Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

Why are there no comparison contrast studies for MHSAS Consumer Run Programs (such as PACT) against a MHSAS system run (PACT team) for outcomes and cost effectiveness? The expense of using only medical model or clinical methods does not allow for the grassroots effort of sustained recovery to gain access to the highest implementation levels in each state. The existing (sometimes outdated)systems receive the funding for 'pilot programs' while the actual evidence based consumer driven project outcomes are unable to get funding.

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

I would like to see the Program of Assertive Community Training be compared by having one clinician run and the other Consumer run. The outcomes data would allow the AHRQ to explore the next research step of building a community of technical assistance teams and those outcomes.

By collecting the outcomes data at each level the overall system would be able to review and reallocate precious few resources to the most effective recovery, prevention and healthcare educative systems.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

The patient group would have a lifespan data approach.Using this approach a longitudinal 'snapshot' of coocurring disorders (MHSAS)and comorbid conditions could be tracked.

The indications for therapeutic needs and interventions on each specific population would be clearly identified with the outcome data.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

While cultural competency is at the forefront of every grassroot effort in services the main subgroup that this research would be able to address severity of are the lives affected by intellectual challenges. Whether traumatic brain injury (post military) or developmental origin the effectiveness of the PACT approach to managing chronic health care conditions will be demonstrated to be the MOST cost effective method of treatment.

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Maximizing EVERY individual's ability to reach their full potential within their community. Full potential results in proactive preventative participation in symptom, diagnosis and treatment compliance or shared responsibility for improvements.

Describe any health-related risks, side effects, or harms that you are concerned about.

The harm that the lack of continued funding or be so temporary that folks would decompensate as they are doing now.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Depression and other mental health disorders
• Developmental delays, attention-deficit hyperactivity disorder, and autism
• Functional limitations and disability
• Substance abuse

AHRQ Priority Populations

• Low income groups
• Minority groups
• Women
• Children
• Elderly
• Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care

Federal Health Care Program

• Medicaid
• Medicare
• State Children's Health Insurance Program (SCHIP)
• Other

Importance

Describe why this topic is important.

The paradigm shift of client driven services and shared responsibility in healthcare is underway. By supporting this shift we assure the public of continued healthcare services from one generation to the next.

That those services will have the effectiveness of partnering with more specialists, clinicians, physicians through maximising the skills of individuals who already are successfully managing their health concerns.

These individuals will mentor to others and reduce the overuse of hospitals, ER's, Crisis teams and so on.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

I am presently working on my Doctorate and have focues my career, education plans and lived experiences with mental health (major depression/PTSD) on the a basic philosophy. People CAN and DO recover.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

The only reason this question or comparison project would represent uncertainty for anyone including policy-makers, clinicians and all other stakeholders is a current lack of data.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

If there were more projects like this one funded and the outcome data compared with the existing clinical care programs it would dramatically reduce health care costs. It would dramatically reduce the health care litigious mentality by closing the gap between health care provider and recipient.

Describe the timeframe in which an answer to your question is needed.

The time frame from team construction to final comparison data collected would be two years as follows:

1. 6 Months building teams and training
2. 6 months accepting participants in both teams
3. Collecting one year outcome data from each team
4. 3 months for each teams to prepare final outcome report
5. Final summary of project

Approximately 2 - 3 years

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

The following populations that would be impacted and disparities addressed are:

1. Mental Health
2. Substance Abuse/Addictive disorders
3. Physically disabled
4. Intellectually challenged
5. All workforce in EVERY business
6. The wellness of EVERY program
7. All disability health issues
8. Deaf and Hard of Hearing
9. Elderly

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

If there were more projects like this one funded and the outcome data compared with the existing clinical care programs it would dramatically reduce health care costs. It would dramatically reduce the health care litigious mentality by closing the gap between health care provider and recipient.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program