Research and Evaluation Projects
The work of the Division of Psychiatric Services Research (DPSR) faculty members is supported by a range of federal, state, and private funding sources. Faculty members actively collaborate with Centers and Divisions within the Department; other Schools within University of Maryland, Baltimore; and the VA Maryland Health Care System. DPSR has maintained a portfolio of funded research and evaluation projects with a total annual budget of approximately $7 million.
Improving Health and Recovery Outcomes for Individuals Living with Serious Mental Illness
DPSR faculty are national experts in developing and testing interventions to improve health, enhance community functioning, support mental health recovery, and improve mental health policy for individuals living with serious mental illness. DPSR faculty and affiliated faculty study ways to help individuals with SMI quit smoking, reduce substance use, manage chronic medical illness, use psychiatric medications effectively, improve sleep, and manage chronic pain.
Improving the Delivery of Psychiatric Services in Community Practice
In many communities, evidence-based mental health treatment services are lacking. DPSR faculty study ways to improve service delivery and make effective interventions available in community mental health treatment settings.
Example: There is a national shortage of psychiatrists. This limits access to behavioral health treatments, including medications, for many people with mental illnesses. Nurse practitioners are permitted to prescribe medications in all U.S. states; however, restrictions on practices (such as requiring supervision) vary by state.
Dr. Julie Kreyenbuhl is leading a project funded by the National Institute of Mental Health that is using nationwide Medicaid and Medicare data to compare the quality and outcomes of prescribing of behavioral health medications between nurse practitioners and physicians, and by nurse practitioners in states that do and do not place restrictions on their prescribing practices. The results of this study will inform the policy debate surrounding the expansion of nurse practitioners’ scopes of practice as one approach to addressing the significant psychiatrist-prescriber workforce shortage. This study illustrates one way in which DPSR research may help to improve mental health service delivery throughout the country.
Evaluating Innovative Mental Health Treatment Programs
DPSR partners with state and local stakeholders to evaluate mental health services. This helps stakeholders make decisions about larger-scale dissemination of mental health services and programs.
Example: Throughout Maryland, individuals with lived experience of mental illness, called Peer Recovery Coaches, are working in hospital emergency departments to help people experiencing drug problems to engage in treatment. Our Systems Evaluation Center, led by Drs. Howard Goldman and Diana Seybolt, collaborated with the Maryland Department of Health/Behavioral Health Administration, Behavioral Health System Baltimore, and Mosaic Group to conduct an evaluation of the state’s Hospital-Based Peer Support Intervention.
This project involved interviews with Peer Recovery Coaches, emergency department staff, hospital administrators, and state leadership to identify successful implementation processes, challenges encountered, strategies developed, and lessons learned. This study illustrates the evaluation work that is done within DPSR that will help to improve the mental health and substance use disorder services provided throughout the state.
Implementation Research
DPSR faculty examine ways to effectively implement evidenced-based practices within mental health care systems. Work in the Division has led to critical improvements in the quality and effectiveness of mental health care throughout Maryland.
Example: A collaborative team of researchers from DPSR and the University of Kentucky Medical School is funded by the Substance Abuse Mental Health Services Administration to integrate HIV and hepatitis screening as well as risk reduction within methadone treatment. The project provides funding to add screening and testing for Hepatitis C, immunization for Hepatitis A and Hepatitis B, risk reduction counseling, and medical referral for both HIV and hepatitis within the Department of Psychiatry’s methadone treatment center.
The project also funds the addition of Trauma Recovery & Empowerment Model treatment groups, developed by colleagues at Community Connections in Washington, DC, to the methadone center. We will be evaluating not only treatment engagement and outcomes, but also participants’ experience with these services. This project will provide critical information on whether this model is effective and worth disseminating to other methadone programs.
Studying Psychiatry Clinical Programs
DPSR faculty partner with the Department’s clinical Divisions to examine the effectiveness of clinical programs and initiatives.
Example: DPSR investigators partner with the Department of Psychiatry Women’s Mental Health Program to develop its Research Core. In turn, questions about the effectiveness of mental health interventions and services co-located with somatic care can be fully answered and used to inform spending and deployment of resources. The Division is a resource that can lead to improvements in the quality and effectiveness of clinical care at UMMC.