The role of SMHAs in the organization and delivery of services to persons with severe mental disorders (PSMD) has devolved to more local governmental levels, and in financing from state/county to contractual arrangements with for-profit corporations. This trend amplifies a consequences for deinstitutionalization: a wider range of institutions and sectors responsible for the care and support of PSMD. The Center in response extends its focus from policy issues of a SMHA to those of the current d facto system. We propose to build on our strong collaborative links with stakeholders to study populations in this broadened venue, their problems, potential solutions, and the methodologies required for such research. Dissemination will take place through stakeholders, small group meetings with planners and policy makers, a WEB page and newsletter as well as through traditional research dissemination strategies. The focal location of the Center is NKI a NYSOMH research institute. It's collaborative sites are the SMHA; and public academic links to SUNY Rockefeller College of Public Affairs and NYU Departments of Psychology, Psychiatry and the Wagner Graduate School of Public Service. Faulty also includes state and local policy staff, consumers and family members. An enlarged policy advisory board will become more diverse, meet more frequently and directly with researchers to assured the national relevance of projects. national relevance will be enhanced by inclusion of research partners from other states and national organizations. The Center will have four interrelated Cores. Methodology provides statistical consultation and support and work to ensure the rigor of all projects. It will also develop new methods and use models to provide quick turn-around information for use in policy debate. Promoting Recovery studies the impact of contemporary public health risks on PSMD and operationalizes recovery constructs for use in the development and study of innovative services. Seeking Systems Integration studies integration between the mental health system and other health and social systems as well as among the components of the mental health system itself. Negotiating Lives in the Communities explicates the workings of the de facto mental health system and explores the consequences of ad hoc arrangements for care and support. The Center, a community of researchers, stakeholders and policy makers, will thus provide a structure and staff to inform the scientific and policy communities on ways to better understand and provide services and supports to PSMD.
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