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Postdoctoral fellow to advance research of mental illness

by Charli Engelhorn

USC School of Social Work postdoctoral fellow Erin Kelly has received a two-year $100,000 award from the Friends of The Semel Institute Scholar Program at the University of California, Los Angeles (UCLA). The award is granted to fellows and junior faculty to support their research efforts in advancing treatment interventions for mental illness. Kelly was one of three scholars out of 44 applicants to receive the award.

Kelly, who is funded by a joint postdoctoral fellowship from USC, UCLA and the Los Angeles County Department of Mental Health, will use this funding to support her research trial on electronic personal health records in conjunction with Professor John Brekke’s peer-navigation intervention. Both trials are in partnership with Pacific Clinics, a Los Angeles-based consortium of mental health clinics, to address the experiences and self-management of care for patients with serious mental illness (SMI).

“I’ve been working to see if we can blend a technological solution to further enhance the self-management skills of people with SMI,” Kelly said. “I am creating a personal health record portal to their mental health records, which their navigator can help them use.”

Personal health records will allow persons with SMI to keep track of appointments, medications, diet and exercise and complete provider or health navigator forms. The hope is that these records will provide the patient with a clearer understanding of their health and a paper trail, which Kelly said is advantageous for this highly mobile population of patients, many of whom are homeless.

Linking the peer-navigation study with electronic personal health records further promotes the recovery movement; the belief is that empowering SMI patients to self-manage their treatment will promote better mental health outcomes.

“Getting consumers involved in their health care management with electronic personal health records could be critical to good health outcomes. This has not been investigated with the seriously mentally ill,” said Brekke, Frances G. Larson Professor of Social Work Research. “These are individuals who are highly vulnerable and who are often disempowered with regard to health care.”

In fact, Kelly said many studies exclude patients with SMI if electronic records are part of the intervention.

“There are concerns that their cognitive deficits will make it more difficult for them to manage those websites and about how well they could understand the information,” Kelly said. “However, with the Affordable Care Act, there is a greater emphasis on electronic health records, and mental health providers are now required to begin using e-health records for Medicaid reimbursement.”

Categorically dismissing the seriously mentally ill’s capabilities to handle certain types of information is unfortunate, Kelly said, and is why she has chosen to focus on the hardest possible group, those with conditions such as bipolar disorder, schizophrenia and major depressive disorder. Kelly believes if they can prove that this population can handle these record systems, then it will serve as a good litmus test for higher-functioning individuals.

“Erin’s plan for training and engagement through personal health records is very innovative and could be a critical ingredient in national efforts to improve health care for this population,” Brekke said.

The Semel award will allow Kelly to conduct two phases of the study. Phase 1 will include interviewing mental health providers, medical providers and consumers about their perceptions of personal health records, in general, and those specific to mental health. In Phase 2, 30 people will complete the health navigation process and a personal health record. Both groups will be re-interviewed to see if their perceptions have changed based on their experiences with people using the tool or with using the tool themselves.

“This funding makes it easier to have the resources to really do this project well,” Kelly said. “It makes it possible for us to pay our participants comfortably and get the technology needed to run the study. It also helps us buy privacy screens for the mental health clinic to avoid an information breach.”

Kelly hopes the outcomes of the study will help to empower those with SMI and also break down misconceptions about mental illness. After the study period is completed, she wants to remain in the Los Angeles area to continue working with the SMI population.

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