A Practice-Based Research Network to Transform Mental Health Care: Science, Service Delivery & Sustainability

Presenter:

Michael C. Freed, Ph.D.
Division of Services and Intervention Research

Goal:

The goal of this initiative is to support a practice-based research network to transform the development, delivery, and sustainability of evidence-based mental health practices and services.

Through a research consortium embedded within large integrated healthcare delivery systems and serving a representative population, this network would result in a continuously learning healthcare system as defined by the Institute of Medicine, to create “a continuous cycle or feedback loop in which scientific evidence informs clinical practice while data gathered from clinical practice and administrative sources inform scientific investigation.” 

Rationale:

Embedding research questions and strategies for addressing those questions into healthcare practice increases the likelihood that the findings would be practice-relevant. Leveraging practice-based networks as platforms for launching large-scale, comparative effectiveness trials offers an efficient alternative to individual de novo trials. Demonstrable capacities and efficiencies are needed to:

1. Identify, recruit and enroll large patient populations into effectiveness and pragmatic trials that align to NIMH priorities
2. Harmonize electronic medical record (EMR) data across multiple integrated systems for research use, to include EMR phenotyping
3. Collect, store, and analyze biologic material
4. Provide rapid responses to address urgent questions from NIMH leadership and stakeholders (e.g., questions related to the clinical epidemiology of mental disorders and/or questions related to the uptake of and outcomes associated with mental health interventions and best practices);
5. Study low base-rate events (e.g., suicide and/or autism spectrum disorders)
6. Improve disparities in mental health status, service utilization, and treatment outcomes
7. Develop strategies using implementation science to secure stakeholder commitment to adopt, implement, and sustain best practices at the patient and health system levels 

This network would embody the research-practice partnership central to a continuously learning healthcare system and serve as a research laboratory to improve mental health outcomes by generating the evidence base that healthcare system decision-makers need. In turn, the healthcare system would drive the research questions based on urgent practice priorities. Studies conducted would be pragmatic, incorporating stakeholder perspectives and characteristics. Effective solutions would be feasible, scalable, adoptable, and sustainable, and could ultimately improve routine mental health services.