Journal of Behavioral Health Services & Research最新文献

{"title":"\"Feeling Like You Matter:\" LGBTQ + Young Adult Perspectives on Affirmative Mental Healthcare.","authors":"Marisa Mondave, Jessica Saleska, Jing Jing Wang, Elliot Bluma, Daynon Jackson, Yara Tapia, Leah Yashar, Bonnie T Zima, Kristen R Choi","doi":"10.1007/s11414-024-09919-x","DOIUrl":"10.1007/s11414-024-09919-x","url":null,"abstract":"<p><p>The purpose of this study was to explore the experiences of LGBTQ + young people in mental healthcare and to understand their perspectives on what affirmative mental healthcare practice should look like. Between June and September of 2023, interviews were conducted with LGBTQ + young people ages 18-26 years in Los Angeles and Seattle. Interviews lasted 30 to 60 min and were transcribed verbatim for thematic analysis (N = 28). Four themes were developed from analysis of the interviews: (1) disconnection from community and self as an impetus for seeking formal mental healthcare; (2) marginalization during mental health service encounters; (3) the therapeutic power of belonging and mattering in the mental healthcare system; and (4) mutual human connection as the foundation for affirming mental healthcare experiences. Affirmative mental healthcare was defined by LGBTQ + young adults as free of judgment with priority placed on the therapeutic power of genuine human connection. The need for trans-specific mental healthcare was also highlighted. Participants also expressed a preference for providers with shared identities and experiences to alleviate feelings of isolation and increase feelings of connectivity. Mental health providers should emphasize connectivity and empathy to offer affirming care with LGBTQ + clients, such asking about client preferences for care, developing knowledge about sexuality and gender identity, and acknowledging provider limitations or knowledge gaps. Improving access to affirmative mental healthcare for LGBTQ + young adults (e.g., workforce development, training requirements) is needed to address the disparities in mental healthcare.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"155-167"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities and Medical Expenditure Implications in Pediatric Tele-Mental Health Services During the COVID-19 Pandemic in Mississippi.","authors":"Yunxi Zhang, Lincy S Lal, Yueh-Yun Lin, J Michael Swint, Ying Zhang, Richard L Summers, Barbara F Jones, Saurabh Chandra, Mark E Ladner","doi":"10.1007/s11414-024-09906-2","DOIUrl":"10.1007/s11414-024-09906-2","url":null,"abstract":"<p><p>Tele-mental health (TMH) services, including both mental and behavioral healthcare (MBH) services, emerged as a cornerstone in delivering pediatric mental healthcare during the coronavirus disease 2019 (COVID-19) pandemic, yet their utilization and effects on healthcare resource utilization (HCRU) and medical expenditures remain unclear. To bridge the gap, this study aims to investigate the association between TMH utilization and sociodemographic factors and assess its associated HCRU and medical expenditures within a pediatric population in Mississippi. Studying 1,972 insured pediatric patients who accessed outpatient MBH services at the study institution between January 2020 and June 2023, age, race, insurance type, rural residency, and household income were identified as key determinants of TMH utilization. Adjusting for sociodemographics, TMH utilization was associated with 122% more MBH-associated outpatient visits and 36% higher related medical expenditures, but 27% less overall medical expenditures. This study reveals sociodemographic disparities in pediatric TMH utilization, highlights its role in augmenting outpatient mental healthcare access, and shows its potential for cost savings. Future efforts should aim at fostering more digitally inclusive, equitable, and affordable pediatric mental healthcare services.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"109-122"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Receipt of Medications for Alcohol and Opioid Use Disorders: The Importance of Service Utilization Patterns.","authors":"Kara M K Bensley, Katherine J Karriker-Jaffe, Joanne Delk, Libo Li, Yu Ye, Aryn Z Phillips, Meenakshi S Subbaraman, Nina Mulia","doi":"10.1007/s11414-024-09918-y","DOIUrl":"10.1007/s11414-024-09918-y","url":null,"abstract":"<p><p>Medications for alcohol use disorder (MAUD) and opioid use disorder (MOUD) are underutilized evidence-based treatments. While patients often receive treatment in multiple medical treatment settings, it is unknown whether certain treatment settings or combinations of settings are associated with increased receipt of MAUD or MOUD. Data from the cross-sectional 2019 National Survey on Drug Use and Health were used to identify treatment settings where adult respondents received any past year alcohol treatment (n = 476, 33% female) or, separately, opioid treatment (n = 337, 38% female). Three-stage latent class analysis assessed the patterns of treatment settings utilization and their associations with receipt of MAUD or MOUD, adjusting for potential confounders. Only 10.9% of those in alcohol treatment received MAUD while 40.9% of those in opioid treatment received MOUD. Analyzing different treatment settings visited by respondents, a four-class model best fit the MAUD sample while a three-class model best fit the MOUD sample. There were significant differences in receipt of MAUD by treatment setting classes in unadjusted models (p < 0.05). There were no significant differences in receipt of MOUD across treatment utilization classes, but MOUD receipt was associated with severity of opioid use in all treatment setting classes. People in treatment for alcohol or opioid use were more likely to receive medication if their use was more severe, and were more likely to receive MAUD if they accessed care in many settings. As MOUD and especially MAUD are underutilized, these findings highlight opportunities to increase access to evidence-based care for alcohol and opioid use disorders.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"123-138"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Services Provided in Spanish in Substance Use Disorder Treatment Facilities: Limited Access in Communities with Fast-Growing Spanish-Speaking Populations.","authors":"George Pro, Tara Bautista, Mofan Gu, Orrin D Ware, Adam Kleinerman, Mps, Julie Baldwin, Martha Rojo","doi":"10.1007/s11414-024-09922-2","DOIUrl":"https://doi.org/10.1007/s11414-024-09922-2","url":null,"abstract":"<p><p>Substance use disorder (SUD) is increasing among primary Spanish-speaking populations, and treatment use is disproportionately low. Patient-provider Spanish language concordance is associated with SUD treatment initiation and better outcomes. Recent geographic shifts within primary Spanish-speaking populations are important considerations in identifying gaps in SUD service delivery in Spanish. This national epidemiologic study used the Mental Health and Addiction Treatment Tracking Repository (2022; N = 9336 facilities) and US census data to pinpoint the location of SUD treatment facilities that offer services in Spanish, and used multilevel models to determine whether access to Spanish services is keeping up with the influx of primary Spanish-speaking populations in new areas that have not historically had a large Spanish language presence. Twenty-two percent of SUD treatment facilities provided services in Spanish. For every 10% increase in the percentage of a census tract speaking Spanish, the odds of SUD treatment facilities offering services in Spanish increased by 30% (aOR = 1.03, 95% CI = 1.02-1.04, p < 0.0001), indicating that Spanish language services were more common in places where people who speak Spanish already live. In contrast, the study team identified no association between the availability of Spanish services and increases in community-level Spanish between 2010 and 2022 (aOR = 1.00, 95% CI = 0.99-1.01, p = 0.87), indicating that access to services is not keeping up with demand as populations move and the Spanish language grows in new areas. SUD treatment services are lagging behind as the location of where primary Spanish-speaking families choose to live changes. Local health policies and ambitious interventions are needed that target the unique needs of SUD treatment clients who speak Spanish.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Dedicated Intake Team Reduces Time to Massed PTSD Treatment.","authors":"Jennifer A Coleman, Brianna Werner, Brian J Klassen, Dale L Smith, Uddyalok Banerjee, Philip Held","doi":"10.1007/s11414-024-09920-4","DOIUrl":"10.1007/s11414-024-09920-4","url":null,"abstract":"<p><p>The Institute of Medicine (2001) describes quality health care as safe, effective, patient-centered, efficient, equitable, and timely. Although this definition highlights the necessity of continuous program evaluation to ensure that these goals are being addressed, there is a notable lack of industry-wide standards and benchmarks, and many clinical programs lack the ability to continually and rigorously evaluate their own performance with data. This might be particularly true in the case of ensuring service members and veterans with posttraumatic stress disorder (PTSD) obtain treatment, as several systemic barriers exist, such as long wait times and lack of equitable treatment for individuals with minoritized identities. The current study examines the impact of a clinic-wide intake redesign for a massed PTSD treatment program to shift the intake process to a small, dedicated team rather than a responsibility shared across all clinicians. The redesign led to significantly shorter wait times for treatment and reduced some types of pre-treatment dropout. On average, patients received an acceptance/rejection decision 1 week sooner, attended the program almost 2 months sooner, and saw a roughly 60% reduction in the odds of dropout at the point of receiving an acceptance/rejection decision. Some disparities in wait times for those who were not partnered, women, and individuals who financially supported more family members remained after the redesign. Results are discussed in light of the importance of continuous program evaluation to address IOM's holistic definition of quality health care.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Perceiving Personality Trait and the Risk for Anxiety and Depression.","authors":"Tetsuo Tsukamoto","doi":"10.1007/s11414-024-09927-x","DOIUrl":"https://doi.org/10.1007/s11414-024-09927-x","url":null,"abstract":"","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Stakeholder Perspectives of Implementing Work-Related Cognitive Behavioral Therapy (WCBT) in Vocational Service Settings: A Qualitative Exploration of Intervention Acceptability and Sustainability.","authors":"Addie Weaver, Richard LeBeau, Daphne Brydon, Marni Rubyan, Josefina Santiago, James Willis, Amy M Kilbourne, Michelle G Craske, Joseph A Himle","doi":"10.1007/s11414-024-09911-5","DOIUrl":"10.1007/s11414-024-09911-5","url":null,"abstract":"<p><p>Growing mental health treatment access disparities elevate the urgency for identifying and implementing innovative approaches for delivering evidence-supported interventions. Work-related cognitive behavioral therapy (WCBT), a technology-assisted CBT (t-CBT) designed to address social anxiety and employment outcomes among job seekers at vocational service centers and for delivery by vocational service professionals, offers a promising way to increase access to needed mental health care. This qualitative study, guided by the Organizational Transformation Model (OTM), explored factors related to WCBT's implementation at two Jewish Vocational Services (JVS) Human Service sites in Detroit, MI and Los Angeles County, CA. Twenty-seven staff-stakeholders across the two JVS sites completed in-depth, semi-structured interviews focused on their experiences with WCBT over the four-year study period. Thematic analysis identified five core codes that most broadly captured participants' perceptions of WCBT implementation and the factors influencing implementation, including: (1) Need, (2) Buy-in and engagement, (3) Communication, (4) Sustainability concerns, and (5) Implementation facilitators. Core codes aligned with OTM factors related to impetus to transform, improvement initiatives, integration across boundaries, alignment from top to bottom, and leadership. Findings identify implementation strategies likely to optimize uptake and sustainability of WCBT within JVS sites that can be tested in a larger, multi-site implementation trial.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Psychological Effects on Firefighters in the Aftermath of the Pazarcik and Elbistan Earthquakes in 2023.","authors":"Erhan Bakirci, Vedat Sar, Ali Cetin","doi":"10.1007/s11414-024-09896-1","DOIUrl":"10.1007/s11414-024-09896-1","url":null,"abstract":"<p><p>In February 2023, two catastrophic earthquakes in Turkey resulted in over 50,000 fatalities and over 300,000 injuries. This study investigated the psychological effects on firefighters who engage in rescue operations following these earthquakes, focusing on trauma-related symptoms, depression, anxiety, stress, and resilience. The research employed validated psychometric instruments, including the Post-earthquake Trauma Level Determination Scale (PETLDS); Depression, Anxiety, Stress Scale-21 (DASS-21); PTSD Checklist for DSM-5 (PCL-5); and Brief Resilience Scale (BRS), to assess the psychological states of firefighters. The primary goal of this study was to evaluate the psychological impact of earthquakes on firefighters. Specific objectives include quantifying trauma levels; identifying the prevalence of post-traumatic stress disorder (PTSD), depression, anxiety, and stress among firefighters; and investigating the role of psychological resilience in mitigating the effects of disaster-related psychological trauma. This study is also aimed at providing empirical evidence to inform the development of psychological support and intervention strategies for firefighters in the aftermath of these earthquakes. In this study of 223 primarily male firefighters, significant psychological impacts from earthquake trauma were observed. The PETLDS scores indicated high trauma levels in 28 participants and modest levels in 195. Subscales revealed affective responses and cognitive structure were most affected. DASS-21 scores showed higher depression, anxiety, and stress in the high trauma group. PCL-5 and BRS analyses confirmed higher PTSD symptoms and lower resilience in high-trauma individuals. Correlation analysis highlighted strong associations between trauma, psychological distress, and decreased resilience. These findings highlight the necessity for targeted mental health interventions and support mechanisms for firefighters, contribute to the establishment of training programs to enhance psychological resilience among firefighters, and add valuable insights to the field of disaster psychology.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"529-544"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators to Staff Recruitment and Retention for ACT Teams: Perspectives of Staff and Participants.","authors":"Miriam C Tepper, Mariah Le Beau, Gary Clark, Helle Thorning, Leah G Pope","doi":"10.1007/s11414-024-09898-z","DOIUrl":"10.1007/s11414-024-09898-z","url":null,"abstract":"<p><p>The behavioral health workforce has been experiencing deepening problems with recruitment and retention, particularly in publicly funded settings serving individuals with serious mental illnesses. This quality improvement project gathered Assertive Community Treatment (ACT) participant (service user) and provider perspectives on workforce challenges. The authors conducted 8 interviews with ACT participants and 9 focus groups with ACT current staff, team leaders, and former staff. Interviewees discussed barriers to recruitment and retention, including inadequate compensation, work becoming more task-oriented during periods of short staffing, a lack of understanding of what ACT work entails, and elements of the team-based model of care; and facilitators of recruitment and retention, including other aspects of the team-based model of care, connections with colleagues and ACT participants, and flexibility. ACT participants had variable experiences regarding availability of their teams. Recommendations from focus groups and interviews include increasing flexibility, improving awareness of ACT work, optimizing team functioning, addressing staff wellness, and attending to risk. Findings include key insights that may help address the critical workforce shortages in public behavioral health settings.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"499-515"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Level and Hospital Treatment-Level Characteristics Predicting Child Readmissions After Psychiatric Inpatient Treatment.","authors":"Danielle Day, Shannon McCullough, Kristin Scardamalia, Miranda Hunter, Sarah Edwards","doi":"10.1007/s11414-024-09915-1","DOIUrl":"10.1007/s11414-024-09915-1","url":null,"abstract":"<p><p>The Institute of Medicine (2001) describes quality healthcare as safe, effective, patient-centered, efficient, equitable, and timely. Although this definition highlights the necessity of continuous program evaluation to ensure that these goals are being addressed, there is a notable lack of industry-wide standards and benchmarks, and many clinical programs lack the ability to continually and rigorously evaluate their own performance with data. This might be particularly true in the case of ensuring service members and veterans with posttraumatic stress disorder (PTSD) obtain treatment, as several systemic barriers exist, such as long wait times and lack of equitable treatment for individuals with minoritized identities. The current study examines the impact of a clinic-wide intake redesign for a massed PTSD treatment program to shift the intake process to a small, dedicated team rather than a responsibility shared across all clinicians. The redesign led to significantly shorter wait times for treatment and reduced some types of pre-treatment dropout. On average, patients received an acceptance/rejection decision 1 week sooner, attended the program almost 2 months sooner, and saw a roughly 60% reduction in the odds of drop out at the point of receiving an acceptance/rejection decision. Some disparities in wait times for those who were not partnered, women, and individuals who financially supported more family members remained after the redesign. Results are discussed in light of the importance of continuous program evaluation to address IOM's holistic definition of quality healthcare.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}