By Katherine Traczyk, College of Nursing intern
SPOKANE – For every dollar spent on costs related to evidence-based treatments for alcohol, drug and mental health disorder, Washington State sees $3.77 in benefits, according to a report from the Washington Institute for Public Policy (WISPP 2006).
A major proponent for the proper care of mental health and substance abuse patients, John Roll is working alongside colleagues to develop a strong line of scientific inquiry into this arena. As the associate dean of research in the College of Nursing, Roll has been awarded grants and contracts to continue his objectives to better the lives of those afflicted with substance abuse and/or mental health concerns.
Center for rural concerns
In particular, a recent multi-million dollar grant from the state Life Sciences Discovery Fund has enabled Roll and his extended team to focus on developing the Program of Excellence in Rural Mental Health and Substance Abuse Treatment (RMHSAT). The major goal of the project is to develop a center focused on creating and disseminating evidence-based care for mental health and substance use concerns in rural areas.
In particular, a recent multi-million dollar grant from the state Life Sciences Discovery Fund has enabled Roll and his extended team to focus on developing the Program of Excellence in Rural Mental Health and Substance Abuse Treatment (RMHSAT). The major goal of the project is to develop a center focused on creating and disseminating evidence-based care for mental health and substance use concerns in rural areas.
As the majority of substance abuse treatment research has concentrated its efforts on urban areas, Roll and his team find a discrepancy towards the care of rural patients.
Almost 60 percent of Washington counties are rural (fewer than 50 people per square mile) or frontier (defined as fewer than seven people per square mile).
Relative to urban areas, rural or frontier areas generally have higher levels of poverty and chronic disease, a lack of medical and behavioral health care providers, less health insurance, more natural barriers (e.g., longer travel distance to health care providers, extreme weather, etc.), lower levels of cultural diversity within the community and older populations.
Because of these characteristics and other issues, evidence-based treatments for substance abuse and mental health problems developed for treating urban populations often do not translate well to rural settings.
Ultimately, the team would like to obliterate the disparity in health care that exists between rural and urban areas.
“Recovery from mental health and substance abuse disorders is not the exception; rather an expectation,” Roll said. “We should expect it no matter where we live.”
Model for the nation
An overarching goal of the program is to adopt state of the art technology transfer methods so that treatments developed and found to be efficacious can be distributed to impact communities in a sustainable fashion. RMHSAT will serve as a standard for the state of Washington, with hopes that it will become a model for the nation.
An overarching goal of the program is to adopt state of the art technology transfer methods so that treatments developed and found to be efficacious can be distributed to impact communities in a sustainable fashion. RMHSAT will serve as a standard for the state of Washington, with hopes that it will become a model for the nation.
Partnering with the University of Washington, Group Health, Washington State Department of Social and Health Services and the Department of Health, the project has extended to a number of seeding projects. The RMHSAT program utilizes an interdisciplinary team approach with expert faculty from nursing, medicine, pharmacology, psychology, health policy administration, biostatistics, health economics and sociology.
The program also serves as a training site for future researchers and clinicians. Both undergraduate and graduate nursing students participate, as do graduate students in experimental and clinical psychology, social work, health economics, health policy and medicine.
With the funding, Roll also has been able to support administrative staff, two new tenure track faculty members in nursing, three postdoctoral fellows and a visiting scholar from the United Kingdom.
Research yielding results, information
Surveying the practices in rural as well as urban areas in Washington has provided more accurate outlooks on the issue. Certain barriers, facilitators and cultural issues impacting the delivery and reception of evidence-based treatment have been recorded.
Surveying the practices in rural as well as urban areas in Washington has provided more accurate outlooks on the issue. Certain barriers, facilitators and cultural issues impacting the delivery and reception of evidence-based treatment have been recorded.
Paralleling prior research, Roll and his team also have found interesting data linking evidence-based treatment and the potential cost offsets. Through the treatment of mental health and substance abuse patients emerges a reduction in healthcare costs and criminal activity, as well as increased economic potential.
Research efforts in the RMHSAT program include treatment for the abuse of prescription opiates, development of an electronic community of care for mental health consumers and their families, evaluation of evidence-based protocols for treating depression, documentation of barriers to the receipt and delivery of evidence-based treatment in rural areas, and extensive coordination between the RMHSAT program and the Program of Excellence in the Addiction (also directed by Roll), which is conducting trials to develop enhanced substance abuse treatment protocols.