Patient-Centered Research Shows that Disparities in the Treatment of Mental Illness can be Improved Through Services like Compressive Primary Care

The high prevalence of mental health illnesses has affected a wide range of people across the nation. According to the National Institutes of Health, one in six adults in the United States had a mental disorder in 2016. By 2030, the estimated cost of mental health disorders is projected to be greater than the combined costs of diabetes, respiratory disorders, and cancer. In an effort to address this issue, The Patient Centered Outcomes Research Institute (PCORI), which was created to help experts improve healthcare delivery and outcomes through evidenced-based research, allocated resources to mental and behavioral health. PCORI funded 107 comparative clinical research studies related to mental health, 23 of which focus solely on minority populations totaling $54 million. PCORI’s projects are important when enacting policies and establishing initiatives focused on preventing, diagnosing and treating mental illnesses in the United States.  

On June 13th, PCPCC attended an event by Research!America, PCORI, National Hispanic Medical Association and the National Medical Association to discuss the disparities in the treatment of mental illness and the role of patient-centered research in addressing the issue. The briefing featured key panelists who combined the PCORI funded resources with unique, forward-thinking ideas to advance mental health efforts in underserved populations. It is striking how many of these recommendations align with the  fundamental principles of the Shared Principles of Primary Care. This epidemic disproportionately affects minorities more than non-Hispanic whites because minorities have less access to primary or behavioral health care, and are less likely to receive diagnoses of mental illnesses leading to poorer mental health outcomes. Through these grants, the panel of researchers discussed their critical work and offered expert opinions that identified the scope of the problem, as well as outlined possible solutions. In addition to the efforts emphasized in the capital hearing, PCORI provided resources highlighting other funded studies happening in their organziation. 

Children in minority groups tend to have a greater risk of mental health problems and less access to care than non-Hispanic whites. Dr. Tumaini Coker, who is the principal investigator of a PCORI-funded project at Seattle Children’s Hospital, said that when she started her research project, she knew that multiple barriers stand between children from low-income families and necessary mental health services. The study focused on an approach that supports the transfer of pediatric care for continued management of children’s mental health conditions. Care coordinated efforts and easier access to a primary care physician would lead to a higher retention of patients and ultimately better outcomes. 

Dr. Alfiee Breland-Noble of Georgetown University offered her thoughts about adolescent mental illness at the Capitol Hill briefing. Nobel believes that in order to develop initiatives for at-need children, it is important to define the scope of the problem. She noted that one in 4 children suffer from anxiety and about 8% of them develop some form of depression over the course of their childhood. Dr. Noble emphasized that providers, patient navigators, and experts from these communities are imperative to this issue. Dr. Pat Corrigan who is the principal investigator on a PCORI-funded comparative research project called “ Integrated Care and Patient Navigators for Latinos with Serious Mental Illness” echoed these sentiments by stating that minorities should be research partners and not just research subjects. Providers who are representative of the community could go a long way addressing the taboo and stigma of mental health in underserved populations. The PCORI funding has granted more capacity to build interventions that prioritize diversity and culturally appropriate methods of patient-centered delivery.

Congressman Raul Ruiz from the 36th district in California stressed that an important key to addressing this problem is health equity and access. Patients do not have access to necessary primary care services which leads to widened disparities in vulnerable communities. Likewise, many patients do not have access to mental health education programs. According to Dr. Elena Rios, PCORI’s role in health equity focuses on patients, providers, and preventative programs. Community based tools such as after school or senior programs would create an educational platform that equips patients with tools to overcome mental health.  

Please find a few other relevant PCORI resources mentioned at the event below:

Delivery of Mental Health Services to Children in Underserved Areas

The Decision Is Yours: Engaging Patients in Depression-Treatment Choices

Using Telehealth to Deliver Developmental, Behavioral, and Mental Health Services In Primary Care Settings for Children in Underserved Areas