Mental Health
Research highlights
CHPR researchers Anthony Jerant, Richard Kravitz and Peter Franks, with CHPR staff support, conducted a randomized controlled trial to test an intervention designed promote discussion of recent active suicide thoughts among middle-aged men. They found that suicide discussion with physicians was more likely among intervention patients (those who used a tailored interactive computer program designed to encourage discussion of suicide with their physician) than those who received standard care.
CHPR partnered with the UC Davis Behavioral Health Center of Excellence to evaluate state-funded programs supporting county mental health crisis services for adult and transitional age youth. CHPR faculty affiliate Joy Melnikow, professor emeritus of family and community medicine, along with Bethney Bonilla-Herrera, clinical research analyst at CHPR, and Katrine Padilla, project policy analyst at CHPR, were involved in the evaluation funded by the Mental Health Oversight and Accountability Commission.
In January 2024, a report was released that provides a detailed formative evaluation of the 15 adult and transitional age youth mental health crisis programs funded by the Investment in Mental Health Wellness Act of 2013 (SB-82) in 2018 and implemented in 14 California counties and one city. This formative evaluation was conducted to understand the implementation of mental health crisis services funded by SB-82 and to obtain generalizable lessons learned that will inform future crisis intervention program development in California.
Tara Niendam and Joy Melnikow collaborated with CHPR staff, funded by the Mental Health Services Oversight and Accountability Commission, to evaluate California’s early psychosis treatment programs. Their survey of representatives of the early psychosis program yielded substantial variability in data collected about services, inclusion criteria, and data recorded. These findings highlight the need to harmonize data collection methods among these programs in California.
CHPR researchers Tara Niendam and Joy Melnikow studied the differences in provider-established start and end points of “duration of untreated psychosis” (DUP), a metric which affects initiation of recommended early psychosis care. They found that front-line providers proposed a more structured operationalization of DUP than any published in the traditional literature.
Niendam was awarded funding by the National Institute of Mental Health to create the California Collaborative Network to Promote Data-Driven Care and Improve Outcomes in Early Psychosis (EPI-CAL). For this project she is evaluating health outcomes associated with Early Psychosis clinics in a recently developed network of such clinics in California that are working collectively to improve their care through prospective collection and feedback from client-reported outcomes.
CHPR researcher Glen Xiong was first author on the paper in which the expert consensus guidelines for clinicians on how to balance the risks and benefits of psychiatric medications that have the potential to increase risk for ventricular arrhythmias were published. The authors developed an algorithm to help clinicians determine whether ECG monitoring should be considered for a given patient.
CHPR researchers have also focused on the intersection of substance use and mental health problems, which frequently co-exist in people presenting to an emergency department. Joy Melnikow, Aimee Moulin and Ethan Evans evaluated six years of California emergency department (ED) data to determine the impact these co-occurring problems were suspected of having on frequent ED use. They found that patients with substance use disorders, who are homelessness and have public healthcare coverage, are more likely to be frequent users of EDs for mental illness.
