Psychiatric services (Washington, D.C.)最新文献_第4页

The Future of Crisis Services: Clarifying Accountability, Improving Coordination, and Promoting Sustainability. 危机服务的未来：明确问责制，改善协调，促进可持续性。

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 Epub Date: 2025-08-14 DOI: 10.1176/appi.ps.20240542

Andrew D Carlo, Matthew L Goldman

引用次数: 0

Building a Coalition for Change: The Yale Department of Psychiatry Accountability, Respect, Community & Humanity Task Force. 建立变革联盟：耶鲁精神病学问责、尊重、社区和人道工作组。

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 Epub Date: 2025-08-08 DOI: 10.1176/appi.ps.20240541

Noah S Triplett, Joy S Kaufman, John H Krystal, Cindy A Crusto

引用次数: 0

Who Gets to Decide? 谁来做决定？

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 DOI: 10.1176/appi.ps.20250410

Lisa B Dixon

引用次数: 0

Education and Navigation Programs to Promote Food and Nutrition Security Among People With Serious Mental Illness. 促进严重精神疾病患者食物和营养安全的教育和导航项目。

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 Epub Date: 2025-08-14 DOI: 10.1176/appi.ps.20240514

Patrick W Corrigan

引用次数: 0

Racial-Ethnic Disparities in Ketamine and Esketamine Therapy for Major Depressive Disorder. 氯胺酮和艾氯胺酮治疗重度抑郁症的种族差异。

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 Epub Date: 2025-06-25 DOI: 10.1176/appi.ps.20240559

Michael Liu, Rachel Branning, Austin Lee, David Kaelber, Keming Gao

{"title":"Racial-Ethnic Disparities in Ketamine and Esketamine Therapy for Major Depressive Disorder.","authors":"Michael Liu, Rachel Branning, Austin Lee, David Kaelber, Keming Gao","doi":"10.1176/appi.ps.20240559","DOIUrl":"10.1176/appi.ps.20240559","url":null,"abstract":"Objective: This study sought to investigate racial-ethnic disparities in the utilization of intravenous ketamine and intranasal esketamine therapy for major depressive disorder.Methods: The TriNetX platform was used to identify 861,179 patients diagnosed as having moderate-to-severe recurrent major depressive disorder between January 2019 and October 2024. Patients were divided into non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic cohorts. Propensity score matching (PSM) was used to match minority cohorts with White patients. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to compare ketamine and esketamine utilization across racial-ethnic groups.Results: After PSM, the authors found that ketamine was prescribed at lower rates among Black (RR=0.75, 95% CI=0.72-0.78), Hispanic (RR=0.71, 95% CI=0.68-0.75), and Asian (RR=0.65, 95% CI=0.57-0.75) patients compared with White patients. Esketamine was utilized at lower rates among Black patients (RR=0.74, 95% CI=0.62-0.88) and at higher rates among Hispanic patients (RR=1.45, 95% CI=1.24-1.69), whereas Asian patients showed no significant difference. Within-group comparison among Black and White patients found that individuals who received ketamine or esketamine in both cohorts had more comorbid general medical and psychiatric conditions than those who did not.Conclusions: Significant racial-ethnic disparities exist in the utilization of ketamine and esketamine therapies for major depressive disorder, particularly affecting Black patients. Future research should investigate the underlying causes of these disparities and develop strategies to ensure equitable access to ketamine and esketamine for all patients with major depressive disorder.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"818-826"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487770","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}

引用次数: 0

Service Users' and Carers' Experiences With Home Treatment Teams Within Mental Health Services: A Scoping Review. 心理健康服务中家庭治疗小组的服务使用者和护理者的经验：范围审查。

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 Epub Date: 2025-06-25 DOI: 10.1176/appi.ps.20240516

Jessica Levy, Prateek Yadav, Gonzalo Martínez-Alés, Amy Ronaldson, Mireia Espallargues, Alex Dregan, Ioannis Bakolis, Lorena Botella-Juan, Antonio J Molina, Vicente Martín, Jose M Valderas, Jordi Alonso, Jorge Arias de la Torre

{"title":"Service Users' and Carers' Experiences With Home Treatment Teams Within Mental Health Services: A Scoping Review.","authors":"Jessica Levy, Prateek Yadav, Gonzalo Martínez-Alés, Amy Ronaldson, Mireia Espallargues, Alex Dregan, Ioannis Bakolis, Lorena Botella-Juan, Antonio J Molina, Vicente Martín, Jose M Valderas, Jordi Alonso, Jorge Arias de la Torre","doi":"10.1176/appi.ps.20240516","DOIUrl":"10.1176/appi.ps.20240516","url":null,"abstract":"Objective: A home treatment team (HTT) is a mental health service that provides fast, intensive interventions to service users who are experiencing a mental health crisis, and it can be an alternative to hospital admission. To date, little research has focused on service users' and carers' experiences. The aim of this scoping review was to analyze the current evidence on service users' and carers' experiences with HTTs to identify key concepts and to highlight gaps in knowledge.Methods: A scoping review was conducted by searching five databases. Relevant secondary sources also were reviewed. Studies that focused on HTT services and on adults or service users of working age (16-64 years) were included. The quality of the articles included in the final review was assessed with different tools, depending on each study's methodology.Results: Seven studies were included, six of which were of moderate or high quality. Overall, service users and carers were satisfied with HTT services, compared with alternatives such as hospitalization. Three themes contributing to experiences with HTTs were identified: accessibility, the relationship with HTT staff members, and a sense of empowerment. Transitions between services were particularly sensitive periods for service users and carers and therefore often a focus of their experiences.Conclusions: The findings of this review show the relevance to HTT service users of HTT accessibility, the interpersonal therapeutic relationship, and the empowerment of patients. These aspects could be helpful in understanding and improving HTT services and the outcomes of those services.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"827-833"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487771","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}

引用次数: 0

State-Level Variation in Racial-Ethnic Disparities in Access to Children's Mental Health Care. 儿童获得心理保健的种族差异在州一级的差异。

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 Epub Date: 2025-08-14 DOI: 10.1176/appi.ps.20240279

Genevieve Graaf, Lonnie Snowden

{"title":"State-Level Variation in Racial-Ethnic Disparities in Access to Children's Mental Health Care.","authors":"Genevieve Graaf, Lonnie Snowden","doi":"10.1176/appi.ps.20240279","DOIUrl":"10.1176/appi.ps.20240279","url":null,"abstract":"Objective: Mental health treatment disparities have been documented among children and youths. This study aimed to examine variations in disparities across U.S. states among Black children and Hispanic children (vs. White children). Disparities in caregiver-reported unmet mental health needs and difficulty in accessing mental health care were assessed.Methods: This retrospective cross-sectional study used pooled data (2016-2019) from the National Survey of Children's Health. Logistic regression, with marginal postestimation and complex survey weights to reflect state and national probabilities, was used to estimate the direction, size, and statistical significance of disparities among Black (vs. White) children (N=5,900) and Hispanic (vs. White) children (N=10,369).Results: Adjusted state estimates showed significant (p<0.05) disparities in four U.S. states among Black (vs. White) children in the probability of having unmet mental health needs. Disparities in care access favoring Black children were found in four states. In one state, Black children were significantly more likely than White children to have caregiver-reported difficulty in accessing treatment. Hispanic (vs. White) children were significantly less likely to have caregiver-reported unmet mental health needs in seven states, but the opposite was found in one state. The probability of caregiver-reported difficulty in accessing care was significantly lower among Hispanic (vs. White) children in two states but was higher in three states.Conclusions: Significant state variation in disparities was obscured by national averages. More policy and systems analysis is needed, especially at the state level, to uncover structural drivers of disparities in children's mental health care.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"809-817"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850368","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}

引用次数: 0

Differential Changes in Use of Medications for Opioid Use Disorder by Race-Ethnicity: Effects of a Hub-and-Spoke Model. 阿片类药物使用障碍的种族差异变化：中心辐模型的影响。

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 Epub Date: 2025-06-25 DOI: 10.1176/appi.ps.20240373

Maureen T Stewart, Shay M Daily, Lee Panas, Sage R Feltus, Margaret Lee, Grant Ritter, Sharon Reif

{"title":"Differential Changes in Use of Medications for Opioid Use Disorder by Race-Ethnicity: Effects of a Hub-and-Spoke Model.","authors":"Maureen T Stewart, Shay M Daily, Lee Panas, Sage R Feltus, Margaret Lee, Grant Ritter, Sharon Reif","doi":"10.1176/appi.ps.20240373","DOIUrl":"10.1176/appi.ps.20240373","url":null,"abstract":"Objective: The authors examined, separately for different racial-ethnic groups, whether use of medications for opioid use disorder (MOUD) increased more among people treated in a hub-and-spoke care model than among people treated in a non-hub-and-spoke model.Methods: Comparative time-series analyses were performed with Washington State Medicaid claims (2017-2019) data for 115,911 enrollees to investigate MOUD use, stratified by care model and enrollee race-ethnicity.Results: Following implementation of the hub-and-spoke model, the proportions of enrollees with opioid use disorder receiving MOUD increased in all racial-ethnic groups. Buprenorphine use increased more among Black, Hispanic, and White enrollees treated in the hub-and-spoke model than among people of the same race-ethnicities treated in a non-hub-and-spoke model (beta range 0.56-0.93, p<0.05). However, within the hub-and-spoke model, rates of buprenorphine use increased more among White enrollees than among American Indian or Alaska Native (AI/AN) enrollees (β=0.84, p<0.001). Methadone use increased more among AI/AN enrollees treated in the hub-and-spoke model compared with AI/AN enrollees treated in a non-hub-and-spoke model (β=0.39, p<0.001).Conclusions: Following implementation of the hub-and-spoke model, MOUD use increased for Medicaid enrollees of all race-ethnicities. The increase in MOUD use for Black, Hispanic, and White enrollees who received treatment in the hub-and-spoke model was greater than that for people of the same race-ethnicities treated in a non-hub-and-spoke model. Thus, the hub-and-spoke model may be a useful strategy to increase use of MOUD treatment.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"795-800"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487768","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}

引用次数: 0

A Patient-Centered Outcomes Framework for Evaluating Behavioral Health Crisis Care. 以病人为中心的评估行为健康危机护理的结果框架。

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 Epub Date: 2025-06-19 DOI: 10.1176/appi.ps.20250040

Ashlyn Burns, Emily Meanwell, Justin Blackburn, Zachary Adams, Leslie Hulvershorn, Bernice Pescosolido

{"title":"A Patient-Centered Outcomes Framework for Evaluating Behavioral Health Crisis Care.","authors":"Ashlyn Burns, Emily Meanwell, Justin Blackburn, Zachary Adams, Leslie Hulvershorn, Bernice Pescosolido","doi":"10.1176/appi.ps.20250040","DOIUrl":"10.1176/appi.ps.20250040","url":null,"abstract":"Objective: Recent federal investments have accelerated a nationwide transformation of the behavioral health crisis care (BHCC) system, raising pertinent questions about quality and effectiveness. In response to calls to collect more data and define outcomes for assessing BHCC, this study sought to identify patient-centered outcomes (PCOs) from the perspectives of individuals with lived experience of a behavioral disorder and individuals who have delivered BHCC services.Methods: Via a multiphased recruitment approach, qualitative interviews were conducted with 120 stakeholders: peers with lived experience (N=21), direct-service providers (N=47), program directors and managers (N=44), and executive leaders (N=8). All interview transcripts were analyzed by using an open coding approach to generate emerging themes that captured measurable components of BHCC and outcomes of interest meaningful to stakeholders.Results: A PCO framework for evaluating BHCC was developed by mapping emerging themes to a conceptual framework adapted from Donabedian's structure-process-outcome model. Forty-five themes were identified and grouped under five domains: system structure, system implementation, system use, social outcomes, and health outcomes.Conclusions: Although further efforts are needed to engage patients and providers in the process of developing specific measures, this framework provides a starting point for PCO research on BHCC.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"834-845"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328475","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}

引用次数: 0

Evaluation of the Low-Demand Model for Serving Unsheltered Homeless Veterans in Transitional Housing. 过渡性住房服务无庇护退伍军人低需求模式的评价。

IF 3.2

Psychiatric services (Washington, D.C.) Pub Date : 2025-09-01 Epub Date: 2025-08-14 DOI: 10.1176/appi.ps.20240510

Jack Tsai, Youngran Kim, Dorota Szymkowiak, Gabrielle Haley, Rebecca Kinney

{"title":"Evaluation of the Low-Demand Model for Serving Unsheltered Homeless Veterans in Transitional Housing.","authors":"Jack Tsai, Youngran Kim, Dorota Szymkowiak, Gabrielle Haley, Rebecca Kinney","doi":"10.1176/appi.ps.20240510","DOIUrl":"10.1176/appi.ps.20240510","url":null,"abstract":"Objective: The U.S. Department of Veterans Affairs (VA) contracts with community-based agencies to operate its Grant and Per Diem (GPD) transitional housing programs, including a low-barrier model called low demand. This study aimed to compare characteristics and outcomes of unsheltered veterans served by the GPD Low Demand program with those of unsheltered veterans served by two other GPD programs (Clinical Treatment and Service Intensive).Methods: National VA administrative data on 16,059 unique unsheltered veterans who participated in GPD programs in fiscal years 2019-2023 were analyzed. Outcomes examined included rates of positive program exit, returns to homelessness within 12 months, and use of VA health care services before and after program admission.Results: The Low Demand program served a higher proportion of unsheltered veterans than the two comparison programs (36.8% vs. 24.0%-26.8%, respectively). Nearly half (46.4%) of unsheltered veterans in the Low Demand program had positive program exits, but they were significantly less likely to have positive program exits and exits to permanent housing, had a shorter length of stay, and were less likely to have reduced acute care use than unsheltered veterans in the two comparison programs. Veterans who were older, were non-Hispanic Black, and had a moderate VA service-connected disability rating were more likely to have a positive exit from the Low Demand program.Conclusions: These findings reflect challenges experienced in low-barrier programs serving unsheltered individuals, who often have high treatment needs. Unsheltered individuals with certain profiles may benefit more than others from low-barrier programs.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"801-808"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850366","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}

引用次数: 0