NIMH Explores the “Next Big Thing” in Mental Health Services Research

November 8, 2018 • Institute Update

What’s the “next big thing” that could help people with mental illnesses get the treatment and services they need? This important question was the theme of the National Institute of Mental Health (NIMH)’s 24th biennial Mental Health Services Research (MHSR 2018) conference held August 1-2, in Rockville, MD.

“This conference brings together mental health researchers and other experts, trainees, consumers, advocates, and mental health care providers to learn about current research findings and discuss new research that might close the gap between what science shows is most effective and what services people actually receive in real-world settings,” explained Michael Freed, Ph.D., EMT-B., a conference co-chair. “We are thrilled that this year the conference had more presentation proposals, more sessions, and more attendees than ever before. There is clearly a lot of interest in this research.”

Health services research is a multidisciplinary scientific field that examines how to improve people’s access to health care providers and services; how to improve the quality, continuity, and equity of the care they receive; how to most efficiently pay for needed health care; and ultimately, how to improve the symptoms and functioning of people with health conditions. The research considers individual and provider preferences and behavior, innovations in technology, and community, organizational, and systems-level factors to understand how to implement effective practices in care-delivery settings.

In his opening address, Dr. Freed acknowledged the participants’ passion and ongoing contributions to mental health services research and challenged them to use the meeting to generate new research ideas. In a pre-recorded welcoming address, NIMH Director Joshua Gordon, M.D., Ph.D., noted that, “Research doesn’t stop with the discovery of a new treatment, because even the best treatment won’t work if people can’t or won’t use it. We also need research to figure out how best to deliver effective therapies and services to those who need it now.”

Judge Leifman presenting the keynote address at the 24th MHSR conference.

The wide range of conference topics reflected the realities of mental health delivery today. Judge Steve Leifman, J.D., Administrative Judge for the Eleventh Circuit Court of Florida, delivered a compelling keynote address, noting that people with mental illnesses are more likely to be in jail—where mental health treatment is typically not available—than in a mental health facility. The key to addressing this problem is to make mental health care more easily available to those who have difficulty obtaining it, and he described his long-time efforts to do just that. Judge Leifman’s advocacy work in Miami-Dade County created an opportunity for the criminal justice system there to divert low-level offenders with mental illnesses to treatment and social services rather than to incarceration. The goal is to reduce psychiatric symptoms in order to break the cycle of repeat arrests and to provide services that lead to community reintegration and stability. This approach has significantly decreased the number of arrests and repeat incarcerations of people with mental illnesses, as well as the overall jail population in the county.

Jürgen Unützer, M.D., M.P.A., M.A., professor and chair of the Department of Psychiatry and Behavioral Health at the University of Washington, delivered the inaugural Wayne Katon Memorial Lecture.Dr. Katon was an accomplished mental health services researcher, teacher, and mentor whose research established the collaborative care approach as an effective intervention in psychiatry).

Jürgen Unützer delivering the inaugural Wayne Katon Memorial Lecture at the 24th MHSR conference.

In his address, Dr. Unützer described the robust body of research supporting the effectiveness of collaborative care, in which primary care physicians actively collaborate with mental health care managers and psychiatric treatment specialists to provide comprehensive patient care. With provider training, he explained, treatment for less severe mental health concerns can be delivered in the primary care setting while patients needing more intensive treatment can be referred to contacts working in mental health specialty settings. He discussed how this approach could address provider shortages and reduce the long wait-times often faced by people seeking mental health care. Dr. Unützer also reviewed the possible—but addressable—challenges to wide-spread adoption of collaborative care and underscored the approach’s potential for broadly improving mental health treatment outcomes.

Two plenary sessions of the conference were directly focused on this year’s theme—what are our visions of “The Next Big Thing” in mental health services and research. Talks in these sessions focused on a wide range of topics including how electronic health records and health information exchanges can be used advantageously in both research and care delivery; research and practice considerations in the use of telehealth platforms; the promise of practice-based research networks; and, the use of learning health networks for improving services for those with severe mental illnesses.

Dr. Michael Freed introducing presenters in one of the sessions focused on the “Next Big Thing" in mental health services research at the 24th MHSR conference.

As in prior years, the conference also provided career development opportunities for a competitively selected group of Early Stage Investigators (ESIs). Thirty ESIs presented posters at the main conference and attended a post-conference New Investigators Workshop. During the workshop, experts from NIMH and academia gave presentations on developing a career in mental health services research and on navigating the process of NIMH grant submissions. ESIs also met with these experts to receive feedback to refine their ideas for future grant applications.

“Thanks to the presenters and attendees, the meeting exceeded our expectations in exploring ideas for new research directions,” stated Denise Juliano-Bult, M.S.W., a meeting co-chair. “The quality of the presentations and panels was outstanding, and it was not only the biggest conference to date but included some of the most visionary sessions we’ve heard. Ultimately, we hope that MHSR 2018 will enable the synthesis of ideas from a broad range of perspectives that can inform the development of future NIMH services research priorities.”

The meeting agenda with links to the video recordings of the presentations are available on the NIMH website.