FQHC – Department of Psychiatry & Behavioral Sciences

Collaborative care for perinatal mental health – the LAMMHA project

Los Angeles Maternal Mental Health Access (LAMMHA) is a five year program (2022 – 2027) funded by The California Health Care Foundation (CHCF) to support health centers in Los Angeles to identify and treat common perinatal mental disorders (CPMD) and reduce the risk of suicide. The LAMMHA initiative is a collaboration between Community Clinic Association of Los Angeles County (CCALAC), Elevation Health Partners (EHP), Maternal Mental Health Now (MMHN), Concert Health and the Department of Psychiatry and Behavioral Sciences at the University of Washington. Co-created with Los Angeles community stakeholders, the LAMMHA program currently offers Los Angeles County providers and community clinics two different levels of support to improve perinatal mental health care.

For more information and/or to apply for the program, please visit the CCALAC LAMMHA page: https://ccalac.org/los-angeles-maternal-mental-health-access-lammha/.

High potency cannabis policy legislative report

Explore and suggest policy solutions in response to the public health challenges of high tetrahydrocannabinol potency cannabis. ADAI will host stakeholder sessions to gain perspectives, seek common ground, evaluate, and assess potential policy solutions culminating in a final recommendation report.

Evaluating Lifelines4Moms (ELM) Study

Perinatal depression affects 10-15% of pregnant and postpartum individuals, with detrimental impacts on both parent and infant. In response to this, our department developed a perinatal consultation line for providers, PAL for Moms, to increase access to specialty perinatal psychiatric expertise and care. The purpose of the Evaluating Lifeline4Moms (ELM) is to assess comparative effectiveness of PAL for Moms and other perinatal psychiatry access and referral programs in addressing maternal depression.

As a community-engaged research endeavor, ELM has convened patient advocates, policy experts, and perinatal clinicians, who oversee the study as partners and advisors. Over a period of three years, the research team will characterize the components, implementation timelines, and state policy contexts of access and referral programs; evaluate the reach and implementation of these programs; and examine the comparative effects on access to and quality of mental health treatment among Medicaid-insured perinatal individuals.

Disseminating a user-friendly guide: Advancing the science of intervention adaptation and improving access to evidence-based psychological treatment

Adaptation of evidence-based practices and programs (EBPs) is a necessary component of the implementation process. EBPs must be adapted to function with the constraints of real-world practice settings, providers’ expertise, and patients’ needs. The science of intervention adaptation is hungry for well-defined methods of EBP adaptation to guide decision making. A how-to guide for EBP adaptation titled MODIFI: Making Optimal Decisions for Intervention Flexibility during Implementation, is under development with NIMH funding (F32 MH116623). MODIFI will be disseminated via multiple strategies locally, nationally, and internationally. Dissemination of MODIFI will improve the practice of intervention adaptation by providing practitioners with a how-to guide that is (a) evidence-based, (b) usable, and (c) supported by the expert consensus of implementation practitioners and researchers.

Improving usability

While evidence-based psychosocial interventions (EBPIs) are important, their design is cumbersome, complex, overwhelming, inflexible, and minimizes factors that are crucial for quality delivery of care.

This study will work with six FQHCs across MT that were recently reorganized under Bighorn Valley Health Center’s umbrella to involve their Therapists and Care Managers in the redesign of an intervention to address their unique patient population and to capitalize on their task sharing model.

Study to Promote Innovation in Rural Integrated Telepsychiatry (SPIRIT)

The primary goal of this project is to quantitatively compare the treatment experience, engagement, self-reported clinical outcomes, and recovery-oriented outcomes of patients initially randomized to telepsychiatry collaborative care and telepsychiatry enhanced referral. In addition, for the subset of patients randomized to telepsychiatry enhanced referral who do not engage in treatment and are still symptomatic at 6 months, an additional goal is to quantitatively compare the treatment experience, treatment engagement, self-reported clinical outcomes and recovery-oriented outcomes of patients randomized to continued- telepsychiatry enhanced referral or phone enhanced referral. Additional goals are to gain an in-depth understanding of patients’ and providers’ treatment experiences and to examine treatment heterogeneity among subgroups of patients based on race/ethnicity, age and clinical severity.

Maternal-Infant Dyad Implementation (MInD-I)

The MInD-I study targets improving dissemination of the evidence based Collaborative Care treatment model for pregnant and postpartum women with depression. Longitudinal remote consultation (LRC) is an implementation strategy that has been have shown to improve fidelity to evidence-based practices and patient outcomes for mental health innovations. The investigators believe LRC can be used with equal benefit for complex interventions such as CC.

The purpose of this study is to compare two implementation strategies for Collaborative Care depression treatment: 1) standard implementation and 2) standard implementation + Longitudinal Remote Consultation (LRC). This research is being done in order to assess implementation and patient outcomes in sites receiving a standard implementation approach with and without LRC. The results of the proposed study will provide information on the benefits and relative value of ongoing consultation, such as LRC, for implementation of complex interventions like collaborative care.