Placement: New York State Psychiatric Institute at Columbia University
Mentor: Harold Pincus, M.D. (Professor and Vice Chair, Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center)
Project: Meeting the Needs of Those with Mental and Physical Health Co-morbidity: The Influence of Structural Factors on Integrating Mental, Physical and Social Care Interventions
Mary Docherty, M.A., M.B.B.S. (Hons), MRCP, MRCPsych, is a 2018–19 U.K. Harkness Fellow in Health Care Policy and Practice. She is an Expert Clinical Advisor to NHS England’s Mental Health Clinical Policy and Strategy Group. She has published research across the translational spectrum, and her research on treatment and outcome gaps within UK mental health provision has informed National Policy. Docherty’s work with the Department of Health, NHS England and the National Institute of Health and Clinical Excellence (NICE) includes leading roles in national and regional programs tackling inefficiencies and inequalities at service interfaces. Outputs include tools and methodology for disinvestment in ineffective practices, standards and implementation of multi-agency crisis care pathways and national guidance and delivery program to reduce premature mortality in individuals with serious mental illness. In addition, she established the first national specialist service for cognitive and negative symptoms in schizophrenia. She holds a First-Class Honors degree and Masters with Distinction in Politics, Philosophy and Economics from the University of East Anglia. She graduated with Honors (Gold medalist) from Hull York Medical School and completed her psychiatry residency in the Maudsley Training program and NIHR research fellowships at the Institute of Neuroscience, Newcastle and the Institute of Psychiatry, Psychology and Neuroscience, London. She is an alumnus of the Chief Medical Officer’s Clinical Advisor’s Scheme and a member of both the Royal College of Physicians and Psychiatrists.
Project Abstract: The persistent poor health outcomes and excess care costs associated with co-morbid mental and physical health conditions remain a priority in both the U.S. and U.K. health systems. Changes to payment and delivery models in the U.S. and increased focus on population-based healthcare approaches in the U.K. offer potential opportunities to improve co-ordination and integration of mental and physical health care pathways. Social determinants of health, such as housing and employment, can impact significantly on the efficacy of health-based interventions and should be addressed within these pathways.
This research will examine a series of programs providing coordinated or integrated packages of physical, mental and social care interventions to those living with mental and physical health co-morbidity. It will focus on the mechanisms being used by health systems and providers to facilitate and incentivize partnerships and transactions between mental, physical and social care providers, including community based human service organizations. A case study approach will enable in-depth analysis of the extent to which factors such as contracts, payments, outcomes frameworks and operational models support conditions of shared accountability and influence coordinated provider activity. A focus on barriers and levers to implementation will help inform policymakers and providers in both countries who are seeking improved outcomes for this population. Consideration will be given to the transferability of findings to different settings, scales and integration challenges.
Harkness-Related Publications:
P. Ramanuj, E. Ferenchik, M. Docherty, B. Spaeth-Rublee, H. Pincus. Evolving Models of Integrated Behavioral Health and Primary Care. Current Psychiatry Reports. 2019.
E. Castillo, R. Ijadi-Maghsoodi, S. Shadravan, E. Moore, M. Mensah, M. Docherty, et al. Community Interventions to Promote Mental Health and Social Equity. Current Psychiatry Reports. 2019.
S. Cheung, B. Spaeth-Rublee, D. Shalev, M. Li, M. Docherty, J. Levenson, H. Pincus. A Model to Improve Behavioral Health Integration into Serious Illness Care. Journal of Pain and Symptom Management. 2019.
D. Shalev, M. Docherty, B. Spaeth-Rublee, N. Khauli, S. Cheung, J. Levenson, H. Pincus. Bridging the Behavioral Health Gap in Serious Illness Care: Challenges and Strategies for Workforce Development. The American Journal of Geriatric Psychiatry. 2019.
