Psychiatric services (Washington, D.C.)最新文献

{"title":"From Radio Waves to On-Demand Video: A Dual-Platform Approach to Chinese American Mental Health Outreach.","authors":"Benjamin K P Woo, Sara Shu","doi":"10.1176/appi.ps.20260285","DOIUrl":"https://doi.org/10.1176/appi.ps.20260285","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20260285"},"PeriodicalIF":3.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Patients Arrive With a Diagnosis: Self-Diagnosis and Diagnostic Flexibility in Mental Health Services.","authors":"Tom Phan","doi":"10.1176/appi.ps.20260342","DOIUrl":"https://doi.org/10.1176/appi.ps.20260342","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20260342"},"PeriodicalIF":3.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Self-Harm Events After Emergency Department Visits Associated With Mental or Substance Use Disorder Diagnoses.","authors":"Rebecca C Rossom, Eric A Johnson, Santiago Papini, Susan M Shortreed, Karen J Coleman, Rebecca A Ziebell, Brian K Ahmedani, Frances L Lynch, Arne Beck, Yihe G Daida, Gregory E Simon","doi":"10.1176/appi.ps.20250697","DOIUrl":"https://doi.org/10.1176/appi.ps.20250697","url":null,"abstract":"<p><strong>Objective: </strong>Using a machine learning model, the authors aimed to predict self-harm events within 90 days of an emergency department (ED) visit associated with a mental or substance use disorder diagnosis.</p><p><strong>Methods: </strong>Electronic health record and claims data of patients ages ≥11 years from seven integrated health systems were used to identify ED visits and diagnoses. Data on 1,254 predictors were extracted for the 60 months before an ED visit, and self-harm was measured in the 90 days after this visit. Logistic regression models were used to estimate self-harm events, with performance estimated by using out-of-sample cross-validation predictions.</p><p><strong>Results: </strong>In a sample of 1,554,828 ED visits for 803,413 patients, self-harm occurred for 19,603 (1.3%) visits. The best-fitting model yielded an area under the curve of 0.85, indicating good overall performance that was consistent across various subgroups. Patients with ED visits estimated to be at the 95th percentile in predicted risk for self-harm had a 10.8% rate of self-harm events, compared with 2.4% for visits estimated at the 50th percentile. Patients with visits estimated to be in the highest risk stratum had an observed risk for self-harm of 27.2%, approximately 136 times greater than the observed risk in the lowest risk stratum.</p><p><strong>Conclusions: </strong>The model performed well in predicting self-harm events in the 90 days after an ED visit for individuals with behavioral health diagnoses. Such machine learning models could be useful in identifying ED patients who may need safety planning and close follow-up after discharge.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250697"},"PeriodicalIF":3.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Depression and Anxiety With Medicare Costs Unaccounted for by Risk-Based Payment.","authors":"Kenton J Johnston, Hefei Wen, Travis Loux, Michelle Hendricks, Karen E Joynt Maddox, Benjamin G Druss, Jason M Hockenberry","doi":"10.1176/appi.ps.20250567","DOIUrl":"10.1176/appi.ps.20250567","url":null,"abstract":"<p><strong>Objective: </strong>The authors aimed to assess whether depression and anxiety are associated with Medicare costs that are unaccounted for by risk adjustment and to estimate the implications of this lack of accounting for risk-based payment.</p><p><strong>Methods: </strong>This 2022-2023 national cohort study of community-dwelling Medicare beneficiaries used data from the Chronic Conditions Data Warehouse (CCW) to evaluate the association of diagnosed depression or anxiety with beneficiaries' risk-adjusted, unaccounted-for 2023 cost predictions and to compare differences in actual-to-predicted costs among beneficiaries with and beneficiaries without these disorders. CCW-based algorithms identified beneficiaries in 2022 with depression with no anxiety, anxiety with no depression, both depression and anxiety, or neither condition. Medicare's risk adjustment model was used to predict beneficiaries' 2023 costs from 2022 medical claims.</p><p><strong>Results: </strong>Among 22,078,394 beneficiaries, 5.8%, 7.4%, and 5.7% had depression without anxiety, anxiety without depression, and both conditions, respectively. Mean 2023 costs were $17,907, $15,100, and $22,414 for beneficiaries with depression, anxiety, and both conditions, respectively, versus $10,902 for beneficiaries without these conditions (p<0.001). Depression was associated with 10.3%-17.7%, anxiety with 9.9%-15.2%, and both conditions with 26.3%-46.2% unaccounted-for costs. On average, the risk model underpredicted costs by $1,567 (95% CI=$1,525-$1,609), $1,159 (95% CI=$1,125-$1,193), and $3,569 (95% CI=$3,522-$3,616) per beneficiary with depression, anxiety, or both conditions, respectively.</p><p><strong>Conclusions: </strong>Medicare's risk-based payment model underpredicts costs for beneficiaries with depression or anxiety, potentially creating incentives to avoid providing care or coverage. To ensure appropriate reimbursement, Medicare should adequately adjust risk for depression and anxiety.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250567"},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Families in the Digital Age: How Clinicians Can Respond to Concerns About Adolescent Media Use.","authors":"Lauren Eales, David J Miklowitz","doi":"10.1176/appi.ps.20260140","DOIUrl":"https://doi.org/10.1176/appi.ps.20260140","url":null,"abstract":"<p><p>Digital media use is increasingly intertwined with adolescents' mental health, yet parents may encounter conflicting or oversimplified information about how online behaviors affect mood, anxiety, and well-being. Clinicians can help parents of adolescents who are experiencing mental health issues (particularly mood or anxiety disorders) by supporting them in both understanding the relationship between digital media use and their adolescents' mental health and identifying specific strategies for their adolescents. In this column, the authors outline practical strategies (e.g., assessing parents' beliefs about mental health and digital media usage, promoting open communication in the family regarding the adolescent's online behavior, encouraging parents to model healthy media habits, and addressing family conflicts about media use) for clinicians to use in providing collaborative care for families.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20260140"},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal Suicide Risk Screening in a Safety-Net Health System: Findings From 5.2 Million Encounters.","authors":"Beth Childs, Olivia Hudgens, Julia Livingstone, Alex Treacher, Jacqueline Naeem, Fuad Khan, Sidra Goldman-Mellor, Kimberly Roaten","doi":"10.1176/appi.ps.20260003","DOIUrl":"https://doi.org/10.1176/appi.ps.20260003","url":null,"abstract":"<p><strong>Objective: </strong>The authors aimed to examine whether universal suicide risk screening was associated with increased identification of suicide risk across demographic and clinical subgroups.</p><p><strong>Methods: </strong>This retrospective observational study analyzed electronic health record data from 5,219,858 encounters at a safety-net health system (2010-2020). The primary outcome was encounter-level suicide risk identification. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) comparing the periods before and after implementation of universal screening.</p><p><strong>Results: </strong>Suicide risk was identified in 0.7% of preimplementation encounters and 3.5% of postimplementation encounters (AOR=5.8, 95% CI=5.7-5.9). Relative increases were greatest among encounters involving older adults, charity or self-pay status, and Black patients and encounters in outpatient settings.</p><p><strong>Conclusions: </strong>Universal suicide risk screening substantially increased identification across settings, a finding that supports its use as a scalable strategy for equitable detection.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20260003"},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Community-Based Pediatric Health Care Professionals' Confidence in Providing Suicide Prevention Services.","authors":"Brian H Pitts, Rachel Cafferty, Lauren Pryce McCarthy, Rachel Kollin, Alethea Chiappone, Bruno Anthony","doi":"10.1176/appi.ps.20250457","DOIUrl":"https://doi.org/10.1176/appi.ps.20250457","url":null,"abstract":"<p><strong>Objective: </strong>Community-based health care has a vital role in identifying youths at risk for suicide, providing initial interventions, and connecting patients to appropriate services. This study aimed to evaluate the reach and effectiveness of a youth suicide prevention training series, developed in accordance with the Extension for Community Healthcare Outcomes (ECHO) model, for community-based pediatric health care professionals.</p><p><strong>Methods: </strong>The training series covered suicide risk screening, risk assessment, safety planning, lethal means safety counseling, referral, and follow-up. Participants' demographic, professional, and practice data were collected via a web-based portal during registration. For this retrospective pre-post study, participants were surveyed after the series to evaluate their confidence in navigating the care pathway and their intent to implement learned skills in their practice. The data were analyzed via descriptive statistics, Wilcoxon signed-rank tests, and chi-square tests.</p><p><strong>Results: </strong>Of 391 registrants, 290 participated in the series, of whom 144 responded to the survey. Most participants were female, were White, and practiced in urban settings. Participants in rural and frontier settings were proportionally overrepresented. The respondents' median confidence increased across all assessed skills (all, p<0.001). Confidence in assessing suicide risk improved the most, increasing from slightly confident to very confident. Ninety percent of respondents reported being likely or very likely to implement the care pathway in their clinical practice within 6 months.</p><p><strong>Conclusions: </strong>This evidence-informed suicide prevention training approach appeared to be effective. The ECHO model may provide a replicable and scalable process to improve suicide prevention skills among community-based pediatric health care professionals.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250457"},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Stigma and \"Good Parenting\" in Child and Adolescent Mental Health.","authors":"Timothy D Becker, Fiona Guo, Bingsong Li, Doron Amsalem, Lawrence H Yang, Leah G Pope","doi":"10.1176/appi.ps.20260129","DOIUrl":"https://doi.org/10.1176/appi.ps.20260129","url":null,"abstract":"<p><strong>Objective: </strong>Parents of children with mental health problems often experience judgment about their parenting. Such stigma is associated with lower parental well-being and greater child symptom severity. Theory-driven descriptions of and interventions for parental stigma are limited. The authors aimed to investigate how parents experience and cope with stigma via the What Matters Most framework.</p><p><strong>Methods: </strong>Interviews were conducted with 24 parents (50% women, mean±SD age=39.8±8.6 years) of children ages 6-17 with depression (N=9), attention-deficit hyperactivity disorder (N=7), or substance use problems (N=8). Interviews explored what parents view as central to being respected as a \"good parent,\" how a child's mental health problems threaten these qualities and shape stigma toward parents, and how parents cope with stigma and restore a positive moral identity.</p><p><strong>Results: </strong>Parents reported being respected for support, open communication, boundaries, role modeling, and their child's well-being. When children have mental health problems, stigma reflects perceived parental failure to meet ideals, leading to emotional distress and self-doubt. With support from peers and clinicians, parents found new ways to fulfill or redefine these ideals, reducing self-stigma.</p><p><strong>Conclusions: </strong>Parental stigma centers on threats to identity as good parents. Mental health services can mitigate stigma by helping parents reinterpret and reasonably fulfill parenting ideals.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20260129"},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming Acute Psychiatric Care: An Innovative Trauma-Focused Inpatient Model of Care for Women.","authors":"Siqi Xue, Suvercha Pasricha, Vicky Stergiopoulos","doi":"10.1176/appi.ps.20260073","DOIUrl":"https://doi.org/10.1176/appi.ps.20260073","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20260073"},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Setting of Alcohol Use Disorder Diagnosis Among Women Enrolled in Medicare.","authors":"Haiden A Huskamp, Alisa B Busch, Shelly F Greenfield, Sharon-Lise T Normand, Sharon Reif, Alene Kennedy-Hendricks","doi":"10.1176/appi.ps.20260041","DOIUrl":"https://doi.org/10.1176/appi.ps.20260041","url":null,"abstract":"<p><strong>Objective: </strong>The authors assessed the setting of an initial diagnosis of alcohol use disorder among Medicare-enrolled women.</p><p><strong>Methods: </strong>Using 2016-2022 Medicare fee-for-service claims, the authors identified the first alcohol use disorder diagnosis for women ages 18-64 years (N=116,226) and ≥65 years (N=264,857) and examined the diagnosis setting. For diagnoses during a hospitalization, the authors determined how often alcohol use disorder was the principal diagnosis.</p><p><strong>Results: </strong>About two-thirds of women ages 18-64 and ≥65 years received an initial diagnosis in a hospital or emergency department. Only 9%-14% of diagnoses were by primary care physicians and 2%-5% by behavioral health specialists in community-based practices. Alcohol use disorder was the principal diagnosis for ≤10% of hospitalizations in which a patient's condition was initially diagnosed, suggesting that it was often identified during acute treatment for other conditions.</p><p><strong>Conclusions: </strong>These results suggest the need for enhanced efforts to encourage early identification and management of alcohol use disorder outside acute care settings.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20260041"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}