1999 — 2003 |
Frueh, B Christopher |
K08Activity Code Description: To provide the opportunity for promising medical scientists with demonstrated aptitude to develop into independent investigators, or for faculty members to pursue research aspects of categorical areas applicable to the awarding unit, and aid in filling the academic faculty gap in these shortage areas within health profession's institutions of the country. |
Mental Health Service Delivery to Trauma Victims @ Medical University of South Carolina
The purpose of this project is to develop the candidate as an independent researcher, investigating issues related to mental health service delivery to racially diverse trauma victims. The project will focus initially on male combat veterans with PTSD receiving services within and outside the VA system, with a plan to broaden the scope of research focus in the last phase to include civilian trauma victims. At this point we know almost nothing about service delivery to combat veterans across different types of service settings. Most of the current treatment research has been conducted at VA research centers, and therefore, we do not have empirical data on a host of relevant variables (e.g., appropriateness of care, treatment effectiveness) in applied, real-world settings such as Vet Centers, community, or primary care clinics. The Career Development Plan includes training to design and conduct research in three important areas: (1) veterans' concerns about services; (2) racial differences; and (3) service costs and effectiveness. This training plan will consist of three components; (a) individually administered mentoring from a multidisciplinary team of specialists; (b) formal course work and seminars to further develop a body of knowledge in relevant areas; and (c) completion of relevant research projects. The mentorship team will be led by Albert O. Santos, M.D., and includes Samuel M. Turner, Ph.D., Terence M. Keane, Ph.D., Dean Kilpatrick, Ph.D., and Judith Cooke, Ph.D. The Research Development Plan consists of three phases: (I) exploration and identification, via focus groups, of salient dimensions of concern, need, and cultural acceptance of mental health services currently delivered, as perceived by service recipients among male veterans with combat-related PTSD; (II) investigation of the hypothesis that African-American combat veterans with PTSD manifest poorer functioning, lower quality of life, and a higher rate of psychiatric symptoms associated with their clinical presentation than Caucasians; (III) development of a series of grant proposals to examine costs and effectiveness associated with treatment for combat-related PTSD, incorporating what was learned in phases I and II; and development of projects to examine service needs among racially diverse groups of civilian trauma victims.
|
1.009 |
2001 — 2002 |
Frueh, B Christopher |
R03Activity Code Description: To provide research support specifically limited in time and amount for studies in categorical program areas. Small grants provide flexibility for initiating studies which are generally for preliminary short-term projects and are non-renewable. |
Disability Benefits and Service Use @ Medical University of South Carolina
The research aim of this proposal is to advance our understanding of the association between disability benefits, service use (medical, mental health, rehabilitation), race, and clinical presentation among trauma victims with severe posttraumatic stress disorder (PTSD) and other associated mental illnesses. It is well accepted that persons with mental illnesses often experience severe occupational impairment and related financial hardships associated with their psychiatric condition. Recent advances in clinical and rehabilitative services, and changes in public opinion and subsequent legislative reform toward welfare and the Work Incentives Improvement Act of 1999, have led policy makers to reconsider multiple aspects of the current disability policies. Unfortunately, rehabilitative efforts have not been shown to significantly increase the work-related income of persons with psychiatric disabilities. Furthermore, we know relatively little about how public disability benefits affect work behavior or use of other services available within various public systems. At present the VA system offers a unique opportunity to study the relationship between clinical symptoms, associated disability, and service use because it is a large, closed system which provides a broad range of medical, mental health, and social services. Furthermore, the clients served by the VA system (i.e., veterans) are of interest in that they represent a population that has high percentages of rural and minority members. Thus, the VA system represents the chance to study a range of variables that are of general interest to policy makers, advocates, and key stakeholders concerned with the welfare of mentally ill persons. In this study we will learn more about the relationship between service use and a number of relevant variables (e.g., race, symptom reporting, disability seeking, employment) by examining archival data, including administrative and medical records, on approximately 450 trauma victims with severe PTSD served within the VA system. These data may have implications for our understanding of service delivery systems for trauma victims with severe PTSD and other associated mental illnesses, including the important interface with associated psychiatric disability and rehabilitation efforts. This proposal is responsive to Health People 2010 and the Bridging Science and Service report recommendation regarding rehabilitation and interventions (recommendation #9).
|
1.009 |
2002 — 2003 |
Frueh, B Christopher |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Trauma Within the Psychiatric Setting @ Medical University of South Carolina
DESCRIPTION (provided by applicant): There is a striking, lack of empirical data regarding the prevalence, perceptions, and consequence of potentially traumatic or harmful events occurring within the psychiatric setting (Frueh et al., 2000). Empirical studies are needed to provide a better understanding of these important issues. Such data would be helpful in developing mental health policies, procedures, and clinical training programs to ensure that providers of mental health services meet what is perhaps their most important objective: to do no harm. Administrators and clinicians would do well to remember that all consumers of mental health services, especially those admitted/committed to psychiatric inpatient units, represent the most vulnerable people in our society. They are a group that has quite frequently been traumatized, and may have the most difficulty asserting their needs and understanding the reasons for psychiatric procedures. Viewed in this light, it seems incumbent upon mental health service providers to ?Make an extra effort to ensure that services delivered within psychiatric settings (i.e., sanctuary) are delivered in a manner that is most sensitive to the potentially adverse consequences of traumatic, frightening, or humiliating (i.e., harmful) experiences. The research aim of this proposal is: To advance our understanding of the frequency perceptions, and consequences of potentially traumatic or harmful events occurring within the psychiatric setting ?by examining these factors among a sample of mental health consumers within a state-funded-mental health system. We propose to evaluate these issues among consumers served within the South Carolina Department of Mental Health (SCDMH). Study participants will be 200 randomly selected adult male and female consumers recruited from two programs affiliated with the Charleston/Dorchester Community Mental Health Center. All participants will complete a short battery of self-report measures and will be the subject of a chart review; a subgroup of 40 will complete a short battery of clinical and thematic interviews. Measures will be designed to assess sanctuary trauma and harm, general trauma exposure, PTSD symptoms, and psychiatric diagnoses. The obtained data will be analyzed via quantitative and qualitative methods.
|
1.009 |