Overview

I am an Associate Professor in Culture and Health Inequalties and a Director of the WHO Collaborating Centre for Culture and Health based at the University of Exeter.

My work is focused on understanding how cultures - encompassing societal values and norms, working practice, and regulatory and research cultures – intersect to impact on health and social care delivery, particularly for marginalised population groups. I have a particular interest in the intersections between poverty, mental health, and medicalisation, and in improving social care practice to support families with complex needs. I work in collaboration with service users, patients and health and social care providers to understand the cultural contexts that shape their experiences, and to design and lead impactful studies that shift working practice to create more ethical and sustainable health and social care.

I am an applied social scientist with an interdisciplinary background. I draw mainly on narrative, ethnographic and engaged research methods. 

Research group links

• Institute of Health Research

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Research

Research interests

My work is focused on understanding and addressing health and social care inequalities. I am especially interested in understanding how cultures - encompassing societal values and norms, working practice, and regulatory and research cultures – intersect to impact on health and social care delivery, particularly for marginalised population groups. I have a particular interest in the intersections between poverty, mental health, and medicalisation, and in improving social care practice to support families with complex needs. I work in collaboration with service users, patients and health and social care providers to understand the cultural contexts that shape their experiences, and to design and lead impactful studies that shift working practice to create more ethical and sustainable health and social care.

Research projects

Current and recent research grants:

• Implementing effective primary care responses to poverty-related mental distress (2021-2023, NIHR ARC Health Inqualities Consortium). Project webpage www.destressproject.org.uk. Research team: Felicity Thomas (PI), Katrina Wyatt (Exeter), Richard Byng (Plymouth), Susanne Hughes (Exeter), Jane Horrell (Exeter), Ilse Lee (UCL Partners), Kathryn Berzins (UcLan)

• Supporting parents at risk of repeat child removal (2023-2024, Torbay Medical Research Fund). Research team: Felicity Thomas (PI), Thomas El-Hoss, Susanne Hughes

• Neonatal palliative care for ethnically diverse families (2023-2024), Wellcome Centre Transformative Research Award. Research team: Marie Clancy (PI), Felicity Thomas

• Nurture-U: Student Wellbeing (2021-2025) UKRI. Compassionate Campus workstream research team: Ed Watkins (PI); Louise Lawrence, Felicity Thomas, Jemima Dooley, Polly Card

• Understanding the high number of children in statutory care in Torbay: an engaged approach to supporting families (2021-2023, Torbay Medical Research Fund). Research team: Felicity Thomas (PI), Felix Gradinger (Plymouth), Susanne Hughes (Exeter), Tom El-Hoss (Exeter), Torbay Council Public Health and Children's Services teams

• Health and wellbeing in the Belarusian diaspora (2022-2024, WCCEH). Research team: Felicity Thomas (PI), Aliaksandr Kazakou (Exeter)

• Poverty, pathology and pills: moral narratives and the medicalisation of distress (2016 - 2019, ESRC ref: ES/N018281/1). The provision of effective treatment and support for mental distress is a stated aim of the British Government and many civil society organisations. Within low-income communities, use of antidepressant medications is relatively high. However, current strategies frame mental distress as a psychological problem that lies within the individual concerned. This not only suggests that such distress can be 'corrected' through medical treatment, but also masks the factors that often underlie the root causes of suffering e.g. poor living conditions, unemployment. At the same time, policies in place to restrict welfare support, and popular media e.g. Benefits Street, draw on moralising narratives that promote the idea that people should take responsibility for their actions and circumstances. This research is exploring how people in low-income communities perceive and respond to mental distress caused by material deprivation and social disadvantage. Addressing key knowledge gaps, attention will be given to understanding: i) the role of moral narratives in influencing decisions to seek medical support for mental distress; ii) how these narratives manifest within GP consultations and influence treatment decisions and patient wellbeing. Research team: Felicity Thomas (PI), Katrina Wyatt (Exeter), Rose McCabe (Exeter) and Richard Byng (Plymouth).

• Cultural contexts of health (on-going collaboration with WHO Regional Office for Europe). Our experiences of health, and our interactions with those who care for us, are strongly influenced by the cultural contexts we inhabit. Yet whilst there has been a recent drive to understand the social determinants of health, the ways in which societal norms, value systems, working practice, traditions and beliefs impact on health pathways and outcomes are often ignored, as is the frequently positive, protective impact that culture can have in the face of certain health challenges. We are working with WHO to systematically investigate the cultural contexts of health and well-being across the European Region, and to embed humanities and social sciences research and methodological approaches into the public health sector. Current work here includes on-going collaborations relating to the culture and reform of mental health care in Central and Eastern Europe; reporting on the cultural aspects of antibiotic resistance; the development of a model for reporting on wellbeing across the WHO Europe Region; development of a toolkit on intercultural competence and diversity sensitivity within healthcare.

• Mental health outcomes of early life trauma in Belarus and Ukraine (MRC TrACES fund 2018 - 2019). Early life trauma (ELT) is known to be a key determinant of later life health and wellbeing. Within Belarus and Ukraine, high levels of ELT have been associated with some of the highest levels of suicide and substance abuse amongst young people and adults in the world. Whilst this situation has been widely linked to the significant social, political and economic upheavals experienced in the Central and Eastern European Region over the past three decades, there is a dearth of detailed analysis of the causes of early life trauma in Belarus or Ukraine, or the socio-cultural context in which it is experienced, understood and responded to. This is due in large part to the continuing dominance of psychiatric and biomedical models of understanding, which pay little attention to the socio-cultural factors underpinning people’s lives, and to the lack of funding that has been available for non-clinical research. This project involves running a series of workshops with partner organisations (Ukrainian Catholic University and Minsk Regional Centre for Psychiatry and Addiction) to bring together key stakeholders from diverse disciplinary and service provider backgrounds in Belarus and Ukraine in order to i) support key stakeholders and service providers working with those affected by early life trauma to better understand its causes and the ways that multiple traumas interact to establish risk for negative mental health, substance abuse and suicide; ii) identify the factors and mechanisms which promote resilience amongst those affected by ELT and protect against negative mental health, substance abuse and suicide. Research team: Felicity Thomas (PI), Mark Jackson, Dzmitry Krupchenka, Olga Kazakova, Orest Suvalo

• Reducing inequalities in psychological support for people affected by cancer (Engaged Reearch Exploratory Award, 2018). High levels of cancer exist within low-income communities in the UK. Since the publication of best practice guidance (National Cancer Equality Initiative 2010), efforts have been made to increase parity of cancer healthcare and treatment. Yet whilst people’s medical needs are increasingly well met, little attention has focused on supporting their mental health and emotional wellbeing, crucial when over half now live for ten years or more following diagnosis (Macmillan 2014). People diagnosed with cancer often report feeling overwhelmed with despair, grief and depression, factors that can be vastly exacerbated when they and their families are living concurrently with material hardship and deprivation. The NHS Cancer Strategy (2016) calls for accelerated commissioning of support services, such as those provided through specialist counselling and psychological support. However, this is not provided routinely within NHS care, and little is known about the factors that influence referral to, or awareness of, this kind of service, or the long-term impact counselling has on service users. Working with partner organisations We Hear You (WHY); Wessex Cancer Trust and The Harbour, this project sekes to: identify lived experiences and gaps in current service provision for low-income groups; ii) provide a forum for low-income communities to feed in to the development and implementation of local Sustainability and Transformation Plans (STPs); iii) identify research priorities to help reduce inequalities in the provision of psychological support for people affected by cancer. Research team: Felicity Thomas (PI), Lorraine Hansford

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Publications

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External Engagement and Impact

Committee/panel activities

I am a member of WHO Europe's Technical Advisory Group on Behavioural and Cultural Insights for Health. I have also served as a member of WHO Europe's Cultural Contexts of Health Expert Advisory Group, and their Monitoring and Indicators Expert Advisory Group. 

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Teaching

Modules

2023/24

• HUMM018 - Cultures and Environments of Health

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