Effectiveness of Mental Health Clinical Training Programs Cannot Be Evaluated

In response to a congressional request, GAO reviewed the extent to which the National Institute of Mental Health (NIMH) has allocated clinical training funds among mental health disciplines during fiscal years 1980 through 1983 and targeted such funds to priority mental health needs.

Accurate nationwide data on the supply and distribution of various mental health providers would help NIMH focus its clinical training grants in areas with identified shortages. GAO found that inherent problems exist in developing such data because of lack of staff and funding resources and lack of universal definitions of the various mental health professions. In addition, licensing and certification requirements vary among the States which do not collect data on mental health providers. GAO noted that, during fiscal years 1980 through 1983, Congress identified 18 funding priorities for the NIMH clinical training program, which generally paralleled the recommendations of the President's Commission on Mental Health. NIMH estimated the number of grants and funding amounts that addressed the various priorities but did not develop data on the extent to which project funds were actually used for priorities. Although NIMH policies encourage participants of clinical training projects to work in underserved locations, NIMH does not routinely follow up to determine where grantees or trainees work after graduation. GAO found that, because of inadequate reporting and monitoring systems, NIMH finds it difficult to enforce the payback obligations of students receiving stipends. Finally, GAO noted that uncertainty about the continuation of the clinical training program and decreases in funding and staffing have affected NIMH evaluation efforts.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Franklin A. Curtis Team: General Accounting Office: Human Resources Division Phone: (202) 275-5451