Priorities for Strategy 4.4
Updated: January 2019
Develop new capacity for research that evaluates the public health impact of mental health services innovations
The public health impact of services innovations can be measured by examining the reach and effect of those interventions in target populations. Innovations in team-based care, system integration, registry tracking and decision support, data aggregation, and financing models necessitate new ways of defining populations. For example, service delivery using social networking and other new and unconventional platforms can exponentially expand the reach of services to the general population and populations who would otherwise not be identified. These innovations provide multiple leverage points to encourage adoption, implementation, and quality improvement of preventive, treatment, and services interventions across multiple settings providing mental health care to ultimately improve outcomes and strengthen public health impact.
NIMH recognizes that the next generation of investigations will require a range of platforms to study the population epidemiology and clinical epidemiology of mental illnesses, quality of care, practice variations, and the impact of new innovations on access, efficiency, clinical outcomes and epidemiologic indicators. Moreover, the field needs better research designs, measures, and statistical approaches to support testing of system improvement efforts and to facilitate analyses of complex streams of data. Achieving high-impact public health research demands new training models that embrace the emerging digital enterprise, including advanced information and communication technologies, and assessment and analytic strategies for complex data. Therefore, NIMH encourages applications to develop and validate tools and platforms to conduct robust, rigorous, and efficient practice-based research and foster better integration of research methods and measures within multiple service systems and community settings, to promote ongoing care improvement.
Furthermore, NIMH strongly encourages investigators to collaborate with public and private stakeholders responsible for surveilling and incentivizing high quality mental health service access and delivery. Such stakeholders include but are not limited to: federal agencies (e.g., Substance Abuse and Mental Health Services Administration, the Health Resources and Services Administration, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, and the Social Security Administration); accrediting and licensing organizations (e.g., Joint Commission, National Committee for Quality Assurance, guild and professional organizations); and, the various stakeholders responsible for developing, implementing, tracking, and incentivizing use of quality of care metrics and workflows, such as developers and vendors of electronic health records.
- Develop assessment platforms within service systems that allow ongoing monitoring of mental illness prevalence, service access, quality, efficiency of care, and outcomes for people with mental illnesses.
Priority areas include:
- Examining mental illness prevalence, service use, treatment response, and relapse, via data from large, diverse, and representative population samples or practice-based research networks.
- Monitoring real-time trends in suicidal behavior and promoting effective data-driven planning to improve detection and prevention of suicide.
- Linking multiple sources of information (e.g., electronic health records, epidemiologic surveys, administrative claims data) to yield more textured information about clinical samples, health/community service resources, and health practices which may influence the overall health of the population represented.
- Develop valid and reliable measures of treatment quality and outcomes that can be feasibly applied at the person, clinic, system, and population levels.
Priority areas include:
- Developing, refining, or applying new methodological approaches for the analysis of complex and dynamic systems affecting mental health outcomes, with the goal of demonstrating the impact of such factors on client outcomes.
- Designing or validating instruments to measure dissemination, implementation, or sustainability processes in diverse settings; to measure changes in consumer functioning, provider practice, or metrics of population health; or, to assess organizational or systems processes and environments.