Dr Madeleine Ferraro

Dr Madeleine Hinwood is using research to strengthen our knowledge of how mental illnesses develop, advance evidence-based treatments and preventions, and improve public access to safe, effective medication.

Madeleine is committed to improving the way mental and neurological disorders are treated and prevented in Australia. From preclinical research to informing health policies, the impact of Madeleine’s work is two-fold: contributing to a better understanding of stress-related disorders, and ensuring safe, effective medications are accessible to the public.

Delivering affordable treatments

While mental illness has received greater public attention and research funding in recent years, getting effective and affordable medication on the shelves for patients remains challenging.

“There are so many interesting preclinical (animal) studies happening to further our understanding of the brain and the disorders of the central nervous system. However, the translation of these studies into useful clinical applications is notoriously difficult.

“Even when research does translate to improved medications, we face the challenge of access and affordability for the general public. How do we get safe, effective medication into the hands of those who need it?”

In her role as an external academic evaluator for the Pharmaceutical Benefits Scheme, Madeleine provides expert clinical and economic advice to the federal government to inform decisions about which new medicines should be subsidised for the Australian public, to make them more accessible.

Since 2015, Madeleine’s work has helped deliver subsidised pharmaceuticals for thousands of patients annually.

“We evaluate the effectiveness, safety, and cost-effectiveness of new pharmaceutical listings. This is multi-million dollar applied research and evaluation that directly informs health policy and clinical practice, and impacts upon public access to medicines.”

Innovative mental health research

Alongside her evaluation work, Madeleine is involved in several innovative neurological research projects in collaboration with researchers from Hunter New England Health, the Stroke Research Group (Hunter Medical Research Institute and the University of Newcastle), and the Centre for Brain Repair and Rehabilitation at Sahlgrenska Academy, Gothenburg University in Sweden.

Still in the early development stages, the team’s collaborative research will explore how chronic stress can change the brain’s wiring, potentially making people more vulnerable to common mental health illnesses such as depression.

“I have a long standing interest in studying the changes in brain and behaviour that occur in response to stress. Increasingly, people are being exposed to detrimental levels of stress. And while short bursts are beneficial—allowing us to appropriately respond to potential threats—long-term, chronic stress can take a toll on the body’s resources.

“Stress is a key behavioural risk factor for a number of disorders, including diabetes and cardiovascular disease. However, it hasn’t received the same attention as other behavioural risk factors, such as smoking or physical activity. Investigating the contribution of stress to these disorders provides an opportunity to dramatically improve health outcomes.”

As well as understanding the effects of stress, Madeleine’s team is looking for ways to combat it, by examining whether there is a gold standard for stress intervention strategies and exploring the interactions between stress and the immune system.

“There is a rapidly growing number of medicines that target the immune system. I’m interested to see how these medicines affect disorders of the central nervous system, and how this might interact with stress.

“For example, we can link the use of certain medicines to positive and negative mental health outcomes—such as risk of dementia or depression—in certain high-risk cohorts over long periods of time.”

Madeleine’s team is exploring new ways to mitigate the effects of chronic stress using a combination of treatments, such as pharmacological treatment and cognitive-behavioural strategies.

“The big question is: what strategies can we use to mitigate the presence of chronic stress? Currently, no one strategy has been shown to work conclusively, but we are committed to finding new solutions.”

Looking to the future

Madeleine’s work is attracting well-deserved attention. Over the past five years, Madeleine has secured $5.6 million in research funding, received a University of Newcastle Faculty of Health and Medicine award for best PhD thesis and, in 2018, she was selected to participate in the Faculty-facilitated ThinkWell Early and Mid-Career Women’s Development Program. The program provides support for emerging researchers, helping them progress in their field and make their mark.

For Madeleine, the idea of “making a mark” means building on preclinical research to help in the translation of novel prevention strategies and treatments for mental and neurological disorders.

“We are still at the beginning of our understanding about the brain and disorders of the central nervous system. I’d love to see what we know about how the brain works in another 100 years!”