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State-of-the-art challenges for mental health services research.
1Mount Sinai School of Medicine, Department of Psychiatry, One Gustave L.Levy Place, Box 1230, New York, NY 10029-6574, USA, SusanEssock@smtplink.mssm.edu
The Journal of Mental Health Policy and Economics
|April 23, 2002
Summary
Implementing evidence-based treatments for serious mental disorders requires defining "adequate care" and ensuring quality delivery. Bridging the gap between research and practice is crucial for improving mental health services and patient outcomes.
Area of Science:
- Mental Health Services Research
- Healthcare Policy and Management
- Clinical Psychology
Background:
- State-of-the-art mental health services require effective treatments, synergistic organization, and incentivized financing.
- Significant gaps exist in research translating into policy and practice for serious mental disorders.
- Current research often defines "good care" but lacks clarity on what constitutes an "adequate trial" of treatment.
Purpose of the Study:
- To highlight the gap between identified effective interventions for serious mental disorders and their actual implementation in practice.
- To address the challenge of defining and monitoring "adequate treatment trials" within managed care contracts.
- To explore strategies for disseminating and contracting efficacious treatments in real-world mental health settings.
Main Methods:
- Review of the National Institute of Mental Health (NIMH) services-research portfolio.
- Analysis of challenges in defining and monitoring "adequate care" in managed care contracting.
- Discussion of the need for services research to bridge the gap between known effective treatments and their delivery.
Main Results:
- NIMH research has identified effective patient- and system-level interventions, yet implementation remains limited.
- Defining an "adequate trial" of treatment is a critical, yet underexplored, aspect of mental health service delivery and resource allocation.
- Problem-oriented family therapy for schizophrenia is an example of an effective intervention rarely found in practice.
Conclusions:
- Translating research into practice requires focusing on both "what is good care?" and "how do we get it to happen?".
- Greater attention must be paid to the quality of care actually delivered, not just prescribed or planned.
- Effective contracting and dissemination strategies are essential for ensuring efficacious treatments are utilized and effective in real-world mental health settings.