Psychiatric services最新文献_第2页

Social Media Use Among Emerging Adults With Psychosis: Oversights and Opportunities.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 Epub Date: 2025-02-21 DOI: 10.1176/appi.ps.20240313

Ivy R Tran, Christi L Trask, Aubrey M Moe

引用次数: 0

Postcertification Wages Among Certified Peer Specialists Working in Peer Support and Other Occupations. 在同伴支持和其他职业中工作的认证同伴专家的认证后工资。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 Epub Date: 2024-12-19 DOI: 10.1176/appi.ps.20240195

Laysha Ostrow, Judith A Cook, Morgan Pelot, Mark S Salzer, Jane K Burke-Miller

{"title":"Postcertification Wages Among Certified Peer Specialists Working in Peer Support and Other Occupations.","authors":"Laysha Ostrow, Judith A Cook, Morgan Pelot, Mark S Salzer, Jane K Burke-Miller","doi":"10.1176/appi.ps.20240195","DOIUrl":"10.1176/appi.ps.20240195","url":null,"abstract":"Objective: Although certification can raise the status of peer support work, certified peer specialists (CPSs) may continue to face financial hardship that affects their employment choices. This study aimed to explore how wages and financial well-being changed for CPSs over a 3-year postcertification period.Methods: This study examined wages, job characteristics, and financial well-being for a cohort of 448 employed CPSs working in peer support (PS) or other, nonpeer (NP) jobs during the study period. Self-report survey data were collected on current jobs, hours worked, and job tenure. Financial well-being was assessed by using the Consumer Financial Protection Bureau's Financial Well-Being Scale. Differences in job characteristics over time were described by using chi-square and t tests, and mixed-effects logistic regression models were used to model job attributes and financial well-being.Results: Hourly wages for both PS and NP jobs increased significantly between 2020 and 2022, with smaller increases for PS than for NP positions. Individuals with PS jobs were significantly more likely to have longer job tenures than those with NP jobs. Higher hourly wages were associated with a greater likelihood of longer job tenure. Financial well-being did not improve significantly over time.Conclusions: The larger wage increases and shorter tenures characteristic of NP jobs, relative to PS positions, suggest that workers may have switched from PS jobs to other jobs to improve their financial and career mobility opportunities. CPSs are part of a trend in the general U.S. adult population of declining financial well-being, despite increased wages.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"350-357"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Police Presence in Mental Health and Crisis Care.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 DOI: 10.1176/appi.ps.25076007

Tushar Sood, Saadia Sediqzadah, Lisa B Dixon

引用次数: 0

Learning How to Learn Together: Integrating Lived Experience Into Mental Health Care. 学会如何共同学习：将生活经验融入心理健康护理。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 Epub Date: 2024-09-23 DOI: 10.1176/appi.ps.20230607

Helene Speyer, John T Lysaker, David Roe

引用次数: 0

Elimination of Behavioral Health Wait Times: Impact on "Avoidable" Medical Visits, Productivity, and Revenues.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 Epub Date: 2025-02-13 DOI: 10.1176/appi.ps.20240287

Jules Rosen, Michelle Hoy, Lucy Cordts, Andrea Laplante, Dustin Baker, Daniel Maeng

{"title":"Elimination of Behavioral Health Wait Times: Impact on \"Avoidable\" Medical Visits, Productivity, and Revenues.","authors":"Jules Rosen, Michelle Hoy, Lucy Cordts, Andrea Laplante, Dustin Baker, Daniel Maeng","doi":"10.1176/appi.ps.20240287","DOIUrl":"10.1176/appi.ps.20240287","url":null,"abstract":"Objective: Delayed access to behavioral health services results in poor outcomes and higher costs. This brief report describes the elimination of a 702-person behavioral health waitlist through phase-based care (PBC), an innovative approach that aligns behavioral health resources with new patients with high-acuity need.Methods: Two PBC clinics, one triage and another high-acuity treatment, were established. Comparisons of pre-post interventions analyzed nonbehavioral health medical encounters, behavioral health productivity, and no-show rates.Results: Of 702 waitlisted persons, 614 attended triage clinics within 3.5 months, with patients needing acute care (37%) entering the treatment clinic within 2 weeks. Following evaluation, the waitlisted patients had 23% fewer medical encounters per month (p<0.001), behavioral health revenues increased 29% (p<0.001), behavioral health visits increased 165% (p<0.001), health evaluations increased 287% (p<0.001), and no-shows decreased 33% (p<0.001).Conclusions: Reallocating resources to new patients and those needing acute care resulted in increased behavioral health evaluations and productivity and reduced nonbehavioral health services without adding staff.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"398-401"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of an Organizational Implementation Strategy on Sustainment of Measurement-Based Care in Community Mental Health.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 Epub Date: 2025-01-30 DOI: 10.1176/appi.ps.20240302

Nathaniel J Williams, Gregory A Aarons, Mark G Ehrhart, Susan Esp, Nallely Vega, Marisa Sklar, Kristine Carandang, Lauren Brookman-Frazee, Steven C Marcus

{"title":"Effects of an Organizational Implementation Strategy on Sustainment of Measurement-Based Care in Community Mental Health.","authors":"Nathaniel J Williams, Gregory A Aarons, Mark G Ehrhart, Susan Esp, Nallely Vega, Marisa Sklar, Kristine Carandang, Lauren Brookman-Frazee, Steven C Marcus","doi":"10.1176/appi.ps.20240302","DOIUrl":"10.1176/appi.ps.20240302","url":null,"abstract":"Objective: Little is known about how to sustain evidence-based interventions with fidelity in community mental health settings. Phase 1 of the Working to Implement and Sustain Digital Outcome Measures (WISDOM) trial showed that an organizational strategy improved the implementation of measurement-based care (MBC) in mental health services for youths 1-12 months after clinician MBC training. The authors report results from phase 2 of the trial, in which the strategy's effects on MBC sustainment 13-26 months after clinician MBC training were examined.Methods: Twenty-one outpatient mental health clinics were randomly assigned to MBC training and technical assistance plus the Leadership and Organizational Change for Implementation (LOCI) strategy (11 clinics) or to training and technical assistance only (10 clinics). In phase 2, the primary outcomes of MBC completion rate, youth symptom improvement, and MBC fidelity were examined for 452 youths who entered treatment 13-26 months after clinician MBC training.Results: No differences were found in MBC completion rate or symptom improvement between the two conditions; however, among the 81 youths who received MBC, fidelity was significantly higher at LOCI sites relative to control sites (24%, SE=11.1 vs. 1%, SE=1.0, respectively; p=0.003).Conclusions: During phase 2, LOCI sites (vs. control sites) sustained superior MBC fidelity when MBC was used; however, superior MBC completion rates and clinical outcomes were not sustained. Sustainment of MBC may require strategies that improve its fit with regulatory and reimbursement environments in addition to strategies that develop clinic infrastructure.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"358-365"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of the Clinical High Risk for Psychosis Services Fidelity Scale (CHRPS-FS) for Team-Based Care.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 Epub Date: 2025-02-27 DOI: 10.1176/appi.ps.20240107

Mark Savill, Lindsay M Banks, Briana T Sepulveda, Savinnie Ho, Valerie L Tryon, Kathleen E Nye, Christopher Blay, Misha M Carlson, Adrian F Asbun, Sabrina Ereshefsky, Kristin L LaCross, Stephania L Hayes, Tara A Niendam, Donald E Addington

{"title":"Development of the Clinical High Risk for Psychosis Services Fidelity Scale (CHRPS-FS) for Team-Based Care.","authors":"Mark Savill, Lindsay M Banks, Briana T Sepulveda, Savinnie Ho, Valerie L Tryon, Kathleen E Nye, Christopher Blay, Misha M Carlson, Adrian F Asbun, Sabrina Ereshefsky, Kristin L LaCross, Stephania L Hayes, Tara A Niendam, Donald E Addington","doi":"10.1176/appi.ps.20240107","DOIUrl":"10.1176/appi.ps.20240107","url":null,"abstract":"Objective: This study aimed to develop and pilot the Clinical High Risk for Psychosis Services Fidelity Scale (CHRPS-FS).Methods: A literature review was conducted to identify evidence-based treatments for individuals at clinical high risk for psychosis (CHRP). These findings were compared with the First-Episode Psychosis Services Fidelity Scale (FEPS-FS). Common items were retained, and others were added, modified, or deleted. Next, the Delphi process was conducted with 17 clinical and academic experts in CHRP care to determine consensus on the importance and validity of each item. Concurrently, the preliminary tool was piloted in eight coordinated specialty care (CSC) clinics serving individuals with CHRP.Results: The literature review identified two components of CHRP care that were not detailed in the FEPS-FS and were added to the CHRPS-FS; furthermore, one FEPS-FS item was modified and six were removed. In the Delphi process, clinical and academic experts achieved a consensus of >80% in two rounds, with some changes in item wording and the addition of one item (stepped care approach). A CHRPS-FS assessment was successfully piloted in eight CSC clinics. The mean CHRPS-FS rating score was 3.96 (range 3.75-4.23), and the median proportion of items rated at good to high fidelity was 72% (range 66%-78%).Conclusions: The CHRP-FS is feasible to implement, has face validity based on expert consensus, can be completed in conjunction with a FEPS-FS assessment or alone, and captures variability across programs. The CHRPS-FS measures service delivery and is suitable for clinical trials, learning health care systems, and quality improvement efforts.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"373-380"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of Rurality on Type of Clinicians Delivering Psychotherapy and Prescribing Antidepressants to Veterans. 乡村性对退伍军人心理治疗及抗抑郁药物处方临床医生类型的影响

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 Epub Date: 2024-12-12 DOI: 10.1176/appi.ps.20240186

Luke Rozema, Sarah L Cornelius, Brian Shiner, Bradley Vince Watts, Matthew Vincenti

{"title":"Effect of Rurality on Type of Clinicians Delivering Psychotherapy and Prescribing Antidepressants to Veterans.","authors":"Luke Rozema, Sarah L Cornelius, Brian Shiner, Bradley Vince Watts, Matthew Vincenti","doi":"10.1176/appi.ps.20240186","DOIUrl":"10.1176/appi.ps.20240186","url":null,"abstract":"Objective: Mental health care is delivered by teams that include social workers, psychologists, nonphysician prescribing clinicians (NPPCs), and physicians. The objective of this study was to determine whether patient rurality has an effect on the types of U.S. Department of Veterans Affairs (VA) clinicians delivering psychotherapy and prescribing antidepressants to veterans.Methods: Patients (N=3,537,595) receiving VA mental health services between 2013 and 2022 were stratified by rural, micropolitan, and metropolitan residence. A generalized estimating equation with a negative binomial distribution was used to estimate rates of psychotherapy delivered by social workers or psychologists and antidepressant prescribing rates by NPPCs or physicians. Rate ratios (RRs) comparing rural with metropolitan patients were calculated for each fiscal year.Results: Total psychotherapy visit rates were similar for rural, micropolitan, and metropolitan veterans, but women received psychotherapy from psychologists at higher rates than men and combat veterans received psychotherapy from psychologists at higher rates than noncombat veterans. Rural patients received psychotherapy from social workers more often (RR=1.24-1.30) and from psychologists less often (RR=0.80-0.88) than metropolitan patients. Rural patients were given prescriptions for antidepressants by NPPCs more often (RR=1.28-1.36) and by physicians less often (RR=0.87-0.92) than metropolitan patients.Conclusions: Rural veterans with mental health conditions receive more of their psychotherapy and antidepressant prescriptions from clinicians with master's- versus doctoral-level training. Future work should assess how rural-urban differences in mental health care delivery affect patient satisfaction, cost, and clinical outcomes.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"336-342"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Examining Systemic and Interpersonal Bias in Violence Risk Assessments of Patients in Acute Psychiatric Care. 急性精神病护理患者暴力风险评估中的系统和人际偏见。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 Epub Date: 2024-12-19 DOI: 10.1176/appi.ps.20240108

Christoffer Dharma, Susan J Bondy, Laura Sikstrom, Peter S Muirhead, Juveria Zaheer, Marta M Maslej

{"title":"Examining Systemic and Interpersonal Bias in Violence Risk Assessments of Patients in Acute Psychiatric Care.","authors":"Christoffer Dharma, Susan J Bondy, Laura Sikstrom, Peter S Muirhead, Juveria Zaheer, Marta M Maslej","doi":"10.1176/appi.ps.20240108","DOIUrl":"10.1176/appi.ps.20240108","url":null,"abstract":"Objective: The assessment and management of inpatient risk for violence in acute psychiatric care are challenges that introduce the potential for bias. This study aimed to examine inequities based on social determinants of health (SDoH) (e.g., race-ethnicity, gender, or mode of admission to acute care) that may lead to unfair assessment of psychiatric patients.Methods: The authors analyzed electronic health records of 7,424 acute care patients across 12,650 stays (2016-2022) at a large Canadian psychiatric hospital. Risk ratios (RRs) were calculated by SDoH for staff assessments of high risk (perceived risk), for violent incidents (actual risk), and for potentially biased risk assessment (particularly when a patient was assessed as high risk but did not become violent).Results: In univariate analyses, patients assessed as high risk who did not become violent were more likely to be male than female and to be Black, Indigenous, or Middle Eastern than White. When RRs were mutually adjusted for all variables, the associations for gender and race-ethnicity were attenuated or were no longer statistically significant. Associations with potentially biased risks that remained significant included most psychiatric diagnoses (vs. a depressive or anxiety disorder), supportive or unstable housing (vs. owning a home), and admission by police (vs. self-admission; RR=2.14, 95% CI=1.92-2.40).Conclusions: Systemic factors, such as admission by police and housing status, and having severe mental illness were the primary drivers of observed inequities in risk assessments of patients from racial-ethnic minority groups. Addressing these systemic factors might be key to improving acute psychiatric care.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"326-335"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Youth Inpatient and Residential Treatment Psychiatric Beds: National Trends and Potential Causal Factors, 2010-2022.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-01 Epub Date: 2025-01-30 DOI: 10.1176/appi.ps.20240200

Sushmita Shoma Ghose, Sarah Beehler, Debra A Pinals, Laura Crocker, Tabitha Hoey, N Phil Masiakowski, Howard Goldman, Mustafa Karakus, Tison Thomas, Nikhil A Patel

{"title":"Youth Inpatient and Residential Treatment Psychiatric Beds: National Trends and Potential Causal Factors, 2010-2022.","authors":"Sushmita Shoma Ghose, Sarah Beehler, Debra A Pinals, Laura Crocker, Tabitha Hoey, N Phil Masiakowski, Howard Goldman, Mustafa Karakus, Tison Thomas, Nikhil A Patel","doi":"10.1176/appi.ps.20240200","DOIUrl":"10.1176/appi.ps.20240200","url":null,"abstract":"Objective: Youth inpatient and residential treatment psychiatric services are essential components of the continuum of care. Concern has grown about the diminished availability of these services and the increasing need for them. This study aimed to examine the number of youths treated at inpatient and residential psychiatric facilities over a 12-year period and to assess the perceptions of state mental health authorities (SMHAs) about the reasons for changes in availability.Methods: In this multimodal study, the authors conducted a secondary analysis of a national survey (including all 50 states, Washington, D.C., and Puerto Rico) of mental health facilities that was administered seven times between 2010 and 2022. In addition, the study relied on 2023 data from a survey of SMHAs (N=34 respondents).Results: Most states experienced a decline in the number of youths in inpatient (79%) and residential treatment psychiatric facilities (94%). Although some people posit that increased use of outpatient services may explain such declines, 81% of states had a reduction in community outpatient psychiatric care for youths during the study period. SMHAs reported that the impact of the COVID-19 pandemic and preexisting workforce shortages contributed to the reduction of youths treated.Conclusions: These findings show a nationwide decline in the number of youths treated in inpatient and residential treatment psychiatric facilities over time. Determining causal factors in these declines is challenging, and it is critical to develop a monitoring and reporting system for the number of youths requiring services and the capacity within each state for addressing youth needs.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"343-349"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0