The proposed K01 Mentored Research Scientist Award outlines a program of training and research that focuses on understanding and improving the care that Medicaid-enrolled children with mental health problems receive in safety net clinics. Upon completion of this training program, the candidate will be ideally poised to become an independent mental health services researcher with expertise in understanding how safety net facilities can improve access to and quality of mental health care for children. The goal of the educational component is to obtain the skills necessary to conduct the research and develop a working theoretical framework that will facilitate the transition towards independence. The educational program will provide advanced methodological training in: 1) spatial statistics; 2) qualitative methods; and 3) survey design and implementation. The educational component will also enable the candidate to learn and apply knowledge about youth psychopathology and evidence-based treatments, and about the mental health care safety net system for this population. This training will be obtained via mentoring by Drs. Benjamin Druss, Nadine Kaslow, Claire Sterk, Lance Waller, and Michael Windle; formal didactic coursework and seminars; a directed reading list; and participation in national conferences. The research agenda will draw on the new skills and mentorship obtained in this training program to implement three related research projects. The first project will merge 50-state Medicaid claims data with other databases to examine whether safety net clinic accessibility improves access to and quality of mental health care for disadvantaged youth. The second project will entail a qualitative study to inform the creation of a survey for mental health safety net clinics to better understand their features, services, and challenges in meeting the needs of Medicaid-enrolled children with mental health problems. This study will include parent focus groups and semi-structured interviews with providers and administrators in diverse safety net settings. The third project will develop a survey based on the qualitative data and conduct a pilot test of this instrument among safety net clinics statewide in Georgia. These projects will provide empirical data to refine a conceptual model of how safety net clinics interface with the local community to meet the needs of Medicaid-enrolled children with mental health problems. They will provide an important foundation for future research that informs programs and policies to improve the efficiency and quality of children's mental health services in the public safety net.
Mental health problems are undertreated among Medicaid-eligible children. Although the safety net system plays a crucial role in providing needed services to this population, little is known about which youth are most likely to use these facilities, the quality of care that is received in these facilities, and the types of policies and interventions that can improve the ability of the safety net to serve this population. This K01 award fills a crucial gap in the scientific literature and informs policies and interventions concerning the modifiable factors that can improve the quality and efficiency of mental health services in the safety net for disadvantaged youth.
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