Psychiatric services最新文献

{"title":"Use of Patient-Reported Outcome Measures to Assess the Effectiveness of Hybrid Psychiatric Visits.","authors":"Virginia C O'Brien, Anita S Kablinger, Hayoung Ko, Sydney B Jones, Robert S McNamara, Ashlie R Phenes, Maria Stack Hankey, Alyssa J Gatto, Martha M Tenzer, Hunter D Sharp, Lee D Cooper","doi":"10.1176/appi.ps.20230355","DOIUrl":"10.1176/appi.ps.20230355","url":null,"abstract":"<p><strong>Objective: </strong>Little empirical evidence exists to support the effectiveness of hybrid psychiatric care, defined as care delivered through a combination of telephone, videoconferencing, and in-person visits. The authors aimed to investigate the effectiveness of hybrid psychiatric care compared with outpatient waitlist groups, assessed with patient-reported outcome measures (PROMs).</p><p><strong>Method: </strong>Participants were recruited from an adult psychiatry clinic waitlist on which the most common primary diagnoses were unipolar depression, generalized anxiety disorder, and bipolar disorder. Patients (N=148) were randomly assigned to one of two waitlist groups that completed PROMs once or monthly before treatment initiation. PROMs were used to assess symptoms of depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and daily psychological functioning (Brief Adjustment Scale-6 [BASE-6]). Patient measures were summarized descriptively with means, medians, and SDs and then compared by using the Kruskal-Wallis test; associated effect sizes were calculated. PROM scores for patients who received hybrid psychiatric treatment during a different period (N=272) were compared with scores of the waitlist groups.</p><p><strong>Results: </strong>PROM assessments of patients who engaged in hybrid care indicated significant improvements in symptom severity compared with the waitlist groups, regardless of the number of PROMs completed while patients were on the waitlist. Between the hybrid care and waitlist groups, the effect size for the PHQ-9 score was moderate (d=0.66); effect sizes were small for the GAD-7 (d=0.46) and BASE-6 (d=0.45) scores.</p><p><strong>Conclusions: </strong>The findings indicate the clinical effectiveness of hybrid care and that PROMs can be used to assess this effectiveness.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"1206-1212"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306707","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}

{"title":"Certified Community Behavioral Health Clinic Services for Clients With Co-occurring Disorders: A Latent Class Approach.","authors":"Yuanyuan Hu, Ran Hu, Daniel M Baslock, Victoria Stanhope","doi":"10.1176/appi.ps.20230477","DOIUrl":"10.1176/appi.ps.20230477","url":null,"abstract":"<p><strong>Objective: </strong>Certified community behavioral health clinics (CCBHCs) are designed to provide comprehensive care for individuals with co-occurring mental and substance use disorders. The authors classified outpatient mental health treatment facilities on the basis of provision of services for clients with co-occurring disorders and assessed whether CCBHCs differed from other outpatient mental health facilities in services provided.</p><p><strong>Methods: </strong>The authors used latent class analysis to identify distinct services for clients with co-occurring disorders in 5,692 outpatient mental health facilities in the 2021 National Substance Use and Mental Health Services Survey. Nine indicators were included: treatment for clients with substance or alcohol use disorder co-occurring with serious mental illness or serious emotional disturbance, specialized programs or groups for such clients, medication-assisted treatment (MAT) for alcohol use disorder, MAT for opioid use disorder, detoxification, individual counseling, group counseling, case management, and 12-step groups. A multinomial logistic regression was used to estimate whether CCBHCs were associated with any identified classes after analyses controlled for facility characteristics.</p><p><strong>Results: </strong>A four-class solution provided a model with the best fit, comprising comprehensive services (23.4%), case management services (17.7%), counseling and self-help services (58.6%), and professional services (4.3%). Regressing class membership on facility type and covariates, the authors found that compared with community mental health clinics (CMHCs), CCBHCs were more likely to belong to the comprehensive services class than to the case management services, counseling and self-help services, and professional services classes.</p><p><strong>Conclusions: </strong>CCBHCs were more likely than other outpatient programs to offer comprehensive care, and CCBHC status of a CMHC facilitated enhanced service provisions.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"1192-1198"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564175","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}

{"title":"Ending Involuntary Commitment for People With Treatment-Resistant Mental Illness and Grave Disability.","authors":"Rocksheng Zhong, Tobias Wasser","doi":"10.1176/appi.ps.20230416","DOIUrl":"10.1176/appi.ps.20230416","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"1279-1281"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005103","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}

{"title":"\"Instead, You're Going to a Friend\": Evaluation of a Community-Developed, Peer-Delivered Online Crisis Prevention Intervention.","authors":"Kate Perepezko, Mathew Bergendahl, Christopher Kunz, Alain Labrique, Matthew Carras, Michelle Colder Carras","doi":"10.1176/appi.ps.20230233","DOIUrl":"10.1176/appi.ps.20230233","url":null,"abstract":"<p><strong>Objective: </strong>Online communities promote social connection and can be used for formal peer support and crisis intervention. Although some communities have programs to support their members' mental health, few programs have been formally evaluated. The authors present findings from a mixed-methods evaluation of the Stack Up Overwatch Program (StOP), a digital peer support intervention delivered in an online gaming community.</p><p><strong>Methods: </strong>Data were collected from members of the Stack Up Discord server between June and October 2020 and included chat messages, survey responses, encounter forms (documenting information from private interactions between users and peer supporters), and interviews with peer support team members. The authors analyzed data on demographic characteristics, mental health and crises, use of and experiences with StOP, and chat posts. Thematic analysis and descriptive statistics were combined in a joint display table, with mixed-methods findings explained in narrative form.</p><p><strong>Results: </strong>The findings show that StOP provides users in crisis with a source of mental health support when other options have been exhausted and that military and veteran users valued the connections and friendships they formed while using it. Participants reported that StOP met needs for support and connection when formal services were inaccessible or did not meet their needs, and volunteer peer supporters detailed how StOP's design facilitates use of the intervention. Volunteering offered members of the peer support team a \"family feeling\" facilitated by the unique chat room structure.</p><p><strong>Conclusions: </strong>Community-based crisis prevention programs administered through chat rooms may provide valuable support to both users and peer support providers.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"1267-1275"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760619","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}

{"title":"Involuntary Commitment: Opinions Regarding Patient Autonomy, Legal Parameters, and Behavioral Services Care Delivery.","authors":"Matthew D Erlich","doi":"10.1176/appi.ps.20240268","DOIUrl":"10.1176/appi.ps.20240268","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"1279"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005105","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}

{"title":"Effect of Providing Evidence-Based Mental Health Treatment on Retention in Care Among Medicaid-Enrolled Youths.","authors":"Rebecca E Stewart, Nicholas C Cardamone, Lisa Shen, Natalie Dallard, Carrie Comeau, David S Mandell, Jill Bowen, Aileen Rothbard","doi":"10.1176/appi.ps.20240066","DOIUrl":"10.1176/appi.ps.20240066","url":null,"abstract":"<p><strong>Objective: </strong>Youths who start behavioral health treatment often stop before completing a therapeutic course of care. To increase treatment engagement and quality of care, the Evidence-Based Practice and Innovation Center in Philadelphia has incentivized use of evidence-based practices (EBPs) for mental health care of youths. The authors aimed to compare treatment outcomes between youths who received EBP care and those who did not.</p><p><strong>Methods: </strong>Using EBP-specific billing codes and propensity score matching, the authors compared treatment retention among youths who received trauma-focused cognitive-behavioral therapy (TF-CBT; N=413) or parent-child interaction therapy (PCIT; N=90) relative to matched samples of youths in standard outpatient therapy (N=503).</p><p><strong>Results: </strong>Youths with a minimum of one session of TF-CBT or PCIT attended a second session at higher rates than did youths in the matched control group (TF-CBT: 96% vs. 68%, p<0.01; PCIT: 94% vs. 69%, respectively, p<0.01). On average, these returning youths attended more sessions in the EBP groups than in the control group (TF-CBT: 15.9 vs. 11.5 sessions, p<0.01; PCIT: 11.2 vs. 6.9 sessions, p<0.01).</p><p><strong>Conclusions: </strong>These findings indicate that, in addition to improving quality of care, EBP implementation helps address the major challenge that most youths who engage with treatment are not retained long enough for care to have therapeutic effects. Future research should examine the mechanisms through which EBPs can improve treatment retention.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"1199-1205"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875813","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}

{"title":"Electroconvulsive Therapy, Manufacturers' Liability, and Learned Intermediaries.","authors":"Paul S Appelbaum","doi":"10.1176/appi.ps.20240518","DOIUrl":"10.1176/appi.ps.20240518","url":null,"abstract":"<p><p>Manufacturers of drugs or devices that are prescribed by physicians are protected by the \"learned intermediary rule\" from having to disclose risks directly to patients. Instead, they must inform physicians of these risks. But when a company fails to disclose a known risk, how can a patient gain compensation for any resulting harm? The California Supreme Court considered this question in a case involving alleged memory impairment from electroconvulsive therapy. By broadening the ways by which plaintiffs can demonstrate that the absence of a warning caused their injury, the court made it easier for patients to recover compensation for the consequences.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240518"},"PeriodicalIF":3.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669062","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}

{"title":"Fidelity to Common Elements of Coordinated Specialty Care: Outcomes of Clients With First-Episode Psychosis.","authors":"Abram Rosenblatt, Preethy George, Sushmita Shoma Ghose, Xiaoshu Zhu, Weijia Ren, Tom Krenzke, Jean Opsomer, Tamara Daley, Lisa Dixon, Howard Goldman","doi":"10.1176/appi.ps.20230548","DOIUrl":"10.1176/appi.ps.20230548","url":null,"abstract":"<p><strong>Objective: </strong>The present study examined whether clients enrolled in coordinated specialty care (CSC) programs for first-episode psychosis (FEP) across 22 states and territories showed improved clinical and functional outcomes and assessed whether program- or client-level predictors were associated with client outcomes. The study included CSC programs that subscribe to a variety of models, including Early Assessment and Support Alliance, OnTrack, and NAVIGATE.</p><p><strong>Methods: </strong>Deidentified demographic and outcome data were collected from clients (N=770) receiving CSC services in 36 programs at the time of program entry and every 6 months for up to 18 months. Programs participated in fidelity assessment by using the First-Episode Psychosis Services Fidelity Scale, version 1.0, developed for the study and based on the components of the CSC model defined by NIMH. Additional program-level variables assessed during the study included staff turnover rate and time spent on CSC services.</p><p><strong>Results: </strong>Across programs, clients experienced improved symptoms, higher quality of life, and improved social and role functioning. Of note, participants from high-income families had greater improvement in role functioning than participants from low-income families. Higher levels of fidelity predicted reduced symptoms and improved social functioning. Having a CSC team lead with time dedicated to the program was also associated with greater improvements in clients' symptoms and social functioning.</p><p><strong>Conclusions: </strong>Clients showed improvements, regardless of program or demographic characteristic. Program-level findings suggest that fidelity to the core components of CSC is important for improving client outcomes across a range of specific program models.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20230548"},"PeriodicalIF":3.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669063","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}

{"title":"A Gift of Love.","authors":"Diane Roston","doi":"10.1176/appi.ps.20240512","DOIUrl":"10.1176/appi.ps.20240512","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240512"},"PeriodicalIF":3.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669061","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}

{"title":"Building Financial Wellness: Randomized Controlled Trial of a Financial Education and Support Intervention.","authors":"Judith A Cook, Pamela J Steigman, Jessica A Jonikas, George Brice, Sean Johnson, Claudia Cortez, Jane K Burke-Miller, Margaret Swarbrick","doi":"10.1176/appi.ps.20240210","DOIUrl":"https://doi.org/10.1176/appi.ps.20240210","url":null,"abstract":"<p><strong>Objective: </strong>Many people receiving services for psychiatric disorders live on low incomes, navigate complex financial situations, and have limited economic security. The authors sought to determine whether a financial wellness intervention delivered virtually by peers would increase financial literacy, reduce economic strain, and improve financial competency.</p><p><strong>Methods: </strong>One hundred participants receiving services for psychiatric disorders were recruited from community programs and via social media and were randomly assigned (1:1) to receive either an intervention called Building Financial Wellness (N=51) or services as usual (N=49). The intervention involved six virtual 1.5-hour group sessions, followed by three virtual one-on-one booster sessions. Outcomes were assessed with the Consumer Financial Protection Bureau's Financial Well-Being Scale (primary), Financial Strain Questionnaire, Financial Capability Scale, and Financial Self-Sufficiency Scale. Knowledge regarding money management was measured with a financial literacy assessment based on class content. Intent-to-treat longitudinal multivariable analysis included random-effects linear and logistic regression models.</p><p><strong>Results: </strong>Overall, 86% of the study participants either lived in poverty (46%) or met the federal definition of low income (40%). Participants assigned to the intervention had greater improvement over time in financial well-being, capability, strain, self-sufficiency, and literacy. Satisfaction with the intervention was high. Reports from participants receiving booster sessions indicated that ongoing support facilitated their achievement of longer-term financial goals.</p><p><strong>Conclusions: </strong>Provision of financial education and support improved monetary well-being, competence, and literacy. With poverty long considered to be an intractable problem associated with psychiatric disorders, peer-taught financial education focused on financial wellness can help people acquire money management skills and manage economic stressors.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240210"},"PeriodicalIF":3.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627091","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}