Psychiatric services最新文献_第6页

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 : 2025-05-01 Epub 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":"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":"437-442"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","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

Reply to Karakus et al. 回复Karakus等人。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-05-01 DOI: 10.1176/appi.ps.20250067

Justin D Metcalfe, Robert E Drake

引用次数: 0

Qualitative Analysis of Telephone Logs: Client Engagement and Barriers to Completing an Initial Early Psychosis Assessment. 电话记录的定性分析：客户参与和障碍，以完成最初的早期精神病评估。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-05-01 Epub Date: 2025-03-19 DOI: 10.1176/appi.ps.20230465

Adi Rosenthal, Monet S Meyer, Khalima Bolden-Thompson, Sarah Gobrial, Ruth Shim, Tyler A Lesh, J Daniel Ragland, Rachel Loewy, Mark Savill, Cameron S Carter, Tara A Niendam

{"title":"Qualitative Analysis of Telephone Logs: Client Engagement and Barriers to Completing an Initial Early Psychosis Assessment.","authors":"Adi Rosenthal, Monet S Meyer, Khalima Bolden-Thompson, Sarah Gobrial, Ruth Shim, Tyler A Lesh, J Daniel Ragland, Rachel Loewy, Mark Savill, Cameron S Carter, Tara A Niendam","doi":"10.1176/appi.ps.20230465","DOIUrl":"10.1176/appi.ps.20230465","url":null,"abstract":"Objective: Time between the onset of psychosis and the start of treatment significantly influences outcomes. Rapid access to care is essential, yet barriers such as stigma, difficulties with navigating the mental health system, and financial constraints prolong this process. This mixed-methods study aimed to assess how these barriers affect participation in early psychosis services.Methods: A directed content analysis of telephone log data was conducted from intake assessments at an early psychosis clinic. Stepwise logistic regression and analyses of variance were used to evaluate the impact of barriers on assessment completion and time from referral to assessment.Results: Of 1,048 individuals screened for early psychosis services, 201 completed a telephone assessment. Individuals who dropped out had a higher proportion of barriers overall than did those who completed the assessment (p<0.01). Greater than 50% of interactions included at least one barrier, with logistical issues being the most common. Increased barriers were correlated with longer assessments and lower completion rates. Adults and Hispanic participants reported more barriers, compared with adolescents and non-Hispanic individuals, respectively. Significant contributors to nonengagement included unknown gender, public insurance, and various barriers.Conclusions: Identifiable barriers to intake assessment were frequently reported by clients and were associated with higher intake noncompletion and a longer assessment process. Efforts to address logistical barriers may represent an essential step in improving the linkage process and reducing the duration of untreated psychosis.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"461-468"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658525","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

Outcomes of Flexible Assertive Community Treatment Versus Assertive Community Treatment or Intensive Case Management. 灵活的自主社区治疗与自主社区治疗或强化个案管理的结果。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-05-01 Epub Date: 2025-02-21 DOI: 10.1176/appi.ps.20240163

Martin Rotenberg, Ling Zhuang, Raquel Williams, Diane Versace, Michelle DeSanti, Dan Harren, Alex Raben, Farooq Naeem, Frances Abela-Dimech, Paul Kurdyak, Farhat Farrokhi, George Foussias

{"title":"Outcomes of Flexible Assertive Community Treatment Versus Assertive Community Treatment or Intensive Case Management.","authors":"Martin Rotenberg, Ling Zhuang, Raquel Williams, Diane Versace, Michelle DeSanti, Dan Harren, Alex Raben, Farooq Naeem, Frances Abela-Dimech, Paul Kurdyak, Farhat Farrokhi, George Foussias","doi":"10.1176/appi.ps.20240163","DOIUrl":"10.1176/appi.ps.20240163","url":null,"abstract":"Objective: In the context of increased uptake of flexible assertive community treatment (FACT)-despite a dearth of evidence on its outcomes-the authors aimed to compare the effectiveness of FACT with that of assertive community treatment (ACT) or intensive case management (ICM) for community-dwelling people experiencing serious mental illness.Methods: This quasi-experimental study, using propensity score matching to minimize confounding factors, examined outcomes of acute psychiatric service use among individuals who received FACT (vs. ACT or ICM) at a large Canadian mental health hospital. Data from a period of transition to FACT and an implementation period were analyzed.Results: The matched cohort consisted of 237 FACT and 237 ACT or ICM service users. During the transition period, no significant differences between the two groups were observed in emergency department (ED) visits, hospital admissions, or inpatient days. During the period of full FACT implementation, the FACT group had a significant increase in ED visits, compared with the group that received ACT or ICM (incidence rate ratio=1.65, 95% CI=1.02-2.67), but no significant differences were observed between the two groups in the rate of hospital admissions or inpatient days.Conclusions: To the authors' knowledge, this study is the first of its kind in Canada. Its findings suggest generally comparable outcomes of FACT (vs. ACT or ICM) in acute mental health services use. Although the rate of ED service use increased in the FACT group after implementation, inpatient service use did not increase. The higher rate of ED service use in the FACT group warrants further study.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"430-436"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468867","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

Patients' Preferences and Priorities for Mental Health Care Services: A Scoping Review. 患者对精神卫生保健服务的偏好和优先级：范围审查。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-05-01 Epub 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":"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":"479-485"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","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

Reply to Swartz. 回复斯沃茨。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-05-01 DOI: 10.1176/appi.ps.20250090

Paul S Appelbaum

引用次数: 0

Variation in Hospital Admission Rates for Schizophrenia Spectrum Disorder Emergency Department Visits in 11 States. 11个州精神分裂症谱系障碍急诊科住院率的变化

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-05-01 Epub 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":"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":"443-450"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","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

Empowering Youths and Their Families: Educational Discharge Resources for a Pediatric Psychiatric Emergency Department. 授权青少年和他们的家庭：儿童精神科急诊科的教育出院资源。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-30 DOI: 10.1176/appi.ps.20240601

Sijia Zhang, Christine Novotny, Ekta Patel

引用次数: 0

Implications of Clozapine Monitoring During the COVID-19 Pandemic. COVID-19大流行期间氯氮平监测的意义

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-30 DOI: 10.1176/appi.ps.20240456

Allison L Little, Ashley J Maister, Lauren R Ash, Anuja Vallabh, Tamara J Bystrak, Justin C Ellison, Yinglin Xia, Leah M Rickert, Martin Cruz, Chelsea L Khaw, Brittany L Spitznogle, Rebecca Milovac

{"title":"Implications of Clozapine Monitoring During the COVID-19 Pandemic.","authors":"Allison L Little, Ashley J Maister, Lauren R Ash, Anuja Vallabh, Tamara J Bystrak, Justin C Ellison, Yinglin Xia, Leah M Rickert, Martin Cruz, Chelsea L Khaw, Brittany L Spitznogle, Rebecca Milovac","doi":"10.1176/appi.ps.20240456","DOIUrl":"https://doi.org/10.1176/appi.ps.20240456","url":null,"abstract":"Objective: Clozapine is the drug of choice for treatment-resistant schizophrenia. Routine monitoring of an absolute neutrophil count (ANC) is required to detect severe neutropenia, which is a black box warning for clozapine. However, during the COVID-19 pandemic, laboratory monitoring became less frequent because of decreased access to health care services and concern about increased viral exposure. The purpose of this study was to evaluate the discontinuation rate of clozapine due to severe neutropenia during the COVID-19 pandemic.Methods: This 16-month retrospective study included all adult patients within the Veterans Health Administration who had a clozapine prescription at least 12 months before March 2020. Demographic data included indication for use, concomitant antipsychotic prescriptions, age, and race-ethnicity. Descriptive statistics were performed to analyze study objectives and demographic data.Results: In total, 2,106 patients were included in this study. No patients discontinued clozapine because of severe neutropenia, and only one patient had severe neutropenia during the study period. All-cause clozapine discontinuation occurred for 96 patients (5%). Significant differences were found between individuals who discontinued clozapine and those who did not for the longest ANC gap category (p<0.001), neutropenia category (p=0.042), and duration of clozapine use (p=0.001).Conclusions: Less frequent ANC monitoring as a consequence of the COVID-19 pandemic did not lead to increased incidence of clozapine discontinuation due to severe neutropenia. These results demonstrate the feasibility and safety of extended-interval laboratory monitoring (i.e., every 90 days) for patients receiving clozapine treatment for at least 1 year.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240456"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014363","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

Transitioning Out of Coordinated Specialty Care: Exploration of Service Users' and Families' Goals and Needs. 从协调的专科护理过渡：服务使用者和家庭目标和需求的探索。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-04-23 DOI: 10.1176/appi.ps.20240199

Elizabeth R Fraser, Karina Silva Garcia, Oladunni Oluwoye

{"title":"Transitioning Out of Coordinated Specialty Care: Exploration of Service Users' and Families' Goals and Needs.","authors":"Elizabeth R Fraser, Karina Silva Garcia, Oladunni Oluwoye","doi":"10.1176/appi.ps.20240199","DOIUrl":"https://doi.org/10.1176/appi.ps.20240199","url":null,"abstract":"Objective: This study aimed to describe the goals of service users with first-episode psychosis who enrolled in coordinated specialty care (CSC), along with the goals their family members have for them, and to understand service users' and family members' perceived needs for recovery after discharge from the program.Methods: The authors conducted 32 in-depth interviews in English or Spanish with service users and their family members recruited between September 2021 and December 2022. Transcripts were analyzed to determine the common concerns and expectations of service users and family members.Results: Most service users described wanting financial and social independence from their families of origin, including an education that would allow them to obtain well-paid, stable employment; transportation; and an independent residence. Service users described hoping to replace some of the support they received from CSC with friends they would make in the future; some family members hoped their loved one would be able to develop and sustain romantic relationships. Most family members described not feeling ready to leave CSC at the 2-year mark, whereas service users expressed mixed opinions about their readiness to exit the program.Conclusions: Although service users were excited about the prospect of discharge, they, along with their family members, agreed that ongoing support was needed after CSC. On the basis of the findings, the authors delineate supports that service users and family members believe are necessary for a successful step-down.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240199"},"PeriodicalIF":3.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009550","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