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Factors Influencing Turnover and Attrition in the Public Behavioral Health System Workforce. 影响公共行为健康系统工作人员流动和流失的因素。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 DOI: 10.1176/appi.ps.20240069
Emily M Silver, Talya K Fleming, Nuha ElSayed
{"title":"Factors Influencing Turnover and Attrition in the Public Behavioral Health System Workforce.","authors":"Emily M Silver, Talya K Fleming, Nuha ElSayed","doi":"10.1176/appi.ps.20240069","DOIUrl":"https://doi.org/10.1176/appi.ps.20240069","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470467","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
Lessons From Low- and Middle-Income Countries: Alleviating the Behavioral Health Workforce Shortage in the United States. 中低收入国家的经验教训：缓解美国行为健康人才短缺问题。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 Epub Date: 2024-01-31 DOI: 10.1176/appi.ps.20230348
Franz F Belz, Natan J Vega Potler, Isaac N S Johnson, Rick P F Wolthusen
{"title":"Lessons From Low- and Middle-Income Countries: Alleviating the Behavioral Health Workforce Shortage in the United States.","authors":"Franz F Belz, Natan J Vega Potler, Isaac N S Johnson, Rick P F Wolthusen","doi":"10.1176/appi.ps.20230348","DOIUrl":"10.1176/appi.ps.20230348","url":null,"abstract":"<p><p>The United States is facing a mental health workforce shortage, exacerbated by the COVID-19 pandemic. Low- and middle-income countries (LMICs) have historically grappled with even greater shortages. Therefore, LMICs have thought creatively about expanding the mental health workforce and the settings in which to deliver evidence-based and equitable mental health care. The authors introduce some mental health interventions in LMICs, describe evidence of the efficacy of these interventions gleaned from this context, and discuss the applicability of these interventions to the United States. The authors also reflect on the benefits and challenges of implementing these interventions in the U.S. mental health care system to alleviate its current workforce shortage.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642803","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
Post-Dobbs Psychiatric Exceptions in Abortion-Restricting States. 限制堕胎州的后多布斯精神病例外情况。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 Epub Date: 2024-06-05 DOI: 10.1176/appi.ps.20240212
Yi Wang, Kenneth J Weiss
{"title":"Post-<i>Dobbs</i> Psychiatric Exceptions in Abortion-Restricting States.","authors":"Yi Wang, Kenneth J Weiss","doi":"10.1176/appi.ps.20240212","DOIUrl":"10.1176/appi.ps.20240212","url":null,"abstract":"<p><p>Mental disorders and suicide are important causes of increased morbidity and mortality rates during pregnancy. Since the U.S. Supreme Court's 2022 <i>Dobbs</i> decision, many state legislatures have passed stringent abortion bans and restrictions. These laws define exceptions under which abortion may be legally obtained. Suicidality and other psychiatric symptoms have been excluded from such definitions. In this column, the authors examine how legislatures, courts, and professional regulatory bodies in several abortion-restricting states have defined their medical emergency exceptions. The authors argue that psychiatrists should be concerned about the management of psychiatric emergencies during pregnancy as well as emerging legal intrusions into physician-patient decision making.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248487","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
Patient Flow and Reutilization of Crisis Services Within 30 Days in a Comprehensive Crisis System. 综合危机系统中 30 天内危机服务的患者流量和再利用情况。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 Epub Date: 2024-02-27 DOI: 10.1176/appi.ps.20230232
Milos Tomovic, Margaret E Balfour, Ted Cho, Nishanth Prathap, Gevork Harootunian, Raihana Mehreen, Andrey Ostrovsky, Matthew L Goldman
{"title":"Patient Flow and Reutilization of Crisis Services Within 30 Days in a Comprehensive Crisis System.","authors":"Milos Tomovic, Margaret E Balfour, Ted Cho, Nishanth Prathap, Gevork Harootunian, Raihana Mehreen, Andrey Ostrovsky, Matthew L Goldman","doi":"10.1176/appi.ps.20230232","DOIUrl":"10.1176/appi.ps.20230232","url":null,"abstract":"<p><strong>Objective: </strong>Crisis services are undergoing an unprecedented expansion in the United States, but research is lacking on crisis system design. This study describes how individuals flow through a well-established crisis system and examines factors associated with reutilization of such services.</p><p><strong>Methods: </strong>This cross-sectional study used Medicaid claims to construct episodes describing the flow of individuals through mobile crisis, specialized crisis facility, emergency department, and inpatient services. Claims data were merged with electronic health record (EHR) data for the subset of individuals receiving care at a crisis response center. A generalized estimating equation was used to calculate adjusted odds ratios for demographic, clinical, and operational factors associated with reutilization of services within 30 days of an episode's end point.</p><p><strong>Results: </strong>Of 41,026 episodes, most (57.4%) began with mobile crisis services or a specialized crisis facility rather than the emergency department. Of the subset (N=9,202 episodes) with merged EHR data, most episodes (63.3%) were not followed by reutilization. Factors associated with increased odds of 30-day reutilization included Black race, homelessness, stimulant use, psychosis, and episodes beginning with mobile crisis services or ending with inpatient care. Decreased odds were associated with depression, trauma, and involuntary legal status. Most (59.3%) episodes beginning with an involuntary legal status ended with a voluntary status.</p><p><strong>Conclusions: </strong>Crisis systems can serve a large proportion of individuals experiencing psychiatric emergencies and divert them from more restrictive and costly levels of care. Understanding demographic, clinical, and operational factors associated with 30-day reutilization may aid in the design and implementation of crisis systems.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973228","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 Letter on Clinician Attitudes Toward Suicide Prevention Practices and Their Implementation. 回复 "关于临床医生对预防自杀措施及其实施的态度 "的信件。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 DOI: 10.1176/appi.ps.20240143
Celine Larkin
{"title":"Reply to Letter on Clinician Attitudes Toward Suicide Prevention Practices and Their Implementation.","authors":"Celine Larkin","doi":"10.1176/appi.ps.20240143","DOIUrl":"https://doi.org/10.1176/appi.ps.20240143","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470468","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
Comparative Analysis of School Mental Health Investment Strategies: Insights From Taiwan's Youth Mental Health Support Program. 学校心理健康投资策略的比较分析：台湾青少年心理健康支持计划的启示》。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 DOI: 10.1176/appi.ps.20240174
Lien-Chung Wei
{"title":"Comparative Analysis of School Mental Health Investment Strategies: Insights From Taiwan's Youth Mental Health Support Program.","authors":"Lien-Chung Wei","doi":"10.1176/appi.ps.20240174","DOIUrl":"https://doi.org/10.1176/appi.ps.20240174","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470464","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
Clinician Attitudes Toward Suicide Prevention Practices and Their Implementation. 临床医生对预防自杀措施及其实施的态度。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 DOI: 10.1176/appi.ps.20240081
Bruno de Blaquière, Dieneke Hubbeling
{"title":"Clinician Attitudes Toward Suicide Prevention Practices and Their Implementation.","authors":"Bruno de Blaquière, Dieneke Hubbeling","doi":"10.1176/appi.ps.20240081","DOIUrl":"https://doi.org/10.1176/appi.ps.20240081","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470463","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
Enhancing General Practitioner Training for Suicide Risk Management-A Response. 加强全科医生自杀风险管理培训--回应。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 DOI: 10.1176/appi.ps.20240231
Lauren M O'Reilly, Kelsey Wiggs, Patrick D Quinn
{"title":"Enhancing General Practitioner Training for Suicide Risk Management-A Response.","authors":"Lauren M O'Reilly, Kelsey Wiggs, Patrick D Quinn","doi":"10.1176/appi.ps.20240231","DOIUrl":"https://doi.org/10.1176/appi.ps.20240231","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470466","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
Value-Based Proposition of an Adapted Integrated Care Telehealth Service for Accountable Care Organization Members. 为责任医疗组织成员提供经调整的综合医疗远程保健服务的价值主张。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI: 10.1176/appi.ps.20230287
Jay Shore, Maryann Waugh, Justin Harding, George Roupas, Neil Pepi, Peter Ryan
{"title":"Value-Based Proposition of an Adapted Integrated Care Telehealth Service for Accountable Care Organization Members.","authors":"Jay Shore, Maryann Waugh, Justin Harding, George Roupas, Neil Pepi, Peter Ryan","doi":"10.1176/appi.ps.20230287","DOIUrl":"10.1176/appi.ps.20230287","url":null,"abstract":"<p><p>The authors describe a real-world application of virtually integrated primary and behavioral health care implemented within an accountable care organization (ACO) system. Cost-of-care data from before and after a 6-month intervention were analyzed for 121 Medicaid and Child Health Plan Plus ACO members. The intervention was associated with a significant shift in the distribution of health care costs, from inpatient and emergency care to outpatient and preventive care. The program demonstrates a flexible and replicable approach to integration that can help expand effective primary care.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294398","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
Health-Economic Evaluation of Psychological Interventions for Anxiety Prevention: A Systematic Review. 预防焦虑的心理干预的健康经济评估：系统回顾。
IF 3.3 3区 医学
Psychiatric services Pub Date : 2024-07-01 Epub Date: 2024-02-27 DOI: 10.1176/appi.ps.20230101
Patricia Moreno-Peral, Sonia Conejo-Cerón, Ben Wijnen, Joran Lokkerbol, Anna Fernández, Filip Smit, Juan Ángel Bellón
{"title":"Health-Economic Evaluation of Psychological Interventions for Anxiety Prevention: A Systematic Review.","authors":"Patricia Moreno-Peral, Sonia Conejo-Cerón, Ben Wijnen, Joran Lokkerbol, Anna Fernández, Filip Smit, Juan Ángel Bellón","doi":"10.1176/appi.ps.20230101","DOIUrl":"10.1176/appi.ps.20230101","url":null,"abstract":"<p><strong>Objective: </strong>Although evidence supports the effectiveness of psychological interventions for prevention of anxiety, little is known about their cost-effectiveness. The aim of this study was to conduct a systematic review of health-economic evaluations of psychological interventions for anxiety prevention.</p><p><strong>Methods: </strong>PubMed, PsycInfo, Web of Science, Embase, Cochrane Central Register of Controlled Trials, EconLit, National Health Service (NHS) Economic Evaluations Database, NHS Health Technology Assessment, and OpenGrey databases were searched electronically on December 23, 2022. Included studies focused on economic evaluations based on randomized controlled trials of psychological interventions to prevent anxiety. Study data were extracted, and the quality of the selected studies was assessed by using the Consensus on Health Economic Criteria and the Cochrane risk-of-bias tool.</p><p><strong>Results: </strong>All included studies (N=5) had economic evaluations that were considered to be of good quality. In two studies, the interventions showed favorable cost-effectiveness compared with usual care groups. In one study, the intervention was not cost-effective. Findings from another study cast doubt on the cost-effectiveness of the intervention, and the cost-effectiveness of the intervention in the remaining study could not be established.</p><p><strong>Conclusions: </strong>Although the findings suggest some preliminary evidence of cost-effectiveness of psychological interventions for preventing anxiety, they were limited by the small number of included studies. Additional research on the cost-effectiveness of psychological interventions for anxiety in different countries and populations is required.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973225","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
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