During the last 2-1/2 years we have established a multi-disciplinary Center to study the organization and financing of care for severely mentally ill persons. The Center has successfully developed collaborative relationship, among investigators with expertise in mental health economics and finance, clinical psychology, and social welfare. We have involved two new Center co-investigators, Dr. Catalano and Dr. Vega. Additionally, Center research involves collaboration with affiliated investigators working in public mental health agencies (San Francisco, Santa Clara, and Alameda counties and the State of California) and in several academic settings. Center research has also involved trainees from two related NIMH training programs. Funding for Center projects has been obtained from the State of California, the Robert Wood Johnson Foundation, and the National Institute of Mental Health. The Center has established a working paper series and has participated in building a mental health services research base. The Center has developed 4 areas of research priorities. In the area of organization of services for severely mentally ill persons, we examine innovative means of providing integrated clinical, social, and practical services, with an emphasis on case management and self-help agency models. In the area of financing of public services in counties and institutions we examine the effects of alternative financing methods on the costs, outcomes, and delivery of mental health services at multiple levels. In the area of special populations we examine characteristic patterns of need for and use of mental health services, emphasizing ethnic minority adults, children and youth, and persons with co-occurring substance use disorders. In the area of methodology we identify ways to improve approaches used to study the organizational, epidemiologic, and financial aspects of care for severely mentally ill persons. The main proposal and Appendix M detail the specific projects to be explored in each area.
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