Mental and Behavioral Health
PCORI Answers Critical Questions
PCORI funds studies to help patients and those who care for them answer a range of questions about mental health, such as:
Clinician: I have patients with both medical and behavioral problems. Would integrating a psychologist or social worker into my clinic staff improve patients’ quality of life more than providing patients with access to an offsite specialist would?
Caregiver: How might working with a peer coach or counselor in addition to our pediatrician help achieve the best possible care for my child’s mood and behavior problems?
Care Manager: I work with patients who have untreated posttraumatic stress disorder (PTSD) or bipolar disorder and live in rural areas. Would adding a telehealth component to my patients’ primary care improve their mental health more than virtual care on its own?
Highlights of Study Results Published in Journal Publications
|Matching Patients with Therapists Improves Mental Health Care
Matching patients seeking mental health care with therapists who have a good track record of treating the patients' particular needs and concerns resulted in better outcomes than not matching patients, according to findings from a PCORI-funded study published in JAMA Psychiatry. Therapists tend to have areas of greatest experience and skill, according to the research team at University of Massachusetts Amherst. Matched patients had larger reductions in both specific and general mental health symptoms and impaired functioning and reported feeling less distressed. The match system used in the study required minimal disruption within the mental health care system in which it was tested.
|Comparing Ways to Address Worry among Older Adults
As reported in Depression and Anxiety, a PCORI-funded research team at Wake Forest University found that cognitive behavioral therapy (CBT) and yoga were both effective at reducing worry and anxiety in older adults, while CBT improved sleep more than yoga. In its study, the research team assigned half of the older adults to CBT or yoga by chance; the other half chose between CBT and yoga. These results held regardless of whether the participants chose their treatment or were assigned treatment at random.
|Consequences of Changing, Adding Medications for People With Schizophrenia
This study reviewed how different drug combinations work for people with schizophrenia, who often take several medications to treat different symptoms of their disease. Through a review of 81,921 Medicaid records, the researchers found that people already taking an antipsychotic drug had different benefits and negative outcomes when they used another antipsychotic or added an antidepressant, anti-anxiety medication or mood stabilizer. These results, in JAMA Psychiatry, can help people with schizophrenia and their doctors when they consider adding medicines to patients’ treatment plans.
Evidence Updates from PCORI-Funded Studies
Depression is common in people who are on dialysis and can affect kidney health, as well as overall well-being. A recent PCORI-funded study looked at how well two treatments for depression — talk therapy and an antidepressant — work for people on dialysis. View our latest Evidence Updates for clinicians and patients.
This pair of Evidence Updates highlights a review of research that found several kinds of therapies and medicines can reduce or stop symptoms for people who have experienced traumatic events, such as physical abuse, sexual violence, or natural disaster.
Clinicians often prescribe antipsychotics for children and adolescents diagnosed with attention deficit hyperactivity disorder or disruptive, impulse-control, and conduct disorders. New evidence shows the benefits of antipsychotic treatment may be modest and the harms may be significant.
Study Results that Support Better-Informed Decisions
A PCORI-funded study — comparing a program with and without peer support for parents leaving the neonatal intensive care unit (NICU) for home — has led to improved mental health screenings and the formation of a mental health taskforce at Children's National Hospital.
In a group of 110 Latinx patients with serious mental illness (SMI) in an integrated care setting, those assigned a peer navigator–compared with those who were not assigned one–reported better outcomes, including quality of life and control over their overall health. Peer navigators can guide and support patients and help them overcome barriers to care.
People with depression who live in areas with fewer care resources had more positive long-term effects from participating in a coalition-based approach to care, compared with those in a program that offered staff training by experts in depression care. Under a coalition-based approach to care, clinicians with expertise in depression care and community members work together to train staff who provide depression care.
Latino children with mental illness are half as likely to get mental health care as non-Latino white children. This study created an education program to teach Latino parents skills to help their children get the mental health care they need. Researchers found that the educational program improved parents’ activation skills as well as their skills for working with their children’s school systems.
Mental and Behavioral Health Study Spotlights
People with SMIs are more at risk than the general population for preventable medical conditions, and often don’t receive the basic care they need to address them. Four PCORI-funded projects are using stakeholder input to test ways to help people with SMI get the physical health care they need.
To help rural patients with PTSD and bipolar disorder improve their quality of life, this study is comparing two telehealth strategies. In one, primary care providers and care managers provide patients with telehealth specialist-prescribed therapies and routine check-ins. In the other, patients have regular video sessions with remote specialists.
One in three adults with major depression does not feel better after taking antidepressant medicines. To help them, this study compares electroconvulsive therapy and ketamine, a pain medicine, to see which works best for adults with treatment-resistant depression.