Targeted Condition: General Mental Well-Being

Identifying and treating loneliness in young adults in primary care

Loneliness, defined as the feeling of insufficient personal relationships, affects over 20% of young adults. Those with loneliness are more depressed and anxious and have poorer educational outcomes. Cognitive behavioral therapy and social navigation can successfully treat loneliness but previous studies have mostly looked at older adults.

The objective of this study is to demonstrate the feasibility of identifying and alleviating loneliness in young adults identified in primary care practices. This project will screen young adults ages 18-25 presenting in primary care for loneliness and pilot the interventions of cognitive behavioral therapy and social navigation for those who test positive for loneliness.

Optimizing mental health first-aid programming for sport coaches

Many sport organizations are increasingly vocal about the importance of athlete mental health. Helping organizations move beyond rhetoric to improved athlete wellbeing and safety requires evidence-based resources that are setting-appropriate and feasibly implemented.

This project will develop and obtain feasibility and acceptability data on “Time Out for Mental Health”—a mental health first aid training for sport coaches. This will be accomplished by adapting an existing evidence-based mental health first aid resource to the coach role and sport setting, working closely with a small group of coach partners. The team will focus on ensuring the training is considered useful and feasible by coaches who work in resource deprived school and community-settings given the heightened needs and challenges of youth in such settings, and will train coaches to deliver “Time Out for Mental Health”—to build organizational capacity. “Time Out for Mental Health”—has the potential to strengthen connections between sports organizations and school- and community-based mental health services for millions of adolescents as more than half of high school students play at least one organized school or community sport.

Adapting a resilience intervention for youth athletes

Youth mental health is in crisis and we do not have adequate providers to treat the current burden of illness. We must identify innovative approaches to support youth mental health that utilize the existing infrastructure and can be administered by non-clinicians. While sports are predominantly a positive outlet for youth, they also bring stressors due to experiences with failure, injury and challenging time commitments, and thus provide an ideal laboratory to develop coping skills for managing stress.

This project aims to build psychological resilience in high school athletes by adapting an intervention developed for youth with chronic illness (PRISM). The intervention will be delivered through the coach via an educational platform with five modules: 1) background/ psychoeducation; 2) creating a supportive team culture; 3) stress management (breathing exercises, visualization and mindfulness); 4) mindset (goal setting, cognitive reframing and meaning making); and 5) fueling the machine (sleep and nutrition). The team will utilize a community-engaged research process to adapt the PRISM approach to an athletic space, using the term “Mentally Strong” to center it in the sport context, and will partner with youth athletes and coaches to ensure the tools we develop support their needs. The Mentally Strong approach has the potential to increase the emotional literacy of a broad swath of high school youth beyond the athletic environment, enhancing their ability to negotiate the acute and chronic stressors they encounter in daily life. The ultimate goal of the project is to prevent the outcomes which occur with negative emotional coping—including depression, anxiety, substance use, burnout, violence, withdrawal from school and even suicide.

Reducing barriers to accessing mental health care using a web-based program for young adults

Most young adults with mental health (e.g., depression, anxiety) or substance use disorders do not receive treatment. Untreated mental health and substance use can be associated with impairments in social relationships, overall functioning and suicide. National data indicate that almost half of young adults with symptoms of a mental health disorder reported they needed mental health care in the past year but did not access those services. Barriers to accessing mental health care include stigma, not knowing where to go, lack of transportation and cost.  

This project aims to develop a personalized web-based program for young adults to reduce self-reported barriers and increase motivation to access mental health and substance use services. Investigators will work with clinicians and young adults to develop strategies and solutions to address the identified barriers. The team will work with a community advisory board to develop program content that will be further refined through focus groups and individual interviews with young adults and clinicians. From this, the team will develop the web-based program which will serve as the first step needed to establish a larger program of research focused on reducing barriers and increasing access to mental health care to improve young adult well-being.

Embedded clinical coaching

Using an embedded clinical coaching framework, the Evidence Based Practice Institute (EBPI)/CoLab is promoting the development of quality care expertise within behavioral health agencies to reduce the cost and improve the speed of clinical workforce training. The goal of this project is to move principles of effective behavioral health care more quickly into practice, and to foster agency resilience to workforce turnover. This project is part of a broader Leadership Initiative for Quality.

To develop and eventually implement an embedded clinical coaching model, EBPI/CoLab partnered with multiple organizations in Washington to determine priorities and gather feedback. Through these partnerships, EBPI/CoLab identified key characteristics of an effective clinical coaching model, and incorporated stakeholder feedback to ensure scalability and adaptability. This coaching model includes the development of an asynchronous training for new clinicians, an embedded peer consultation structure, and competency checks through clinician-submitted videos. Through this novel embedded coaching structure, organizations can retain internal expertise and better support a shifting workforce.

Supervisor tools for quality

The Supervisory Tools for Quality initiative recognizes the integral role that clinical supervisors play in supporting behavioral health clinicians’ use of effective practices in community mental health agencies, and aims to leverage this role to improve the scale up and sustained use of quality behavioral health services. Specifically, this project is focused on the development of cost effective, easy to use, and practical strategies to elevate supervision practices. This project is part of a broader Leadership Initiative for Quality.

This initiative involved partnering with supervisors to form a Supervisor Advisory Team. This team worked to provide practical and tangible supports to supervisors in order to improve delivery of quality and effective behavioral health services, and ultimately strengthen outcomes for economically and racially marginalized children and adolescents. This advisory group included experienced supervisors in behavioral health organizations across the state. Geographic regions represented included Bellingham, Bellevue, Lakewood, Spokane, Walla Walla, and Yakima. To date, we have completed three Supervisor Advisory Team meetings.

Expanding culturally responsive care for children and families in Washington State

The Expanding Culturally Responsive Care initiative, a new project funded through a 2022 Washington State legislative proviso, aims to strengthen the lived experience behavioral health workforce and create a culturally responsive care curriculum for statewide implementation in Medicaid-serving organizations. This initiative was developed in response to Washington State’s urgent need for more culturally responsive, effective public behavioral health services–services that many families do not currently have access to. Ideally, this initiative will allow for more families to receive care that promotes true healing, mental health wellness and health equity. Curriculum and strategy development will be done through a participatory, collaborative co-design process with broad ranging input from across the state, and will center community voice, transparency, and accountability throughout all stages of the process. This project is part of a broader Leadership Initiative for Quality.

Opportunity Based Probation

Opportunity-Based Probation (OBP) is a new juvenile probation model that expands on adolescent development research by leveraging adolescents’ drive towards independence as well as their heightened receptivity to rewards. In collaboration with their probation officers, youth create meaningful goals and incentives that reward the development of prosocial behavior. Probation officers scaffold prosocial behavior by reinforcing success and constructively addressing probation violations and problem behaviors. OBP was originally developed through a collaboration between UW CoLab and juvenile court leadership in Pierce County, Washington with funding from the Annie E. Casey Foundation and is now being implemented, refined, and tested for acceptability, implementation, and preliminary effectiveness. In 2021, a second OBP site was started in Hartford County, Connecticut and is currently undergoing co-design and implementation efforts with an eye for eventual testing and expansion statewide.

Accelerating research use in courts

Measuring the use of research evidence within organizations and systems is a rapidly growing area of study in the social sciences as researchers, policymakers, and practitioners in a variety of systems try to bridge the research-to-practice gap. With growing calls for justice systems, especially juvenile justice systems, to integrate developmental and behavioral health science within all aspects of the justice process, it is critical to develop a standardized measure of how individuals use research evidence within these systems. This will allow researchers to examine how research is used across studies, sites, and points in time, as well as to refine and compare new interventions aimed at increasing the use of research. Toward this end, the UW CoLab research team with the help of the William T. Grant Foundation, is developing and validating a measure of research use with collaborators nationwide.

COVID-19 Student Survey

This project involved an anonymous needs assessment for 6th through 12th graders in Washington to collect data on what students thought was going well, what challenges they had encountered, and what their needs were as schools replied to largely in-person instruction following a largely virtually year because of the COVID-19 pandemic.