This application is a competing renewal to continue a multidisciplinary, two-year clinical services research postdoctoral training program based in the Department of Psychiatry, School of Medicine, University of California, San Francisco. Postdoctoral trainees are psychologists, psychiatrist, sociologists, nurses, economists, and other social and behavioral scientist. The major aim of the program is to address the national need for scientists with advanced training and expertise who will lead and conduct research that is critical for enhancement of mental health services and systems of care. Major elements of the training program include required coursework and seminars and a research """"""""apprenticeship"""""""" with a faculty member. Required coursework includes courses in biostatistics, health economics, professional conduct, research ethics and a comprehensive research methods seminar. An additional feature is an ongoing colloquium series to promote professional development in the clinical services research area. Trainees are further encouraged to enroll in elective courses and directed reading to complement required coursework and the research experience. The apprentice role occurs within the context of a preceptor's clinical service-research activities and is progressively expanded into a full collaboration on an aspect of the research problem. Trainees are supported in their development of the multidisciplinary, collaborative, and negotiation skills required of clinical services researchers. Two important program features in this regard are: (a) exposure of trainees to an area of mental health services delivery settings in which ongoing clinical services research in conducted by program faculty and their associates;and (b) formation of collaborative learning and research relationships among the fellows and faculty. The faculty is comprised of senior, established investigators with ongoing clinical services and related research as well as junior investigators who have generated a solid research trajectory. Areas of research currently conducted by participating faculty include: (a) studies of organization, financing, and delivery of mental health and related human services to seriously and persistently mentally ill adults, adolescents, and children;(b) services system studies of the co-occurrence of mental disorder and substance abuse;(c) studies of mental health services in primary care settings;(d) studies of mental health delivery to persons with AIDS;(e) studies of the implications of violence and violence potential for the delivery of mental health services;and (f) studies of the mental health services delivered to vulnerable populations, including older adults and ethnic minorities.
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