This application describes an intensive, five-year period of mentored training in mental health services research with children and adolescents. It lays the groundwork for a career research program aimed at developing effective treatment for mental disorders of childhood. The training and research plans are devised to gain in-depth knowledge and experience through formal coursework and three training modules: (1) epidemiological and preventive approaches to services research; (2) contextual influences, particularly caretaker burden, on the effectiveness of mental health services; and (3) developing collaborative community partnerships for effective interventions. Three research projects investigate contextual factors that affect the perceived need and use of mental health and educational services by ADHD children and their families in real world settings. Although a wealth of studies has demonstrated the efficacy of pharmacological and non-pharmacological treatments for ADHD, few studies have addressed the reasons why such treatment works or fails in the community settings. The projects, each allied with one module of training, are linked by a conceptual model in which relationships between the severity of problems, service use and the resulting effect on multi-level outcomes are mediated by an understudied construct, the perceived burden or impact of the child?s disorder on families and teachers. The first two projects are designed to test the model first in a clinical population and second in an epidemiological sample. The third study develops and tests the feasibility of an intervention aimed at reducing family burden through increasing parent empowerment. The plan benefits from the strong multi-disciplinary effort in health services research, linking public, academic and professional institutions and community partners in the Baltimore area.

K23MH001899

2002-07-22

2007-05-31