Placement: Mailman School of Public Health, Columbia University, and Harvard Medical School
Co-Mentors: Michael Sparer, JD, PhD, Professor and Chair, Health Policy and Management, Mailman School of Public Health, Columbia University
Haiden Huskamp, PhD, Henry J. Kaiser Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School
Project: Impact of Implementing Mobile Crisis Intervention Services on Individuals with Severe Mental Illness: A Mixed-Methods Comparative Study
Jacob Jorem, MD, JD, is a 2024–25 Norwegian Harkness Fellow in Health Care Policy and Practice. He is currently finalizing an interdisciplinary Ph.D. in mental health policy at the University of Oslo, focusing on the impact of introducing capacity-based mental health legislation in Norway. This year, Jorem is a Visiting Fulbright Scholar at Columbia University. He has authored several publications, including scientific articles, reports, and a book chapter, exploring mental health policy, health law, and bioethics. As a psychiatrist and lawyer, his research centers on how legislation affects health care delivery for individuals with severe mental illness.
Previously, Jorem served as Head of the Secretariat for the Expert Committee on Decision-Making Capacity, contributing to vital policy recommendations for Norway’s mental health system. He also authored authoritative interpretations of the Norwegian Mental Health Care Act as a senior adviser at the Norwegian Directorate of Health and represented the Norwegian government in legal cases regarding involuntary hospitalization. As a psychiatrist, he provided quality patient care and served as a chief physician at the adult psychiatric division of Diakonhjemmet Hospital in Oslo.
Project overview: Individuals with severe mental illnesses (SMI) often face barriers in accessing timely mental health care, worsening disparities in mental health outcomes. Such barriers can contribute to more frequent emergency departments visits and increased criminal justice involvement among these individuals.
In recent years, several U.S. states have implemented crisis services to improve access to mental health care. The American Rescue Plan Act of 2021 introduced Mobile Crisis Intervention Services (MCIS) as a state option to improve crisis services for individuals with SMI. Since then, several states have implemented different MCIS policies funded by Medicaid, including both in-person and telehealth crisis services. However, little is known about the impact of implementing MCIS across states.
This study aims to assess MCIS implementation in New York, California, North Carolina, and Texas, evaluate its impact, and identify facilitators and barriers. The study uses a mixed-methods approach, combining quantitative analysis of Medicaid claims data with qualitative semistructured interviews. Expected outcomes include greater utilization of crisis services, with policy implications focusing on evidence-based guidance and reducing disparities in mental health care.