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International experts have recommended actions that funders can take to improve the value of research investments. They state that self-assessment and public sharing are the basis for accountability and improvement. We examined our policies and practice to determine the extent to which the Patient-Centered Outcomes Research Institute's (PCORI) policies and practices as a research funder align with international best practice recommendations. A self-audit of current policies and practice against 17 recommendations and 35 sub-recommendations representing five major stages of research production, based on adapted methods used for self-assessment by another funder, was performed.  Fit of existing PCORI policies and practices with 35 sub-recommendations, qualitative assessment of adequacy (area of strength; area of partial strength; area of growth; not applicable) for 17 recommendations for five stages of research production was assessed. Of the 17 recommendations, 15 were applicable to PCORI's research mission and focus.  PCORI has policies and practices in place for all elements of six recommendations ("area of strength") and policies that address each element but with some still in active development for three ("area of partial strength"). PCORI is partially addressing six of the 15 relevant recommendations ("area of growth"). Areas for growth include making study protocols publicly available, improving policies on data sharing, and enhancing collaboration with other funders to reduce redundant funding. A voluntary consortium of international funders is underway to encourage further progress, including additional self-assessment and public sharing for accountability. These findings indicate PCORI has undertaken efforts to align its funding practices with international recommendations to ensure the value of public dollars invested in research.  Further efforts will likely require additional coordination and collaboration between funders and stakeholders.

ObjectiveThe New York City's Thrive (ThriveNYC) and the Los Angeles County Health Neighborhood Initiative (HNI) are two local policies focused on addressing the social determinants of behavioral health as a preventive strategy for improving health service delivery. On January 29, 2016, leaders from both initiatives came together with a range of federal agencies in health care, public health, and policy research at the RAND Corporation in Arlington, Virginia. The goal of this advisory meeting was to share lessons learned, consider research and evaluation strategies, and create a dialogue between stakeholders and federal funders - all with the purpose to build momentum for policy innovation in behavioral health equity.MethodsThis article analyzes ethnographic notes taken during the meeting and in-depth interviews of 14 meeting participants through Kingdon's multiple streams theory of policy change.ResultsResults demonstrated that stakeholders shared a vision for behavioral health policy innovation focused on community engagement and social determinants of health. In addition, Kingdon's model highlighted that the problem, policy and politics streams needed to form a window of opportunity for policy change were coupled, enabling the possibility for behavioral health policy innovation.ConclusionsThe advisory meeting suggested that local policy makers, academics, and community members, together with federal agents, are working to implement behavioral health policy innovation.

Objective: A threefold increase in the use of antidepressants has been reported among children (18 years old and younger) between 1987 (0.3%) and 1996 (1.0%). The aim of this study was to determine whether pediatric use of antidepressants continued to rise at a national level during the period 1997-2002. Method: The Medical Expenditure Panel Survey (MEPS) database for the years 1997-2002 was analyzed. The MEPS is a yearly survey of a nationally representative sample of civilian, noninstitutionalized U.S. households, conducted by the U.S. Agency for Healthcare Research and Quality. Overall response rate ranged between 64% and 68%. Results: An estimated 1.4 million (95% confidence interval [CI] 1.1-1.7) children received antidepressant medication in 2002 as compared to 0.9 million (95% CI 0.7-1.2) in 1997 (p = 0.01). The percentage of users increased from 1.3% (95% CI 0.9-1.6) in 1997 to 1.8% (95% CI 1.5-2.1) in 2002 (p less than 0.01). Adolescent use (2.1% in 1997 versus 3.9% in 2002 (p less than 0.001) accounted for the increase, with no change among children younger than 13 years. Also among adolescents, the use rate remained stable during the 2000 2002 period. The increase was caused by use of selective serotonin reuptake inhibitors and other newer antidepressants, whereas use of TCAs remained stable in adolescents (p = 0.84) and declined in prepubertal children (p = 0.04). Antidepressant use was similar among males and females and higher among whites than blacks and Hispanics. Conclusions: Nationwide, the use of selective serotonin reuptake inhibitor antidepressant medications continued to increase in adolescents in the late 1990s and until the year 2000, with no further increase through 2002, and remained stable in prepubertal children. (Contains 1 figure and 4 tables.)

This study used Mississippi's Behavioral Risk Factor Surveillance System data to examine the prevalence of depression, service access by adults with depression and a history of selected chronic non-psychiatric illnesses and factors that influence mental health service use. Results indicated a higher prevalence of depression among adults with a history of selected medical conditions, compared to those without. Although they had depression symptoms, one-third with a chronic illness history reported not ever being told they had a depressive disorder, and just over half reported not currently receiving mental health treatment. Adults without a personal healthcare provider were significantly less likely than those with a usual healthcare provider to report mental health service use. Black adults and adults aged ≥ 70 were half as likely to report service use as white adults and adults aged 18-34, respectively. Adults with healthcare coverage were twice as likely to report service use as those without coverage. [ABSTRACT FROM AUTHOR]