Mental Health Services and Policy
The general public and policy makers are increasingly recognizing the burden of mental illness and substance abuse. The alarming statistics of opioid overdose deaths and suicide remind us daily of emotional, social and economic tolls of these conditions. While the expansion of health insurance under the Affordable Care Act has increased access to both prevention and treatment services and expanded supports and services for persons in recovery. Nevertheless, many barriers remain.
Both mental illness and substance abuse remain stigmatized and there are major gender, racial-ethnic, and economic inequities in access, use and quality of services and supports. Many services available are not based on strong empirical evidence and others do not reach quality standards, are too costly, or are not widely accepted by persons at risk for or with mental disorders or substance abuse.
The faculty in the Mental Health Services and Policy Area remain committed to the vision of recovery espoused by the New Freedom Commission as a real possibility and focus their research and practice efforts on finding ways to make this possibility a reality. Faculty members implement their research findings on mental health and behavioral health services and supports in their communities, educational institutions, and employment, both nationally and internationally. Moving beyond specialty mental health or substance abuse sectors, faculty are working to create, study, and disseminate interventions that reduce risk, increase assets and resiliency, provide effective treatment, and aid in long-term recovery.
The faculty members affiliated with this Research Area have diverse research interests, including pre-school and educational programs, community mental health and substance abuse prevention and treatment services for children and adolescents, treatment seeking patterns for children, adolescents, adults, and elderly, public attitudes toward mental illnesses and substance abuse, treatment seeking, pharmaco-epidemiology of psychiatric drugs and psychosocial and behavioral interventions, and economic evaluation of prevention, treatment, and recovery programs, among other areas. The full-time faculty also actively collaborate with other faculty in the Department of Mental Health and in other departments in the Schools of Public Health, Medicine, Nursing, Education, Business, and Arts and Sciences, as well as other academic, local, state, and federal agencies and institutions involved in mental health prevention, treatment and recovery services.
Faculty also participate in the development of community services for patients with serious mental and substance use disorders. There are varied training opportunities through the NIMH-funded Mental Health Services and Systems T32 and related activities. That program, and many of the collaborations, is joint between the Department of Mental Health and the Department of Health Policy and Management. More information can also be found through the Center for Mental Health and Addiction Policy Research, Each faculty member is involved in several projects in which students can gain research experience, both in and outside of the Department of Mental Health. Numerous opportunities are also available for collaboration on scholarly publications in the areas of mental health services.
A major aim of both the 2010 US Affordable Care Act and the 2008 Mental Health Parity legislation was to improve financial access to health care for disadvantaged population groups. We plan to continue evaluating trends in access and utilization of mental health services and trends in inequities in prevention, treatment, and recovery services and supports in future years. .Increasing availability of large scale administrative and clinical data has created exciting opportunities for research and policy evaluation. Faculty and students in this Research Area continued to explore novel statistical approaches to draw valid causal inferences from these data.
The growing use of new technologies in both the service systems and in the community, has opened new potential venues for research and health interventions. A number of faculty are involved in evaluating the use of m-health and electronic medical records in mental health and substance abuse treatment service.
Our Work in Action
The Maryland Medicaid health home waiver created new opportunity to finance the integration of behavioral and somatic health care for beneficiaries with serious mental illness. Several recent studies from DMH faculty have examined the implementation and effects of these waivers and found that the policy is associated with slight decreases in emergency department use, and slight increases in follow-up after hospitalizations, cancer screenings and no effects on inpatient admission, readmission, or cardiovascular quality of care, with the exception of diabetic eye exams.
- EE, Stone EM, Kennedy-Hendricks A, Bandara S, Murphy KA, Stuart EA, Rosenblum MA, Daumit GL. Effects of Maryland’s Affordable Care Act Medicaid Health Home Waiver on Quality of Cardiovascular Care Among People with Serious Mental Illness. Journal of general internal medicine. 2020 Nov;35(11):3148-58.
- SN, Kennedy-Hendricks A, Stuart EA, Barry CL, Abrams MT, Daumit GL, McGinty EE. The effects of the Maryland Medicaid Health Home Waiver on Emergency Department and inpatient utilization among individuals with serious mental illness. General hospital psychiatry. 2020 May 1;64:99-104.
Sachini Bandara, PhD ’18, MS, studies how public health policies can improve wellbeing for people who use drugs, have mental illness, or are involved in the carceral system.
Elizabeth Stuart, PhD, uses statistical methods to help learn about the effects of public health programs and policies, often with a focus on mental health and substance use.