Health Services and Psychiatric Epidemiology
**For information and application materials for our NIMH T-32 Psychiatry in Primary Care Fellowship, please click here.**
The University of Washington Department of Psychiatry and Behavioral Sciences is a thriving and growing research environment. In 2005, it ranked 14th among the nation’s departments of psychiatry in NIH funding, with over $19 million in research and training grants. As of 2013, the Department of Psychiatry Research grant funding has grown to over $30 million. Among the research faculty in the Department, there are three major areas of strength: the Division of Health Services and Psychiatric Epidemiology, the Division of Integrated Care and Public Health, and the Division of Neurosciences.
The mission of the Health Services Division is "to develop interventions to improve the care of patients with mental illness across systems of care. To increase the awareness of the public and health policy administrators, and providers in systems of care regarding the adverse impact of mental health and substance abuse problems on individuals, families, and vocational, medical, and legal systems."
The Division of Health Services at the University of Washington includes over 40 faculty members actively involved in research programs. Faculty members are spread over four teaching hospital systems, including the University of Washington Medical Center, Veterans Administration Hospital, Children's Hospital and Medical Center, and Harborview Medical Center.
Researchers are involved in several key areas, including primary care, psychiatric and medical comorbidity (i.e. heart disease or diabetes and depression), alcohol and substance abuse, chronic mental disorders, prevention of suicide, and a range of childhood and adolescent research. The Division has many joint research projects with the Center for Health Studies at Group Health Cooperative of Puget Sound. These projects include collaboration on multiple NIMH grants that helped establish the effectiveness of collaborative depression and anxiety care models in improving quality of mental health care and outcomes compared to usual primary care. Division investigators have also been involved in large longitudinal epidemiologic studies that have shown that comorbid depression is very common in patients with chronic medical illnesses such as diabetes and heart disease, impairs self-care of these conditions (i.e. adherence to diet, exercise and taking medications as prescribed), and is a significant risk factor for complications of these illnesses as well as mortality. In recent years, Division researchers (Wayne Katon MD, Paul Ciechanowski MD, MPH) have collaborated with Group Health investigators (Michael Von Korff ScD, Elizabeth Lin MD, MPH, and Evette Ludman PhD) to develop the TEAMcare multi condition intervention which was shown to improve quality of both mental health and physical health care, and depression and medical disease control for patients with comorbid depression and poorly controlled diabetes and/or heart disease. Other Division investigators have developed interventions to help improve to outcomes of patients involved in traumatic accidents who develop PTSD or have alcohol problems (Doug Zatzick MD, MPH), patients with comorbid depression and traumatic brain injury (Jesse Fann MD, MPH), as well as educational interventions to help improve safety of opiate prescribing for patients with chronic benign pain (Mark Sullivan MD, PhD).
In addition, the Division also has close ties with the Seattle School System (Elizabeth McCauley, PhD and Ann Vander Stoep, PhD, Principal Investigators) and the Washington State federally qualified primary care system (Jürgen Unützer, MD, MPH, Principal Investigator). Drs. McCauley and Vander Stoep have developed longitudinal studies of at risk youth in middle school to determine risk factors for development of depressive disorders in later adolescence, as well as studies testing interventions for these youth. Dr. Kathleen Myers has adapted collaborative care principles in a large NIMH funded grant aimed at improving quality of mental health care via telemedicine for youth with ADHD in rural Washington and Oregon. In collaboration with the Community Health Plan of Washington, Public Health Seattle, and King County, Dr. Unützer has helped implement depression collaborative care in over 130 federally qualified primary care clinics in Washington state.
The Division offers an NIMH National Research Service Award T-32 training grant: the Psychiatry in Primary Care Fellowship
(Wayne Katon, MD, Principal Investigator). This grant trains physicians in mental health services research skills, and is closely allied with the University of Washington School of Public Health.
Dr. Katon has strong partnerships with two large health services research and dissemination groups at the University of Washington: the Integrated Care and Public Health Division (Dr. Jürgen Unützer, Director), which includes the Advancing Integrated Mental Health Solutions (AIMS) Center (Jürgen Unützer, Principal Investigator) (uwaims.org), and Dr. Paul Ciechanowski’s Training xChange Program (trainingxchange.org) in University of Washington Center for Commercialization (C4C) Office. The focus of the Division, as well as the AIMS Center, is on supporting primary care systems in integrating collaborative care models into primary care systems to improve outcomes of patients with depression and anxiety, while the Training Xchange Program helps to disseminate the TEAMcare intervention (teamcarehealth.org), in addition to providing a wide range of training programs on other evidenced based models of care, such as PEARLS and CALM.
A major strength of the University of Washington Medical Center is in developing research on improving outcomes of patients with anxiety and depression in primary care, and understanding the epidemiology of the adverse impact of depression and anxiety in patients with chronic medical illness. Historically, Harborview Medical Center and the Veterans Administration Hospital have had major strengths in epidemiologic and treatment research on patients with alcohol and substance abuse, suicide prevention, trauma and post-traumatic stress disorder, as well as patients with chronic severe mental illness. The University of Washington Medical Center, Harborview Medical Center, and the VA sites have received funding for extensive psychiatric research grants to study the impact of psychiatric illness on patients with chronic medical conditions such as HIV, diabetes, epilepsy, traumatic brain injury, spinal cord injury, and COPD. Children's Hospital and Medical Center continues to focus on improving quality of care and outcomes of youth with ADHD, depression, and autism spectrum disorders.