Research Programs

The Department of Psychiatry’s externally funded research portfolio currently exceeds $15 million and is growing rapidly. The Department’s research program includes several research programs, including the Maryland Psychiatric Research Center (MPRC), the Division of Services Research (DSR), the Center on Behavioral Treatment of Schizophrenia (CBTS), and the Mental Illness Research Education and Clinical Center at the VISN 5 Veterans Affairs Medical System.

Together these centers represent one of the most comprehensive programs of research on psychotic disorders in the world, with research that includes basic histologic and neurochemical studies of brain tissue, animal models for the substrates of psychosis, genomics and proteomics, clinical trials of experimental therapeutic agents, behavioral treatments for substance abuse and disability among patients with psychosis, studies of the impacts of psychosis on the health behaviors of patients, experimental studies of community interventions to improve patient functioning (assertive community treatment, supportive employment) and healthcare policy studies. We've also recently been given the opportunity to expand our research programs in three other areas: mood and anxiety disorders, child and adolescent psychiatry and geropsychiatry. We are actively recruiting researchers in all three areas.

Division of Services Research

History, Goals and Objectives

The Division of Services Research (DSR), a division of the University of Maryland Department of Psychiatry, conducts applied research and policy studies on the delivery of services to adults with severe and persistent mental illnesses and to children with and at risk for serious emotional disturbances. It also disseminates the results of this research, provides training on its service delivery and policy implications, and offers technical assistance.

DSR consists of two programs: The Center for Mental Health Services Research (CMHSR), directed by Dr. Lisa Dixon; and the Mental Health Systems Improvement Collaborative (MHSIC), directed by Dr. Howard Goldman. MHSIC is affiliated with and receives core funding from a larger NIMH-funded Center for Research on Services for Severe Mental Illness, in collaboration with investigators at the Johns Hopkins University School of Public Health and Department of Psychiatry. The Center was created in 1990, merging the Mental Health Policy Studies Program directed by Dr. Howard Goldman and the Walter P. Carter Center Research Program directed by Dr. Anthony Lehman.

The DSR has a portfolio of projects with a total annual budget of approximately $3.5 million. It receives funding from multiple federal, state and private sources, including NIMH, NIDA, Agency for Health Care Policy and Research, Center for Mental Health Services, the Robert Wood Johnson Foundation, the MacArthur Foundation, the John A. Hartford Foundation, National Association of State Mental Health Directors, Maryland Department of Health and Mental Hygiene and the Veteran's Administration. The DSR collaborates with the VA Capitol Network (VISN 5) Mental Illness Research Education Clinical Center, directed by Alan Bellack, Ph.D., and the Maryland Psychiatric Research Center, directed by William T. Carpenter, Jr., M.D.

The DSR provides core support for faculty who are planning and conducting services research on severe and persistent mental illnesses, including statistical consultation and support, computer support, research design consultation and administrative supports. Among the DSR's major projects, past and current, are the National Evaluation of the Robert Wood Johnson Program on Chronic Mental Illness (RWJ/NIMH); Implications of Substance Abuse Among Psychiatric Patients (NIDA); Baltimore McKinney Program for the Homeless Mentally Ill (CMHS); Center for Research/Technical Development/Knowledge Dissemination on Housing for the Mentally Ill (CMHS); Patterns of Service Utilization for Schizophrenia (NIMH); Maryland Training Collaborative (MD. DHMH); the Schizophrenia PORT (AHCPR); the Employment Demonstration Project for Persons with Severe Mental Illness (CMHS); the evaluation of the CMHS ACCESS Program; the MacArthur Foundation Network on Mental Health Policy Research; the Maryland Evidence-based Practice Center and the Maryland Systems Evaluation Center (MD/DHMH), Evaluation of the NAMI Family to Family Education Program (FFEP); and Smoking Cessation Program for Persons with Schizophrenia.

The Goals of the DSR are:

• Conduct mental health services research to produce new knowledge about the effectiveness, organization, financing and delivery of services to person with severe and persistent mental illnesses.
• Disseminate new knowledge about services for person with severe and persistent mental illnesses.
• Provide technical support and mentoring to faculty and trainees who are interested in mental health services research.
• Collaborate with other divisions in the Department of Psychiatry, other components of the University of Maryland at Baltimore, and other mental health services organization to develop mental health services research.

The Center has worked closely in a partnership with the Department of Psychiatry clinical services over the years, especially the Division of Community Psychiatry. The Center has been able to utilize Department clinical services as natural laboratories to conduct its studies. The clinical services have benefited directly through the addition of new, model service programs under the Center’s demonstration projects, as well as from the more generic enhancements that clinical teaching environments experience ,as applied research provides intellectual stimulation, teaching and self-scrutiny.

The Center has also maintained a close link to department teaching programs. The model clinical services developed under Center initiatives -- for example, the Assertive Community Treatment Program for Homeless Persons with Mental Illness -- have provided excellent clinical training experiences for residents and medical students. Center faculty participate actively in the training programs of the Department as teachers and mentors. Finally, the Center has worked actively with the community, collaborating with the Baltimore Mental Health Systems, Inc. (the city-wide mental health authority), the State Department of Health and Mental Hygiene and local advocates for persons with mental illness (Alliance for the Mentally Ill, HealthCare for the Homeless, On Our Own).

The Center’s team of investigators includes:

Lisa B. Dixon, MD, MPH, is Professor in the Department of Psychiatry at the University of Maryland School of Medicine at Baltimore, received a Bachelor’s Degree in Economics at Harvard College. She then completed her Medical Degree at the Cornell University Medical College, a research fellowship at the Maryland Psychiatric Research Center, and a Masters of Public Health at the Johns Hopkins School of Hygiene and Public Health. Dr. Dixon joined the faculty of the University of Maryland School of Medicine in 1990, serving as the Medical Director of the Assertive Community Treatment Team for Homeless Mentally Ill Adults. She became Director of Education and Residency Training in 1998, a position she held until 2002. Dr. Dixon joined the VA as Associate Director of Research for the Mental Illness Research, Education and Clinical Center in 2001 and assumed the additional role of Director of the Division of Services Research in 2002.

Anthony F. Lehman, MD, MSPH, is Professor and Chair of the Department of Psychiatry, as well as a member of the Division of Services Research at the University of Maryland School of Medicine. He was a Robert Wood Johnson Clinical Scholar at UCLA before joining the faculty at the University of Rochester in 1981. There Dr. Lehman directed the Long-Term Care Program before moving to the University of Maryland in 1986. His clinical, teaching and research activities have focused on serving persons with severe and persistent mental illnesses. Much of his research has examined outcomes, in particular assessing quality of life. He has also studied the impacts of substance-use disorders among person with mental illnesses on diagnosis and outcomes. In his current work, Dr. Lehman continues to develop and assess outcome measures, evaluate innovative treatment programs for the homeless and persons with psychiatric disabilities, and study the quality of care for persons with schizophrenia. In addition to numerous scientific articles, Dr. Lehman is co-author of two books, "Working with Families of the Mentally Ill" and "Double Jeopardy: Chronic Mental Illness and Substance Use Disorders". He was Principal Investigator for the Schizophrenia Patient Outcomes Research Team (PORT), funded by the Agency for Health Care Policy and Research and the National Institute of Mental Health. He is also Principal Investigator on the Maryland Employment Demonstration Project for Persons with Psychiatric Disabilities, funded by the Center for Mental Health Services; Co-Principal Investigator on the NIMH-funded Center for Research on Services for Severe Mental Illnesses; and Co-Principal Investigator for the Maryland Medicaid Patterns of Care and Outcomes Study, also funded by NIMH. Dr. Lehman received the American Psychiatric Association's Senior Award for Research Development for Mental Health Services in 1994. He is the recipient of numerous community service awards in Rochester and Baltimore, has been cited by the National Alliance for the Mentally Ill as an Exemplary Psychiatrist, has been named in Best Doctors in America, and in 1998 was presented the Distinguished Service Award by the National Alliance for the Mentally Ill. In January 2003, the American Psychiatric Association Committee on Membership and Board of Trustees elected Dr. Lehman to be a Distinguished Fellow. In October 2004, Dr. Lehman was presented the 2004 Robert Cancro Best Chairman Award by the American Academy of Child and Adolescent Psychiatry.

Howard H. Goldman, MD, MPH, PhD is a Professor in the Department Psychiatry at the University of Maryland School of Medicine at Baltimore, where he is Director of Mental Health Policy Studies. From 1983-1985 he served as Assistant Institute Director at the National Institute of Mental Health (NIMH), where he was responsible for mental health care financing policy and related research. He continues to consult to the federal government on health care finance, including his service on the President’s Task Force on Health Care Reform in 1993. Dr. Goldman is a frequent contributor to the professional literature in mental health services research and economics. He has authored over 200 publications. His editorial board appointments have included Health Affairs, Psychiatric Services and the American Journal of Psychiatry. In addition, he has just started the sixth edition of his textbook for medical students, "Review of General Psychiatry". Currently, Dr. Goldman is Research Director for the evaluation of Mental Health and Substance Abuse Services Parity for the Federal Employees Health Benefit Program for the federal government. Recently, he and his colleagues completed an eight-year study of the U.S. Center for Mental Health Services' ACCESS-demonstration program. Dr. Goldman has received awards for mental health services research from the American Public Health Association (Carl A. Taube Award, 1992), the American Psychiatric Association (Senior Award for Research Development in Mental Health Services, 1991), Columbia University College of Physicians and Surgeons Mumford Medal , 1995), University of North Carolina at Chapel Hill (Sheps Award, 1998), and the University of Arizona (Schorr Family Award, 2001). He was the Senior Scientific Editor of the Surgeon General’s report on mental health, for which he received the Surgeon General’s Medallion in 2000.

Richard W. Goldberg, PhD is a psychologist and Associate Professor in the Department of Psychiatry at the University of Maryland School of Medicine. He is also a research investigator in the Veterans Affairs Capital Health Care Network Mental Illness Research, Education, and Clinical Center (MIRECC). He completed his undergraduate work at Cornell and received his PhD in clinical/community psychology from the University of Maryland at College Park. Dr. Goldberg’s clinical and research experiences have focused on improving the quality of care available to people living with schizophrenia and other serious mental illnesses. He was the recipient of a National Alliance for Research on Schizophrenia and Depression (NARSAD) young investigator award in 1998. In 2001, Dr. Goldberg was awarded a five-year NIMH Career Development grant to study the quality of somatic care among adults with serious mental illness. In addition to studying access and utilization of HIV- and Hepatitis C-related treatment among those living with serious mental illness, Dr. Goldberg’s work also focuses on how to integrate psychiatric and somatic services and how to translate research into effective practice. He is also actively involved in the clinical and research supervision of both psychology and psychiatry trainees.

Laurel J. Kiser, PhD, MBA is a psychologist and Associate Professor in the Department of Psychiatry at the University of Maryland School of Medicine. She received a doctorate from Indiana University in 1981 and completed internships and post-doctoral training in child clinical psychology. In 1986, she obtained a Master’s of Business Administration from the University of Memphis. Dr. Kiser’s career focus has been on the delivery and evaluation of alternative mental health services. Specifically, she has been involved in developing, directing and researching child and adolescent partial-hospitalization services since 1979. In 1994, she expanded her experiential base by organizing an academic managed-care division with responsibility for 33,000 covered lives. She served as a member of the Board of Directors and as president of the Association for Ambulatory Behavioral Healthcare (AABH), formerly the American Association for Partial Hospitalization. She led development of a conceptual model for ambulatory levels of care and is co-editor of a book on system integration. In addition to her services research on partial hospitalization, Dr. Kiser has directed two statewide studies of the TennCare Partners Program, Tennessee’s managed Medicaid behavioral healthcare carve-out. Her current research focus is on the protective role of rituals and routines within families, schools and neighborhoods. Her articles appear frequently in professional literature, and she is a regular presenter and invited lecturer at national conferences.

Julie Kreyenbuhl, PharmD, PhD is an investigator with the VA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC) and Assistant Professor within the Department of Psychiatry at the University of Maryland, Baltimore. She completed her post-doctoral training at Maryland Psychiatric Research Center under the direction of Dr. Raymond C. Love, Pharm.D. and Dr. Robert R. Conley, M.D. Dr. Kreyenbuhl’s primary research focus is the pharmacoepidemiology of schizophrenia, which involves examining patterns of care and outcomes of pharmacologic treatments in typical clinical practice settings. Specifically, she is interested in comparisons of conventional and new-generation antipsychotic medications in terms of side effect burden (particularly weight gain and hyperglycemia) and differential rates of adherence to therapy. In addition, she is interested in the practice of polypharmacy (including both psychiatric and somatic medications) in psychiatry and its relationship to patient outcomes. Dr. Kreyenbuhl has also collaborated on investigations of the conformance of pharmacologic treatment patterns for schizophrenia with the nationally recognized Schizophrenia PORT treatment recommendations. In addition, she has studied health care provider behavior change strategies, and coordinated a pilot study of academic detailing to disseminate the PORT pharmacologic to psychiatric health care providers.

Kenneth M. Rogers, MD, MSHS is Assistant Professor of Psychiatry and Director of the Child and Adolescent Residency Training at the University Of Maryland School of Medicine. Dr. Rogers completed his medical degree at the University of South Carolina, a research fellowship at the UCLA Neuropsychiatric Institute and a Masters of Science in Health Services at the UCLA School of Public Health. His clinical experience and research have focused on mental health services for juveniles with disruptive disorders and/or delinquency issues. Specifically, Dr. Rogers’ research has focused on the identification and referral of youth for mental health services in the juvenile justice system. He is also interested developing linkages between the faith community and law enforcement agencies as a means of reducing arrests and preventing recidivism among youth in the African-American community. Currently, Dr Rogers is working with the Maryland Department of Juvenile Justice to develop mental health assessment procedures for youth arrested in the state.

Maryland Psychiatric Research Center

The primary mission of the Maryland Psychiatric Research Center (MPRC) is the study of the manifestations, causes and innovative treatments of schizophrenia. The origins of neurodegenerative diseases such as Huntington's and Parkinson's diseases are also studied. The MPRC is a joint program of the University of Maryland School of Medicine/Department of Psychiatry and the State of Maryland Department of Health and Mental Hygiene. Its annual budget of approximately $10 million is comprised of multiple federal, state and private sources. Research and treatment resources include two inpatient wards (comprised of 50 beds), the Maryland Brain Collection, basic neuroscience laboratories, a brain imaging program and three outpatient research clinics. All MPRC programs conduct extensive training, seminars and conferences to disseminate new knowledge concerning the causes and treatment of schizophrenia and related disorders.

The Outpatient Research Program and Treatment Research Program conduct studies of the etiology, pathophysiology, neuroanatomy, phenomenology and therapeutics of schizophrenia. The Schizophrenia Related Disorders Program conducts studies with community and familial cohorts of schizophrenia spectrum traits and subjects with tardive dyskinesia. This program hosts a genotype/phenotype program, a first episode and early intervention clinic and hosts the MPRC-wide normal volunteer unit.

These clinical research programs are supported by neuroimaging, human physiology and cognitive laboratories, as well as an Intervention Research Center infrastructure, including biostatistics. Basic neuroscience and disease pathology are the focus of the Neuroscience Program, with laboratories dedicated to neurodevelopment, neurobiology of stress, behavioral genetics, neuronal physiology, neuroanatomy, electron microscopy and brain biochemistry.

The close connection of clinical and neuroscience scientists has created a leading center for translational research. The Maryland Brain Collection at the MPRC provides a unique resource for this work, and advanced technologies of the post-genomic era are applied.

Center on Behavioral Treatment of Schizophrenia

Directed by Alan S. Bellack, PhD, this Center focuses on the development and evaluation of behavioral treatments for schizophrenia and the integration of psychosocial and pharmacological treatments. Dr. Bellack has earned an international reputation for his seminal work on social skills training over the past 25 years. He has developed one of the two most widely used models for conducting skills training, and has published a series of widely cited papers and books on rehabilitation strategies, the role of cognitive factors in social behavior and skills acquisition, and on social perception in schizophrenia. A major focus of work at the Center is substance abuse by schizophrenia patients. The Center has developed a highly structured intervention that combines skills training, education, and contingency management procedures. This intervention has proven to be highly applicable to people with schizophrenia, and has great promise for reducing substance use in this population. A NIDA funded randomized clinical trial to evaluate the treatment is currently underway. Other NIDA funded projects include longitudinal studies to examine the process of change in substance use by people with schizophrenia, and factors associated with victimization and abuse among women with schizophrenia.

VA Mental Illness Research Education and Clinical Center (MIRECC)

The Capitol Network (VISN 5) MIRECC is a center for research, training and service for veterans with schizophrenia and their families. The work -- particularly in regard to substance abuse, women and mental health service systems and health care economics -- extends to veterans with other severe and persistent mental illnesses (SPMI) as well. The center is based at the Baltimore Division of the Veterans Affairs Maryland Health Care System (VAMHCS), and involves substantial integration with the scientific expertise on schizophrenia and mental health services at the University of Maryland School of Medicine and the Johns Hopkins University School of Public Health.

Active links and programs are maintained throughout the VISN, especially the Perry Point Division of the VAMHCS and the Washington VAMC. The MIRECC is a multilevel program that extends from development and testing of new antipsychotic medications through psychosocial treatment, rehabilitation and mental health services research. New findings are disseminated through comprehensive education programs for VISN staff, veterans, their families and other VAMCs. Clinical demonstration programs are conducted to test new strategies and to serve as models for dissemination.

Consistent with the overall mission of the VISN 5 MIRECC to improve the quality and cost-effectiveness of services for veterans with schizophrenia and their families, the MIRECC Research Program emphasizes research that promotes the translation of research findings into evidence-based practice. The MIRECC supports a large group of independent investigators, including seven physicians, six psychologists, two pharmacists and a biostatistician, along with two post-doctoral Fellows and a number of research technicians and support staff.

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