Optimizing implementation of evidence-based interventions to promote reach and retention in mental health services

The prevalence of mental disorder is three times greater in complex emergencies relative to global averages. There are many challenges to implementing mental health services in complex emergencies, including population mobility and weakened health systems. Innovative strategies are needed to improve access to mental health services for mobile and emergency-affected populations. The goal of this K01 Mentored Research Scientist Development Award is to prepare the candidate for an independent research career dedicated to improving access to evidence-based mental health services for mobile populations and in complex emergencies. Through this K01 award, the candidate will leverage the training resources available through Columbia University and her mentorship team to acquire the skills needed in systems science and human-centered design to develop and test strategies for improving reach and retention in scalable psychological interventions. The goal of this K01 research is to optimize implementation of scalable psychological interventions to improve reach and retention for mobile populations with mental health problems. This research builds on an ongoing research partnership between Columbia University and HIAS, a non-governmental organization. The specific aims are: 1) To describe the individual-, community-, and systems-level relationships that influence reach and retention in mental health services among mobile populations using group model building; 2) To design and optimize an implementation plan to improve reach and retention in scalable mental health interventions among mobile populations through human-centered design; and 3) To compare reach and retention in mental health services using the community-designed implementation plan relative to implementation-as-usual among mobile populations with a comparative interrupted time series analysis. This research is an integral component of a rigorous training and career development plan involving intensive training and mentorship in systems science, human-centered design, adapting implementation strategies, and understanding social determinants of access to care in complex emergencies. This study will be the first to optimize implementation of mental health interventions for emergency-affected communities and will provide critical preliminary data to inform an R01 application to test promising implementation approaches at scale. This research aligns with NIMH’s strategic objective to develop innovative service delivery models to improve mental health.