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Highlight: Learning Mental Health System—Narrowing the Gap from Science to Service

Dynamic Sustainability Framework chart shows a dynamic view of mental healthcare sustainability.

The Dynamic Sustainability Framework (DSF) depicts a dynamic view of sustainability, which allows for the evolution of an intervention within a changing delivery system.40 The changes in the shape of the puzzle pieces and of the contexts reflects the ongoing change to interventions, practice settings, and care systems, and shows the use of quality improvement methods to optimize the “fit” and improve the public health benefit of sustained use of interventions

Source: David Chambers, D. Phil., Services Research and Clinical Epidemiology Branch, Division of Services and Intervention Research, NIMH

The mental health care system can learn a thing or two from business. Nearly every business collects metrics on inventory, sales, and workplace process. In contrast, mental health care has been slow to measure these kinds of outcomes, taking more than a decade to incorporate research results into community care programs. Increasingly, mental health care, via either managed care or large practice settings, is improving by collecting data through electronic health records and refining practice based on what works—becoming, in essence, a “learning mental health system” (LMHS).39

Looking to narrow the time gap for feedback to guide practice, the Seattle-based Mental Health Research Network (MHRN) has integrated electronic health records for 12.5 million patients with mental illnesses across 13 health system research centers. Now, the MHRN is better equipped to answer questions about suicide prevention and management of depression. Similarly, the Boston-based Mood Patient Powered Research Network is creating a cohort of 50,000 people with major depressive disorder or bipolar disorder to serve as a platform for mood disorder research. Results from both groups will aid in identifying best practices, tracking outcomes, and improving mental health care.

Programs like these are providing models for how the health care community can ensure that the lessons learned from research and clinical experience are systematically and rapidly put to use to improve patient care.

Highlight from Strategic Objective 4