We propose to establish a research center which brings together a multidisciplinary group of researchers and practitioners to examine the organization and financing of care for the severely mentally ill. The center will provide an organizational structure and environment which will facilitate the interaction and cooperation of investigators in developing and conducting research projects. Center investigators will study and evaluate the current system of care for the severely mentally ill, as well as suggest ways to improve the organization and financing of care. The Center will: provide a setting that will facilitate collaborative multidisciplinary research; strengthen and develop collaborative research arrangements with public mental health delivery systems; train students and young investigators; disseminate research findings to the academic community and to policymakers and develop and evaluate demonstration projects implemented in public mental health delivery systems. The Center is composed of a multidisciplinary group of investigators with expertise in: biostatistics, economics, finance, organizational sociology, social welfare policy, health services research, clinical aspects of care, and the mental health service delivery system. The Center has established a working relationship with the mental health system of the City and County of San Francisco, and is working on linkages with other public delivery systems. The core of the Center consists of the Director, Co-Investigators and Clinical Associates who will develop proposals and direct ongoing projects. A research staff, including a biostatistician, will provide support for all grants and projects. An Advisory Board, composed of established researchers and community leaders, will review Center work and suggest overall direction. A group of affiliated investigators is available to work with the Center to develop projects. The Center Investigators have proposed 12 research projects on the organization and financing of care for the severely mentally ill. The projects cover four major areas: overall estimates of the cost of severe mental illness; the structure, organization and financing of hospital services; the continuity and quality of care as patients move through the public mental health delivery system; and the cost and utilization patterns of subgroups of the severely mentally ill, e.g. Asians, Blacks, children and elderly.
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