She has secured over €0.25 million as lead applicant and €10.5 million as co‑applicant across competitive funding schemes. She led the ENHANCE study – funded by the Irish Cancer Society and the National Cancer Control Programme (the NCCP) – which examined the effectiveness and acceptability of treatments for depression among patients with cancer.
Dr Pertl is also a committed advocate for meaningful Public and Patient Involvement (PPI) in health research and is actively involved in advancing PPI capacity and practice. She contributes to national PPI development through her role as RCSI Site Lead for the PPI Ignite Network.
Dr Paul Hanly is a lecturer in Economics in the Department of Economics, Cork University Business School, University College Cork. As an internationally recognised expert in health economics and behavioural economics, Dr Hanly’s research explores the intersection of health, human capital, productivity, and public policy—focusing on the economic burden of disease, behavioural interventions for cancer prevention and the labour market impacts of illness. His work continues to shape both scholarship and policy, with research that informs healthcare decision-making and economic policy development at national and international levels.
Dr Hanly is an award-winning and internationally recognised researcher with over 50 peer-reviewed publications in leading journals. His research has generated over 2,000 citations with a h-index of 30, and he has successfully attracted almost €2 million in research funding from prestigious bodies including the Health Research Board, Irish Cancer Society, and MSD Oncology. His work has won numerous prizes across internationally recognised research societies, including the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Best New Investigator Award. He maintains an extensive international research collaboration network with centres of excellence including the International Agency for Research on Cancer (IARC), Newcastle University Centre for Cancer, American Cancer Society, Royal College of Surgeons in Ireland (RCSI) and Trinity College Dublin.
Dr Hanly teaches across undergraduate and postgraduate programmes at University College Cork (UCC). In recognition of his teaching excellence, he received the Teaching Hero Award in 2021 from the National Forum for the Enhancement of Teaching and Learning in Higher Education and has created an Economics Learning YouTube channel with nearly one million views.
Dr Luke Solomons is a consultant liaison psychiatrist at Oxford University Hospitals NHS trust and honorary senior clinical lecturer with the University of Oxford, with substantial experience of leading proactive and integrated psychiatric services for medical patients. He was part of the team that delivered a large, randomised trial (The HOME Study) of proactive integrated consultation liaison psychiatry (PICLP), which found PICLP to improve care and be cost effective, with some indication of lessening time in hospital. Dr Solomons has particular expertise in psycho-oncology and leads services within the Oxford Cancer Centre. He brings expertise in the implementation of collaborative care in oncology settings, and was part of the team that implemented the SMaRT Oncology model in Oxford. Dr Solomons is also the simulation and technology enhanced learning (STEL) tutor for Oxford University Hospitals and has just finished editing the first edition of the Oxford Handbook of psychiatry in the general hospital.
Professor Frank Doyle is an Associate Professor in the Department of Health Psychology, RCSI. His wide-ranging research interests include depression, psychometrics, health behaviours and complex interventions and he has published over 150 peer-reviewed articles in these areas. Professor Doyle has contributed to policy by being an invited expert in numerous external bodies, including a National Clinical Guidelines group, the All-Island Institute of Hospice and Palliative Care (AIIHPC), and the World Health Organisation, the Irish Association for Cardiac Rehabilitation, and Writing Committees for the European Association of Preventive Cardiology. His research has been supported by national (e.g. Irish Research Council, Health Research Board, Research Ireland) and European (e.g. H2020 Research and Innovation Action, CHITIN) funders and he has obtained >€10 million in competitive funding from European and national funders. Prof Doyle has supervised 14 PhD students and 13 postdocs to publication, various awards, and supported them to obtain tenured faculty positions. He is a Fellow of the Psychological Society of Ireland since 2019 and was elected as a Fellow of the European Health Psychology Society in 2022.
The project will be based in RCSI
