Background

The Ethel & James Flinn Foundation supports research on serious mental illnesses. Its general direction for grant support since 2000 is to “bridge the gap” between what we know and what clinicians actually do. To further develop this theme, the Flinn Foundation began a project in 2002 to phase in the use of medication guidelines and algorithms across Michigan over time. The project is directed by Public Sector Consultants (PSC) in Lansing.

During phase 1 of the project, PSC facilitated and provided research support to a steering committee of 25 leaders in Michigan’s mental health service delivery and financing systems. The committee's charge was to develop an action plan to improve the quality of mental health services in Michigan through dissemination and adoption of medication guidelines for treating schizophrenia, major depression, and bipolar disorder. These guidelines would then be slated for implementation throughout Michigan in both the private and public health systems.

Over the course of 18 months, the committee provided valuable input on the review and modification of existing guidelines while addressing barriers to guideline adoption. The resulting action plan was presented to practitioners, policymakers, consumers, and others at a special conference in the fall of 2004. The plan identified the medication guidelines and algorithms used for the Texas Medication Algorithm Project (TMAP), and made specific recommendations on strategies and tactics for their adoption in Michigan. The plan called for a period of pilot-testing the recommendations in a limited number of settings before launching a statewide campaign.

The project is now in phase 2, where six pilot programs around Michigan are implementing the action plan for three years. Phase 3 will begin at the end of that period (2008), when the initiative will disseminate the guidelines and algorithms for use statewide.