Norwegian Harkness fellows 2024-2027

The Harkness Fellowship is a one-year scholarship in health care research and health policy in the United States. The Norwegian Fellow is part of a group of 10-15 Fellows from various countries placed at top US universities and of a joint program organized by the Commonwealth Fund. The Commonwealth Fund is a private American foundation whose purpose is to "promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, and people of color." Each fellow runs an individual project of relevance to both Norwegian and American health care with prominent mentors and supervisors. Besides increasing personal competence in health service research and insight into international health policy, networking is an important goal of the fellowship. The Harkness Fellowship was established in 1925 and will celebrate its centenary in November. Norway has been a member of the scheme since 2010. Previous Norwegian Harkness Fellows are: Berit Bringedal (2010-11), Atle Fretheim (2011-12), Hans Olav Melberg (2012-13), Jan Frich (2013-14), Bjørn Hofmann (2014-15), Meetali Kakad (2015-16), Birgitte Graverholt (2016-17), Marianne Storm (2017-18), Unni Gopinathan (2018-19), Christer Mjåset (2019-20), Ane-Kristine Finbråten (2021-22), Hanne Marie Rostad (2022-23) and Iselin Dahlen Syversen (2023-24). Harkness Fellow 2024-25, Jacob Jorem, MD, JD, is a psychiatrist, lawyer, and researcher focusing on mental health policy, law, and ethics. His work centers on improving access to and quality of mental health care. He conducted two Harkness projects: “Telemedicine Adoption and the Geographic Reach of Mental Health Specialists” and “Implementing Increased Medicaid Funding for Mobile Crisis Teams under the American Rescue Plan Act”. He was placed at Department of Health Care Policy, Harvard Medical School, and at Department of Health Policy and Management, Columbia University Mailman School of Public Health. His co-mentors were Haiden Huskamp, PhD, Henry J. Kaiser Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School and Michael Sparer, JD, PhD, Professor and Chair, Department of Health Policy and Management, Columbia University Mailman School of Public Health. In his final report to the Commonwealth Fund, Jorem stated that both Norway and the United States face significant disparities in mental health care access, particularly for underserved and rural populations. Patients may need to travel long distances and often face long waiting times for care. While primary care physicians can address some mental health needs, access to community-based specialists remains limited in many areas. This service gap increases reliance on law enforcement, emergency departments, and hospitalizations, highlighting the need for more accessible and community-oriented mental health services. Both telemedicine and Mobile Crisis Teams (MCTs) have become increasingly important in addressing access barriers. Despite differences between the U.S. and Norwegian health care systems, understanding these policy approaches offers insights for improving access. His first Harkness project analyzed Medicare data to examine the association between telemedicine uptake and the geographic reach of mental health specialists. Findings showed that expanding telemedicine use alone will not lead to substantial improvements in access for underserved or rural populations. To realize telemedicine’s full potential, tailored policy interventions seem to be needed. Jorem’s second project explored the implementation of increased Medicaid funding for MCTs following the American Rescue Plan Act (ARPA). Findings highlighted a core policy challenge: balancing local autonomy with the need for access to quality services funded at the national level. Aligning broader Medicaid reforms in well-established crisis response systems with strong interagency collaboration appeared to facilitate ARPA implementation. Sustaining MCTs will require diversified and stable funding beyond ARPA’s temporary support, as well as adaptability in federal funding requirements to align programs with state-specific contexts. Stronger integration of MCTs into the mental health continuum is key to reducing reliance on emergency departments, hospitalizations, and law enforcement. Experiencing the disparities in health care access and outcomes in the United States has been another important lesson for Jacob Jorem, as for previous Harkness Fellows. A limited public safety net leaves many vulnerable populations without adequate care. Jorem has stated, in an article in the journal Michael: “The true measure of a nation is how it treats its most vulnerable. Experiencing these disparities firsthand has strengthened my conviction that robust safety nets and a publicly funded health care system are essential to ensuring access for all.”