Department of Health and Human Services
	Research, Demonstration, and Evaluation Activities FY 2003 Plan and Budget February 2002

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RESEARCH AND DEMONSTRATIONS

(by HHS Strategic Plan Objective)

INCREASE THE AVAILABILITY AND EFFECTIVENESS OF MENTAL HEALTH CARE SERVICES (OBJECTIVE 3.8)

FY 2003 Priorities

HEALTH SERVICES RESEARCH (NIH)

Research: In FY 2003, NIH funds will be used to continue to support research on access to and effectiveness of health care for people with severe mental disorders, particularly those whose illness or other needs make it difficult for them to obtain effective care. FY 2003 priorities include:

Research supported by The National Institute of Mental Health (NIMH) will include:

• a series of community-based clinical effectiveness trials seeking to ascertain that interventions shown to be efficacious in rigorous clinical trials are, indeed, effective in routine practice settings.
• seeking new ways of importing mental health intervention strategies into general medical and human service system settings such as day care centers for older persons with dementia or patients receiving home care because of physical mobility limitations.
• exploring innovative uses of telemedicine, interactive CD-roms for patients with mental disorders, and web-based information and support for families to provide information about and actually extend mental health care services to difficult-to-reach populations.
• improving the availability of mental health services needed by trauma victims.
• developing and refining dissemination and implementation strategies (for mental health treatments) as warranted on the basis of new information about barriers to care in both specialty mental health care and general health care treatment settings.

NIH funds will also be used to support research on the effective use of appropriate health services by generating information that will benefit people with mental disorders who seek care outside the speciality mental health sector, as well as through enhancing the capacities of patients and providers to use general medical care services and systems more effectively.

NIMH will also:

• explore means of encouraging adherence to medical treatment, including the complex regimens associated with use of protease inhibitors and antiretroviral therapy in HIV/AIDS (specifically targeted populations will include HIV-infected youth, serodiscordant couples, and groups whose literacy levels limit understanding of the need for strict adherence to treatment plans).
• seek to improve the quality of services available for persons with depressive and anxiety disorders who are seen primarily or exclusively in the primary care sector, in part by examining why certain decisions are made by both physicians and patients regarding treatment.
• develop behavioral interventions designed to prompt health care personnel to adhere more strictly to procedures and protocols that enhance outcomes and prevent treatment sequelae.
• address means of improving the quality of general medical care available for persons with severe mental disorders, particularly homeless persons and others living independently in the community.
• develop innovative means of disseminating and implementing mental health treatments with engagement strategies to use with parents and family members of patients to make them more active partners in mental health care of a family member.

In FY 2003, NIH funds will be used to support research on the effective use of appropriate health services by generating information that will benefit people with mental disorders who seek care outside the speciality mental health sector, as well as through enhancing the capacities of patients and providers to use general medical care services and systems more effectively.

The National Cancer Institute (NCI) will support efforts to improve mental services for cancer patients’ families coping with treatment-related side-effects in order to:

• understand how this major, unpaid segment of our health care system works.
• determine the impact that care giving has on the quality of life of spouses of cancer patients.

PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE - CENTER FOR MENTAL HEALTH SERVICES (SAMHSA)

Research: SAMHSA will conduct research to promote the quality and availability of services and delivery systems for children and adults with serious mental illness by developing and testing various models consumer-operated human services programs for mental health difficulties. Priority areas include:

• research efforts that build on the mental health consumer constituency for recovery community organizations to develop recovery support centers, developed by and for people in mental health recovery and their family members.
• support six evidence based practices treatment guideline areas, such as supported employment, assertive community treatment, medications, and self management.
• identify and document evidence-based best practices in clinical services and service delivery mechanisms.
• study and make recommendations for improving the mental health service delivery system, including the availability an delivery of new treatments and technologies for people with sever mental illness.

Evaluations: Priorities include:

• evaluation of new ways of translating findings and using technologies to disseminate findings and facilitate new findings translation into practice.
• evaluations from five multi-site studies in areas such as access to community care and effective services supports, homelessness prevention, jail diversion, and primary care research on mental health and substance abuse challenges for the elderly.