Early Mortality in People with Serious Mental Illness Virtual Roundtable

Background: People with serious mental illness (SMI) die approximately 10–25 years earlier than the general population, irrespective of geography or race and ethnicity. Poor health behaviors are identified as the prominent contributors to preventable early mortality. As such, self-management interventions were developed to promote positive health behavior change to address these modifiable risk factors in people with SMI. Yet, after billions of dollars and decades of research dedicated to developing interventions and disseminating evidence, the mortality gap between those with SMI and the general population is increasing.

Proposed Solution to the Problem: This convening meeting will establish the Early Mortality in People with Serious Mental Illness Virtual Roundtable, a collaborative of patients, researchers, policymakers, and organizations committed to address the early mortality health disparity in people with SMI through patient-centered outcomes research (PCOR). The establishment of the Early Mortality in People with Serious Mental Illness Virtual Roundtable and the proposed activities is designed to lend itself to advancing comparative clinical effectiveness research through the following: (1) the research agenda will delineate gaps in existing interventions (e.g., most interventions solely focus on health behaviors) and gaps in PCOR approaches to healthcare (e.g., lack of integration of PCOR such as patient-identified outcomes including trauma and loneliness to address the early mortality health disparity); and (2) the strategic plan will delineate for the first time in history patient-identified (a) intervention targets, (b) research questions, and (c) outcomes for future comparative clinical effectiveness research.

Objectives:
1. Understand the state of science through a historical review (deliverable)
2. Train patients and scientists to engage in PCOR (deliverable)
3. Develop PCOR research agenda (deliverable)
4. Develop strategic plan (deliverable)
5. Disseminate research agenda and strategic plan as a plain-language summary and video blog (deliverable)

Activities: To understand early mortality in people with SMI, a historical review will be conducted. Next, this knowledge will be presented to Roundtable members to develop a PCORI research plan, using the Delphi method, followed by the Story with a Gap technique to develop a strategic plan.

Projected Outcomes and Outputs:
Short-term (during the project period)
• Unify stakeholders, establish, and strengthen relationships
• Increase stakeholder awareness and understanding of research designed to address early mortality in people with SMI 
• Train stakeholders in PCOR 
• PCOR research plan and a strategic plan 
• Disseminate research agenda and strategic plan in the form of plain-language summary and video blog 

Medium-term (post-project period)
• Ongoing stakeholder engagement and collaboration beyond the project period
• Increased funding to address early mortality in people with SMI 

Long-term (post-project period)
• Inclusion of PCOR priorities in research (e.g., comparative effectiveness studies, patient-centered outcomes, implementation considerations). Specifically, the establishment of the Early Mortality in People with Serious Mental Illness Virtual Roundtable and the proposed activities is designed to lend itself to advancing comparative clinical effectiveness research through the following: (1) the research agenda will delineate promising interventions or PCOR approaches to health care that align well with future comparative clinical effectiveness research; and (2) a strategic plan that integrates patient-identified research questions and outcomes for future comparative clinical effectiveness research. 
• New breakthroughs in science that lead to increased life expectancy of people with SMI

Patient and Stakeholder Engagement Plan: Using the Peer and Academic Partnership, the Roundtable will bring together 30 stakeholders unified by their interest in addressing early mortality in people with SMI. Following the Roundtable, the Co-PIs will support the development of PCOR committees led by self-selected Roundtable members to address strategic plan tasks. Quarterly updates will be publicized on the website and through the Co-PIs newsletters and Roundtable members’ newsletters.  The team will also assist in coordinating meetings with Roundtable members and offering expertise or resources available at the Co-PIs organizations.

Project Collaborators: This proposal includes the following lead organization: Dartmouth-Hitchcock Clinic