This is a new application for an NIMH K01 Mentored Scientist Development Award for New Minority Faculty (MSDA/NMF) entitled """"""""Appropriateness and Compliance in Depression Treatment"""""""". The candidate's primary career interest is in studying and improving the quality of mental health services. The candidate's experience in epidemiology, psychiatry, and psychopharmacology have drawn his attention to the important gaps that exist between knowledge on the optimal management of psychiatric illnesses such as depression, and the actual care received by many patients. However, he recognizes that he needs additional skills to rigorously define the determinants, utilization, appropriateness, and outcomes of mental health service delivery and ultimately to improve its quality and cost-effectiveness. Therefore, he now seeks further training in mental health services research, quality improvement, mental health policy, and health care economics to equip him to build upon his background in epidemiology to conduct mental health services research in this important area. The candidate's proposed research project contains two broadly defined types of mentored research. The first are a series of studies combining health services research with epidemiology to measure current patterns and predictors of inadequate treatment for depression and treatment noncompliance in several different patient populations. The second will consist of an experimental study, in which interventions on the determinant of inadequate treatment and non- compliance found in the first series of studies will be developed and pilot-tested in order to improve these outcomes. Through his proposed training and mentored research, the candidate will acquire a set of synergistic skills which will prepare him to become an independent and productive mental health services researcher.
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