This application proposes to establish the Center for Rural Mental Health Care Research. This will be the first of its kind, providing an interdisciplinary environment to address major policy and service issues related to the provision of rural mental health care. The Center will serve as a national resource to enhance the nation's understanding of effective and efficient approaches to meet the needs of rural populations for mental health care. The ultimate goal of the Center is to improve the clinical mental health care provided to rural populations by addressing the specific problems. These include problems of access, utilization, measurement of mental health outcome, effectiveness of mental health services, and testing interventions to mental health care delivery. The Center will have two broad thematic areas which span three areas of emphasis. The two thematic areas are: 1) access to and utilization of mental health services in rural populations and 2) assessment of the outcomes and the effectiveness of mental health care provided in rural settings. The three areas of emphasis are: 1) childhood and adolescent mental disorders, 2) schizophrenia, and 3) cognitive impairment in the elderly. A unique feature of the proposed Center is the """"""""natural laboratory"""""""" for rural research available in the State of Arkansas. The state has broad rural diversity ranging from the Lower Mississippi Delta to the Ozark Highlands. This diversity will enable the findings from the Center's research to be widely generalized. Additionally, virtually every sector of the mental health system in this rural state is collaborating enthusiastically with the Center's research. The faculty for the Center will be multidisciplinary and include representatives from medicine (psychiatry, pediatrics, internal medicine), nursing, behavioral sciences, economics, psychology, social work, law, public health, epidemiology, agriculture/cooperative extension service, rural sociology, and biostatistics. Finally, the center is organized to respond to several NIMH priority areas. These include Public/Academic Liaison, childhood mental disorders, seriously mentally ill adults, research on Alzheimer's Disease and cognitive impairment, and research on effectiveness and outcomes of mental health services.
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