Carole Siegel, Ph.D., Division Director

Web site: http://ssrd.rfmh.org

Research in statistical sciences, mathematical methodologies, innovative computer technology, epidemiology, and service delivery as applied in mental health settings has been a feature of the Nathan Kline Institute since its inception. The Multi-State Information System was an early NIMH-funded project that provided data for administrative and fiscal planning, and broad scale research on the etiology, treatment options, and outcomes of mental illness while protecting privacy and confidentiality within a large psychiatric database.

In 1983, the research component of the Information Sciences Division was restructured as the Statistical Sciences and Epidemiology Division, with Eugene Laska, Ph.D. serving as its Director. In 2003 the division was redesignated the Statistics and Services Research Division (SSRD) to reflect the scope of its current research, and Carole Siegel, Ph.D. became its Director. Current research foci of the division continue along historical lines but have greatly expanded to include a major research program that concerns the service related issues of the reintegration of persons with multiple behavioral health care problems into the community, promotes research on processes toward recovery and the attainment of successful clinical and community focused outcomes.

Since 1985, the Division has been a World Health Organization Collaborating Center for Training and Research in Mental Health and in the Prevention of Substance Abuse. Eugene Laska, Ph.D. is Director of the Collaborating Center with Carole Siegel, Ph.D. and Marc Galanter, MD serving as Deputy Directors. The Collaborating Center supports WHO in its efforts to promote information transfer technologies within a global framework.

In 1993, the Division became the administrative base for the Center for the Study of Issues in Public Mental Health, an NIMH-funded project conducted in collaboration with the New York State Office of Mental Health, the Nelson A. Rockefeller College of Public Affairs and Policy at the University at Albany of the State University of New York, and the Robert F. Wagner Graduate School of Public Service of New York University. The Center supports projects that study ways to improve the outcomes of public mental health services by integrating research findings with policy recommendations and practice innovations. Carole Siegel, Ph.D. is the Director and Principal Investigator for the Center.

SSRD is comprised of three laboratories:

• The Statistical Sciences Laboratory, headed by Eugene Laska, Ph.D., performs basic research in mathematical statistics including experimental design and estimation theory. The Division has six doctoral level statisticians, and computer scientists with emphasis on statistical computing and data base organization. Its research portfolio includes development of statistical methods for cost-effectiveness analysis; single sample methods for estimating population size; optimal design of crossover trials in the presence of carryover effects, and ordered inferential procedures. The laboratory also provides statistical consultation services to mental health research investigators.
• The Social Sciences and Innovations Laboratory, headed by Mary Jane Alexander, Ph.D., performs quantitative and qualitative health services research focused on innovation at individual, practice and system levels of inquiry. Psychology, anthropology, sociology, public health, criminology and statistics are represented in the laboratory. The SSRI research portfolio maintains a focus on recovery for people with complex and serious mental health problems. Current projects include mental health and chemical dependency case finding across systems of care; local strategies to integrate systems and services for people with co occurring disorders, consumers’ strategies for adhering to prescribed medications; recovery narratives; healing from sexual abuse trauma; costs of trauma to state systems of care; natural helping networks, including clergy; cultural competence of providers of mental health services. Projects typically rely on collaborative relationships with policy makers in mental health, chemical dependency and social welfare, or directly with consumer stakeholders. The laboratory provides technical assistance in qualitative methods to investigators, and on practice and policy strategies for integrating services for people with co occurring disorders to localities and state agencies.
• The Analytic Policy Support Laboratory, headed by Judith Samuels, Ph.D. has been engaged in finding interventions to support mothers with mental illness or substance abuse disorders in caring for their dependent children while navigating complex multiple social systems. A study combining Family Critical Time Intervention with transitional housing is underway (described below). The laboratory has sponsored conferences and workgroups on issues related to mothers with mental illness.

Some recent projects of the Division include:

• Cost-Effectiveness Analysis (NIMH-funded Grant, Siegel, C., P.I.) For evaluation studies of mental health service interventions to be useful for resource allocation, benefits and/or effects need to be examined in conjunction with their associated costs. Cost-benefit/effectiveness analysis is a classical, largely economic, technique for guiding choices among alternative policies or programs. The focus of work is the development of statistical methods for cost-effectiveness analysis in the context of randomized, quasi-experimental and naturalistic studies.
• Estimating the Size of Populations (NIMH-funded Grant, Laska, E., P.I.) To address major planning, management, policy and fiscal issues facing a mental health service delivery system, it is important to know the size and composition of the target population. Three "single sample methods" for estimating the size of a population have been introduced. For many situations, these techniques enable unbiased population size estimates that previously could not be obtained. These methods have been used to estimate the unduplicated number of individuals who received treatment in any mental health setting in New York State and the number of street dwelling homeless individuals on a particular night.
• Estimating Capacity Requirements for Mental Health Services Post-Disaster (NIMH-funded Grant, Siegel C., P.I.) In the chaotic aftermath of a disaster, an extensive array of services needs to be provided to the affected population, as occurred after 9/11. Planning efforts require estimates of both anticipated mental health needs, the capacity required to respond to this need and potential shortfalls. This project addresses ways to obtain and estimates of these factors.
• Cultural Competency Performance Measures (SAMHSA-funded Grant, Siegel C., P.I.) A movement to promote cultural competency in mental health and behavioral health care has developed to assure that programs and providers are attuned to the specific needs of the cultural groups served. There Is substantial evidence that members of ethnic groups do not have equal access to services or attain equitable outcomes when contrasted with the dominant served population. In this project researchers working with multi-cultural and multi-disciplinary panels identified domains within behavioral care where culturally competent approaches are needed, specified performance measures and indicators of cultural competency, benchmarked a selected list of measures, and developed a Cultural Competency Assessment Scale that is now being tested on its psychometric properties. An offshoot of this effort will be the potential establishment of the relationship between cultural competency and disparities.
• Critical Time Intervention with Homeless Families (SAMHSA and NIMH-funded Grants, Samuels J., P.I.) A randomized trial focuses on the outcomes attained when homeless families whose mothers experience mental illness or substance abuse disorders receive expedited placement in transitional housing augmented by critical time intervention, an intensive case management model. The President’s New Freedom Commission on Mental Health cited this study as an innovative project in promoting evidence-based practices.
• Screens for Co-occurring Disorders (Collaboration with NYS Office of Mental Health/ Office of Alcohol and Substance Abuse Interagency Workgroup, Alexander MJ, P.I.) Project addresses the lack of systematic tools to differentiate mental illness and substance abuse disorders, a major barrier in providing coordinated adequate services. Two instruments, the MINI for mental health problems and the DALI for substance abuse problems, have been adapted and validated, and are being pilot implemented with several large providers. The developed screens have proven highly useful in defining the interventions need for high-risk populations.
• Pathways through TANF (Temporary Assistance for Needy Families) (Collaboration with the NYC Human Resources Administration, Shinn M, P.I.) Under welfare reform, individuals may remain on public assistance for limited time periods. This project examines the incidence and significance of depression, anxiety, phobias and post-traumatic stress disorder in preventing individuals from exiting welfare and gaining employment.

For further information contact Dr. Siegel at (845) 398-6590 or by email at