Cornerstone: Boundary Spanning Case Management and Peer Support for Youth

基石：跨界案例管理和青少年同伴支持

• 批准号: 8772997
• 负责人: MICHELLE R. MUNSON
• 金额: $ 15.84万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8772997
• 关键词: Achievement; Address; Adult; Age; Ambulatory Care Facilities; Anger; Caring; Case Management; Case Manager; Child; Clinic; Collaborations; Commit; Communities; Consensus; Coping Skills; Coupled; Data; Depressed mood; Development; Diagnostic; Education; Educational process of instructing; Employment; Evidence based intervention; Foundations; Goals; Group Interviews; Health Insurance; Health Services Research; Health system; Healthcare; Housing; Hybrids; Individual; Intervention; Interview; Knowledge; Low income; Manuals; Mediating; Medicaid; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methods; Modeling; New York; Outcome; Policies; Positioning Attribute; Process; Protocols documentation; Provider; Qualitative Methods; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recovery; Relative (related person); Research; Sampling; Science; Scientist; Secure; Services; Social support; System; Testing; Time; Training; Work; Youth; base; care systems; clinical practice; cost; design; experience; functional outcomes; improved; in vivo; innovation; meetings; member; multidisciplinary; payment; peer; primary outcome; public health relevance; response; role model; skills; social stigma; treatment as usual; young adult

DESCRIPTION (provided by applicant): In response to PA-12-279, the goal of this R34 is to refine and examine the feasibility, acceptability and preliminary impact of a theoretically guided intervention that provides system 'boundary-spanning' services to improve mental health service use and outcomes for low-income, transition-age youth with mental disorders (TAYMD). Through the refinement and testing of this intervention, called Cornerstone, we aim to address mental health challenges as well as the practical obstacles, such as lack of education, housing, and employment, that impede successful transition to adulthood. Cornerstone addresses these challenges by providing a service delivery strategy that spans the transition from the child to the adult system. Cornerstone centers on addressing three pressing problems: (1) the discontinuation, or at best fragmentation, of mental health care for TAYMD, (2) the lack of evidence-based interventions for TAYMD, and (3) the reality that promising practices for TAYMD, many of which Cornerstone builds upon, have not been tested with a sample that moves from child to adult services. Cornerstone deals with these problems in innovative ways at a time of transformation in health care. First, Cornerstone provides a 'boundary spanning case manager' (BSCM) across the transition. That is, rather than extending the age of service provision in the child system, we prioritize collaboration with the adult system and practical assistance to assure that the transition to developmentally and clinically appropriate adult services and independent adulthood happen at age 18. Second, Cornerstone incorporates an innovative form of social support, namely a recovery role model mentor (RRM) who is a decade older than TAYMD. The RRM co-facilitates weekly groups and provides important information and mentoring (i.e., modeling, connection) for TAYMD. Third, the development of Cornerstone is aligned with policy and practice transformation, particularly Affordable Care Act and New York State Medicaid Redesign, prioritizing coordinated, evidence-informed care for TAYMD, expansion of the workforce, and an emphasis on achieving functional outcomes and wellness. The aims are 1) to develop and refine all manuals and protocols for Cornerstone, 2) to determine the feasibility, acceptability, and preliminary impact of 'Cornerstone' relative to treatment as usual (TAU) on mediating outcomes (e.g., stigma), service use, and improved mental health and functioning outcomes, and 3) to explore implementation of Cornerstone through individual and group interviews with key stakeholder partners on aspects of the transforming local, state and national service context (e.g., staffing, payment). As a multidisciplinary team of professionals on the local, state, and national level we are committed to bridging the science to service gap for youth transitioning to adulthood with mental health challenges. Using qualitative methods and an RCT, this study is the first to examine a true transition intervention. We believe mental health services research that focuses on the transition to adulthood with innovative service delivery strategies that span developmental silos will decrease the number of TAYMD with unmet mental health needs.

描述（由申请人提供）：为了响应PA-12-279，该R34的目的是完善和研究理论上指导干预措施的可行性，可接受性和初步影响，该干预措施提供了“跨越边界”服务，以改善精神卫生服务的使用，以改善低收入，精神病患者（Taymd）的低收入，过渡时期的年轻人（Taymd）。通过对这种干预措施的完善和测试，我们旨在应对精神健康挑战以及诸如缺乏教育，住房和就业之类的实际障碍，这些障碍阻碍了成功过渡到成年。基石通过提供服务交付策略来解决这些挑战 成人系统。 基石以解决三个紧迫问题的中心：（1）taymd心理保健的中断或最多分裂，（2）（2）缺乏对Taymd的基于证据的干预措施，以及（3）对Taymd的有希望的实践的现实，其中许多基础的构建尚未与成人服务的样本相结合。基石在医疗保健转型时以创新的方式处理了这些问题。首先，基石在整个过渡过程中提供了一个“边界跨越案例管理器”（BSCM）。也就是说，我们不是延长儿童系统中的服务年龄，而是优先考虑与成人系统的合作以及实际的帮助，以确保向发展和临床适当的成人服务和独立成年期间的过渡。其次，Cornerstone融合了社会支持的创新形式，即是decade of decade of the decade of the the decade of the decade of the the the the themm decade的创新形式。 RRM共同利用每周的小组，并为TAYMD提供重要的信息和指导（即建模，连接）。第三，基石的发展与政策和实践转型保持一致，特别是负担得起的护理法和纽约州医疗补助重新设计，优先考虑对TAYMD的协调，循证的护理，劳动力的扩大，并强调实现功能成果和健康。 目的是1）开发和完善基石的所有手册和协议，2）确定“基石”相对于往常的治疗（TAU）对中介结果（例如Stigma）（例如Stigma），服务使用，服务使用以及改善的精神健康和功能范围的实施者的可行性，可接受性和初步影响，以及探索个人和群组的构成，并构成了Sysements of Systore and Orkessore of Cornersers的组成部分，以及众所转型的本地，州和国家服务环境（例如，人员配备，付款）。作为当地，州和国家一级的专业人士的多学科团队，我们致力于将科学弥合，以使青年人过渡到成年后，以应对心理健康挑战。使用定性方法和RCT，这项研究是第一个检查真正的过渡干预措施的研究。我们认为，精神卫生服务的研究重点是通过创新的服务交付策略过渡到成年，跨越发育筒仓将减少未满足心理健康需求的Taymd数量。