The results of the Center's DECIDE clinical trial are now published in JAMA Psychiatry.
The DECIDE intervention was tested in 13 outpatient community mental health clinics across 5 states and 1 US territory from 2009 to 2011. DECIDE is an educational strategy that teaches patients to ask questions and make collaborative decisions with their behavioral health care professional. Results show that the DECIDE intervention appears to help patients learn to effectively ask questions and participate in decisions about their behavioral health care. The study was funded by the National Institute on Minority Health and Health Disparities.
Read more about the Center's follow-up study incorporating a health care professional component, Effectiveness of DECIDE in Patient-Provider Communication, Therapeutic Alliance, and Care Continuation, funded by the Patient Centered Outcomes Research Institute (PCORI).
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International Latino Research Partnership (ILRP) staff and advisors meet in Madrid for our first Advisory Board meeting in March, 2014. Partners came together at the Fundacion Jimenez Diaz, our partner in Madrid, and included collaborators from the Center, Vall D'Hebron Univeristy Hospital in Barcelona, and the Univeristy of Puerto Rico. Together wih a team of advisors from Spain and the U.S., we worked together to refine project strategies to best test an integrated care model for the Latino immigrant population in both countries.
African Americans Less Likely to Receive Follow-Up Care After Psychiatric Admission
Poor integration of follow-up treatment into the continuum of psychiatric care leaves many individuals, particularly blacks, with poor-quality treatment, according to a report, "Quality of Follow-Up After Hospitalization for Mental Illness Among Patients From Racial-Ethnic Minority Groups," published online today in Psychiatric Services in Advance.
Researchers at the Center for Multicultural Mental Health Research, Cambridge Health Alliance, and Department of Psychiatry at Harvard Medical School used the Medical Expenditure Panel Survey (2004–2010) to identify adults with any inpatient psychiatric treatment (N=339). They then estimated predictors of outpatient follow-up or the beginning of adequate outpatient follow-up within seven or 30 days following discharge. Predicted disparities were calculated after adjustment for clinical-need variables but not for socioeconomic characteristics, consistent with the Institute of Medicine definition of health care disparities as differences that are unrelated to clinical appropriateness, need, or patient preference.
Rates of follow-up were generally low, particularly rates of adequate treatment, which were on average less than 26%. Outpatient treatment prior to inpatient care was a strong predictor of follow-up. After adjustment for need and socioeconomic status, the analyses showed that blacks were less likely than whites to receive any treatment or begin adequate follow-up within 30 days of discharge.
“Culturally appropriate interventions that link individuals in inpatient settings to outpatient follow-up are needed to reduce racial-ethnic disparities in outpatient mental health treatment following acute treatment,” the researchers stated.
For more information on health disparities in mental illness and its treatment, see the Psychiatric News article, "Overcoming Health Disparities is Goal of Baltimore Experiment."
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Current CMMHR Projects:
- EXPORT II - UPR/CHA Research Center
- Effects of Social Context, Culture and Minority Status on Depression and Anxiety
- International Latino Research Partnership
- PCORI: Effectiveness of DECIDE in Patient-Provider Communication, Therapeutic Alliance & Care Continuation
- Understanding Mechanisms of Mental Health Care Disparities
- RWJF Mentoring and Training