Opportunities in mental health services research.

Initiation and Use of Public Mental Health Services by Persons With Severe Mental Illness and Limited English Proficiency

A Prospective Examination of Service Use by Abused and Neglected Children Followed Up Into Adulthood

Ethnic Disparities in Antipsychotic Drug Use in British Columbia: A Cross-Sectional Retrospective Study

Project Liberty: New York's Crisis Counseling Program Created in the Aftermath of September 11, 2001

Focus on Transformation: A Public Health Model of Mental Health for the 21st Century

Back to table of contents Previous article Next article Government NewsFull AccessCongress Boosts Budget For MH Research, TreatmentChristine LehmannChristine LehmannSearch for more papers by this authorPublished Online:1 Feb 2002https://doi.org/10.1176/pn.37.3.0002In December Congress approved a 15 percent increase in funding for the National Institutes of Health (NIH), which will allow it to continue expanding its research portfolio in Fiscal 2002. President George W. Bush immediately signed the federal spending measure into law.The increase of nearly $3 billion—which gives NIH a total budget of $23 billion—drew praise from APA and other members of the Mental Health Liaison Group for being nearly half a billion dollars more than what Bush and the House of Representatives had recommendedRoughly 1 percent of that increase is slated for non-NIH activities, leaving the NIH with a funding increase of 14 percent, according to Lizbet Boroughs, an associate director of the APA Division of Government Relations.The Mental Health Liaison Group and the Ad Hoc Group on Research Funding, of which APA is also a member, have advocated each year for specific increases in the NIH budget with the goal of doubling the total budget over a five-year period ending next fiscal year. The Ad Hoc Group on Research Funding was successful in obtaining increases of 15 percent in FY 1999 and FY 2000 and 14 percent in FY 2001 and FY 2002.The Senate typically passes higher increases for NIH than does the House. The conference agreement reflects the average between the two bodies’ recommendations. In 2001 the Senate passed an increase for NIH of 16.5 percent, for which the Ad Hoc Group on Research Funding had advocated, but the House passed the president’s requested increase of 13.5 percent; the difference was split in conference.Similar budget compromises were reached last December for the three institutes involved in mental health and addictive disorders. The budget for the National Institute of Mental Health (NIMH) was increased 13 percent, for a total of $1.249 billion; the budget for the National Institute on Drug Abuse (NIDA) was increased 12 percent, for a total of $888 million; and the budget for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) was increased by 12 percent, for a total of $384 million, according to the final conference agreement. Last year’s increases were 14 percent for NIMH and NIDA, and 16 percent for NIAAA.Jeremy Lazarus, M.D., chair of APA’s Joint Commission on Government Relations, commented to Psychiatric News, “We are pleased with the substantial increases for these institutes and mental health and substance abuse treatment and prevention. Congress is increasingly aware of the importance of research and treatment of those with mental illness or substance abuse. We applaud their approval of the increases that will advance research and treatment of our patients.”As the Senate and House began the appropriations process last spring, members of APA’s Academic Consortium visited key representatives and aides on Capitol Hill (Psychiatric News, May 4, 2001) to convey the message that medical research can significantly improve people’s lives.“Patient advocates described to congressional aides how they have benefited from the newer medications,” said Boroughs. “A veteran with schizophrenia said he went from being homeless and in and out of hospitals to working part time and living independently.”The budget for the Substance Abuse and Mental Health Services Administration (SAMHSA) was increased by roughly 6 percent, to $3.138 billion for FY 2002. The FY 2002 budget for the Center for Mental Health Services (CMHS), which is part of SAMHSA, is $832 million, representing an increase of 6 percent. Specific programs within CMHS were also increased:• The Mental Health Block Grant, which is administered by the states to fund programs serving people with severe mental illnesses and children with severe emotional disturbances.• The Projects for Assistance in Transition From Homelessness (known as PATH), which is another state-administered grant program to fund community-based services for homeless individuals with mental illness.• Programs of Regional and National Significance, which include funding for new national initiatives. These include the jail-diversion program that would fund treatment and community supports for nonviolent criminal offenders with severe mental illnesses, research and treatment of youth with posttraumatic stress disorder, the development of model suicide-prevention programs, mental health counseling of public safety workers, and mental health education and services to senior citizens.• The Children’s Mental Health Program, which grants funding to states to provide community-based services to children with serious emotional disorders.• The Youth Violence Prevention Program, which funds state efforts to reduce school-based violence through early intervention and treatment.Congress approved a 5 percent increase for the Center for Substance Abuse Treatment within SAMHSA, for a total FY 2002 budget of $2.017 billion. The Center for Substance Abuse Prevention had a budget increase of 13 percent, for a budget of $198 million. ▪ ISSUES NewArchived

Information about mental health systems is essential for mental health planning to reduce the burden of neuropsychiatric disorders. Unfortunately, many low- and middle-income countries lack systematic information on their mental health systems. The objectives, scope, structure, and contents of mental health assessment and monitoring instruments commonly used in high-income countries may not be appropriate for use in middle- and low-income countries. The World Health Organization (WHO) has recently developed the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS), a comprehensive assessment tool for mental health systems designed for middle- and low-income countries. WHO-AIMS was developed through an iterative process that included input from in-country and international experts on the clarity, content, validity, and feasibility of the instrument, as well as a pilot trial. The resulting instrument, WHO-AIMS 2.2, consists of six domains: policy and legislative framework, mental health services, mental health in primary care, human resources, public information and links with other sectors, and monitoring and research. These domains address the ten recommendations of the World Health Report 2001 through 28 facets and 155 items. All six domains need to be assessed to form a basic, yet broad, picture of a mental health system, with a focus on health sector activities. WHO-AIMS provides essential information for mental health policy and service delivery. Countries will be able to develop information-based mental health policy and plans with clear baseline information and targets. Moreover, they will be able to monitor progress in implementing reform policies, providing community services, and involving consumers, families, and other stakeholders in mental health promotion, prevention, care and rehabilitation. This article provides an overview of the rationale, development process, and potential uses and benefits of WHO-AIMS.

The Impact of Mental Illness Status on the Length of Jail Detention and the Legal Mechanism of Jail Release

Medicaid Enrollment and Mental Health Service Use Following Release of Jail Detainees With Severe Mental Illness

The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study

In April 2003 the Alberta government integrated specialized mental health services, formerly organized independently, with the health regions, which are responsible for general health services. The objective of this article is to determine whether the transfer was associated with an increase or decrease in the share of resources in the region allocated to mental health care relative to total spending for health care. The measure of the share for mental health care is the total costs for mental health care resources as a percentage of total health care spending. Resources and spending examined were those that were actually or potentially under the regions' control. Annual costs for mental health services in the province were obtained for a seven-year period (fiscal year [FY] 2000 through FY 2006) from provincial utilization records for all residents in the province. Unit costs were assigned to each visit. The trend in the share measure was plotted for each year. The share for mental health care increased overall from FY 2000 (7.6%) to FY 2003 (8.2%), but returned to pre-FY 2003 levels in the three years after the transfer (7.6%). Despite concerns expressed before the transfer by federal and provincial reports over the level of expenditures devoted to mental health care, the integration of mental health services with other health services did not result in an increase of the share for mental health care.

Building on growing interest in translational research, this paper provides an overview of a special issue of Administration and Policy in Mental Health and Mental Health Service Research, which is focused on the process of forging and sustaining partnerships to support child mental health prevention and services research. We propose that partnership-focused research is a subdiscipline of translational research which requires additional research to better refine the theoretical framework and the core principles that will guide future research and training efforts. We summarize some of the major themes across the eight original articles and three commentaries included in the special issue. By advancing the science of partnership-focused research we will be able to bridge the gap between child mental health prevention and services research and practice.

County-Level Estimates of Need for Mental Health Professionals in the United States

This study examined the relationship of age and gender with risk of arrest among adolescents and young adults who were intensive adolescent users of public mental health services. Data were obtained from the Massachusetts Department of Mental Health (DMH) and juvenile and criminal courts. Participants were youths receiving DMH adolescent case management services sometime in 1994-1996 who were born between 1976 and 1979 (781 males and 738 females). They were cross-matched to document arrests between age seven and 25. The study examined age at first arrest, age-specific risk, and the relationship between arrest history and arrest risk by gender and age. Most males (69%) and almost half the females (46%) were arrested by age 25. First arrest was most common before age 18. As in the general population, males' arrest patterns were more concerning than those of females, although patterns were of concern in both groups. Most female arrestees had multiple arrests, many as adults. No gender differences were observed for several factors, including risk of first arrest over age 18. Risk was far greater for those arrested in the previous year than for those never arrested. Findings justify concerns of public mental health systems regarding justice system involvement of adolescent clients. Risk of first arrest was significant from early adolescence through age 24, indicating a need for arrest prevention into young adulthood. The heightened arrest risk at all ages among those who were recently arrested demarcates a population in need of immediate intervention.

Issues in Medicaid Policy and System Transformation: Recommendations From the President's Commission