Mental Health studies

Our investigators research the role of mental illness in the development of chronic diseases, especially cardiovascular disease, obesity, and cancer. We also study mental health in children and adolescents, smoking and depression in teens, and psychosocial distress and treatment among breast cancer survivors. We participate in the HMO Mental Health Research Network, which is building the infrastructure for large multi-center research studies on the causes and treatment of mental illness in managed care settings.

An Evaluation of the National Zero Suicide Model across Learning Healthcare Systems

Our project seeks to develop metrics to measure fidelity and outcomes for the National Zero Suicide Model components implemented in each system using electronic health records and insurance claims data sources that are easily extractable and generalizable to other systems. Then, we propose to use these metrics to conduct fidelity and outcome evaluation of the various Zero Suicide Initiative approaches in each system using Interrupted Time Series Designs, which are among the strongest, pragmatic designs appropriate for evaluating care system intervention and policy changes in ‘Learning Healthcare Systems.’ We hypothesize that the implementation of various National Zero Suicide Model components will significantly reduce suicidal behavior within and across the participating systems. We seek to accomplish the following aims: 1) Collaborate with health system leaders to develop EHR metrics to measure specific quality improvement targets and care processes tailored to local Zero Suicide Initiative implementation; 2) examine the fidelity of the specific Zero Suicide Initiative care processes implemented in each system; and 3) investigate suicide attempt and mortality outcomes within and across Zero Suicide Initiative healthcare system models.

Site Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

National Institute of Mental Health (NIMH)

Funding Years:

2017 - 2022

Biobehavioral Vulnerability to Accelerated Aging in Breast Cancer Survivors

The aim of this project is to examine cellular and genomic markers of inflammation, telomere erosion, telomere length, and microarray data of 300 breast cancer survivors and comparison women who are enrolled in the KPSC-UCLA collaborative STRIVE1 and STRIVE2 studies.

Site Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

American Cancer Society

Funding Years:

2016

Building Capacity for Stakeholder Engagement in the Mental Health Research Network

This Eugene Washington engagement award will be used primarily to support the development of the involvement of our patients with mental health conditions, their caregivers and/or families, and national mental health community and advocacy groups who represent them in all phases of mental health research. The goals of this project are to: 1) Add the patient, caregiver, and family stakeholder voice and the community and advocacy groups who represent them to the national Mental Health Research Network (MHRN) executive leadership team to develop a shared direction for the network and a shared national voice for mental health comparative effectiveness research (CER); 2) Develop and pilot a strategy for stakeholder engagement within one MHRN-affiliated health system and the communities it serves to identify priorities for mental health CER; and 3) Develop and submit at least one new research proposal using the processes used in #1 and #2 at the end of the engagement award.

Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

Patient-Centered Outcomes Research Institute (PCORI)

Funding Years:

2018 - 2020

Care of Mental, Physical, and Substance Use Syndromes (COMPASS)

KPSC is one of nine sites throughout the country funded by an Innovation Award from the Centers of Medicare and Medicaid to implement a coordinated care model for depressed patients with cardiovascular disease. We have the following goals for this project: 1. To implement in three stages a multiple condition collaborative care management model in primary care clinics of care systems in states. 2. To demonstrate that this model improves care quality, patient experience and health, provider satisfaction, and total healthcare costs for the Medicare and Medicaid patients with the targeted conditions. 3. To develop role descriptions and training for the two new types of workers required for this model – care managers and care consultants. 4. To identify the costs and payment models needed by care systems to sustain and spread this care model.

Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

Institute for Clinical Systems Improvement (ICSI)

Funding Years:

2012 - 2015

Depression and Functional Outcomes in COPD: Impact of Genetics and Inflammation

This is a longitudinal observational study of the biological causes and functional consequences of depression in patients with stable COPD.

Principal Investigator:

Huong Q. Nguyen, PhD, RN

Funding Source:

National Institutes of Health (NIH)

Funding Years:

2013 - 2016

Development of a Population-Based Risk Calculator for Suicidal Behavior

We will use population-based data from seven large health systems to develop an evidence-based risk calculator for mental health and primary care clinicians. In order to address the gaps in evidence described above, we will expand current MHRN work on prediction of suicide risk by (1) expansion to a larger and more diverse sample, (2) Inclusion of encounters with “missing" risk assessments, (3) Examination of specific psychiatric and substance use diagnoses, and (4) applying analytic methods to account for potential biases due to patient- and provider-driven timing of assessments.

Site Principal Investigator:

Jean M. Lawrence, ScD, MPH, MSSA

Funding Source:

National Institute of Mental Health (NIMH)

Funding Years:

2015 - 2017

Effects of Medical Products on Suicidal Ideation and Behavior in Serious Mental Illness

Reducing risk of suicidal behavior is an urgent public health priority. Suicide accounted for approximately 45,000 deaths in the United States in 2016. While most major causes of death have steadily declined, suicide mortality in the US has increased by over 25% in the past 15 years, with greater increases in young people. Increasing rates of suicidal behavior are intertwined with prescription opioid use and opioid overdose. Traditional clinical trials will not be able to enroll large enough nor generalizable enough samples of patients to adequately inform regulation regarding these issues. We propose a comprehensive program of infrastructure development and methods development to support future generation of real-world evidence addressing these critical gaps. The project team will include health systems and embedded research organizations with deep expertise in stakeholder engagement, medical informatics, data science, clinical epidemiology, biostatistics, pragmatic clinical trial methods, implementation science, and innovations in care delivery. This program will be embedded in 4 integrated health systems serving a combined population of approximately 10 million members. This work will be conducted in collaboration with health system and patient/family stakeholders, to assure that methods and evidence developed will actually address real-world questions.

Site Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

Food and Drug Administration (FDA)

Funding Years:

09/30/2018 - 09/30/2021

Mental Health Research Network II

We have established a Mental Health Research Network including 13 established public-domain research centers based in integrated not-for-profit health systems. These systems provide care to a diverse population of 10 million people in 11 states, and they share rich and compatible data resources to support a range of effectiveness research. Diversity of member demographics, insurance coverage, and organization of health services make this network an ideal environment for studying variation in care, comparing effectiveness and cost of treatments across practice environments, and studying dissemination and health policies. Participating research centers are experienced in a wide range of clinical areas and research methods. The long-term objectives are to expand the Mental Health Research Network to include additional health systems and external investigators, to conduct multi-site observational and experimental studies of comparative effectiveness, to develop and evaluate methods for dissemination and implementation, and to become a national resource of research methods and effectiveness evidence for researchers, patients, providers and healthcare leaders.

Site Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

National Institute of Mental Health (NIMH)

Funding Years:

2014 - 2019

Patterns and Predictors of Transitions in Adult Attention-Deficit Hyperactivity Disorder

This study will estimate the epidemiologic and economic outcomes associated with the adult attention deficit hyperactivity disorder (ADHD). We also assess characteristics, predictors, and time frame for patients who transition to more complex ADHD within the inception cohort and generate prediction models for transition. The study also examines treatment patterns, medication adherence and healthcare utilization patterns of the inception cohort.

Principal Investigator:

Aniket A. Kawatkar, PhD, MS

Funding Source:

Shire Pharmaceuticals

Funding Years:

2009 - 2012

REPRISE 2: Is depression associated with prostate cancer progression?

This study examines if depression and its treatment can affect the course of prostate cancer.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2018

Sleep Disturbance, Inflammation & Cellular Aging in Breast Cancer Survivors (STRIVE 2)

The goal of this prospective recruitment study is to evaluate longitudinal differences in the rates of change in inflammation and telomere erosion in breast cancer survivors vs. non-cancer comparison women to determine if such molecular changes are due to cancer biology, or its treatment, or consequences of aging.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2016

Sleep Inflammation and Depression Occurrence in Breast Cancer Survivors (STRIVE1)

The aim of this prospective study is to examine the association between sleep disturbance, cellular and genomic markers of inflammation, and depression occurrence in breast cancer survivors.

Site Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2012