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

{"title":"Suicide Risk and Health Care Utilization Among Veterans Contacting the Veterans Crisis Line: Retrospective Cohort Study.","authors":"Kiersten L Strombotne, Sivagaminathan Palani, Yufei Li, Matthew Podlogar, Jolie Bourgeois, MaryGrace Lauver, Elizabeth Schaper, Gissa Hernandez, Rachel Sayko Adams, Melissa M Garrido","doi":"10.1176/appi.ps.20250129","DOIUrl":"10.1176/appi.ps.20250129","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess associations between characteristics of contacts with the Veterans Crisis Line (VCL) and subsequent Veterans Health Administration (VHA) mental health care use, suicide-related events (SREs), and suicide mortality from 2016 to 2023.</p><p><strong>Methods: </strong>This retrospective cohort study used VCL user data and administrative records from the Veterans Affairs Corporate Data Warehouse for 365,222 unique veterans who contacted the VCL between January 2016 and December 2022. The authors examined relationships between VCL contact characteristics, including contact type (calls, texts, and transfers), responder-assessed suicide risk level, and day of contact, and outcomes within 12 months of VCL contact (VHA mental health care use, VHA emergency department use, SREs, all-cause mortality, and suicide-specific mortality).</p><p><strong>Results: </strong>High-risk users, those requiring emergency dispatch or welfare checks, and those contacting VCL on weekends were more likely than their counterparts to use mental health services and experience SREs. Users contacting the VCL by text had a lower likelihood of all-cause mortality than direct callers. Changes in user characteristics since VCL service expansion in 2016 were observed, indicating a broader demographic reach and altered risk profiles.</p><p><strong>Conclusions: </strong>The findings underscore the critical role of the VCL in facilitating access to health care for veterans experiencing a crisis and the necessity of targeted interventions for high-risk groups. The evolution in VCL user profiles and contact characteristics suggests ongoing changes in veterans' needs and preferences, reinforcing the importance of continuous adaptation of suicide prevention strategies. Future evaluations should focus on longitudinal outcomes and qualitative user experiences to enhance the effectiveness of crisis intervention services for veterans.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"397-404"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314762","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":"Clozapine Monitoring: Form Follows Function.","authors":"Abigail L Donovan, Cheryl Y S Foo, Carol Lim, Sarah A MacLaurin, Oliver Freudenreich","doi":"10.1176/appi.ps.20250479","DOIUrl":"10.1176/appi.ps.20250479","url":null,"abstract":"<p><p>The elimination of the clozapine risk evaluation and mitigation strategies program provides an opportunity to design a new clozapine monitoring system in which medical monitoring follows a conceptual treatment framework that includes three phases: clozapine trial, treatment optimization, and treatment consolidation. Each phase incorporates reverse medical-psychiatric integration and has distinct treatment goals and monitoring schedules. Each phase begins with a therapeutic decision point when prescribers, patients, and families or legal guardians engage in shared decision making to evaluate treatment options.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"470-473"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470849","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":"Quality of Lethal Means Counseling Documentation in the Veterans Health Administration.","authors":"Gillian Geffen, Lauren R DiPaolo, Christopher B Roberts, Matthew Wilson, Joseph Simonetti, Marianne Goodman, Kelly L Green, Gabriela Khazanov","doi":"10.1176/appi.ps.20250200","DOIUrl":"10.1176/appi.ps.20250200","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the characteristics and quality of lethal means counseling (LMC) action plans documented as part of the Safety Planning Intervention (SPI) carried out in U.S. Department of Veterans Affairs Medical Centers (VAMCs), as well as differences in documentation quality based on patient and clinical characteristics.</p><p><strong>Methods: </strong>Three authors rated 910 LMC action plans abstracted from six VAMCs selected for geographic and facility-level diversity. Ratings, based on the SPI scoring algorithm, range from 0 (no text pertaining to lethal means access reduction) to 3 (highly specific).</p><p><strong>Results: </strong>LMC action plans received low quality scores (mean±SD=1.29±0.86). Documentation was often vague or reviewed past actions instead of formulating a specific plan for lethal means access reduction. Steps to reduce firearm access were documented in plans for 74% of veterans reporting firearm access (54% of all veterans). Steps to reduce access to medications (20%) and other lethal means (13%) were less frequently documented. Plan text was in veterans' own words, as intended, only 27% of the time. Quality of LMC action plans was rated higher for male versus female veterans, for veterans with versus without documented access to firearms, and for outpatient versus residential and emergency settings.</p><p><strong>Conclusions: </strong>In this study examining documentation quality of a sample of LMC action plans across a health care system, the average score for quality was low. Findings indicate clinician awareness of firearm risks but less discussion about other lethal means. Future work should develop training and implementation strategies to improve LMC action plan documentation.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"412-420"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470811","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":"Justice Came With a Leash.","authors":"Joey Ramp-Adams","doi":"10.1176/appi.ps.20260135","DOIUrl":"10.1176/appi.ps.20260135","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"484-485"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597743","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":"Personal Accounts in Psychiatric Services, Part 2: Systems of Care, Advocacy, Professional Development, and Clinical Identity.","authors":"Andrew D Carlo, Lisa B Dixon","doi":"10.1176/appi.ps.26077005","DOIUrl":"https://doi.org/10.1176/appi.ps.26077005","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"77 5","pages":"490-491"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826335","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":"The Need for Acute Psychiatric Care.","authors":"Michael J Williams","doi":"10.1176/appi.ps.20250728","DOIUrl":"https://doi.org/10.1176/appi.ps.20250728","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"77 5","pages":"487-488"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826371","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":"Public Mental Health Workers' Policy Recommendations to Address the Behavioral Health Workforce Shortage.","authors":"Elyse Ganss, Vanesa A Mora Ringle, Temma Schaechter, Kofi Adutwum, Torrey A Creed, Cherry Du, Natalie Dallard","doi":"10.1176/appi.ps.20250259","DOIUrl":"10.1176/appi.ps.20250259","url":null,"abstract":"<p><strong>Objective: </strong>The authors sought to elicit public mental health workers' recommendations for increasing the behavioral health workforce.</p><p><strong>Methods: </strong>Semistructured interviews were conducted with 20 mental health workers in Philadelphia from September to October 2024. Thematic analysis was used to determine the most effective strategies for recruiting and retaining the behavioral health workforce.</p><p><strong>Results: </strong>The workers supported various policy strategies to increase the workforce, such as employment and financial incentives, including sign-on bonuses and health care benefits. Workers noted that regarding current policies, updated information on federal loan forgiveness programs was challenging to find. They also emphasized that combining several policy strategies would effectively sustain the workforce.</p><p><strong>Conclusions: </strong>Comprehensive efforts are needed to adequately address the shortage of behavioral health workers in community settings. Workers championed a combination of several changes to increase the behavioral health workforce, with implications for mental health research, systems, and policies.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"457-461"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314748","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":"Bridging the Hospital Discharge Gap: Pilot Trial of a Digital Smoking Cessation Program for Psychiatric Inpatients.","authors":"Melanie E Bennett, Faith Dickerson, Sarah Cha, Brian J Brandler, Alicia A Lucksted, Deborah Medoff, Christopher Marano, Stephanie Knight, Amanda L Graham","doi":"10.1176/appi.ps.20250326","DOIUrl":"10.1176/appi.ps.20250326","url":null,"abstract":"<p><strong>Objective: </strong>This randomized pilot trial aimed to evaluate the feasibility, acceptability, and preliminary outcomes of a digital smoking cessation intervention (DSCI)-adapted for psychiatric inpatients and designed to bridge the postdischarge treatment gap-and compare the DSCI with brief counseling (BC).</p><p><strong>Methods: </strong>Psychiatric inpatients who were tobacco users were randomly assigned to DSCI or BC and assessed at 1 and 3 months postdischarge. Feasibility was examined via enrollment rates, acceptability was assessed by examining program engagement and satisfaction, and preliminary outcomes were assessed via abstinence outcomes at 1 and 3 months following hospital discharge and via postdischarge smoking cessation treatment use. Potential mechanisms of action (tobacco craving, abstinence self-efficacy, and abstinence motivation) were also evaluated.</p><p><strong>Results: </strong>Among 218 eligible patients, 27% (N=58) enrolled in the trial. Among DSCI participants with available data (N=31), 84% used at least one intervention component in the month following discharge, with website visits (65%) and community engagement (58%) being most common. At 1-month follow-up, significantly more DSCI participants reported 7-day abstinence compared with BC participants (N=6 vs. N=0, p=0.04). DSCI participants showed significantly greater increases in abstinence motivation from baseline to 1 month (p=0.05), whereas BC participants' motivation decreased. In qualitative interviews, DSCI participants valued the hospital-based orientation to DSCI and found automated text messages helpful for maintaining abstinence goals.</p><p><strong>Conclusions: </strong>This pilot trial demonstrated promising signals regarding the feasibility, acceptability, and preliminary postdischarge outcomes of a digital intervention for promoting smoking cessation among psychiatric inpatients.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"421-428"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518331","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":"Perinatal Mental Health in the Context of Immigration.","authors":"Sai Snigdha Talluri, Sang Qin","doi":"10.1176/appi.ps.26077011","DOIUrl":"https://doi.org/10.1176/appi.ps.26077011","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"77 5","pages":"385"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826330","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":"My Lifelong Search for Relief From Obsessive-Compulsive Disorder and My Hope in Novel Treatments.","authors":"Robert Milan","doi":"10.1176/appi.ps.20260029","DOIUrl":"10.1176/appi.ps.20260029","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"482-483"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350119","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}