Psychiatric services最新文献

{"title":"Financial Strain on and Systemic Barriers in Mental Health Treatment.","authors":"Michael W Flores","doi":"10.1176/appi.ps.25076003","DOIUrl":"https://doi.org/10.1176/appi.ps.25076003","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":"76 2","pages":"109"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075246","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":"Trends in Formulary Restrictions for Long-Acting Injectable Antipsychotic Medications Among Medicare Drug Plans, 2019-2023.","authors":"Samuel R Bunting, Robert O Cotes, Kathryn Gray, Kristen Chalmers, Thuy D Nguyen","doi":"10.1176/appi.ps.20230593","DOIUrl":"https://doi.org/10.1176/appi.ps.20230593","url":null,"abstract":"<p><strong>Objective: </strong>Long-acting injectable antipsychotics (LAIAPs) enable safe and effective long-term management of chronic psychotic disorders but are underused in clinical practice. The authors examined whether Medicare formulary restrictions (prior authorization [PA] or step therapy) impose barriers to LAIAP uptake.</p><p><strong>Methods: </strong>The authors analyzed formulary restrictions and patient cost-sharing for several LAIAPs and estimated the percentage of plans (N=2,494 were available per year) applying formulary restrictions. Analyses were stratified by Medicare Advantage, dual Medicare-Medicaid eligibility plans, and Part D plan group and weighted by the number of enrollees at the per-year, per-plan level.</p><p><strong>Results: </strong>Application of formulary restrictions for LAIAPs was low (<12% requiring PA [apart from olanzapine] and <4% requiring step therapy) and decreased among nearly all plan types between 2019 and 2023.</p><p><strong>Conclusions: </strong>Formulary restrictions do not appear to present a significant barrier to use of LAIAPs for psychiatric patients with Medicare prescription drug coverage. Additional research is needed to further understand factors influencing LAIAP use.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"0"},"PeriodicalIF":3.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067252","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":"Changes in Recovery Assessment Scale Scores During a Treatment Episode Among Patients in a Large Behavioral Health Care System.","authors":"Loreen Straub, Shelbi A Cox, Lauren V Moran, Matthew Ruble, Rajendra Aldis, Jason B Gibbons, Jun Liu, John Peloquin, Rachel Wood, Alyson Albano, Josephine S Au, Jennifer R Henretty, Philip S Wang","doi":"10.1176/appi.ps.20240187","DOIUrl":"https://doi.org/10.1176/appi.ps.20240187","url":null,"abstract":"<p><strong>Objective: </strong>The authors utilized patient-reported outcomes from a large U.S. behavioral health care system to evaluate the strength of improvements in patients' self-perceived recovery during mental health treatment.</p><p><strong>Methods: </strong>This was a cohort study conducted with electronic health records from 2021-2022 Discovery Behavioral Health patients. Patients were grouped according to their 41-item Recovery Assessment Scale (RAS) scores at admission. Linear regression models accounting for patient characteristics were used to estimate RAS score changes from admission to discharge and RAS score at discharge.</p><p><strong>Results: </strong>Of 9,441 patients, those belonging to groups with lower RAS scores at admission showed substantial score improvements, although their scores at discharge were still much lower compared with those of patients with higher admission scores. Results were consistent across secondary analyses.</p><p><strong>Conclusions: </strong>Substantial improvements in recovery were evident during treatment, especially for patients with lower RAS scores at admission. The findings underline the importance of research into enhanced personalized treatment approaches to optimize recovery.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240187"},"PeriodicalIF":3.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024607","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":"Clinical and Programmatic Considerations for Enhancing Developmentally Informed Care in Psychosis Risk Programs for Youths.","authors":"Leslie E Horton, Tushita Mayanil, Lauren M Bylsma","doi":"10.1176/appi.ps.20240002","DOIUrl":"https://doi.org/10.1176/appi.ps.20240002","url":null,"abstract":"<p><p>A national and global focus on expanding identification and treatment of youths who are at clinical high risk for psychosis (CHR-P) highlights an urgent need to develop clinical services for this population; however, questions remain regarding program structures and treatment approaches in CHR-P clinics. The authors of this Open Forum expand on previous recommendations and argue that a focus on enhancing developmentally informed care should serve as a central principle for structuring macrolevel service policies and programs as well as person-specific treatment approaches. The authors discuss developmental considerations in program planning and service provision and offer recommendations for providers and other stakeholders to enhance developmentally informed care for individuals at CHR-P.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240002"},"PeriodicalIF":3.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010635","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":"Implementing a Patient-Centered, Rapid-Access Substance Use Treatment Pathway in Primary Care.","authors":"Scott Jeansonne, Alex R Dopp, Christina Phillips, Marion Cook, Laura Brown, Miriam Komaromy, Kimberly Page, Katherine E Watkins","doi":"10.1176/appi.ps.20240150","DOIUrl":"https://doi.org/10.1176/appi.ps.20240150","url":null,"abstract":"<p><p>Despite the effectiveness of treating substance use disorders in primary care, access to such services remains limited. In this project, quality improvement methods were used to create and evaluate a rapid-access pathway for substance use treatment services in community health clinics. A \"secret shopper\" test gathered information about wait times and requirements. Results informed the development of a patient-centered pathway, in which patients requesting substance use treatment services were offered an immediate telehealth appointment with a provider and then linked to ongoing care services. This treatment pathway was feasible to implement, resulted in high treatment access rates, and was minimally disruptive to clinic operations.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240150"},"PeriodicalIF":3.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010638","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":"Demographic and Clinical Characteristics of Mental Health Crisis Line Callers Who Were Transferred to 911.","authors":"Matthew L Goldman, Andrea Elser, Hsueh-Han Yeh, Megan McDaniel, Lisiyu Ma, Brian K Ahmedani, Ashley A Foster","doi":"10.1176/appi.ps.20240050","DOIUrl":"https://doi.org/10.1176/appi.ps.20240050","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe the characteristics of callers to a statewide mental health crisis line who were transferred to 911 (active rescue).</p><p><strong>Methods: </strong>This retrospective cohort study examined mental health crisis line calls transferred to active rescue (N=3,538 calls; N=3,132 unique callers) from the Georgia Crisis and Access Line (2016-2018). Chi-square analyses and t tests were used to examine descriptive differences between caller characteristics and call features.</p><p><strong>Results: </strong>Of crisis line callers with a contact that resulted in active rescue, 53% were male, and 53% were Black. Youth callers represented 11% of all rescue calls; 74% of these callers had Medicaid. Active rescue most frequently occurred because of a danger to oneself (58%). Reasons for active rescue differed by race (p<0.001).</p><p><strong>Conclusions: </strong>Most crisis calls resulting in active rescue occurred because of concern about self-harm. Demographic differences by reason for active rescue reveal gaps in the understanding of crisis care delivery.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240050"},"PeriodicalIF":3.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953933","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":"Addressing Health Care Disparities and COVID-19: Mental Illness Prevention in Communities of Color.","authors":"Neal Cohen, Dolly John, Ann Marie Sullivan","doi":"10.1176/appi.ps.20230536","DOIUrl":"https://doi.org/10.1176/appi.ps.20230536","url":null,"abstract":"<p><p>As the COVID-19 pandemic emerged in March 2020, the New York State Office of Mental Health received funding from the Federal Emergency Management Agency to implement the agency's Crisis Counseling Assistance and Training Program statewide. Because COVID-19 infections were disproportionately affecting minority communities of color, engagement strategies that prioritized contracting with community agencies that were already well established in the most highly affected racial-ethnic minority neighborhoods were used. This approach to outreach successfully made engagement and counseling support available to Black and Hispanic citizens, at levels significantly exceeding their proportional representation in the state population. These efforts identify an opportunity for a postpandemic paraprofessional workforce to address general medical health and mental health inequities in underresourced racial-ethnic minority communities.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20230536"},"PeriodicalIF":3.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953683","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":"Emerging Trends in Research on Assisted Outpatient Treatment in the United States: A Narrative Review.","authors":"Chad J Valasek, Kris L Nelson, Danielle L Fettes, David H Sommerfeld","doi":"10.1176/appi.ps.20240190","DOIUrl":"https://doi.org/10.1176/appi.ps.20240190","url":null,"abstract":"<p><strong>Objective: </strong>The use of court-ordered mental health treatment through programs such as assisted outpatient treatment (AOT) carries substantial ramifications for the welfare of individuals with serious mental health conditions.</p><p><strong>Methods: </strong>In this review, the authors used a narrative methodology and performed an interpretive synthesis of existing U.S.-based literature (2008-2023) on AOT implementation and outcomes.</p><p><strong>Results: </strong>The search yielded 21 peer-reviewed articles published between 2009 and 2022 that assessed various aspects and outcomes of AOT. Although many of these studies generally supported the use of AOT, most used a limited data set (i.e., AOT program data from New York or Ohio between 1999 and 2007). Much of the latest research on AOT did not include attention to possible mechanisms to explain observed outcomes. The emerging literature suggests that increased outreach and less coercive tactics may lead to better outpatient treatment outcomes. However, more research, especially from the point of view of individuals enrolled in AOT programs, is needed.</p><p><strong>Conclusions: </strong>The authors strongly recommend that research into these interventions be broadened and include more geographic locations. A greater emphasis should be placed on identifying potential disparities, developing a better understanding of AOT-specific mechanisms of change, and continuing efforts to identify and use high-quality comparison groups.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240190"},"PeriodicalIF":3.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954008","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":"Characterizing Schizophrenia Spectrum Disorders: Results of the U.S. Mental and Substance Use Disorders Prevalence Study.","authors":"Natalie Bareis, Mark Edlund, Heather Ringeisen, Heidi Guyer, Lisa B Dixon, Mark Olfson, Thomas E Smith, Lydia Chwastiak, Maria Monroe-DeVita, Marvin Swartz, Jeffrey Swanson, Elizabeth Sinclair Hancq, Paul Geiger, Noah T Kreski, T Scott Stroup","doi":"10.1176/appi.ps.20240138","DOIUrl":"10.1176/appi.ps.20240138","url":null,"abstract":"<p><strong>Objective: </strong>Current information on treatment and clinical characteristics of U.S. adults with schizophrenia spectrum disorders (i.e., schizophrenia, schizoaffective, and schizophreniform disorders) may help inform public health policy and service development for this population.</p><p><strong>Methods: </strong>Data were from the U.S. Mental and Substance Use Disorders Prevalence Study, conducted from October 2020 to October 2022. Clinicians administered the Structured Clinical Interview for the DSM-5 for past-year psychiatric and substance use disorder diagnoses among adults ages 18-65 years. Using sampling weights, the authors examined clinical and treatment characteristics among those with schizophrenia spectrum disorders and compared sociodemographic characteristics and comorbid behavioral health conditions of individuals with or without such disorders (N=4,764).</p><p><strong>Results: </strong>Among 114 adults with schizophrenia spectrum disorders, the most common comorbid conditions were major depressive episode (52%, 95% CI=34%-69%) and alcohol use (23%, CI=3%-43%), cannabis use (20%, 95% CI=1%-39%), and posttraumatic stress (17%, 95% CI=5%-30%) disorders. Global Assessment of Functioning scores were lower among people with than among those without schizophrenia spectrum disorders (mean±SE=44.8±2.0 vs. 77.2±0.5, p<0.01, respectively), indicating worse functioning. In the past year, 71% (95% CI=55%-87%) of adults with schizophrenia spectrum disorders received at least some mental health treatment, and 26% (95% CI=13%-38%) received minimally adequate treatment.</p><p><strong>Conclusions: </strong>Individuals with schizophrenia spectrum disorders face substantial challenges in the United States, including high rates of comorbid mental health conditions and substance use; few received adequate treatment. A strong social safety net and active clinical interventions are required to address the socioeconomic challenges and unmet mental health service needs of this population.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"2-12"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294054","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}

{"title":"Digital Terror: Its Striking Impact on Public Mental Health.","authors":"David Roe, Eva Gilboa-Schechtman, Amit Baumel","doi":"10.1176/appi.ps.20240169","DOIUrl":"10.1176/appi.ps.20240169","url":null,"abstract":"<p><p>Digital terror refers to the use of digital technology to disseminate graphic images of acts of violence to frighten the public. On October 7, 2023, militants of the Palestinian organization Hamas launched a brutal attack on Israel and used digital terror to magnify their acts. Although the purposeful spreading of terror via digital means is not new, the Hamas attack was significant for the scope, immediacy, and widespread dissemination of its digital content. This column aims to describe and analyze the psychological significance of this new form of terror, the public mental health challenges raised, and the interventions needed to assist those exposed to digital terror.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"99-101"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470457","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}