Mental Health Services, Translations, and Outcomes
 Frederic C. Blow, Ph.D. Section Director |
The faculty and staff of the Mental Health Services, Translation and Outcomes section of the University of Michigan Department of Psychiatry conduct health services research, defined by the American Academy for Health Services Research and Health Policy as studying how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to health care, the quality and cost of health care, and ultimately our health and well-being. Its research domains are individuals, families, organizations, institutions, communities, and populations. The faculty in MHSOT conduct research in the areas of mental health, substance abuse, and co-occurring mental and physical health disorders. They work to develop innovative methods of intervention and treatment for vulnerable populations and provide new information on quality and outcomes that impact public mental health policy and practice.
The MHSOT faculty have joint appointments with the Department of Veterans Affairs at the Ann Arbor VA in the National Serious Mental Illness Treatment Research and Evaluation Center (SMITREC). SMITREC was created by Congress in 1991 to provide Veterans Health Administration (VHA) with critical, timely information to help the system evaluate the care received by VA patients with serious mental illnesses. The overall mission of SMITREC is to conduct critical evaluation and research that will: 1) enhance the mental and physical health care of veterans with serious mental illnesses (SMI) by providing clinicians with state-of-the-art information on the effectiveness of treatment options; 2) inform the VHA on issues of access to care, customer and clinician satisfaction, efficiency, and delivery of quality healthcare; and 3) provide VHA policy makers with relevant and timely guidance on key issues important to optimizing the system-wide delivery of health care to veterans with SMI. SMITREC has developed longitudinal national registries to monitor care in the VHA system, the National Psychosis Registry and the National Registry for Depression. The investigators have developed the methodologies to efficiently provide answers to emerging VHA clinical and policy needs, and to conduct longitudinal studies of veterans with SMI who are often difficult to treat, require extensive clinical and financial resources, and often move from facility to facility in the VHA.
Many of the research efforts in MHSTO and SMITREC overlap, complement, and inform each other. Current work includes:
Suicide
- Suicide mortality among patients with depression in VHA/prevention strategies
- Clinical, pharmacological, and social predictors of suicide
- Substance use disorder treatment and attempted
- Suicidality screening and outreach in primary care
Access/barriers to care for the seriously mentally ill
- Treatment retention among patients with SMI in VHA
- Impact of geographical distance on access to care for patients with SMI
- Innovative treatment models to integrate medical and psychiatric care for persons with serious mental illness
- Health economics, organization, and financing of SMI treatment models
Primary and mental health care integration
- Evaluate the implementation of the Washtenaw Community Health Organization central entry point for all Medicaid-eligible and indigent residents in need of medical and mental health services
- Evaluate the VHA-wide initiative to provide mental health services in primary care settings
- Organizational factors associated with integrated care and quality improvement in mental disorders
- Behavioral interventions for SMI (e.g., cardiovascular disease risk, tobacco cessation)
Patient registries
- The National Psychosis Registry (NPR) and the National Registry for Depression (NARDEP) include data from multiple VHA sources for all VHA patients with these diagnoses. The registries form the basis for research efforts and are the source of data to help inform VHA policy decisions
- Large prospective clinical databases to better understand predictors of outcome (e.g., antipsychotic use in dementia, bipolar disorder and medical comorbidity)
Mood Disorders (Depression, Bipolar Disorder)
- Depression screening and care in the primary care setting
- Depression and bipolar disorder among the elderly
- Predictors of quality and outcomes of care for depression and bipolar disorder in a national sample
- Quality measurement and guidelines for depression and bipolar disorder
- Depression and cost-related medication nonadherence
Substance abuse disorders and dual diagnoses
- Outcome predictors for substance abuse treatment
- Brief interventions for substance use disorders
- Psychiatric symptom exacerbation during substance abuse treatment
- Coping strategies and self-efficacy in maintenance of sobriety
- Classifying service needs among Persons in outpatient substance abuse treatment
