Planning Improved Medication Management for Arkansas SMI

Arkansas State Hospital, Little Rock AR

Investigators

Abstract

DESCRIPTION: The proposed project will seek to form a sustainable partnership infrastructure that includes all major stakeholders in Arkansas that will be involved in a planning process to achieve consensus on identifying priority problem areas and designing interventions to address these problems with the overall goal of improving medication management for persons with schizophrenia in Arkansas. The project's focus on medication management for patients with schizophrenia reflects 1) the seriousness of this disorder, which is estimated to account for almost half of current mental health care expenses, and 2) evidence suggesting that despite recent advances in psychopharmacology and development of well-accepted evidence- and consensus-based guidelines on medication management for the treatment of schizophrenia, translation and dissemination of these guidelines and treatments have been less than successful. In Arkansas, poor implementation is the result of multiple factors, many of which can be traced to the lack of stakeholder input regarding identification of problem areas and development of interventions and the fragmented nature of the state's public mental healthcare system. This project proposes to create a sustainable partnership infrastructure that joins groups from the state's large public mental health system--with large, diverse consumer and provider populations--with the expertise of nationally known mental health services researchers. The proposed project will use a bottom-up approach that includes often-neglected stakeholders, such as consumers and providers, in determining and prioritizing research questions. We expect this approach to produce realistic and workable solutions to a complex problem. To achieve these solutions, the proposed project will 1) form a partnership infrastructure that includes representatives from all stakeholder groups; 2) develop consensus on a specific problem area; 3) develop and select an intervention that addresses the specific problem area; 4) pilot the intervention in the public sector; and 5) seek external and internal funding to enable implementation of a large-scale version of the intervention tested. The first four aims will be completed in Phase I, and the fifth aim in Phase II of the planning grant. This project is vitally important because developing this innovative partnership among stakeholders and researchers will help create the synergy all parties need to increase the balance between research and clinical practice; a balance that will improve medication management for schizophrenia and ultimately benefit the consumers of mental health care.