In addition to increasingly severe physical symptoms, Parkinson's can cause distressing mental health issues. These include anxiety, depression, and memory and thinking problems, caused by a combination of biological and psychological factors. They can be more disabling than physical symptoms, reduce quality of life and increase risk of mortality. They are also upsetting for family members and unpaid carers, and may necessitate transfer to institutional care. They also increase NHS costs because of expensive hospital admissions. Despite this, there are few specialist mental health professionals or psychological interventions available to help people with Parkinson's.

This study will address this by developing an effective programme of evidence-based psychological interventions for mental health issues in Parkinson's that can be easily delivered by non-experts. Parkinson's mental health specialists at UCL Queen Square Institute of Neurology will work with people affected by Parkinson's and non-psychology health professionals to design specialist interventions for three key mental health needs in Parkinson's, targeted at distinct stages:

1. Adjusting to diagnosis; empowering people to feel more in control.
2. Anxiety and/or depression; using cognitive-behavioural therapy techniques to improve mood, with particular focus on Parkinson's-specific concerns.
3. Advanced Parkinson's; helping people with Parkinson's and those around them to improve management of memory and thinking problems.

The research team will design companion booklets for participants, summarizing each session. The treatment will be piloted for one year. If the interventions prove beneficial to participants and are cost-effective, the resources will be made immediately available to healthcare staff across the UK to improve access to specialist psychological services.

All participants will be recruited from the National Hospital for Neurology and Neurosurgery, Queen Square, London.

Inclusion Criteria:

1. Diagnosis of Parkinson's AND

   1. within three years of diagnosis OR
   2. anxiety/depression, as judged by scores above clinical cut-offs on standardized measures OR
   3. developing Parkinson's-related cognitive impairment/hallucinations/delusions, but retaining capacity to consent, as judged by their medical consultant.

2. Aged 18 years and above

3. Sufficiently fluent in English

4. Able to give informed consent

5. Able to attend Queen Square for the intervention

6. Able to complete the self-report questionnaires

Exclusion Criterion:

• Already participating in psychological therapy or research aimed at improving psychological wellbeing.

We do not have explicit consent for sharing of IPD at present.