University of Texas at Austin Pharmacy professor’s efforts in mental health system reform presented to President Bush

Jan. 17, 2003

AUSTIN, Texas—A project co-directed by a University of Texas at Austin professor of pharmacy is featured in the President’s New Freedom Commission on Mental Health’s interim report to President George W. Bush as a model for improving the quality of care for serious mental illness.

The Texas Medication Algorithm Project model uses a step-by-step procedure in the form of a flow chart to help physicians deliver quality care via the best choice of medications and brief assessment of whether they work. The entire algorithm package includes patient education, frequent medical visits, medication availability and consultation. The target population is serious and chronically ill people served by public programs.

The program was directed by Dr. Lynn Crismon, a faculty member in the university’s Center for Pharmacoeconomic Studies, Dr. John Rush, professor of psychiatry at the University of Texas Southwestern Medical Center, and Dr. Steve Shon, medical director of the Texas Department of Mental Health and Mental Retardation.

President Bush created the commission in April 2002 to find ways to improve the country’s mental health services. In its interim report, commission members concluded that the mental health services delivery system is “in shambles because it is incapable of efficiently delivering and financing effective treatments such as medications, psychotherapies and other services.”

Responsibility for these services, the report said, is scattered among agencies, programs and levels of government. “There are so many programs operating under such different rules that it is often impossible for families and consumers to find the care that they urgently need,” commission members said. The interim report identified several community-based models showing how services can be innovatively and effectively delivered “in spite of these overwhelming barriers.”

The Texas Medication Algorithm Project shows that high quality, research-based care can be delivered to people with serious mental illness. The project fills a critical link in the system because it provides up-to-date and research-based procedures—and expert advice—for doctors to consider when prescribing medications, Crismon said.

“The quality treatment facilitated by the algorithm program, including information for consumers and families, leads to improved consumer satisfaction and adherence with recommended care, greater symptom relief and fewer side effects,” he said.

The project has been so successful, it has been adopted by health organizations in 12 other states. Results have shown that the program is more effective than standard treatment for depression, bipolar disorder and schizophrenia. It reduced symptoms, side effects and improved functioning. The effects on service utilization and health care costs are being analyzed.

For more information contact: Nancy Neff, Office of Public Affairs, 512-471-6504.