Targeted Condition: Bipolar Disorder

Raising Washington

A PARTNERSHIP TO PROVIDE COMPREHENSIVE PERINATAL MENTAL HEALTH AND PARENTING SUPPORT FOR THE FIRST 1,000 DAYS (peripartum period through child’s 2nd birthday)

Every year, some 10,000 of the 85,000 babies born in Washington State are born into circumstances considered high-risk, often the result of a parent’s mental health or substance use disorders. These disorders are associated with poor health outcomes for children and are a leading cause of maternal mortality.

Effective care for perinatal depression, substance use, and other behavioral health challenges is one of the best strategies we have to help women during critical periods in their lives, to support families with new children, and to prevent future mental health and substance use problems. A number of health systems and community-based resources are available, but they don’t always reach people in need and they can be complicated to access. Currently only 1 in 5 people with mental health or substance use disorders receive effective, comprehensive care before and after pregnancy.

THE VISION: HEALTHY FAMILIES, HEALTHY BABIES
Long term goal: make UW Medicine and ultimately Washington state the healthiest place in the country to have a baby.

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 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.

THE PROGRAM
Raising Washington is supported by the Garvey Institute and UW Medicine Advancement to develop an evidence-based fully integrated perinatal support program at the University of Washington. The initiative has strong Executive leadership from UW Medicine departments of Family Medicine, Obstetrics and Gynecology, Midwifery, Pediatrics, and Psychiatry and Behavioral Sciences and the Schools of Nursing and Social Work. The Clinical Leadership Team consists of providers working with families, parents, and babies through the perinatal continuum to develop the perinatal support program. Critical to the success of this program is the development of a Navigator team who will work alongside parents and clinical providers to support families during pregnancy and the child’s first 1000 days.

In Spring of 2026 through 2027 we will launch a Pilot of Raising Washington to test this program with 100 women delivering a child at UW Medicine.

To learn more this work, please contact Lori Ferro, MHA, project manager (ljf9@uw.edu).

Empower Through Health

Empower Through Health (ETH) is a healthcare, research, and education 501c3 organization operating in rural eastern Uganda. ETH runs a health center that provides general medical care for surrounding communities and delivers psychiatric and neurological services across Buyende District (population >400,000). ETH’s research focuses on reducing demand-side barriers to care and partnering with existing community structures to improve mental health outcomes and support recovery after mental health crises. ETH hosts the Global Health Experiential Fellowship (GHEF), a hands-on training program that pairs Ugandan and U.S. trainees on community-engaged research. ETH is also expanding its education mission by launching a primary school to strengthen long-term community wellbeing.

Developing a Therapeutic Community in Washington State

We are exploring the feasibility of establishing a long-term, residential Therapeutic Community in Washington State for adults living with schizophrenia, schizoaffective disorder, biplolar disorder and other serious mental illnesses. Such a facility would fill a critical gap in our current system, providing a complete spectrum of care for those in our community with chronic mental health conditions. Beyond offering patients and families a safe and therapeutic way to continue their recovery, we would hope to develop this program as a site of research and innovation and a site where we can teach and inspire the next generation of mental health care professionals for our state. Ultimately, we would like to help other communities build programs of their own.

Optimizing telemental health with live artificial intelligence clinical scaffolding and feedback

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.

Monitoring mood symptoms in young adults at-risk for bipolar disorder

The ages of 18-25 years are ‘peak onset’ times of major depression and bipolar disorder. These disorders have different courses and treatments, but diagnosing bipolar disorder is difficult because manic symptoms occur less often than depressive symptoms and many individuals do not recall manic symptoms. A ‘misdiagnosis lag’ of 8-10 years can contribute to prolonged periods of potentially ineffective treatments and suboptimal outcomes such as high symptom burden, relationship problems, educational attainment and occupational functioning.

This project will use remote prospective assessment and monitoring of depressive and manic symptoms in at-risk patients in-between patient visits to increase the ‘data points’ clinicians have when assessing a bipolar disorder diagnosis. This is especially important for people at risk for bipolar disorder (for example those with a family history of bipolar disorder) because manic symptoms can be provoked by first-line medication treatments for major depression. The project will use a new manic symptom measure (the Patient Mania Questionnaire-9) and a commonly used depressive symptom measure (the Patient Health Questionnaire-9) to monitor symptoms, and learn how clinicians and patients use this information clinically.

Bipolar disorder measures in clinical care

The goals of this project are to 1) determine which validated bipolar disorder patient-reported symptom measure is most acceptable and helpful to patients and clinicians in clinical care, 2) demonstrate that the preferred measure can be used to monitor outcomes with high fidelity in routine care, and 3) assess the feasibility of comparing effectiveness of measurement-based care (MBC) to usual care in a randomized trial.

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.

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.