Jack Tsai, PhD
Assistant Professor of Psychiatry
Co-Director, Division of Mental Health Services and Treatment Outcomes Research
Robert Rosenheck, MD
Professor of Psychiatry and of Public Health
Co-Director, Division of Mental Health Services and Treatment Outcomes Research
The task of health services research is to provide information on what benefits the health system actually delivers, and what benefits it has the potential to deliver for the people it serves. Services research is concerned with the benefit or harm that actually accrues to patients in ordinary treatment programs in the real world. Health services research addresses the organizational, financial and political context which profoundly shapes the delivery of care. Mental health services research can be conceptualized as constituting three broad areas which this Division focuses on: clinical services research; service systems research; and research in the organization and financing of mental health services. The Division of Mental Health Services & Treatment Outcomes Research along with other Yale faculty in the Departments of Psychiatry and Public Health are providing national leadership in these areas. The mission of this Division is to 1) facilitate collaboration between mental health services researchers, 2) provide training and educational opportunities for interns, residents, fellows, and faculty, and 3) create an avenue for researchers to receive feedback on ideas and disseminate findings.
Interested students, fellows or faculty who are interested in joining and participating in the Division are welcome to contact Jack.Tsai@yale.edu. Please sign up for our listserv or if you want to just send a message to our list members, you can email us at firstname.lastname@example.org.
We have a meeting every two months at the VA MIRECC conference room (Building 35 Lower Level at 950 Campbell Ave., West Haven). The meetings usually begin with announcements, discussion of ongoing projects, and other issues followed by scheduled speakers who present their work.
Each meeting will allow time to discuss collaborations and training opportunities. We also have an email listserv that sends a monthly update on members’ achievements, ongoing work, and other important issues. Individual meetings among Division members aside from these formal meetings are also encouraged.
Datasets Available for Division Members
To encourage collaboration among Division members and to provide opportunities for trainees, we have various public and private datasets available for students, interns, residents, fellows, and other faculty to work on. These datasets are owned by various Division members and interested individuals should contact Jack.Tsai@yale.edu. You will be asked to submit a brief one-page proposal and the Division Director will then liaison with the owner of the dataset to grant you access. Some of the current available datasets are listed below:
Waves 1 and 2 of the National Health and Resilience in Veterans Study (NHRVS)
- Pietrzak, R. H., & Cook, J. M. (2013). Psychological resilience in older US veterans: results from the national health and resilience in veterans study. Depression and anxiety, 30(5), 432-443.
- Tsai, J., El-Gabalawy, R., Sledge, W. H., Southwick, S. M., & Pietrzak, R. H. (2015). Posttraumatic growth among veterans in the United States: Results from the National Health and Resilience in Veterans Study. Psychological Medicine, 45(1), 165-179.
Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Wave 1 was 2001-2002 and Wave 2 was 2004-2005)
- El-Gabalawy, R., Tsai, J., Harpaz-Rotem, I., Hoff, R., Sareen, J. & Pietrzak, R (2013). Predominant Typologies of Psychopathology in the United States: A Latent Class Analysis. Journal of Psychiatric Research, 47(11), 1649-1657.
- Tsai, J., Harpaz-Rotem, I., Pilver, C. E., Wolf, E. J., Hoff, R. A., Levy, K. N., Sareen, J., & Pietrzak, R. H. (2014). Latent class analysis of personality disorders in adults with posttraumatic stress disorder: A nationally representative study. Journal of Clinical Psychiatry, 75(3), 276-284.
The 2001 and 2010 National Survey of Veterans (NSV)
- Elhai, J. D., Grubaugh, A. L., Richardson, J. D., Egede, L. E., & Creamer, M. (2008). Outpatient medical and mental healthcare utilization models among military veterans: results from the 2001 National Survey of Veterans. Journal of Psychiatric Research, 42(10), 858-867.
- Tsai, J., Pilver, C., & Hoff, R. A. (2014). Potential mental health needs of U.S. residents under different provisions of the Affordable Care Act. Journal of Clinical Psychiatry, 75(12), 1402-10.
The Collaborative Initiative to Help End Chronic Homelessness (CICH; 2003-2008)
- Mares, A. S., & Rosenheck, R. A. (2010). Twelve-month client outcomes and service use in a multisite project for chronically homelessness adults. The journal of behavioral health services & research, 37(2), 167-183.
- Tsai, J., Mares, A. S., & Rosenheck, R. A. (2010). A multi-site comparison of supported housing for chronically homeless adults: “Housing first” versus “residential treatment first.” Psychological Services, 7(4), 219-232.
National and local VA administrative data (multiple years)
- Harpaz-Rotem, I. & Rosenheck, R. A. (2014). Serving those who served: Retention of newly returning veterans from Iraq and Afghanistan in mental health treatment. Psychiatric Services, 62(1), 22-27.
- Tsai, J., Edens, E. L., & Rosenheck, R. A. (2011). Nicotine dependence and its risk factors among users of veterans health services, 2009. Preventing Chronic Disease, 8(6), A127.
The Clinical Antipsychotics Trials of Intervention Effectiveness (CATIE) study
- Rosenheck, R. A., Leslie, D., Sindelar, J., Miller, E. A., Lin, H., Stroup, S., et al. (2006). Cost-Effectiveness of Second Generation Antipsychotics and Perphenazine in a Randomized Trial of Treatment for Chronic Schizophrenia. American Journal of Psychiatry, 163(12), 2080-2089.
- Hermes, E. D., Sokoloff, D. M., Stroup, T. S., & Rosenheck, R. A. (2012). Minimum clinically important difference in the Positive and Negative Syndrome Scale using data from the CATIE schizophrenia trial. The Journal of clinical psychiatry, 73(4), 526.
Survey of Experiences of Returning Veterans (SERV) study
A 5-year project that involves interviewing more than 700 veterans across the country to determine whether there are gender differences in how male and female military veterans adjust to civilian life.
Predictors of Response to Cognitive Remediation in Schizophrenia
Individuals with psychosis were randomized to two months of cognitive remediation (n=50) or two months of treatment-as-usual (n=25). Comprehensive assessments including demographic, symptom, functioning and cognition were conducted at intake, end of the 2 month active phase, and 2 month follow-up.
Efficacy of Social Cognition Training in Schizophrenia
Individuals with psychosis were randomized to group social cognition training (n=25) or treatment-as-usual (n=25). Comprehensive assessments including demographic, symptom, functioning, cognition and social cognition were conducted pre, post- and at follow-up.
Social Cognitive Training for Psychosis: Phase I Treatment Development
In this project, we developed an individually administered, bottom-up, drill-based training for social cognition (Theory of Mind and Attributional Bias specifically), and conducted initial feasibility pilot (n=38 completers). This was a within-subject, double baseline design, with assessments consisting of demographics, symptoms, functioning, cognition and social cognition.
Improving Cognitive Rehabilitation Engagement and Adherence in Schizophrenia
In this proof-of-concept trial, we evaluated the efficacy of 2-session motivational interviewing in improving engagement and adherence to a cognitive remediation analog in individuals with psychosis, randomized to motivational interviewing (n=30) or active control (n=30). Assessments of demographics, symptoms, cognition and motivation conducted pre-post.
Psychotropic Drug Safety Initiative (PDSI)
The PDSI is a nation-wide quality improvement (QI) program in which every VHA facility across the country participates. Each facility chooses an area of prescribing on which to focus their local QI efforts and develops their own local plan for improvement. The national PDSI program office supports these local QI efforts by providing data, informatics tools, trainings and educational resources, and feedback and technical assistance. National, VISN, and facility level data are available for over 30 metrics that assess psychotropic prescribing practices across broad categories of mental health diagnosis (e.g. PTSD, depression, dementia, schizophrenia, bipolar) and medication classes (e.g. antipsychotics, benzodiazepines, antidepressants).