Improving Evidence-based Behavioral, Somatic and Social Service Delivery for SMI

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 DESCRIPTION (provided by applicant): Persons with serious mental illness (SMI) are one of the most vulnerable populations in the US, experiencing significant premature mortality, high rates of co-morbid chronic conditions, and negative social outcomes such as unemployment and homelessness. This population costs society an estimated $317 billion per year, and persons with SMI are the largest and fastest growing subgroup of social security disability beneficiaries. NIMH's Strategic Plan, the Institute of Medicine and SAMHSA all emphasize decreasing mortality for persons with SMI as priorities. Despite the high need for healthcare and social services in this group, most persons with SMI do not receive guideline-concordant somatic or behavioral healthcare or evidence-based social services, such as supported employment. This resubmission application for a NIMH K01 mentored research scientist development award seeks support for a new Assistant Professor at the Johns Hopkins Bloomberg School of Public Health who aspires to a career focused on improving health and social outcomes for persons with SMI by increasing uptake and sustained delivery of evidence-based healthcare and social services for this group in diverse settings. Dr. McGinty's doctoral work and prior research has focused on quality of care and criminal justice issues in persons with SMI. Her immediate career objectives are to: 1) Gain the knowledge and skills needed to assess organization and provider-level factors that facilitate and impede delivery of evidence-based healthcare and social services for SMI; and 2) Gain the knowledge and skills needed to evaluate strategies to coordinate delivery of somatic, behavioral, and social services for persons with SMI. Through this K01, Dr. McGinty will gain enhanced understanding of healthcare delivery systems and new knowledge and skills in implementation research, specifically new skills in qualitative research and multilevel modeling. The proposed research will employ mixed methods to study implementation of evidence- based healthcare and social services for persons with SMI in the context of the Medicaid health homes program in Maryland. Health home implementation requires delivery organizations and providers to fundamentally shift their missions away from solely providing care within their specialty areas to providing integrated healthcare for the "whole person" with SMI. Coordinating these fragmented services presents a host of implementation challenges, making it critically important to study uptake and sustained delivery of evidence-based services for persons with SMI in this context. By providing salary support, training, freedom from administrative responsibilities, and a formal mentorship structure, this award will facilitate Dr. McGinty's transition to an independent research career focused on improving health and social outcomes among persons with SMI.