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Knowledge Network Summit Initiative
Executive Summary

Fifty award-winning community mental health center leaders, leading mental health researchers, and national representatives from NIMH, SAMHSA, MHCA and NCCBH participated in the inaugural Knowledge Network Summit: Using Collaboration to Close the Science to Service Gap in Behavioral Healthcare. With numerous challenges currently facing U.S. mental healthcare providers in providing the highest quality care, participants created a four-component cross-disciplinary initiative meant to engage stakeholders from different sectors of the industry in more quickly moving research findings into the clinical setting, resulting in improved treatment for individuals with mental illness.

Currently, it takes approximately 17 years for the best treatments to start being used in the community. One glaring example of that problem is the fact that despite numerous research studies and millions of dollars spent proving that clozapine, a generic medication for schizophrenia, is the most effective treatment to prevent suicide and early death for people with schizophrenia, more costly and less effective treatments are being prescribed.

This results in millions of dollars of unnecessary hospitalization costs for cash-strapped states and cities. It also results in untold amounts of unnecessary anguish for people with schizophrenia and their family and friends.

The participants agreed that there are four key components to integrating science into the service of behavioral health: Research, Technology, Implementation, and Policy.

Creating Collaborations with Academic Researchers & Community Mental Health Centers

Knowledge Network Initiative Research Component

The Problem: There exists a gap between those who conduct Research and those who provide care. Besides the time lag, many provider organizations do not have mechanisms that allow known Research findings to become visible within their organizations .

Proposed Solution: Knowledge Network members developed a plan to expand the number of academic-CMHC research collaborations. Members will develop an online clearinghouse where 1) researchers and CMHCs can submit research protocol ideas and see how they can work together to collaborate, 2) report on the what works and doesn’t work in these collaborations, and 3) report the results of their studies.

Tracking Progress in Community Mental Healthcare

Knowledge Network Initiative Technology Component

The Problem: Part of the barrier to implementing science-based care is lack of an electronic clearing house that would allow providers to work together on research projects and data mining opportunities across multiple sites nationwide.

Proposed Solution: Knowledge Network members collaborating on technology created a plan to set up a data warehouse. This data warehouse would collect de-identified data that would track the progress of implementing research-based practices for participating Knowledge Network Community Mental Health Centers. Members first plan to use the data warehouse to collect anonymous data from each participating organization on how many individuals with schizophrenia who have screened at-risk for suicide have been prescribed clozapine.

Developing & Using a Rapid-Cycle Implementation Plan to Transform CMHC Practice

Knowledge Network Initiative Implementation Component

The Problem: Even the best research projects fail because organizations do not share best practices about how they were successful. Typically, only the results from research initiatives are made known but it is clear that some strategies are more successful than others. Focusing on how in addition to what will lead to improved adoption of research based interventions .

Proposed Solution: Knowledge Network members collaborating on implementation created a plan to increase the prescription of clozapine for individuals with schizophrenia who screen positive for suicide risk and agreed to share the specifics of how they conducted their project with other members. The group agreed to track and share successes and failures in their respective implementations so that others might benefit from their experiences. The clozapine implementation project will serve as a model to be used in the future to assist in quickly implementing important research-based treatments directly into CMHC practice.

Enabling All Community Mental Health Centers to Participate

Knowledge Network Initiative Policy Component

The Problem: Unless there is significant change in legislation and national policy regarding behavioral health funding, implementing research-based care will be financially and practically impossible despite providers’ best intentions. Knowledge Network members recognized the challenges in this area are many including: awareness by policy makers of the clinical efficacy of behavioral health interventions; the bifurcation of policy between health care and behavioral healthcare and the importance of protecting parity legislation; and the lack of funding available in Health Information Technology (Health IT) for behavioral health providers.

Proposed Solution: Knowledge Network members will start by working together advocating to congress for legislation that would help more CMHCs have necessary Health IT capabilities. Currently, not even 10% of all community mental health providers have the IT capacity to be part of these Knowledge Network projects. In order to provide all people with mental health needs throughout the U.S. with the same high-quality care and to be able to communicate with health care providers as they move to a new electronic environment, all community mental health centers need to have Health IT. Without Health IT, CMHCs can’t provide common-sense, cost-saving, life-saving treatments like ensuring that their patients with schizophrenia who are at-risk for suicide receive clozapine or be able to coordinate care for their seriously mentally ill constituents who die 25 years sooner than the general population. Members will work with NCCBH to advocate for a bill to be introduced in the spring of 2010 and conduct a Knowledge Network-sponsored congressional briefing in DC on the necessity of Health IT to provide high-quality mental health care.

To learn more about the Knowledge Network, please visit www.knproject.org.