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Priorities for Strategy 4.1

Updated: January 2019

Improve the efficiency and effectiveness of existing mental health services through research

In rapidly changing health care environments, existing mental health and other service systems have great opportunities to improve the degree to which people with mental illnesses seek and find help, receive high quality care, and maximize functioning within the community. At all levels and across multiple sectors, leverage points exist to optimize the current standard of care by employing existing data collection systems to identify strategies for improving accessibility, continuity, quality, equity, and value of mental health services in diverse populations. Local innovations may show promise for improving system outcomes, but if understudied, may not have sufficient evidence to understand mechanism of change, to more broadly generalize, or to meaningfully inform potential for wider scale-up efforts. Given the link between mental health care financing and receipt of care, particularly for children and adolescents with developmental precursors of mental illnesses and people with serious mental illnesses, NIMH considers research on the impact of various strategies for providing and paying for care as vital for public and commercial (i.e., private) health systems to determine value.

Research Priorities

  1. Employ existing real-world data collection systems to identify strategies for improving access, quality, and equity of mental health services in diverse populations.

    Priority areas include:

    1. Researching and developing performance feedback systems and quality improvement processes, which can be utilized across a range of systems (e.g., primary care, schools, criminal justice system, child welfare agencies, long term care facilities, geriatric service programs) throughout the developmental lifespan from childhood into old age, to understand and leverage mechanisms of change associated with feedback used in these systems to ultimately optimize the delivery of effective mental health interventions.
    2. Developing pragmatic, valid, and reliable measures of intervention fidelity, quality, and outcomes that can be applied at the person, clinic, system, and/or population levels.
    3. Applying computational modeling and data analytics to electronic health records (EHRs), claims data, and data from other sources to study mental health service use, delivery, quality, and outcomes; to predict low base rate events (e.g., suicide behaviors); and, to identify high-impact targets for services interventions.

  2. Identify, validate, and scale-up innovative programs currently in use that improve mental health services for underserved populations.

    Priority areas include:

    1. Studying innovative and practical approaches to reduce empirically documented disparities in care access, quality, and outcomes for racial and ethnic minority groups, sexual and gender minorities, individuals living in rural areas, socioeconomically disadvantaged persons, and other underserved groups.
    2. Identifying and interrogating mutable factors which impede or facilitate the delivery and sustainability of care in highly generalizable delivery systems serving populations in need. 
    3. Conducting research to better understand, predict, and reduce mental health workforce shortages, especially shortages in mental health providers for pediatric and geriatric populations.

  3. Optimize financing models for adults and children with serious mental illnesses to provide efficient and effective care in public and private health care systems.

    Priority areas include:

    1. Investigating alternative financing mechanisms that promote high quality, clinically effective, and efficient community-based care for adults with serious mental illnesses and children with serious emotional disturbance; and that discourage low-value services.
    2. Optimizing financing mechanisms to provide integrated care packages that include personalized evidence-based services (such as pharmacological treatment and psychotherapy) for people with serious mental illnesses.
    3. Studying the impact of national, state, provincial, or other health care system rules and regulations on participation in provider reimbursement and/or waiver programs in populations that include youth with developmental precursors of mental illnesses and people with serious mental illnesses.