Psychiatric services最新文献_第4页

Accuracy of Self-Report Questionnaires and Records-Based Risk Scores to Identify Adolescents' Risk for Self-Harm.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-03-19 DOI: 10.1176/appi.ps.20240427

Gregory E Simon, Christine C Stewart, Julie E Richards, Rebecca Ziebell, Gwen T Lapham, Andrea J Hoopes

{"title":"Accuracy of Self-Report Questionnaires and Records-Based Risk Scores to Identify Adolescents' Risk for Self-Harm.","authors":"Gregory E Simon, Christine C Stewart, Julie E Richards, Rebecca Ziebell, Gwen T Lapham, Andrea J Hoopes","doi":"10.1176/appi.ps.20240427","DOIUrl":"https://doi.org/10.1176/appi.ps.20240427","url":null,"abstract":"Objective: This study aimed to evaluate screening strategies for identifying risk for self-harm among adolescents making outpatient health care visits.Methods: Health system records were used to identify a prospective cohort of adolescents completing the Patient Health Questionnaire-9 (PHQ-9) at outpatient visits between October 1, 2015, and March 15, 2020, and a retrospective cohort of adolescents experiencing self-harm events (ascertained from health records and state mortality data) during the same period. Self-harm risk scores were computed from health records. Analyses of the prospective sample examined the sensitivity and positive predictive value (PPV) of questionnaires and risk scores, separately and in combination. Analyses of the retrospective sample examined the proportion of self-harm events that could have been detected by different screening strategies.Results: The prospective sample (N=8,929) included 43,548 questionnaires, with 1,045 questionnaires followed by a self-harm event within 180 days. A score of ≥2 on PHQ-9 item 9 had a sensitivity of 0.37 and a PPV of 0.09 for self-harm within 180 days of a mental health specialty visit, with similar results for primary care visits. In the retrospective sample, 89% of adolescents made a mental health specialty visit or a primary care visit with a recorded psychiatric diagnosis in the 180 days before a self-harm event.Conclusions: Responses to PHQ-9 item 9 and risk scores computed from health records accurately identified adolescents needing additional assessment for risk for self-harm. Over 80% of adolescents experiencing self-harm could have been identified by screening during an outpatient health care visit.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240427"},"PeriodicalIF":3.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658439","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

Exploring the Widening Trend in Racial and Ethnic Differences in Youth Mental Health Service Use.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-03-19 DOI: 10.1176/appi.ps.20240334

Stephanie Rennane, Flora Sheng, Bradley D Stein, Andrew W Dick

{"title":"Exploring the Widening Trend in Racial and Ethnic Differences in Youth Mental Health Service Use.","authors":"Stephanie Rennane, Flora Sheng, Bradley D Stein, Andrew W Dick","doi":"10.1176/appi.ps.20240334","DOIUrl":"https://doi.org/10.1176/appi.ps.20240334","url":null,"abstract":"Objective: The authors examined trends in racial and ethnic disparities in youth mental health treatment for internalizing and externalizing conditions in the United States from 2002 to 2019.Methods: Using data from the Medical Expenditure Panel Survey-Household Component, the authors analyzed trends in mental health treatment between 2002 and 2019 for youths ages 5-21 years (N=139,242). Logistic regression models predicting treatment were adjusted for age and sex and also for health status, household income, insurance coverage, and geographic region.Results: The treatment rate for internalizing conditions grew faster for White youths than for Hispanic or Black youths, and this difference tripled (from 1.6 to 5.4 percentage points) from 2002 to 2019. For externalizing conditions, the treatment rate grew twice as fast for White youths compared with Hispanic youths and 50% faster relative to Black youths. Uninsured status was significantly and negatively associated with treatment for externalizing conditions (b=-0.928, SE=0.342) but not internalizing conditions (b=-0.440, SE=0.317). Family income was most strongly linked to treatment among Hispanic youths. For internalizing conditions, adjustments for health, household income, insurance status, and region explained 18% of the treatment gap for Hispanic youths but only 6% of the gap for Black youths in 2016-2019.Conclusions: These findings highlight widening racial and ethnic disparities in youth mental health treatment. The demographic and socioeconomic factors associated with these disparities varied by type of condition. Addressing socioeconomic determinants alone is insufficient to ensure equitable access to mental health services. Tailored approaches considering clinical, cultural, and societal needs are essential to mitigate treatment disparities.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240334"},"PeriodicalIF":3.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658524","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

Disparities in Use of Out-of-Network Mental Health and Substance Use Treatment Versus Medical or Surgical Treatment.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-03-11 DOI: 10.1176/appi.ps.20240448

Tami L Mark, Miku Fujita, William J Parish

引用次数: 0

Psychiatrists' Complicated Relationship With Hospitalization and Implications for Emergency Psychiatry.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-03-11 DOI: 10.1176/appi.ps.20240617

Scott A Simpson

引用次数: 0

Patients' Preferences and Priorities for Mental Health Care Services: A Scoping Review.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-03-11 DOI: 10.1176/appi.ps.20240312

Klaudia Kristensen, Louise Steen, Luise Skinnerup, Malene Terp, Søren Paaske Johnsen, Jan Brink Valentin, Jan Mainz

{"title":"Patients' Preferences and Priorities for Mental Health Care Services: A Scoping Review.","authors":"Klaudia Kristensen, Louise Steen, Luise Skinnerup, Malene Terp, Søren Paaske Johnsen, Jan Brink Valentin, Jan Mainz","doi":"10.1176/appi.ps.20240312","DOIUrl":"https://doi.org/10.1176/appi.ps.20240312","url":null,"abstract":"Objective: To meet the demand for high-quality care, health care organizations are directing policy and care delivery toward person-centered care. Yet, knowledge of what patients value most in their encounters with the mental health care system is lacking. This scoping review aimed to synthesize the current evidence on patients' preferences during episodes of care within the mental health care system and to identify categories and subthemes of these preferences.Methods: A comprehensive search of Embase, PubMed, and PsycInfo was conducted in accordance with the revised JBI methodology for scoping reviews. The literature review included studies of inpatients and outpatients (ages ≥18 years) with mental disorders. The primary concepts of interest were patients' preferences and priorities for mental health care services.Results: Twenty-seven publications from the period 2000-2022 were included in the scoping review. Ten categories of patient preferences were identified: interactions with health care staff, involvement in care, diagnosis and symptom relief, interpersonal skills of health care staff, access and time, pharmacological treatment, coping and recovery, physical environment, information, and continuity of care. Interactions with health care staff, involvement in care, and diagnosis and symptom relief were most mentioned by patients as important aspects of care.Conclusions: The scoping review highlighted the importance to patients of their interactions with health care staff. The results can be used to inform decision making for enhancement of person-centered care. Further research should include diagnosis-specific preferences, longitudinal study designs, and a systematic framework to assess patients' preferences.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240312"},"PeriodicalIF":3.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597106","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

Variation in Hospital Admission Rates for Schizophrenia Spectrum Disorder Emergency Department Visits in 11 States.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-03-11 DOI: 10.1176/appi.ps.20240441

Y Nina Gao, Mark Olfson

{"title":"Variation in Hospital Admission Rates for Schizophrenia Spectrum Disorder Emergency Department Visits in 11 States.","authors":"Y Nina Gao, Mark Olfson","doi":"10.1176/appi.ps.20240441","DOIUrl":"https://doi.org/10.1176/appi.ps.20240441","url":null,"abstract":"Objective: The authors examined patterns in hospital admission rates for patients with a schizophrenia spectrum disorder (SSD)-related visit to an emergency department (ED).Methods: The authors identified 116,928 ED visits for SSD across 1,071 hospitals in an 11-state sample drawn from the 2020 State Emergency Department Databases and State Inpatient Databases. The distribution of hospital-level admission rates was described by using a finite mixture model. Hospital- and county-level characteristics were compared across hospitals with low, medium, or high SSD admission shares.Results: Admission shares for patients with an SSD ED visit were highly variable and multimodal across hospitals. Although the overall mean admission share for patient ED visits with a primary SSD diagnosis was 56.6% (95% CI=53.0%-60.2%), the mean admission share was 5.6% (95% CI=4.8%-6.4%) in the lowest quintile and was 95.4% (95% CI=94.6%-96.3%) in the highest quintile. The presence of psychiatric beds in a hospital was associated with increased odds of admission (OR=2.56, 95% CI=1.83-3.59). A hospital's size, mental health visit volume, urbanicity, availability of psychiatric consultation, emergency mental health services, and outpatient mental health services, as well as county-level inpatient beds, were not significantly associated with admission rates.Conclusions: Hospital admission rates for patients with an SSD ED visit varied widely, and the presence of inpatient psychiatric beds was positively associated with admission. These findings raise equity concerns by suggesting that variation in inpatient psychiatric bed availability contributes to ED disposition of patients with an SSD-related visit.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240441"},"PeriodicalIF":3.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597512","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

Poverty.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-03-06 DOI: 10.1176/appi.ps.20250028

Cheryl Howe

引用次数: 0

Provision of Social Care Services by Mental and Behavioral Health Organizations.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-03-06 DOI: 10.1176/appi.ps.20230385

Bradley Edward Iott, Tran Thu Doan

{"title":"Provision of Social Care Services by Mental and Behavioral Health Organizations.","authors":"Bradley Edward Iott, Tran Thu Doan","doi":"10.1176/appi.ps.20230385","DOIUrl":"https://doi.org/10.1176/appi.ps.20230385","url":null,"abstract":"Objective: Despite substantial interest in identifying and addressing patients' social needs in health care settings, little is known about the characteristics of mental health organizations associated with providing social care services (SCSs; i.e., services that may help to address patients' social needs). This study aimed to characterize the prevalence of 10 SCSs among mental health organizations in the United States.Methods: Cross-sectional data from the Substance Abuse and Mental Health Services Administration's 2018-2020 National Mental Health Services Survey (2018, N=11,580; 2019, N=12,355; 2020, N=12,109 organizations) were used to characterize SCS provision by mental health organizations. Poisson and logistic regression analyses were used to identify characteristics of mental health organizations that were associated with SCS provision.Results: The proportion of organizations offering SCSs increased between 2018 and 2020. The number and types of SCSs varied by organization type, ownership, primary treatment focus, and whether integrated treatment for co-occurring mental and substance use disorders was offered. For example, U.S. Department of Veterans Affairs Medical Centers offered an average of 5.31 SCSs during the study period, compared with 2.27 offered by partial hospitalization or day treatment organizations. Public agencies offered an average of 3.95 SCSs, compared with 2.26 offered by private for-profits.Conclusions: This study examined the prevalence of SCSs provided by mental health organizations in order to promote research addressing the social needs of patients with mental illness. Extensive variation across organization types suggests that the uneven provision of social care may contribute to inequities in service access, indicating the need for policies and incentives to encourage SCS implementation.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20230385"},"PeriodicalIF":3.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567979","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

Bridging the Gap Between Joint Commission Accreditation and High-Quality Behavioral Health Care: Reflections on a Survey.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-27 DOI: 10.1176/appi.ps.20240339

Benjamin D Brody

引用次数: 0

State Laws on Law Enforcement Custody and Transportation in the Process of Involuntary Civil Commitment. 各州在非自愿民事拘押过程中的执法羁押和运输法律。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-21 DOI: 10.1176/appi.ps.20240345

Marvin S Swartz, Megan Moore, Katie Lazar

{"title":"State Laws on Law Enforcement Custody and Transportation in the Process of Involuntary Civil Commitment.","authors":"Marvin S Swartz, Megan Moore, Katie Lazar","doi":"10.1176/appi.ps.20240345","DOIUrl":"https://doi.org/10.1176/appi.ps.20240345","url":null,"abstract":"Objective: Involuntary civil commitment statutes codify the process of involuntary admission to a health care facility. Many statutes assign law enforcement to preside over custody and transportation during the commitment process, which can be traumatizing to people taken into custody. States and localities are seeking to develop alternative crisis response approaches that reduce law enforcement involvement. This study aimed to document variations in state laws pertaining to custody and transportation during involuntary civil commitment.Methods: The research team analyzed statutes (in effect as of March 1, 2024) of 50 states and the District of Columbia governing custody and transportation during involuntary civil commitment.Results: Although every state and the District of Columbia had laws pertaining to responsibility for custody and transportation during involuntary civil commitment, laws varied on the entities that were allowed to transport individuals being considered for involuntary civil commitment and when non-law enforcement transport was permissible. Only seven states barred non-law enforcement transportation under any circumstance: Alabama, Georgia, Indiana, Maryland, Missouri, Montana, and Wyoming. However, even in the 44 jurisdictions where alternative transportation was permitted, law enforcement often served as the default transporter because of a lack of available alternatives.Conclusions: Laws specifying responsibility for transport of people being considered for involuntary civil commitment vary by state, and the statutory opportunities to implement non-law enforcement transport are plentiful. Research is needed to guide policy making and implementation regarding involuntary civil commitment.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240345"},"PeriodicalIF":3.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468869","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