This project aims to develop a clinical scaffolding system to enhance telemental health care by providing real-time coaching and actionable suggestions during video-based sessions. Modeled after live supervision methodologies, it supports clinicians by identifying intervention targets and offering text-based coaching prompts to guide care. Unlike automated chatbots, this approach enables clinicians to adapt suggestions to patient needs, balancing automation with oversight for safer AI-supported mental healthcare. The proposed in-session support will facilitate efficient implementation of strategies and clinician skill development. This project seeks to enhance data privacy by processing all data on-device and avoiding external data transfers.
Funding Type: Philanthropy
Developing a hospital-based treatment engagement program for Alcohol Use Disorder
Alcohol use disorder (AUD) frequently results in serious illness, injuries, and hospitalizations. Surviving illness or injuries related to alcohol use can motivate behavior change that could be harnessed through treatment engagement for AUD in the hospital; however, in general hospital settings, patients are rarely presented with more than a piece of paper with phone numbers to call for help with their drinking. This project is focused on designing and evaluating a shared decision making approach for AUD treatment in hospitalized patients. We are interviewing people who are hospitalized with complications of AUD to better understand their unique needs and preferences. We are using the knowledge gained from interviews with patients to adapt a paper-based decision aid that was originally designed to help clinic patients think about changing their drinking, and creating an interactive web-based interface, tailored to hospitalized patients. We will then evaluate the use and effectiveness of this new online decision aid for engaging hospitalized patients in AUD treatment. The overarching goal of this research is to more effectively use hospitalizations to bridge individuals to long-term, potentially lifesaving AUD care.
Partnering with patients to re-envision psychiatric hospitalization and discharge
We will analyze people’s stories about psychiatric hospitalization, interview people with experiences surrounding psychiatric hospitalization, and co-design with them to identify alternative approaches that would help people care for themselves as they transition out of the hospital. We will build upon our prior work on understanding patients’ challenges and co-designing new systems that help patients transition from psychiatric hospitalizationto self-management. In particular, we will focus on how we could redesign psychiatric hospital systems with the people who have experienced them, identifying patient insights on the knowledge, resources, and self-efficacy they need to help them return to the community.
Coach up the coaches: extending the reach of mental health professionals in sport settings
More than half of school-aged youth in the US play at least one organized sport, are similarly at-risk for mental health disorders as compared to their non-athlete peers, and face heightened barriers to seeking and sustaining mental health care. While coaches are not licensed mental healthcare providers, there is a robust evidence-base about laypeople (e.g., parents, teachers) effectively delivering brief interventions across population settings to help reduce psychological distress and increase the adoption of health behaviors. However, such brief interventions have not as-yet been adapted for the sport setting, or delivered by coaches.
The overarching goal of this project is to identify sport setting appropriate (very) brief interventions and adapt them for coach delivery in the sport setting. This will be accomplished by working in partnership with coaches, athletes, and licensed mental health care providers. We will use University of Washington’s First Approach Skills Training (FAST) training model (originally designed to train primary care clinicians in mental healthcare skills) to train a pilot cohort of coaches to deliver these interventions. This project is the starting point for a potentially transformative opportunity to extend the reach of mental healthcare professionals into the large and often underserved population of youth sport participants.
Establishing a direct clinical – law enforcement partnership to address dementia crisis intervention across WA state
Although medical care and law enforcement may intersect in an emergency situation, cross-communication and mutual education opportunities prior to the critical tipping point are currently sorely lacking. Our innovative partnership seeks to address these gaps by determining the specific steps dementia clinicians and law enforcement in WA state can take together to improve community health.
For Phase I of this project, we are initiating a direct collaboration between clinicians and law enforcement for dementia crisis intervention, in order to establish appropriate safety measures to be enacted in WA communities. An essential component of ensuring lasting impact can only be achieved by determining the local availability, usability, and effectiveness of proposed safety interventions.
UW dementia specialists will partner with law enforcement across Washington state to jointly identify the resources necessary for effective dementia crisis response. We seek to bridge the gap between medical care and community safety concerns, specifically at a crisis point when a community member feels compelled to summon law enforcement due to perceived significant threat or lack of awareness of other, more appropriate resources. We will conduct interviews with clinicians, police departments, and community stakeholders, review police call logs, and perform ride alongs. The information gathered will be analyzed for major themes related to knowledge and resource gaps, as well as any existing solutions. Three crisis response priorities will be identified, and corresponding “safety packet” content will be outlined in preparation for community partnership input, local adaptations, and ultimately state-wide dissemination.
Partnering with the Quinault Indian Nation to develop a community-based contingency management intervention
Indigenous knowledge remains strong in American Indian/Alaska Native (AI/AN) communities despite colonization, postcolonial efforts to assimilate and eradicate AI/AN people, present-day inequities and structural racism. Despite strength and resilience, AI/AN populations have high rates of unintentional overdose and death by suicide. There is an urgent need for evidence-based, culturally responsive approaches to increase protective factors against substance use and mental illness in AI/AN communities.
This study is a partnership between University of Washington researchers and the Quinault Indian Nation’s behavioral health providers and community. We will design a culturally adapted community-based contingency management intervention to increase positive reinforcement for adolescents and young adults at risk for substance use and mental illness. This intervention will focus on community identified target behaviors rather than abstinence. By prioritizing the needs of the community we will develop an intervention that is effective, usable and sustainable.
Adopting a lifespan approach for ADHD management
ADHD is common, heritable and impairing. As recognition of the negative functional impacts associated with ADHD in adulthood has grown and stigma around the diagnosis has diminished, demand for ADHD care across the lifespan has increased.
This project will begin foundational work to inform the development of a family-focused lifespan clinic at UW serving adults and children with ADHD. For such a program to be effective, equitable, and sustainable, we must clarify the true needs of individuals living with ADHD as well as the professionals caring for them. We will convene four groups of key community partners: (1) Adults with ADHD whose children have ADHD, (2) Adolescents with ADHD, (3) Mental health professionals representing the fields of psychiatry, psychology, psychiatry advanced practice nursing, school-based counseling, (4) Primary care providers. Results will guide program development and illuminate future research opportunities.
Family and Caregiver Training and Support Program (FACTS) pilot
We know from decades of research that caregiver involvement, including family and non‐family members, in a patient’s mental health treatment can make a tremendous difference in the trajectory of their loved one’s life by supporting recovery, reducing relapse, and decreasing mental health crises. Family and caregiver involvement also decreases provider stress, improves caregiver well-being, and can lead to lower patient healthcare utilization and costs. But despite their importance, many family members and caregivers struggle to engage in the kind of support that can benefit the patient and themselves. They often lack access to education, resources, or skills to step into this critical role despite a desire to help. Our initiative intends to develop a pilot Family and Caregiver Training and Support Program (FACTS) program that aims to decrease barriers to caregiver involvement and improve caregiver support.
Our team will develop online training that will include an orientation to having a loved one who is psychiatrically hospitalized and will teach families and caregivers practical communication skills while their loved one is in our care. These topics would be relevant regardless of a patient’s diagnosis and will be adapted from existing evidence‐based models. The pilot will be tested with caregivers of patients hospitalized at the new Center for Behavioral Health and Learning and we will proactively integrate input and feedback from participants to inform program improvements along the way.
We will also build a public-facing website to host FACTS training materials as well as mental health information and resources that we will curate for accuracy and reliability. We expect the FACTS pilot content will serve as a foundation for additional offerings that will include diagnosis specific skills trainings as well opportunities for in-person sessions and Family Peer Support programming.
Assessing need and acceptability of a family intervention for individuals with Opioid Use Disorder
Many people love someone who uses substances in a harmful way and want to help that person. Family members and friends often are key supports in people seeking and staying engaged in treatment and services. At the same time, family members and friends feel like they lack the skills or support to help their loved one effectively. This may be especially true for opioid use disorder, where the strongest evidence for treatment is for medication for opioid use disorder, but families and friends don’t know how to help their loved ones access and stay on these life-saving medications.
Our study will talk with people who are getting medications to treat opioid use disorder and ask about the involvement of their family members and friends in their lives and recovery. We will reach out to these key supports to ask how they would want to do a group-based program to help them develop skills and knowledge to support their loved one’s care. These groups would be delivered by nurses with specialized training in opioid use disorder and treatment. Group content will be based on an existing, evidence-based treatment designed for family members and will help people understand the role of medications in treating opioid use disorder and teach skills to support their loved one.
Pilot of an inpatient Family Bridger Model to support families with loved ones who experience psychosis
Despite treatment advances, psychotic disorders remain among the costliest and most disabling conditions worldwide. One of the best ways to help those experiencing psychosis is to involve their families in treatment. Empirical evidence suggests that family interventions for psychosis confer numerous benefits for both families and their loved ones who experience psychosis. However, behavioral health providers experience multiple barriers to engaging families in treatment, resulting in poor accessibility to family interventions for psychosis and worse outcomes for families and their loved ones alike. For example, families who receive no family interventions for psychosis experience higher rates of stress, burnout, depression, anxiety, caregiver burden, relationship strain, and inadequate social support. These outcomes are further compounded during their loved one’s hospitalization.
Family peer specialists are family members with lived experience who have received specialized training to assist other families with a loved one with mental illness. Such models have been found to improve both patient and family outcomes. One such promising model is a Family Bridger program. Modeled after the Peer Bridger program, we previously piloted a Family Bridger program that deployed family peer specialists to support families who have a loved one with psychosis by providing emotional support, education, advocacy, resource brokerage, and skill-building while their loved one was engaged in an early psychosis outpatient program. For this project, we propose to meet the following specific aims: (1) adapt the Family Bridger program for an inpatient setting, and (2) evaluate the feasibility, acceptability, appropriateness, and preliminary effectiveness of Family Bridgers in an inpatient setting.
