CORE--PRINCIPAL RESEARCH

改善社会服务中精神卫生保健研究中心(C-RIMMS)的主要研究核心(PRC)将支持研究议程的产生、实施和成熟，以解决当前卫生政策中最紧迫的问题：精神卫生保健质量、弱势群体的质量，以及通过具有最大潜力减少种族和民族差异的环境来提高质量。我们的实践和系统研究将与社会服务机构合作进行，在社会服务机构中，精神障碍的发生率很高，最脆弱的客户占主导地位。五个拟议的试点 研究将涉及三个目标：(1)从关键利益攸关方的角度了解社会服务中精神障碍护理质量的构成；(2)在相互竞争的需求的背景下，评估护理质量的实践差异，并确定提供者、服务对象和系统生态结构对这种差异的影响；以及(3)努力“从战壕到板凳，再回到战壕”，制定和测试社会服务机构心理健康护理的质量改进菜单。由多学科团队领导，每个试点研究 将使用业务核心的资源，按顺序或同时采用混合方法，受益于研究网络开发核心中建立的机构伙伴关系和利益攸关方网络，并由研究方法核心中的方法小组提供信息。所有试点将导致NIMH R01、R03、R21和R34拨款提案。纳入来自特定背景的客户和背景(即付款人、管理者、一线提供者、消费者、家庭成员、精神健康倡导者)的“本地知识”将指导我们努力制定可接受和持久的质量改进。利用社交服务设置来接触和 治疗精神障碍患者很有可能确保对目前未被发现的精神障碍患者进行治疗，改善对那些目前服务不佳的人的护理，并减少护理方面的差距。这一议程高度响应了总统关于精神健康的新自由委员会报告、国际移民组织的护理质量报告、卫生局局长的报告以及衔接科学和服务报告中反映的优先事项。

The Principal Research Core (PRC) of the Center for Research to Improve Mental Health Care in the Social Services (C-RIMMS) will support the generation, implementation, and maturation of a research agenda that addresses the most pressing issues in current health policy: quality of mental health care, quality for vulnerable populations, and quality improvement through settings with the highest potential to reduce racial and ethnic disparities. Our practice and systems research will be conducted in partnership with social service agencies, where prevalence of mental disorder is high and the most vulnerable of clients predominate. Five proposed pilot studies will address three aims: (1) understand what constitutes quality of care for mental disorders in the social services from the perspective of key stakeholders; (2) within the context of competing demands, assess practice variation in quality of care and identify provider, client, and system ecostructure influences (including financing) on that variation; and (3) working "trench to bench and back to trench," develop and test a menu of quality improvements for mental health care in social service agencies. Led by muttidisciplinary teams, each pilot study will use resources of the Operations Core, employ mixed methods in sequence or concurrently, benefit from agency partnerships and stakeholder networks developed in the Research Network Development Core, and be informed by methods teams in the Research Methods Core. All pilots will lead to NIMH R01, R03, R21, and R34 grant proposals. The incorporation of"local knowledge" from setting-specific clients and contexts (i.e., payers, administrators, front-line providers, consumers, family members, mental health advocates) will guide our efforts to develop acceptable and durable quality improvements. Leveraging social service settings to reach and treat persons with mental disorder has high potential to ensure treatment to persons whose disorder currently goes undetected, to improve care for those now poorly served, and to reduce disparities in care. This agenda is highly responsive to priorities reflected in the President's New Freedom Commission Report on Mental Health, IOM Quality of Care, Surgeon General's and Bridging Science and Services reports.