# StepWell: Stepped Care  Mental Health and Substance Use Telehealth  Services for COVID-19 Affected Patients

> **NIH NIH U19** · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · 2020 · $411,638

## Abstract

Social isolation, economic insecurity, and rapid increases in numbers of COVID-19 cases and deaths are
resulting in alarming rates of mental health and substance use disorders.
Furthermore, existing social, health,
and mental health (MH) disparities among racial/ethnic minorities have exacerbated
. MH care systems and
collaborative care systems, which integrate MH into primary care settings, have been hard pressed to provide
psychiatric care to new patients with MH and substance use (SU) disorders (MHSUDs) arising from the pandemic
– including patients recovered/ recovering from COVID-19 (“COVID survivors”) and their families. The necessity
of using telehealth strategies to protect patients and providers has posed additional challenges for MH/SU care
systems. Although telehealth may increase patient engagement, no research has identified optimal, resource-
efficient strategies for its use in MHSUD screening and care delivery. Thus, a novel approach that meets both
the demand and the safety challenges of the COVID-19 era is required to address the burgeoning COVID-related
MHSUD care needs. Coupling a stepped-care strategy with automated triage, psychoeducation, and shared
decision-making can not only address capacity and system-level barriers, but also potentiate treatment effects
and address patient/provider-level barriers to engagement. To meet the critical MH challenges presented by the
COVID-19 pandemic, the proposed supplement research will adapt and apply a technology developed in the
parent grant, the Electronic Mental Wellness Tool (EmwT), that guides providers in screening patients for any
MHSUDs using 3 validated items with high sensitivity and then, using another 9 validated items, triages patients
to specific evidence-based treatments according to diagnostic categories with good specificity. The initial 3 items
also can detect, by proxy and with high sensitivity, any MHSUDs among relatives. We will extend this work to
develop and implement StepWell, a telehealth stepped-care approach to MHSUD treatment that integrates the
EmwT with an electronic patient-facing depression and anxiety care shared decision-making tool in use at New
York Presbyterian Hospital (NYPH). In a new cohort of 1,000 recently discharged COVID patients being followed
by NYPH for one year, we will test the feasibility of using StepWell to identify MHSUD problems among COVID
survivors and their families and address their MHSUD treatment needs while monitoring MH outcomes for 1
year. We will use human-centered design principles to integrate the eSDM (patient preference) and EmwT
(assessment and treatment) technologies to develop StepWell. In a mixed-methods pilot test, we will examine
feasibility, acceptability, and factors influencing StepWell implementation in preparation for a larger
implementation science R01 proposal. This project addresses calls to monitor and address the MH impact of
COVID-19 infected and affected patients, while expanding the ability of the hea...

## Key facts

- **NIH application ID:** 10198125
- **Project number:** 3U19MH113203-04S3
- **Recipient organization:** NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
- **Principal Investigator:** Maria A Oquendo
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $411,638
- **Award type:** 3
- **Project period:** 2017-05-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10198125

## Citation

> US National Institutes of Health, RePORTER application 10198125, StepWell: Stepped Care  Mental Health and Substance Use Telehealth  Services for COVID-19 Affected Patients (3U19MH113203-04S3). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10198125. Licensed CC0.

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