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

{"title":"Rights-Based Recovery and Cultural Worth Orientations in Psychiatric Services.","authors":"Yasuhiro Kotera, Mike Slade","doi":"10.1176/appi.ps.20260311","DOIUrl":"https://doi.org/10.1176/appi.ps.20260311","url":null,"abstract":"<p><p>Personal recovery and rights-based approaches have become central to psychiatric services, but assumptions about individuals being entitled to support may not be culturally neutral. This column introduces worth orientations as a cultural dimension that shapes how service users interpret quality of life. In countries that use a dignity-based worth orientation, support is grounded in the inherent human value of a person. In countries with an effort-based worth orientation, support is linked more strongly to contribution, endurance, or deservingness. Recognizing these differences can help psychiatric services communicate recovery goals more sensitively and develop culturally responsive practices.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20260311"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123032","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":"Enhancing the Role of Digital Health Navigators With Lived Experience: AI-Assisted Conavigation for Safety, Support, and Engagement.","authors":"Carla Gorban, Spencer Roux, Sean Ryan, John Torous","doi":"10.1176/appi.ps.20250679","DOIUrl":"https://doi.org/10.1176/appi.ps.20250679","url":null,"abstract":"<p><p>As artificial intelligence (AI) expands across mental health services, questions arise about whether it can replace digital health navigators (DHNs), including those with lived experience. The DHN role generally resists automation because lived experience deepens specific dimensions that AI cannot replicate. Drawing on emerging evidence of AI's limitations in contextual reasoning, cultural sensitivity, and clinical safety, the authors identify where DHNs with lived experience are least substitutable: real-world knowledge of services, cultural grounding in the communities they serve, and relational trust. A practical model is also outlined in which AI augments DHN workflows through triage, documentation, and engagement monitoring.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250679"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122970","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":"Racial-Ethnic and Sex Disparities in Mental Health Service Use Before Self-Harm Among Young People Enrolled in Medicaid.","authors":"Erin R Orlins, Susan De Luca, Cynthia A Fontanella, Jeffrey A Bridge, Gabriela Rodriguez, Danielle L Steelesmith","doi":"10.1176/appi.ps.20250557","DOIUrl":"https://doi.org/10.1176/appi.ps.20250557","url":null,"abstract":"<p><strong>Objective: </strong>This study examined racial-ethnic and sex differences (and their intersections) in mental health service use prior to deliberate self-harm among young people enrolled in Medicaid.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted by using Medicaid data from 25 states between January 1, 2011, and December 31, 2021. The cohort included 222,924 young people ages 9-25 years with a new self-harm diagnosis. Primary outcomes were any mental health service use 1, 6, and 12 months prior to self-harm, categorized as outpatient, inpatient, or emergency department visits. Logistic regression models with sex × race-ethnicity interaction terms estimated associations with service use, clustered by state and adjusted for covariates.</p><p><strong>Results: </strong>Overall, 34.2% of the cohort had a mental health visit in the month prior to self-harm, and 54.5% had a visit in the preceding year. The highest probabilities of any mental health service use in the month prior to self-harm were among non-Hispanic White (NHW) male (adjusted predicted probability [APP]=58.14%) and NHW female (APP=54.72%) individuals. The probabilities and odds of service use were higher for NHW, non-Hispanic Black, and Hispanic male individuals compared with their respective female counterparts for all service types and periods.</p><p><strong>Conclusions: </strong>Among young people enrolled in Medicaid, patterns of mental health service use prior to self-harm varied by sex and race-ethnicity. Culturally tailored mental health promotion strategies that address structural racism, provider bias, and system fragmentation may help reduce disparities in care and mitigate risks for self-harm and suicide.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250557"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123057","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":"Supervision as Clinical Infrastructure.","authors":"Eboni L Ceasar","doi":"10.1176/appi.ps.26077025","DOIUrl":"https://doi.org/10.1176/appi.ps.26077025","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"77 10","pages":"917-918"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123907","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":"Location of Crisis Service Delivery for Medicaid-Enrolled Youths With Behavioral Health Conditions.","authors":"Ashley A Foster, Mark Zamani, Jennifer A Hoffmann, Anna M Cushing, Naomi Bardach, Mark I Neuman, Chuan-Mei Lee, Joel Hudgins, Matt Hall, Stephanie K Doupnik","doi":"10.1176/appi.ps.20250581","DOIUrl":"10.1176/appi.ps.20250581","url":null,"abstract":"<p><strong>Objectives: </strong>National guidelines emphasize the value of community-based behavioral health crisis care for youths, including mobile crisis response and telehealth. This study aimed to assess characteristics associated with receipt of crisis care via mobile or community services and telehealth among Medicaid-enrolled youths.</p><p><strong>Methods: </strong>A retrospective study was conducted of a national sample of youths ages 6-17 years who received crisis services and had data in the 2022 Merative MarketScan Medicaid database. Locations of care included mobile or community, telehealth (i.e., virtual), in-person onsite (e.g., hospitals), and other. Multivariable logistic regression was used to evaluate sociodemographic and clinical factors associated with receipt of crisis services via mobile or community response and via telehealth.</p><p><strong>Results: </strong>The sample included 18,993 youths who received behavioral health crisis services in 2022. The most frequent service location was in person onsite (63.0%), followed by mobile or community (29.2%), other (9.3%), and telehealth (9.1%). Compared with results for White youths, the odds of receiving crisis care via mobile or community services were higher for Black youths (adjusted odds ratio [AOR]=1.12) and Hispanic youths (AOR=1.26), and the odds of receiving crisis care via telehealth were higher for Black youths (AOR=1.30) and lower for Hispanic youths (AOR=0.05).</p><p><strong>Conclusions: </strong>Despite recommendations that prioritize community-based behavioral health crisis care, most crisis services occurred in person onsite. Racial-ethnic differences were found in receipt of mobile or community and telehealth crisis care. Future research to investigate facilitators, barriers, and preferences may enable more youths to receive community-based crisis care.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"955-962"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407865","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}

{"title":"Improving Psychiatric Care for Black Men Experiencing Racial Trauma.","authors":"Yamonte Cooper","doi":"10.1176/appi.ps.20260018","DOIUrl":"10.1176/appi.ps.20260018","url":null,"abstract":"<p><p>Black men experience disproportionate exposure to structural violence through policing, housing instability, economic exclusion, and psychiatric misrecognition. These conditions shape clinical presentation, diagnostic trajectories, and engagement with mental health services, yet they are rarely treated as etiological factors in psychiatric care. The author argues that structural violence functions as a chronic psychiatric exposure that produces predictable emotional and behavioral adaptations that often are misread as pathology. Reframing structural conditions as psychiatric exposures is essential for care. Drawing on clinical evidence and structural analysis, the author outlines implications for diagnosis, documentation, and treatment planning and proposes service-level reforms to improve psychiatric care for Black men.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"1002-1004"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311315","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":"Perspectives of Individuals With Lived Experience on Obsessive-Compulsive Disorder Treatment Delivery, Supports, and Research.","authors":"Amy M Rapp, Laura Bernero, Rhea LaFleur, Gail Cridland, Miranda Muca, I-Chin Chiang, H Blair Simpson, Sapana Patel","doi":"10.1176/appi.ps.20240401","DOIUrl":"10.1176/appi.ps.20240401","url":null,"abstract":"<p><p>An online survey was conducted to understand the perspectives of adults with obsessive-compulsive disorder (OCD; N=378) on modes of treatment delivery, importance of educational resources and supports, and priorities for research. Quantitative and qualitative data analyses revealed interest in in-person rather than remote treatment, medication-specific educational resources, and various research topics, including treatment development, factors that contribute to recovery or relapse, methods to improve access to evidence-based care, and causes of OCD. The findings point to key areas to better align treatment delivery and research with the needs of those with lived experience.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"1008-1011"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371766","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":"Moving From How to Why: An Endorsement of the Desirability of Outcome Ranking in Psychiatric Clinical Trials Research.","authors":"Stephanie A Rolin, Megan G Flores, Alexander K Thiersch, Kristal Taylor, Annah J Chollet, Alicia I Rolin, Toshimitsu Hamasaki, Scott Evans","doi":"10.1176/appi.ps.20250195","DOIUrl":"10.1176/appi.ps.20250195","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"1000-1001"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709282","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 Support for State Laws Requiring Addiction Programs to Offer FDA-Approved Medications for Opioid Use Disorder.","authors":"Colleen L Barry, Sarah Gutkind, Jeff Niederdeppe, Erika Franklin Fowler, Emma E McGinty","doi":"10.1176/appi.ps.20250646","DOIUrl":"10.1176/appi.ps.20250646","url":null,"abstract":"<p><strong>Objective: </strong>The study reported here aimed to examine public attitudes regarding state licensure laws requiring addiction treatment programs to offer Food and Drug Administration-approved medications for opioid use disorder.</p><p><strong>Methods: </strong>A national survey with a probability-based national sample of 1,552 adults was fielded April 7-28, 2025, by using a probability-based web panel designed to be representative of the U.S. population.</p><p><strong>Results: </strong>Seventy-four percent of respondents supported licensure laws requiring addiction treatment programs to offer medications for opioid use disorder. No differences were detected by race or personal experience with addiction or overdose. Although political conservatives were less likely than moderates or liberals to support licensure laws, support was >66% across the ideological spectrum. Support was high even among respondents reporting high social stigma toward or discriminatory beliefs about people with opioid addiction.</p><p><strong>Conclusions: </strong>Robust public support suggests that licensure policies supporting addiction treatment programs could be a promising approach for states to reduce overdose deaths.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"977-980"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623828","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":"Mental Health Treatment Utilization Among Patients Receiving Collaborative Care for Co-occurring Disorders.","authors":"Alexandra Bilder, Lauren Kelly, Rebecca Weir, Lisa S Meredith, Beth Ann Griffin, Sapna Mendon-Plasek, Jasen Christensen, Katherine E Watkins","doi":"10.1176/appi.ps.20250723","DOIUrl":"10.1176/appi.ps.20250723","url":null,"abstract":"<p><strong>Objective: </strong>The authors aimed to examine the relationship between characteristics of patients and health systems and receipt of mental health treatment among patients assigned to collaborative care (CC) for opioid use disorder co-occurring with depression, posttraumatic stress disorder (PTSD), or both.</p><p><strong>Methods: </strong>This secondary analysis used data from the intervention arm (N=400 participants) of a randomized clinical trial of CC, implemented in 18 low-resourced clinics, for patients with opioid use disorder co-occurring with depression, PTSD, or both. Outcomes were receipt of psychiatric medication or counseling during the 6-month intervention, as obtained from the electronic health records data or a caseload tracking tool. Baseline characteristics were assessed by using t tests for continuous variables and chi-square tests for categorical and binary measures. Adjusted logistic regression was used to identify associations between treatment receipt and characteristics; predicted probabilities for covariates were used to demonstrate effect size.</p><p><strong>Results: </strong>Of the patients, 51% received psychiatric medication and 44% received counseling. In the adjusted models, co-use of stimulants was associated with less likelihood of receiving psychiatric medication (adjusted odds ratio [AOR]=0.95) or counseling (AOR=0.92), as was lower education. Male sex and health system characteristics were associated with a lower likelihood of receiving counseling; non-Hispanic ethnicity and more severe depression and PTSD symptoms were associated with a greater likelihood of receiving counseling.</p><p><strong>Conclusions: </strong>Even within CC settings, substantial unmet need for mental health treatment remained, particularly among individuals co-using stimulants. Future research should examine additional support to increase mental health treatment among individuals with co-occurring disorders.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"947-954"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682010","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}