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

 描述（由申请人提供）：严重精神疾病（SMI）患者是美国最脆弱的人群之一，经历了显着的过早死亡率，高并发症慢性疾病的发病率，以及失业和无家可归等负面社会后果。这一人群每年给社会造成的损失估计为3，170亿美元，重度精神疾病患者是社会保障残疾受益人中人数最多、增长最快的亚组。NIMH的战略计划、医学研究所和SAMHSA都强调将降低重度精神障碍患者的死亡率作为优先事项。尽管这一群体对医疗保健和社会服务的需求很高，但大多数重度精神障碍患者没有得到与指南一致的身体或行为医疗保健或循证社会服务，如支持就业。 这个重新提交申请NIMH K01指导的研究科学家发展奖寻求支持在公共卫生的约翰霍普金斯布隆伯格学院的新助理教授谁渴望职业生涯专注于改善健康和社会成果的人与SMI通过增加摄取和持续提供循证医疗保健和社会服务，为这一群体在不同的环境。McGinty博士的博士工作和先前的研究集中在SMI患者的护理质量和刑事司法问题上。她的直接职业目标是：1）获得所需的知识和技能，以评估组织和提供者层面的因素，促进和阻碍为SMI提供循证医疗保健和社会服务;和2）获得所需的知识和技能，以评估战略，以协调为SMI患者提供身体，行为和社会服务。 通过这个K01，麦金蒂博士将获得医疗保健提供系统和新的知识和技能，在实施研究，特别是在定性研究和多层次建模的新技能的增强理解。拟议的研究将采用混合方法，研究在马里兰州医疗补助健康之家计划的背景下，为重度精神障碍患者实施循证医疗保健和社会服务。健康之家的实施要求交付组织和提供者从根本上改变他们的使命，从仅仅在他们的专业领域提供护理，到为SMI的"整个人"提供综合医疗保健。协调这些分散的服务提出了一系列的实施挑战，使其至关重要的是，在这种情况下，研究的摄入量和持续提供基于证据的服务，为重度精神障碍患者。通过提供工资支持，培训，免于行政责任和正式的导师结构，该奖项将促进McGinty博士过渡到独立的研究职业生涯，专注于改善SMI患者的健康和社会成果。

 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.