Community Mental Health Journal最新文献

{"title":"Bridging the gap of Inequity in Implementation Science: Adaptations of Group EBPs for those with Serious Mental Illness in the Public Sector.","authors":"Erika R Carr","doi":"10.1007/s10597-024-01371-7","DOIUrl":"10.1007/s10597-024-01371-7","url":null,"abstract":"<p><p>There are many group EBPs that are now listed as effective treatments for those with serious mental illness (SMI). Despite this, there are few of these group EBPs that are being delivered consistently in the public sector, causing disparity. This article reviews the challenges that relate to implementation science and those with SMI receiving group EBPs to help them live a life of meaning as they define. The article discusses the need for adaptations of EBPs as individuals with complex concerns need different approaches to implementation science. Next, the article conveys what core constructs of group EBPs have to be maintained as they are and what elements of EBPs need adapting to empower those with SMI in engagement. This article provides knowledge of practical application of implementation science approaches while providing dialectical behavior group therapy and cognitive behavior group therapy for psychosis adaptations for those with SMI in a public sector inpatient setting.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"639-648"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing Quality Improvement Initiatives Within Community Psychiatry: Challenges and Strategies.","authors":"Lucy Ogbu-Nwobodo, Anya Fang, Harminder Gill, Sam Ricardo Saenz, Paul Wallace, Christina Mangurian, Johanna B Folk","doi":"10.1007/s10597-024-01375-3","DOIUrl":"10.1007/s10597-024-01375-3","url":null,"abstract":"<p><p>Implementation of quality improvement (QI) initiatives within community mental health settings is crucial to addressing equity-related issues affecting mental health services delivery, including for co-occurring substance use disorders. Given the growing recognition of QI interventions as an effective framework to facilitate structural change within systems of care, it is important to equip mental health providers with the knowledge and ability to execute QI initiatives that are feasible, sustainable, and integrate a health equity lens. To demystify the QI process, we describe the design and methodologies of four fellows' capstone projects conducted during the 2022-2023 academic year at the University of California, San Francisco (UCSF) Public Psychiatry Fellowship at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG). By highlighting fellows' experiences with leading QI initiatives within community mental health settings, we discuss strategies for overcoming implementation barriers including stakeholder engagement and transparency factors, resource and time constraints, unexpected changes in direction, and lack of infrastructure for QI. Lastly, we reflect on best practices and sustainability considerations for leading QI initiatives in partnership with academic centers, departments of public health, and community mental health clinics.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"674-681"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood Homelessness as an Adverse Childhood Experience (ACE): Adult Mental Health Outcomes.","authors":"Jeff M Downes, Julie M Smith-Boydston","doi":"10.1007/s10597-025-01466-9","DOIUrl":"10.1007/s10597-025-01466-9","url":null,"abstract":"<p><p>Adverse childhood experiences (ACEs) are experiences of abuse, neglect, and other household problems occurring before age 18 and contribute to the development of both physical and mental health concerns. People experiencing homelessness report disproportionately higher rates of ACEs and negative mental health concerns; however, little research has been conducted regarding the relationship between ACEs and mental health outcomes specifically for homeless populations. A dearth of research also exists regarding how childhood experiences of homelessness interact with ACEs and mental health outcomes. The present study examined the mental health outcomes for people experiencing homelessness, as well as how childhood experiences of homelessness may fit into the ACEs model using archival data. People experiencing homelessness (n = 100) completed the ACEs questionnaire, a demographics questionnaire, and a health appraisal questionnaire. Results found ACEs significantly predicted negative mental health outcomes for people experiencing homelessness. Childhood experiences of homelessness were predictive of negative mental health outcomes; however, this relationship became negligible when acting as a covariate with ACEs. This result suggests that the ACEs framework adequately explains the effects of traumatic events for children experiencing homelessness and the subsequent negative mental health outcomes.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Choosing your Own Path\": Patterns of Use of Psychiatric Medication among Individuals with Serious Mental Illness.","authors":"Maia Asher, David Roe, Rivka Tuval-Mashiach, Ilanit Hasson-Ohayon","doi":"10.1007/s10597-025-01465-w","DOIUrl":"https://doi.org/10.1007/s10597-025-01465-w","url":null,"abstract":"<p><p>Most individuals with serious mental illness (SMI) are advised to take psychiatric medication, but about half of them do not take it as prescribed. The binary concepts of \"adherence\" and \"non-adherence\" do not seem to capture the actual patterns of medication use. The current study mapped the different patterns of medication use among people with SMI and explored the characteristics of each pattern. Sixteen participants diagnosed with an SMI that used psychiatric medications for at least one year, were interviewed, and data were analyzed using ideal-type analysis. Analysis revealed four patterns of medication use: (1) adherence without doubt; (2) adherence after attempts to stop/reduce; (3) flexible use over time; and (4) tapering off medication. Individuals may shift between these different patterns in their recovery journey, creating the need for tailored therapeutic interventions that adapt to individuals' evolving needs, beliefs, and preferences.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Family-Based Interventions for Immigrant/Refugee Children: Exploring Intergenerational Trauma.","authors":"Jeeyeon Hong, Hector Chaidez Ruacho, Xiaoyi Zeng, Cynthia Franklin","doi":"10.1007/s10597-025-01463-y","DOIUrl":"https://doi.org/10.1007/s10597-025-01463-y","url":null,"abstract":"<p><p>Immigrant and refugee families often experience significant trauma, which can be transmitted across generations. Nonetheless, little is known about interventions that mitigate intergenerational trauma within these populations. We conducted a scoping review to synthesize research evidence on family-based trauma interventions for immigrant and refugee children and their families, focusing on intergenerational trauma. Our search included peer-reviewed studies published globally from 1990 to 2024 that tested intervention effectiveness using pre- and post-intervention outcomes and involved both children and family members. Five studies met our inclusion criteria, comprising two parenting interventions, two multifamily group interventions, and one schoolbased intervention. All five interventions improved the children's mental health, while mixed findings were shown with parent mental health. Only one study explicitly named intergenerational trauma as their intervention goal, revealing a significant gap in this area. Recommendations for future studies are provided to guide practice and research in this critical area.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Just Wouldn't Like Him to go Through What I Went Through as a Kid\": A Qualitative Study on the Mitigating Effects of Positive Childhood Experiences in Mothers with a History of Adverse Childhood Experiences in an Irish Population.","authors":"Lamia Tadjine, Lorraine Swords","doi":"10.1007/s10597-024-01353-9","DOIUrl":"10.1007/s10597-024-01353-9","url":null,"abstract":"<p><p>Adverse Childhood Experiences (ACEs) are increasingly being acknowledged as a major risk factor for instigating and sustaining cycles of trauma between mother and child. Recently, the concept of Benevolent Childhood Experiences (BCEs) has been introduced to ACEs research as a buffer against the transmission of ACEs between generations. Positive childhood experiences such as attachment to caregivers, positive peer relations and positive sense of self have been found to counteract the effects of adverse childhood experiences. The emergence of positive childhood experiences as an adaptive capacity against ACEs should be explored as a tool for psychological change, to help break the cycle of inherited trauma between generations. The present study aims to examine the lived experiences of mothers with a history of ACEs, if they consider their positive childhood experiences when parenting, and how they use these positive experiences to break the cycle of intergenerational trauma. Three women residing in a low-support service for parenting were recruited for this study. Participants were all low-income, first-time single mothers in their early thirties. A qualitative approach was designed for the study. ACEs and BCEs questionnaires were administered to participants and scores were taken into account to contextualise participant interviews. A semi-structured interview was designed in accordance with IPA guidelines. Questions were directed towards phenomenological material, focusing on participants' understanding of their experiences as mothers. Analysis of the interview data revealed three superordinate themes (replicating positive experiences, creating new positive experiences and protecting children from intergenerational trauma) related to participants' BCEs, their children's BCEs and their desire to break the cycle of intergenerational trauma. The findings of this study, namely that participants intentionally tried to create positive experiences with their own children through drawing on their own positive experiences in childhood, supports the idea that BCEs are a legitimate source of adaptive capacity for mothers with ACEs. Parenting interventions for parents with ACEs should be developed taking into account ACE and BCE scores.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"492-501"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between the Type of Mental Health Treatment Received, Metropolitan Status and Gender.","authors":"Robin Danek, Eric Reyes","doi":"10.1007/s10597-024-01367-3","DOIUrl":"10.1007/s10597-024-01367-3","url":null,"abstract":"<p><p>The purpose of this study is to examine the relationship between the type of mental health care received and metropolitan status. We combined data from the National Survey for Drug Use and Health (NSDUH) to examine mental health treatment. We grouped participants by metropolitan status and receipt of mental health treatment. We conducted a logistic regression using interaction terms to compare the likelihood of receiving inpatient and/or outpatient treatment for mental health, relative to prescription medication alone. There was an association between the type of mental health treatment received and metropolitan status. For women, living outside a large metropolitan area was associated with a higher likelihood of receiving only prescription medication (p < 0.001). Policy makers may use these results to consider ways to increase access to care, including increasing funding for behavioral health or recruitment incentives for specialists.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"598-602"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Lived Experiences of Medication for Opioid use Disorder Treatment: A Qualitative Study among a Crowdsourced Convenience Sample.","authors":"Grant Victor, A Kheibari, J C Strickland","doi":"10.1007/s10597-024-01345-9","DOIUrl":"10.1007/s10597-024-01345-9","url":null,"abstract":"<p><p>Given the effectiveness of medication for opioid use disorder (MOUD) and low engagement of treatment among people who use drugs (PWUD), it is important to better understand how to engage treatment clients with MOUD care. The current study aimed to achieve this goal by using qualitative methodology to characterize the MOUD treatment experiences. Participants (N = 52) were recruited for an online semi-structured interview. Qualitative analysis revealed varied treatment experiences, with the majority expressing irregular and intermittent MOUD treatment engagement. The therapeutic effects of MOUD in curbing withdrawal symptoms in conjunction with counseling services was frequently mentioned, as well as a preference for methadone maintenance treatment (MMT) to buprenorphine or naltrexone. Many participants described barriers to treatment and continuation of care, including failed drug screens for non-opioid drugs, perceived stigma, and physician-initiated discontinuation of treatment. The current study revealed that patients had favorable experiences with MOUD treatment, particularly when supplemented with counseling services.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"411-419"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detailing Healthcare Claims Data Evidence of Extrapyramidal Symptoms in Medicaid Patients with Schizophrenia after Second-Generation Antipsychotic Medication Initiation.","authors":"Kristin Richards, Michael Johnsrud, Christopher Zacker, Rahul Sasané","doi":"10.1007/s10597-024-01347-7","DOIUrl":"10.1007/s10597-024-01347-7","url":null,"abstract":"<p><p>Researchers have used elements of administrative healthcare claims data (e.g., diagnosis codes and medications) to calculate rates of extrapyramidal symptoms (EPS) in patients with schizophrenia who utilize second-generation antipsychotics (SGAs). However, a detailed description of claims-based EPS evidence has not been previously provided, which is the objective of the current study. This descriptive study, using 2016-2020 de-identified multi-state Medicaid administrative claims data, followed patients diagnosed with schizophrenia for 12 months after initiation of SGA therapy to identify and describe the first evidence of EPS. Time to EPS evidence was calculated and continuously-eligible patients were followed for an additional 12 months to examine EPS medication utilization and costs. Following SGA initiation, 13.6% (n = 2,288) of patients had evidence of EPS during the 12-month follow-up period. Mean time to first evidence of EPS after SGA initiation was 103.7 days (sd = 112.2, median = 58). For a majority of patients (n = 1,636, 71.5%), an EPS medication claim was the initial evidence of EPS, rather than an EPS diagnostic claim. Additionally, a quarter of patients (25.3%) in the EPS evidence cohort had a claim for an EPS medication on the same date as SGA initiation, possibly indicating prophylactic prescribing to prevent EPS development. Nearly 93% of those with EPS medication claims were treated with benztropine, while less than 2% received deutetrabenazine or valbenazine (indicated for tardive dyskinesia (TD)). Annual per patient EPS medication expenditures were $804 (sd = 7,080) overall, but only $40 (sd = 104) when excluding the higher-cost TD medications. Nearly 14% of Medicaid patients with schizophrenia who initiated SGA treatment had evidence of EPS based on claims data. The majority of the time, this evidence was derived from a prescription claim for a medication to treat EPS, rather than an EPS diagnostic claim. Prophylactic prescribing for EPS occurred more often than expected and should be explored more fully. While the cost of traditional EPS medications minimally contributes to the overall cost of care in schizophrenia, use of newer TD drugs can substantially increase spending.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"432-439"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Examination of Clinician Anxiety about Suicide Prevention and Its Impact on Clinical Practice.","authors":"Jesslyn M Jamison, Megan Brady, Annalisa Fang, Trà-My N Bùi, Courtney Benjamin Wolk, Molly Davis, Rinad S Beidas, Jami F Young, Jennifer A Mautone, Shari Jager-Hyman, Emily M Becker-Haimes","doi":"10.1007/s10597-024-01364-6","DOIUrl":"10.1007/s10597-024-01364-6","url":null,"abstract":"<p><p>Clinician distress about working with patients at risk for suicide is well documented in the literature, yet little work has examined its pervasiveness across clinical settings. We conducted a secondary analysis of qualitative data gathered from 26 clinicians in primary care and outpatient mental health clinics serving both adult and child clients on their perception of evidence-based practice use for suicide screening, assessment, and brief intervention. Qualitative data were coded for any mentions of clinician anxiety or emotional response, and brief quantitative measures were collected to characterize our sample. When discussing broader barriers to implementation, 85% of participants spontaneously mentioned anxiety or heightened emotional responses related to delivering suicide prevention practices to those at risk for suicide. Common themes included low self-efficacy in suicide prevention skills, distress related to escalating care, efforts to alleviate such distress, and difficulty related to tolerating the uncertainty inherent in suicide prevention work. Similarly, while standardized anxiety ratings for participants were consistent with those of non-clinical norming samples, clinicians reported mild to moderate anxiety when screening for suicide risk (M = 3.64, SD = 2.19, Range = 0-8) and engaging in safety planning (M = 4.1, SD = 2.88, Range = 1-7) on post-interview surveys. In contrast, survey responses reflected generally high self-efficacy in their ability to screen for suicide risk (M = 7.66, SD = 1.29, Range = 5.25-10) and engage in safety planning (M = 8.25, SD = 0.87, Range = 7-9.5). Findings highlight pervasiveness of clinician distress when implementing suicide prevention practices and can inform future suicide prevention implementation efforts.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":"568-575"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}