The Mental Health Services Improvement Collaborative
Eileen Hansen, MSSW and Sandra Sundeen, MS

     The Mental Health Services Improvement Collaborative(MHSIC) at the University of Maryland School of Medicine is housed within its Department of Psychiatry and Human Behavior. It is administratively part of the Division of Services Research(directed by Lisa Dixon, MD) and is  overseen by Howard Goldman, MD, PhD. It is an academic-public partnership with the Mental Hygiene Administration(MHA) that is divided into three centers.  One of its components, the Mental Health Services Training Center, has operated since 1991.  The Collaborative was established in 2001, when the two other components–-the Evidence-Based Practice Center(EBPC) and the Systems Evaluation Center(SEC)-- were created.

    The Training Center provides a wide array of teaching for professionals who provide services.  Some of these activities take place at the annual MHA conference.

    The Evidence-Based Practice Center trains professionals and assists them in delivering evidence-based practices, including Supported Employment, Family Psychoeducation, and Assertive Community Treatment.  It currently uses federal funds granted to the Mental Hygiene Administration to teach techniques designed to reduce the use of seclusion and restraint. 

   The Systems Evaluation Center has done numerous evaluations for the MHA, including designing a statewide Outcomes Management System and developing a survey tool to measure how patients perceive the cultural competence of the professionals who treat them.

    An example of the delivery of a major initiative in Supported Employment can illustrate the functions of each of the centers and the Collaborative as a whole.  This initiative developed as part of two national projects in evidence-based practices.  The MHA agreed to implement Supported Employment in three sites as part of the national EBP project co-sponsored by SAMHSA and the Robert Wood Johnson Foundation and to add three more sites as a part of another initiative funded by the Johnson & Johnson family of companies.

    The Collaborative then began working with the above initiative through its Training Center.  Using the MHA Annual Conference in 2001 as a kickoff, it sponsored training by Robert E. Drake, MD, PhD and other evidence-based experts. Supported Employment Consultant/Trainers at the six sites taught organizational change and consensus-building, and provided on-site consultation.  The Systems Evaluation Center’s role was to monitor the progress of the implementation in each of the six sites.  Additionally, the SEC Implementation Monitor and the Evidence-Based Practice Center (EBPC) Consultant/Trainer together conducted monitoring activities every six months, designed to measure if the EBP model was being followed.  This information was then shared in a report to the sites by the EBP Trainer/Consultants so that ongoing technical assistance could be provided; it then served as the basis for ongoing technical assistance.

    As implementation and monitoring continue to be performed by the EBPC and the SEC, the Training Center sponsors additional teaching activities to promote the adoption of evidence-based practices throughout the state.  In this way, the three MHSIC centers address practice improvement initiatives independently, but collaboratively.