Outreach Partnership Program 2018 Annual Meeting: Overview
In July, the National Institute of Mental Health (NIMH) convened representatives from state and national mental health organizations for the 2018 annual meeting of the NIMH Outreach Partnership Program (OPP). The gathering provided an opportunity for the Program’s Outreach Partners, heralding from every state, the District of Columbia, and Puerto Rico, and National Partners to hear updates from NIMH leadership, to learn about NIMH-supported research, and to discuss the mental health needs of their constituents with NIMH staff and their fellow Partners.
Dr. Gordon delivers opening remarks. Source: NIMH
In his opening address, NIMH Director Joshua Gordon, M.D., Ph.D., provided Partners with updates about NIMH activities and research priorities. Highlights included an overview of Institute efforts in the areas of suicide prevention research, understanding and addressing schizophrenia and psychosis, and big data in mental health research and precision medicine. Dr. Gordon thanked the Partners for their continued support of NIMH and NIH, sharing the specific example of the Partner’s efforts to promote the All of Us Research Program. This big-data study aims to recruit one million adult volunteers to share a variety of data, including electronic health records, health and family medical histories, and biological samples to support research and uncover paths to the delivery of precision medicine.
Genetic Links to Mental Illness
Dr. State delivers presentation on genetics and mental illness.
In the first talk of the meeting, Mathew W. State, M.D., Ph.D., from the University of California, San Francisco, provided an overview of the dramatic progress that has been made in the last decade in understanding genetic contributions to mental illness. Dr. State discussed the role of spontaneous and inherited mutations on the development of mental illnesses and described how the commonality of a genetic variation impacts risk (common variations in the genetic code contribute to a low risk for disease while rare mutations contribute to a high risk for disease). Even though this research has come a long way, Dr. State noted that, in mental illness, genetic risk is not fate. While current clinical applications of the findings are limited, they lay the groundwork for further study of the biology of illness, which may lead to the development of targeted therapeutics.
Collaborative Care for Primary Care Settings
Dr. Kern shares the collaborative care model.
John Kern, M.D., of the Advancing Integrated Mental Health Solutions (AIMS) Center at the University of Washington (UW), gave the second talk of the meeting, in which he described the psychiatric collaborative care model. Collaborative care is an integrated, team-based approach, which is implemented in primary care settings. It has been tested in more than 80 randomized controlled trials and has been shown to be more effective than usual care for treating depression and anxiety. The model allows for less severe mental illnesses to be treated in a primary care setting, reserving limited specialty mental health care resources to treat the more severe cases. The collaborative care model, according to Dr. Kern, can serve as a potential solution to the nationwide shortage of psychiatrists and the insufficient identification and treatment of common mental health conditions.
Mobile Health and the Future of Mental Health Care
Dr. Ben-Zeev talks with Outreach Partners, Tom Lane with NAMI Washington and Kate Farinholt with NAMI Maryland.
The third talk of the meeting focused on the work of Dror Ben-Zeev, Ph.D. from the UW mHealth for Mental Health Program. Dr. Ben-Zeev shared examples from his research developing and testing mobile-phone-based interventions designed to improve access to care for individuals with serious mental illness. He described positive outcomes from several NIMH-funded studies that tested mobile-phone applications designed to help patients connect with care providers, engage in skills training, access medication-related information, and cope with symptoms. Dr. Ben-Zeev concluded by describing his current research using a smartphone application that collects passive sensor data to understand behavior patterns—and ultimately prevent relapse— in patients with schizophrenia who have been discharged from the hospital. Although the applications Dr. Ben-Zeev discussed in his talk are not available for use yet, this research points to the transformative role that technology will play in making mental health care more accessible in the future.
Panel members address questions during discussion on school-based mental health programs.
In the meeting’s final session, Partners heard from panelists who discussed research and community approaches to addressing mental illnesses in school settings. Marc Atkins, Ph.D., from the University of Illinois, Chicago, described his work developing and testing a mental health service model called Links to Learning (L2L). This model features interventions targeting disruptive behavior and behaviors that promote effective learning. The interventions are incorporated into the environments where kids spend most of their time—the classroom and the home. A randomized controlled trial conducted in six high poverty Chicago public elementary schools found positive results from the L2L model, showing it improved academic engagement and reduced disruptive behavior compared with services as usual. The findings suggest the potential mental health benefits of leveraging intervention resources within the classroom and home environments and for increasing parent, teacher, and child engagement in learning as part of mental health management.
Holly C. Wilcox, Ph.D., from Johns Hopkins University, described a universal, school-based intervention that addresses adolescent depression—the Adolescent Depression Awareness Program (ADAP). ADAP seeks to encourage depressed youth to seek treatment by providing them information about recognizing, managing, and preventing depression. Dr. Wilcox shared the results of an NIMH funded study showing that ADAP significantly increased depression literacy and increased treatment-seeking behavior. Marcie Gibbons, a social worker at a Maryland high school, shared her real-world experiences implementing the program, where it has been integrated into the school’s health class. Both presenters shared how the program shows promise for reaching students with depression and how integration into school curriculums supports the implementation and sustainability of this program.
The final panelist, Sarah Davidon, Ed.D., with Mental Health Colorado (MHC) and the NIMH Outreach Partner in Colorado, described the School Mental Health Toolkit, which MHC recently developed as a result of community conversations about the need to address mental health in Colorado schools. The Toolkit provides information about best practices related to implementing, funding, and sustaining mental health services in schools. As such, the Toolkit can serve as a guide for community members, schools, local leaders, and districts who wish to incorporate mental health services into their schools. Dr. Davidon shared how MHC is conducting extensive outreach to promote the Toolkit to communities by engaging statewide mental health partners, developing a grassroots advocacy network, and implementing pilot activities in several local school districts.
Partner Sharing and Dialogue
Zima Creason, with Mental Health America California comments during visioning session.
During three Partner sharing sessions, Outreach and National Partners and representatives of federal agencies presented posters describing their outreach activities addressing mental health in diverse populations (including youth, families, and older adults) and settings (such as criminal justice, workplaces, and schools). Meeting participants expressed appreciation for the opportunity to learn how other Partners are spreading awareness and educating the public about mental health in their states.
In addition to hearing about research efforts, the meeting offered several opportunities for the Partners to engage in a dialogue with each other—and with NIMH leadership—about their outreach efforts and community needs. In a visioning session, Partners learned about the tools and resources available for sharing NIMH research and then offered ideas for improving and broadening NIMH outreach and communication efforts with Institute Director Dr. Gordon.
Partner Sharing Session
To close out the meeting, Partners gathered in roundtable discussions and shared their takeaways from the presentations they had heard, how they would disseminate what they learned to their constituents, and ways they could expand their local outreach efforts to engage with new audiences.
In closing, the meeting provided a valuable forum for dialogue between NIMH leadership and its stakeholders about Institute activities and an opportunity for those stakeholders to hear about NIMH-supported research that helps transform the understanding and treatment of mental illnesses and the delivery of mental health services.