In response to the ACISR Program Announcement, we propose to establish the Center for Research to Improve Mental Health Care in the Social Services (C-RIMSS). Our research agenda addresses quality of mental health care in settings with the highest potential to reduce racial and ethnic disparities. Studies will be conducted in social service agencies, where prevalence of mental disorder is high and vulnerable of clients predominate. A cultural exchange perspective informs our work at the mental health-social service intersect, and across the academic-practice divide. Through the work of seven units, our Operations Core will provide an infrastructure for research, methodological advances, and partnerships with community agencies. The Principal Research Core will support pilot studies to address three aims: (1) understand quality of care for mental disorder in the social services from stakeholder perspective; (2) assess practice variation in quality of care for mental disorder and identify provider, client, and system ecostructure and economic influences on that variation; and (3) working """"""""trench to bench and back to trench,"""""""" test a menu of quality improvements for mental health care in the social services. The Research Methods Core's two units--Qualitative Methods and Statistical Analysis -- will provide ongoing, state of the art support to investigators. The RMC will support projects and provide consultation for stakeholder preference assessment, quality indicators, and organizational research methods. Our outcomes will include completed pilot projects, generation of RO 1, R21, or R34 studies, scientific publications, strengthened agency partnerships and infrastructure for research, and dissemination of findings to academic and stakeholder networks. Improving mental health care to social service clients can increase treatment to persons whose disorder currently goes undetected, improve the quality of evidence-based care to those who are now served poorly, and reduce racial/ethnic disparities in care. Our research agenda is responsive to the recommendation of the President's New Freedom Commission Report on Mental Health to improve the response to mental disorder in readily accessible and low-stigma settings where a high level of risk for mental health problems exists, especially all federally-funded health and human services.
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