{"title":"Generosity of States' Medicaid Home and Community-Based Programs for Youths With Complex Mental Health Needs.","authors":"Genevieve Graaf, Monica Cañizares, Douglas Leslie","doi":"10.1176/appi.ps.20250005","DOIUrl":"https://doi.org/10.1176/appi.ps.20250005","url":null,"abstract":"<p><strong>Objective: </strong>Medicaid's Home and Community-Based Services (HCBS) waiver programs, authorized by section 1915(c) of the Social Security Act, are widely used to finance care for individuals experiencing complex health needs. Programs for youths experiencing complex behavioral health needs are less numerous and comprehensive than are programs for other populations, and little is known about variations in coverage and benefits across states. This study aimed to quantify and compare the benefits of different states' HCBS waiver programs for youths experiencing behavioral health needs.</p><p><strong>Methods: </strong>States' initial, renewal, and amendment applications (2006-2022) for HCBS waiver programs for youths experiencing behavioral health needs were collected from states and the Centers for Medicare and Medicaid Services. Data collected included the following elements that were used to construct the Generosity Index-a monthly measure of program generosity-for each state: annual costs per person, maximum number of participants, cost limits, age ranges related to eligibility, services covered, service limits, geographic exclusions, allowances for participant-directed care, and authorizations for family members to provide care.</p><p><strong>Results: </strong>Consistent with studies examining section 1915(c) waiver programs for youths with other types of complex health needs, characteristics of programs for youths experiencing behavioral health needs varied substantially across states and evolved over time. Wisconsin consistently provided the most generous benefits and coverage (index score=1.64 in 2022), whereas substantial declines in program generosity were observed at certain times in Wyoming and Kansas.</p><p><strong>Conclusions: </strong>Heterogeneity among mental health waiver programs for youths must be accounted for in assessing the impacts of waiver policies.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250005"},"PeriodicalIF":3.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747063","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}
Kathryn K Ridout, Erik Vanderlip, Andrew D Carlo, Bashkim Kadriu, Cecilia Livesey, John Torous, Carol Alter
{"title":"Considerations for Implementation of Measurement-Based Care: Focus on Solo and Small-Group Practitioners.","authors":"Kathryn K Ridout, Erik Vanderlip, Andrew D Carlo, Bashkim Kadriu, Cecilia Livesey, John Torous, Carol Alter","doi":"10.1176/appi.ps.20240372","DOIUrl":"10.1176/appi.ps.20240372","url":null,"abstract":"<p><p>Measurement-based care (MBC) is the structured process of repeatedly assessing patient-reported outcomes, including recovery, quality of life, function, satisfaction, and psychiatric symptomatology, to inform the process of care. Backed by years of experience and scientific evidence, the use of standardized rating scales in psychiatric practice is associated with significant gains in the efficiency of care delivery, achievement of superior clinical outcomes, and improved patient wellness and experience. Private and public payers increasingly require evidence of MBC implementation across practice settings to satisfy reimbursement criteria, and accreditation bodies are adding routine use of symptom measures to their requirements for ongoing accreditation. Several technological advances have improved the tracking of symptoms as part of routine clinical care. Despite increased calls for the adoption of MBC, the psychiatric field has been slow to implement MBC in routine practice. In 2023, the American Psychiatric Association's Board of Trustees approved as a resource document a report by the Council on Quality Care, \"Implementation of Measurement-Based Care.\" This article reviews this resource document, including the rationale and evidence behind MBC; highlights payment and practice incentives to entice clinicians to consider more consistent MBC implementation; and describes strategies and best practices to aid MBC adoption.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"665-674"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228422","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":"Early Psychosis Intervention, Part 1: Addressing Inequities in Access to and Outcomes of Early Intervention Programs.","authors":"Beatrice Todesco, Nicole Kozloff, Lisa B Dixon","doi":"10.1176/appi.ps.25076010","DOIUrl":"https://doi.org/10.1176/appi.ps.25076010","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"76 7","pages":"702"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532871","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":"From Data to Action: Scaling Early Intervention Services.","authors":"Samuel R Bunting","doi":"10.1176/appi.ps.25076011","DOIUrl":"https://doi.org/10.1176/appi.ps.25076011","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"76 7","pages":"619"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532872","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 Gap From Efficacy to Effectiveness to Reduce Duration of Untreated Psychosis.","authors":"Mark A Sanders, Matthew E Hirschtritt","doi":"10.1176/appi.ps.25076009","DOIUrl":"https://doi.org/10.1176/appi.ps.25076009","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"76 6","pages":"535-536"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251971","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":"Rapprochement and Reform: Overcoming Factionalism: Response to Commentaries.","authors":"William R Smith, Dominic A Sisti","doi":"10.1176/appi.ps.22073013","DOIUrl":"https://doi.org/10.1176/appi.ps.22073013","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"1312"},"PeriodicalIF":3.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40460479","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}
Laysha Ostrow, Judith A Cook, Mark S Salzer, Morgan Pelot, Jane K Burke-Miller
{"title":"Employment Outcomes After Certification as a Behavioral Health Peer Specialist in Four U.S. States.","authors":"Laysha Ostrow, Judith A Cook, Mark S Salzer, Morgan Pelot, Jane K Burke-Miller","doi":"10.1176/appi.ps.202100651","DOIUrl":"https://doi.org/10.1176/appi.ps.202100651","url":null,"abstract":"<p><strong>Objective: </strong>A 3-year study explores employment outcomes of certified peer specialists (CPSs). Analyses reported here identified relationships between demographic, clinical, work history, and geographic characteristics and employment status and current employment in peer services jobs versus other jobs.</p><p><strong>Methods: </strong>The study recruited adults who recently became a CPS, regardless of current employment status, in four states. Online survey data were collected from March to October 2020 and included demographic information, health status and diagnoses, mental health service use, motivations for becoming certified, employment history, and job characteristics, including job satisfaction. Descriptive statistics and logistic regression models were used to compare groups.</p><p><strong>Results: </strong>Of 681 respondents, 591 provided data on current employment and were included. Participants who received Social Security Disability Insurance or Supplemental Security Income, veterans, those who used outpatient counseling or therapy, and those who did not disclose their mental health status in the workplace were less likely to report current employment. Lack of disclosure and higher local unemployment rates contributed to a lower likelihood of working in peer services jobs, whereas individuals reporting depressive disorders were more likely to hold such jobs. Compared with those in other jobs, those in peer services jobs reported longer job tenure, and a larger proportion received employee benefits. Job satisfaction was significantly higher among those with peer services jobs.</p><p><strong>Conclusions: </strong>Workers with a CPS credential had higher employment rates, compared with adults with psychiatric disabilities, and the quality of peer specialist jobs was equal to or higher than the quality of other jobs held by study participants.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"1239-1247"},"PeriodicalIF":3.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40239093","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}
Evan V Goldstein, Elise V Bailey, Fernando A Wilson
{"title":"Discrimination and Suicidality Among Hispanic Mental Health Patients, 2010-2020: A Natural Language Processing Approach.","authors":"Evan V Goldstein, Elise V Bailey, Fernando A Wilson","doi":"10.1176/appi.ps.20220240","DOIUrl":"https://doi.org/10.1176/appi.ps.20220240","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"1313-1314"},"PeriodicalIF":3.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40453646","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}