The Brief Intervention for School Clinicians (BRISC) has been the subject of two research studies funded by the Institute for Education Sciences (IES). In the most recent study, 48 high schools in three states (WA, MD, MN) were recruited and assigned to BRISC (n=23) or school-based services as usual (SAU; n=25). Clinicians working in schools assigned to BRISC gave positive ratings of BRISC feasibility, learnability, and acceptability. Students receiving BRISC (n=259) were more likely to receive SMH services at 2 months, more likely to have discharged from SMH by 6 months, and less likely to have received other MH services at 6 months. BRISC students showed greater rates of resolution of their self-reported problems and were more likely to move out of the clinical range for anxiety.
Geographic Area: Washington
Workforce for Student Well-being Initiative (WSW)
In 2023, Washington state was awarded $6 million from the U.S. Department of Education to create a pipeline from Washington state’s five accredited Masters in Social Work training programs to K-12 schools. Called the Workforce for Student Well-being Initiative (WSW), 100 aspiring school social workers will receive conditional scholarships based on their financial need so the cost of getting an education is not a barrier to their getting an advanced degree and then committing to working in a high-need public or tribal school. The goal of the WSW is to help all K-12 students in Washington to thrive by advancing the careers of skilled school social work professionals through training and mentorship.
Washington State Behavioral Health-Student Assistance Program
The Washington State Behavioral Health Student Assistance Program (BH-SAP) is a research-based, statewide model that places trained Student Assistance Professionals (SAPs) in schools to deliver prevention, early intervention, and referral support within Washington’s Multi-Tiered System of Support (MTSS) framework. Through our collaboration with the Assocation for Educational Service Districts, the UW SMART Center’s Training and Technical Assistance Core supports this project through program evaluation efforts including overseeing collection of student, school, and district outcome data, analyzing data, and producing reports to inform continuous improvement.
Raising Washington
A partnership to provide comprehensive perinatal mental health and parenting support for the first 1,000 days
The Raising Washington Initiative seeks to develop an evidence-based fully integrated perinatal support program that will offer mental health care, parent training and support services for the first 1,000 days of a baby’s life (conception through child’s 2nd birthday) for every high-risk baby born in Washington. This will include creating care pathways informed by the needs of patients and providers, navigators to help guide families through the many care transitions in the perinatal period and accessible information to keep parents and babies healthy.
To learn more this work, please contact Project Manager Lori Ferro, MHA at ljf9@uw.edu.
Development of a task to measure the impact of PTSD symptoms on cognitive control and physiologic endpoints in response to interpersonal stressors
Posttraumatic stress disorder (PTSD) is linked to altered physiologic functioning, including increased blood pressure and heart rate, especially in response to stressors. Increased cardiovascular reactivity to trauma-related stressors may link PTSD to poorer cardiovascular health and thus an increased risk of cardiovascular disease. Prior work by our lab suggests that these effects of trauma may be due to persistent changes in the central and peripheral nervous systems’ stress-response system. While there is an urgent need to address these effects, limitations in our ability to effectively measure these changes have led to a paucity of data regarding the impact of current PTSD treatments on these important endpoints.
We propose to develop a novel emotional Stroop task that will quantify physiologic reactivity to interpersonal and affective cues, and quantify the impact of affective and physiologic reactivity on cognitive control. In a Veteran sample, we will characterize how performance on this task relates to PTSD symptom burden and physiologic reactivity to tilt-table testing, and gather pilot data assessing its response to pharmacologic treatment.
Engagement patterns in pediatric integrated behavioral health: investigating service utilization and attrition among children with mental health and neurodevelopmental disorders
Children with comorbid mental health and neurodevelopmental disorders (NDDs) often require more intensive and coordinated care than those with mental health disorders alone. These two categories of disorders often present with comorbidity and engagement disparities in integrated behavioral health programs among this population remain poorly understood. This study examines differences in service utilization and attrition rates between these two populations using retrospective electronic health record (EHR) data from the SCCN study population (ages 6-18) across multiple primary care sites.
We will analyze visit frequency over a 6-12 month period to assess whether children with comorbid NDDs have higher service utilization. Additionally, early dropout rates will be examined using Kaplan-Meier survival analysis and Cox proportional hazards models to identify risk factors for attrition. Findings will provide critical insights into engagement patterns, informing strategies to enhance retention, reduce access disparities, and improve care coordination for children with complex behavioral needs. This study will contribute to investigating further integrated care model improvements in order to ensure more equitable and sustained mental health treatment for vulnerable pediatric populations.
Discovering how a task-shifted Care Manager workforce of community health workers can address geriatric mental health
Older adults are less likely to receive the recommended standard of care for preventative services, chronic diseases and geriatric concerns such as complex care navigation. Late-life depression is a common chronic disease, and older adults face multiple barriers obtaining depression care from healthcare settings, especially if things like fragility, social needs, and transportation limit access to primary care. Offering depression care in non-traditional healthcare settings is one way to increase access. Community health workers (CHWs) are trusted community members who increase the health of communities through care coordination, health education and outreach. One approach is to task-shift the Care Manager (CM) role of a Collaborative Care framework to CHWs in the community. Global health work has demonstrated that non-clinicians can conduct low-intensity psychosocial interventions for depression. However, task-shifting the Care Manager role in a non-clinical setting requires additional skills and poses added challenges. We have gathered prior formative work among CHWs on what they think about being trained and supported in the skills of CM. We now seek to understand Collaborative Care stakeholders’ perspectives on this proposed role expansion of CHWs to CHW Care Managers (CHW-CMs) to understand how to design this role.
Subtyping the neurobiology of PTSD through novel methods for the alpha- and beta-adrenergic autonomic nervous system components: a pilot study
Trauma and posttraumatic stress disorder (PTSD) are common in veteran and civilian populations. Meanwhile, observationally estimated half of people cared for at UW autonomic nervous system (ANS) disorder clinic have a history of trauma. Increasingly, research explains this observation through an evolving understanding of the complex interplay of peripheral and central catecholamine signaling that appear to underlie much of the persistent impact of trauma. An improved understanding of ANS changes in trauma and their relationship to the complex symptoms people experience is an important research frontiers to improve a) our understanding of PTSD, b) our ability to predict effective treatment for a given person, and c) the development of new treatments for PTSD. We propose implementing a novel analysis method for non-invasive autonomic testing in context of several clinical studies at VA Puget Sound. The proposed research aims to 1) make use of ANS testing results already available to provide quantitative data for adrenergic signaling, 2) test associations of extracted biomarkers with symptoms of PTSD, and 3) collect prospective data to test the relationship of peripheral autonomic signaling to quantitative measures of central nervous system (CNS) catecholamine signaling measured by event-related potential (ERP).
Improving risk-stratification of substance-induced psychosis: incorporating stakeholder perspectives and implementing a standardized assessment of risk factors
First-episode substance-induced psychosis (SIP) presents a clinical challenge in which treatment decisions cannot rely on evidence-based guidelines and long-term outcomes are not well understood. Preliminary findings from our retrospective study of psychiatry inpatients at Harborview Medical Center (HMC) suggest that patients with first-episode SIP had similar rehospitalization rates to those with first-episode psychosis (FEP) but were less likely to receive long-acting injectable antipsychotics (LAIs) even though LAIs may reduce the risk of 30- and 180-day rehospitalization. Our study has also revealed inconsistent assessment of key risk factors for rehospitalization—such as family history of psychosis and patterns of cannabis use—that may be limiting informed decision-making, including appropriate LAI use. This project seeks to improve the risk stratification of first-episode SIP by addressing these gaps. Aim 1 will use qualitative interviews with inpatient attending psychiatrists, psychiatry residents, and patients to explore factors influencing the management of first-episode SIP. Aim 2 will evaluate the acceptability and feasibility of implementing a standardized assessment of cannabis use and family history of psychosis on HMC inpatient psychiatry units. This project will lay the groundwork for future clinical interventions that optimize treatment decisions and improve patient outcomes in psychiatric inpatient settings.
Behaviors and Executive Skills in T21 (BEST21)
We are conducting a study to understand the role of problem-solving in challenging behaviors for children with Down syndrome so that we can better understand the development of and treat these behaviors. If you agree to participate, this study will involve questionnaires, some of which may be completed at home. You would also attend an in-person visit that involves measuring your child’s naturally-occurring brain activity with EEG as well as cognitive assessments. We would schedule your visit around your schedule to the best of our ability and we can schedule this visit in a location that is convenient for you (UW, home visits, etc.). Participants will receive an $80 gift card to thank them for their time.
