Critical Gaps in Assisted Outpatient Treatment Research in the United States.

In 2023, the White House included the implementation and improvement of assisted outpatient treatment in a list of under-researched strategies to support recovery and long-term treatment engagement for people with serious mental illness. Assisted outpatient treatment is a community-based, court-ordered, mental health treatment program for a subset of individuals with serious mental illness who have a history of difficulty adhering to treatment and staying well while living in the community. There is research supporting the use of assisted outpatient treatment for this specific population, however, the majority focuses on limited geographic regions, specific program organizations, and is outdated. Meanwhile, assisted outpatient treatment programs have increasingly been adopted by counties and states across the country. More research is needed to ensure that assisted outpatient treatment programs are being implemented in the most effective and equitable way possible. In this paper, the authors identify several key gaps in the current literature base relating to the effectiveness and implementation of assisted outpatient treatment.

The Continuing Decline of Clinical Research on Serious Mental Illnesses at NIMH.

It has been claimed that the National Institute of Mental Health (NIMH) budget, which traditionally has been evenly balanced between basic and clinical research, has shifted sharply and that 90% of NIMH resources are funding basic research. The authors used public data sources to assess this claim: the Research Condition and Disease Categorization Database, ClinicalTrials.gov, and the NIMH Strategic Plan for Research for 2020-2024. From 2016 to 2019, NIMH expenditures on bipolar disorder research decreased 25%, and those for schizophrenia research decreased 17.5%. From 2003 to 2019, NIMH support for treatment trials for schizophrenia, bipolar disorder, and major depressive disorder decreased 90%. NIMH's Strategic Plan for Research for 2020-2024 suggests that the shift toward basic research will continue. Because NIMH's primary purpose is to develop better treatments for current patients as well as future ones, the authors recommend that the ratio of basic to clinical research be readjusted to approximately 50:50.