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Model Program: Quality Medications Care for Serious Mental Illnesses

Texas Medication Algorithm Project (TMAP)

Goal

To ensure quality care for people with serious mental illnesses by developing, applying, and evaluating medication algorithms. An algorithm is a step-by-step procedure in the form of a flow chart to help clinicians deliver quality care through the best choice of medications and brief assessment of their effectiveness. The target population is people with serious mental illnesses served by public programs.

Features

Development of algorithms as well as development of consumer education materials and other tools for treating serious mental illnesses. Public sector-university collaboration with support of stakeholders, education and technical assistance, and administrative supports to serve the most medically complex patients. Early phases of the project developed the algorithms and tested the benefits of their use; the program's latest phases focus on implementing TMAP in mental health treatment settings throughout the State.

Outcomes

The algorithm package implemented by Texas was more effective than treatment-as-usual for depression, bipolar disorder and schizophrenia. It reduced symptoms, side effects and improved functioning.166-168 The package's benefit for reducing incarceration is being studied. In addition, medication algorithms have been developed for treating children with depression or attention deficit hyperactivity disorder (AD/HD). TMAP algorithms have also been adapted to treat adult consumers who have co-occurring mental and substance use disorders.

Biggest challenge

To ensure that the entire algorithm package - patient education, frequent medical visits, medication availability, and consultation - is properly implemented in other States and localities.

How other organizations can adopt

Conduct an active planning process, including meetings with stakeholders, to examine what organizational changes are needed to make the algorithm work best.

Sites

Texas; Nevada; Ohio; Pennsylvania; South Carolina; New Mexico; Atlanta and Athens, GA; Louisville, Kentucky; Washington, D.C.; San Diego County, CA; and private sector in Denver, Colorado.

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