From ‘trial and error’ to precision targeting: $17.9 million grant accelerates UM mental health research

People with depression, anxiety, and other mental health problems face many options for managing their symptoms, from talk therapy and medication to movement, sleep, and mindfulness.

However, no combination is proven to be the best, so it may take months or years to find an option or combination that works for everyone. It can also take several weeks to see if mental health treatment is helping.

Additionally, the process of finding an effective combination only begins after someone has made an appointment with a mental health provider and accepted their insurance.

All this is a waste of time, money and, in the most serious cases, loss of life.

A and a new $17.9 million grant Researchers at the University of Michigan aim to change that.

The team will enroll thousands of patient volunteers by invitation before they start providing mental health care at UM Health. The new study is called COMPASS, A Comprehensive Motion Accuracy Approach for Scalable Solutions in Mental Health Treatment.

The COMPASS team hopes to use mobile technology, genomic, behavioral and electronic health record data to create decision-support tools that will make it easier to predict which approach will work best for an individual.

Their goal: accuracy in mental health care for patients and providers alike in the treatment of many types of cancer, heart disease, diabetes and other conditions.

The new scholarship National Institute of Mental Health, part of the National Institutes of Health. This acknowledges the promise shown in previous UM studies involving small groups of people.

How the survey works

The COMPASS study will soon be offered to thousands of patients seeking mental health care at UM Health’s extensive outpatient and student-centered clinics. This includes those using the Collaborative Care model, where psychiatrists support UM Health’s primary care providers in treating patients with mild to moderate mental illness.

Both patients who had not received mental health care and those who had previously received mental health care from non-UM providers were eligible for the new survey one week prior to their first visit with a UM provider. The researchers will ask for permission to access information about previously used mental health medications.

If patients agree to enroll in COMPASS, they will have free access to the mobile mental health app while they wait for their first appointment with their UM provider. They will also receive a wearable tracker and undergo a year of research and genetic testing.

Researchers hope that combining this information with patients’ responses to treatment will pave the way for using data science and machine learning tools to look for patterns and predictions.

More about the study

The COMPASS team is led by researchers UM School of Medicine and School of Public Healthbecome members of UM Eisenberg Family Depression CenterUM Precision Healththe UM Opioid Research Institutethe Michigan Neurological Institute and UM Institute for Health Policy and Innovation.

They received a grant as part of the NIMH Effects on mental health effort.

“We need better ways to predict which patients will improve with digital solutions and lifestyle changes, which may need specific medications or specific types of therapy, and which may require more intensive treatments such as ketamine, rTMS, or ECT,” he said. . Srijan Sen, MD, PhD, co-leader of the new study and director of the Eisenberg Family Depression Center, a psychiatrist and neuroscientist at the School of Medicine. Both rTMS, which stands for Repetitive Transcranial Magnetic Stimulation, and ECT, which stands for Electroconvulsive Therapy, have been approved for severe depression and other conditions unresponsive to other treatments.

Based on the promising results of previous initiatives, the team secured funding Comprehensive Mental Health Treatment (PROMPT) research and the Mental Health Biobank funded by EFDC, Precision Health and other sources.

Initial data from the PROMPT study were presented in early June National Ambulatory Evaluation Society Meeting at UM and is in the process of being published in a peer-reviewed journal.

The research team also hopes that patient volunteers recruited through COMPASS and the data collected will provide a foundation for other UM researchers interested in studying specific patient populations or data types.

The UM team will work with teams from other universities that receive IMPACT-MH funding from NIMH to learn from each other’s findings and validate new digital tools.

Weaving genetics with other information

Sen notes that the genetic component of the research goes beyond current commercial genetic tests that use changes in DNA metabolism to try to predict which mental health drugs may have more or fewer side effects for a given person.

Instead, the team will use a genome-wide assessment of each volunteer to help predict treatment response.

Co-leader of the project Lars Fritsche, Ph.D., Associate Scientist in the School of Public Health’s Department of Biostatistics, an expert in statistical genetics, will bring this expertise to the study.

“By integrating genetic, particularly pharmacogenetic, and polygenic predictors with electronic health record and behavioral data, this innovative and comprehensive approach will improve the prediction of treatment response and outcome, and ultimately improve personalized mental health care.” ” said Fritsche.

“Our goal is to integrate information to create tools that help care providers choose the right treatment and support program at the right time,” he said. Amy Bohnert, Ph.D., MHS, co-leader of the project, professor of the Department of Anesthesiology, School of Medicine.

“We want to help patients get to the point of recovery faster.”

Bridging the gap in mental health care

The importance of reducing recovery time can address fundamental issues related to access to mental health care.

Currently, the high demand for mental health care from UM’s psychiatrists, psychologists, mental health nurses, and hospital social workers means that weeks or even months can pass between the time a person is called for an appointment and the day of the appointment. .

In fact, researchers say, this gap between contact and care is particularly important when using other tools to support patients. Such gaps are common across the country due to increased numbers of people seeking mental health care.

Mental health smartphone apps can fill this gap.

Although there are hundreds of mobile apps that claim to have an effect on mental health, there is little concrete evidence to show which ones are most effective and which ones work for which people.

Sen said the COMPASS team hopes to help evaluate mental health apps and use these tools to meet the demand for mental health services.

He and his colleagues envision a physician dashboard to help providers view aggregated data from patient smartphone apps and wearable devices in real time. This dashboard helps patients monitor whether their health is good or their mental health is deteriorating, and can indicate when they need help.

Such dashboards are already helpful in treating other chronic conditions, such as high blood pressure, diabetes, and asthma.

Another goal is to help patients understand how to get the most out of their personal devices, such as sleep, exercise, exposure to natural light, monitoring screen time, setting goals, and more.

The COMPASS study is supported by grant U01MH136025 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.