Elizabeth M.Z. Farmer

Elizabeth M.Z. Farmer (Betsy) (she/her) is dedicated to improving systems and services to more fully and adequately meet the needs of youth and their families. Her work for the past 35 years has focused on youth with mental health disorders, particularly youth who are served across multiple sectors of the child-serving system, with a focus on understanding patterns and pathways through the service system, improving quality of services, and supporting long-term positive outcomes for youth. This work has been supported by a series of NIMH-funded studies and collaborations with colleagues in social work, psychology, psychiatry, education, and other disciplines across the nation.

Farmer brings a strong interdisciplinary lens to these issues, and has held faculty positions in social work (Case Western Reserve University, Virginia Commonwealth University), health policy (Penn State University), and psychiatry (Duke University). Her graduate studies focused on comparative/historical sociology, with a particular focus on revolutions and social movements and the influence of large-scale social institutions/structures on individual lifecourse trajectories.  During her graduate school years, Farmer worked in the mental health field, first as a house parent with young adults who were dually diagnosed with mental health and intellectual disabilities and then as a treatment foster parent with youth who had mental health disorders and significant aggressive behavior. These experiences transformed her interests in the intersection of individual lives, social structures, organizational systems, and lifecourse pathways. As a treatment foster parent, Farmer grappled with the challenges and opportunities of public child-serving systems (particularly the ways that mental health, education, and child welfare intersect and influence youths’ lives), the juxtaposition of serious problematic behavior and typical developmental processes, and the necessity for providers to navigate the opportunities and difficulties of working within large-scale bureaucracies while striving to provide appropriate, high quality, individualized, future-oriented services, supports, and environments for youth. Through it all, she was struck by the amazing resilience of youth and the tremendous need for professionals who could recognize youths’ strengths and challenges, support them across time, and provide the relationships, skills, and expertise necessary to create a world in which they could grow and flourish.

With this real-world experience informing her emerging academic interests, Farmer completed an NIMH-funded post-doctoral fellowship in mental health services and systems research at Duke University and the University of North Carolina at Chapel Hill. Since this foundation, Farmer has been involved in a wide variety of studies over the years: large-scale epidemiologic work on children’s mental health problems and service use; analyses of patterns and pathways through the child-serving sectors; evaluations of policies and interventions; and a program of NIMH-funded research focused on understanding and improving out-of-home treatment (i.e., group homes, treatment foster care) for youth with serious mental health problems. This final line of work has involved intervention development, a large-scale randomized trial, and ongoing implementation and dissemination of an evidence-based approach to treatment foster care, Together Facing the Challenge (TFTC), that is now being utilized by agencies in more than 20 states.

Farmer’s efforts in recent years have focused on creating organizational infrastructure to support social work research; developing the next generation of social work scholars, educators, and researchers; and working with a variety of collaborators to increase community-engaged projects, knowledge, and innovative solutions. In addition, she is co-editor (with her husband, Tom Farmer) of the Journal of Emotional and Behavioral Disorders, an interdisciplinary journal focused on services for youth.

Research Interests

• Children’s Mental Health
• Mental Health Services Research
• Mental health service utilization
• Kinship foster care
• Residential care
• Intervention Development/Testing
• Longitudinal outcomes
• Access, Quality, and Disparities
• Implementation/Dissemination
• Community-engaged Approaches