Improved financial literacy among people living with serious mental illness (SMI) is associated with a higher quality of life, fewer hospitalizations, and better treatment adherence. Yet people living with SMI frequently express how their lack of financial knowledge has negative personal consequences and that they don’t know where to turn for assistance. This project will gather qualitative and quantitative data from people admitted to the Center for Behavioral Health and Learning, a psychiatric hospital, to understand the need and desire for a financial skills intervention and its role in discharge planning. The assessment will also seek input from family members/caregivers, representative payees/fiduciaries and experts in the community. Ultimately, we hope to create a replicable, standardized intervention that can be evaluated and implemented in inpatient settings and modified as necessary for outpatient settings.
Targeted Condition: Serious Mental Illness
Using Natural Language Processing to risk-stratify inpatient psychiatry conflict and violence
This QI project aims to expand from general medical wards to inpatient psychiatry the use of predictive risk-modeling for violence or restraint, using Natural Language Processing of clinical notes. We will also assess whether NLP paired with generative AI can accurately summarize a wider range of clinical notes relevant to behavioral emergencies
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.
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.
Partnering with community pharmacies to enhance access to long-acting injectable antipsychotics in Washington State
Medication nonadherence is common among patients with serious mental illness, including schizophrenia. The use of long-acting injectable antipsychotics (LAIAs) for schizophrenia is an evidence-based practice that improves medication adherence, decreases symptomatic recurrence and reduces hospitalizations. However, patients and clinicians often face several challenges in access and coordination resulting in the underutilization of LAIAs in care.
Administering LAIAs at community pharmacies could potentially increase accessibility, reduce barriers for treatment and improve patient outcomes. This project aims to assess the fit or compatibility of LAIA administration in community pharmacies. We will survey community pharmacy staff and behavioral healthcare providers in Washington State to assess the acceptability, appropriateness and feasibility of LAIA administration in community pharmacies. If LAIA administration at community pharmacies is found to be a good fit, the next steps will be to develop strategies to support implementation. A scalable and adoptable model for administering LAIAs at community pharmacies could have substantial impacts on public health through increasing access to treatment and expanding behavioral health services at the community level and in rural areas.
Training psychiatry residents in complex communication skills for working with clients and their supports
Individuals with serious persistent mental illness (SPMI) and their families and communities face significant challenges during psychiatric hospitalization. Persons with SPMI and their supporters express a need for enhanced communication from their behavioral healthcare teams during these pivotal periods of time where symptoms are new or intense. Yet, a substantial number of mental health providers have limited training in communicating complex topics such as diagnosis and prognosis. This can lead to providers avoiding essential conversations; individuals with SPMI can be unheard or excluded from participating in treatment planning.
This educational initiative seeks to craft an innovative curriculum for psychiatry residents focused on person-centered communication skills. Drawing from proven communication training frameworks within palliative care, the training will equip residents with strategies such as: utilizing person-centered language; conducting family meetings; delivering diagnostic and prognostic information. The curriculum will be developed with guidance from individuals with lived experienced of SPMI and their supporters. Moreover, the project will deliver a dedicated online portal featuring educational materials, recorded presentations, role-play scripts, and communication guides. Tools, such as self-assessment and evaluation rubrics, will be created to evaluate efficacy.
Cognitive-Behavioral Therapy for psychosis workforce development
Cognitive Behavioral Therapy for psychosis (CBTp) is a time-limited, structured form of talk therapy that is indicated for individuals who experience distress related to psychotic symptoms. Although evidence demonstrates effectiveness in enhancing care and outcomes for clients with psychosis, CBTp is not widely available in the United States. The UW SPIRIT Lab in the Department of Psychiatry & Behavioral Sciences (PI: Sarah Kopelovich, PhD) applies evidence-based implementation and dissemination strategies such as blended learning, train and trainer, Project ECHO, longitudinal consultation to agencies, supervisors, and practitioners, fidelity assessment and monitoring, and sustaining the first CBTp Provider Network in the United States. The CBTp workforce development project aims to sustain and expand access to CBTp across publicly-funded behavioral health settings in Washington State.
Developing a digital training resource for clinicians learning CBT for psychosis (CBTpro)
The Cognitive Behavioral Therapy Training Study will rigorously test CBTpro — a novel tool that uses spoken language technologies and conversational Artificial Intelligence to train behavioral health practitioners in Cognitive Behavioral Therapy. We conducted a 2-week field trial, followed by a Randomized Clinical Trail in community mental health agencies to evaluate both learner and client outcomes. The study aims to expand global access to CBT training to students and practitioners, support quality psychological treatments for clients with a range of behavioral health disorders (including Serious Mental Illness), and support ongoing clinical quality assurance in routine care settings.
Establishing the Current State of Assertive Community Treatment (ACT) Implementation in the U.S.
This study aims to fill a significant knowledge gap that has impeded empirically-informed implementation and sustainability of high-fidelity Assertive Community Treatment (ACT). Investigators are conducting a survey of ACT stakeholders, including specialty adaptations (e.g., Forensic ACT [FACT]) across all U.S. states and territories, examining the relationship between ACT fidelity and outcomes, and examining contextual factors (e.g., financing and policy) that impact high-fidelity ACT implementation and sustainability.
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. |
