Rutgers University will receive $4.2 million in federal funding over five years to create a regional center — one of ten nationwide — to train and provide other support services to community-based mental health providers.
The money from the federal Substance Abuse and Mental Health Services Administration is going to the Rutgers School of Health Professionals to set up the Mental Health Technology Transfer Center in an effort to improve the operations and patient outcomes in behavioral health services in federal Region 2, which encompasses New Jersey, New York, Puerto Rico and the U.S. Virgin Islands.
The new program — which echoes federal models used to address other care needs, like addiction — will enable Rutgers to identify practices that address widespread problems, such as the ongoing workforce shortage, and create education initiatives to disseminate effective solutions. Staffing is a persistent challenge for these providers, given the low pay and high turnover.
But the center will go beyond teaching best-practice protocols to provide expertise and other support to help organizations incorporate improvements in ways that will make them part of their daily routine and, over time, result in measurable improvements in patient care. In particular, the Rutgers program will focus on children with emotional challenges and adults with serious mental illness.
The overarching goal is to put into wider practice approaches that have been documented to work but are not used as much as they could be, explained Kenneth Gill, who chairs Rutgers department of psychiatric rehabilitation and counseling, and wrote the successful SAMHSA proposal.
Gill, who will co-chair the center, said this includes trauma-informed care — which takes into account the harmful impacts of adverse childhood experiences, something that was documented decades ago to be important — and housing-first initiatives, which are based on the concept that a safe home is the foundation of a healthy life; despite the clear benefits, these practices are not standard. Another target is improving supportive employment programs, which aim to integrate individuals into the workforce, and can be highly effective when done right, he said.
Gill said, “There is a pretty big lag in general in translating science into practice,” a result of the overwhelming demands on community-care organizations and the usual resistance to change among some individuals. “The research has been out there for some time, but the same old things are being done,” he said.
While this may be true throughout medicine, “It’s a little more pronounced in psychiatry and mental health,” according to Gill, who added, “If the research-based practices are better implemented, there will be better outcomes for people with serious mental illnesses.”
‘Years of research and knowledge…’
The funding for Rutgers — anticipated to be $750,000 annually for five years — is part of the more than $9 million SAMHSA, as part of the U.S. Department of Health and Human Services, set aside in the current budget year to support Mental Health Technology Transfer Centers in each of the ten federal regions.
Funding will also go to centers focused on Hispanic and Latino care and another to serve Native American tribes, as well as a national oversight program. Programs were also approved at Yale University in Connecticut, Georgia’s Emory University, the University of Iowa, and Stanford University in California, among others, and for a handful of non-academic research facilities.
Similar to SAMHSA-funded national regional initiatives for drug addiction and prevention, the mental health program is designed to speed up the adoption of best-practice protocols, strengthen the workforce, ensure diverse and culturally appropriate patient resources, and shore up programs that provide free or low-cost services to those in need, according to the grant application posted in May.
“Years of research and knowledge of evidence-based practices related to mental disorders show that well-designed prevention, treatment, and recovery support efforts are effective and can have multiple benefits for individuals with mental health disorders, including serious mental illness. It is SAMHSA’s intent to ensure that the public has the resources it needs to be successful in treating these conditions,” the grant announcement reads.
Trying to reach a wider audience
The Rutgers program will be housed on its Piscataway campus and is expected to be fully operational next year. School of Health Professions Dean Gwendolyn Mahon said the national center is a natural fit for the school, given its longtime work in the region on these types of issues. Gill said the school has worked with New Jersey state government and providers on a variety of efforts, including payment reforms, and with New York State to expand peer-training services.
“It has provided educational and technical assistance services to New Jersey for 17 years, and more recently, New York and Washington states, and the City of New York,” Mahon said.
With a handful of staff, and assistance from Ann Murphy, who heads the Ph.D program for psychiatric rehabilitation and will co-lead the center, Gill said the new federally funded center will seek to scale up some of the models it has created for a much wider and more diverse audience. “It’s going to be a challenge,” he noted.
To disseminate this information, the center will create training programs for providers and their staff and provide technical assistance and other support to organizations in implementing change, Gill explained. It will also establish a “train the trainer” system to help reach a wider audience, beyond the capacity of Rutgers staff alone.
One problem Rutgers and other regional centers are unlikely to tackle is the lack of funding, Gill conceded, something that is a chronic problem for community-based providers, many of which are nonprofit organizations. Limited budgets put things like pay hikes out of reach and can limit the ability of such providers to adopt new practices, he said.
“A good chunk” of the challenges these organizations face are related to funding, Gill acknowledged. “It’s a big problem and it’s interwoven with a lot of things.”