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

{"title":"Expanding Access to Specialized Mental Health Services for Youths in Crisis Through a State-Provider-University Partnership.","authors":"Kyrill Gurtovenko, Robyn E Metcalfe, Carlos E Yeguez, Winslow Lewis, Paul Davis, Sarah C Walker","doi":"10.1176/appi.ps.20250318","DOIUrl":"10.1176/appi.ps.20250318","url":null,"abstract":"<p><p>Self-injurious thoughts and behaviors (SITBs) pose a clear risk to adolescents' health and well-being. Although established treatments (e.g., dialectical behavior therapy [DBT]) for youths experiencing SITB exist, numerous challenges reduce the feasibility of delivering such treatments in community-based settings. To address the need for increased access to specialized mental health treatments among youths, a state, provider, and university partnership was developed to codesign and implement a DBT-informed clinical training model within the existing community-based mental health provider teams and service structures.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"898-901"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311300","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":"Unanticipated Effects of Parental Social Media Use: Guidance for Clinicians.","authors":"Alina May Mitchell, Akeem N Marsh, Amy J L Baker, Marla R Brassard","doi":"10.1176/appi.ps.20260078","DOIUrl":"10.1176/appi.ps.20260078","url":null,"abstract":"<p><p>\"Sharenting,\" the practice of parents posting photographs, videos, and information about their children on social media, has an ever-growing presence in modern society. However, researchers and the public are now recognizing the potential consequences of sharing, including creation of permanent digital footprints, strained familial relationships, and threats to children's safety. Despite this emerging evidence, no U.S. clinical or legal guidelines exist for parents on safe sharing. Visits with behavioral health providers and family physicians can serve as key points for intervention. This column aims to provide clinicians with a better understanding of sharenting and its potential effects on patients and families, guidance on discussing safe online sharing, and a tool for parents and other caregivers to use when deciding whether to post.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"887-890"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371789","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 Medicaid Behavioral Health Crisis Reporting: A Multisource Approach to Capturing Crisis Service Events.","authors":"Mustafa Karakus, Michelle Cornette, Victoria Nelson, Peter Lee, Cristian Ilie, Howard H Goldman, Laura House, Sushmita Shoma Ghose","doi":"10.1176/appi.ps.20250564","DOIUrl":"10.1176/appi.ps.20250564","url":null,"abstract":"<p><strong>Objective: </strong>The authors aimed to assess the adequacy of traditional billing codes for capturing behavioral health crisis events and to develop a comprehensive claims-based methodology for identifying such events among Medicaid beneficiaries.</p><p><strong>Methods: </strong>In this retrospective analysis of Medicaid claims data collected from 2016 to 2021, the authors conducted a five-step, multisource approach that incorporated traditional crisis service codes, behavioral health-related encounters in emergency department and urgent care settings, diagnosis codes indicating suicide attempts or intentional self-harm, naloxone administration, and emergency procedures associated with behavioral health diagnoses. Diagnosis, service, and place-of-service indicators were used to identify crisis service events beyond those captured by traditional billing codes.</p><p><strong>Results: </strong>In 2021, traditional crisis billing codes identified 645,940 beneficiaries compared with >2.3 million identified with the expanded approach, capturing <28% of individuals experiencing a behavioral health crisis. From 2016 to 2021, the rate of individuals experiencing a crisis service event increased by 6.6% (from 31.8 to 33.9 per 1,000 beneficiaries), with the largest increases observed for naloxone administration (50.0%) and suicide attempt or self-harm events (14.8%). Compared with traditional codes, the expanded method identified a higher proportion of rural residents, older individuals, and individuals without a formal behavioral health diagnosis.</p><p><strong>Conclusions: </strong>Reliance on traditional crisis billing codes was found to significantly underestimate the true burden of behavioral health crises among Medicaid populations. A multisource approach incorporating diagnosis, service, and place-of-service indicators provides a more accurate and inclusive framework for crisis surveillance, with important implications for evaluating and strengthening behavioral health crisis systems.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"832-838"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311284","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":"Peer Support at a Crossroads: Introducing a New Column on Peer Support Services.","authors":"Dana Foglesong","doi":"10.1176/appi.ps.20260266","DOIUrl":"10.1176/appi.ps.20260266","url":null,"abstract":"<p><p>Peer support services have expanded rapidly across mental health and substance use systems in the United States. With this growth has come increased policy recognition, workforce development, and integration into clinical and community settings. At the same time, fundamental questions about the nature and implementation of peer support have intensified. This column focuses on examining these questions. The new Peer Support Services column will provide analysis and practical insight into the evolving application of peer support, with attention to the tensions between expansion and fidelity, standardization and authenticity, and integration and independence. The column is intended to inform clinicians, administrators, policymakers, and researchers working to strengthen the quality and impact of peer support services.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"884-886"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623787","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 Disclosure Gap: AI's Potential Role in Suicide Prevention.","authors":"Molly I Ball, Evan M Kleiman","doi":"10.1176/appi.ps.20250521","DOIUrl":"10.1176/appi.ps.20250521","url":null,"abstract":"<p><p>Conversational artificial intelligence (AI) tools-specifically, general-purpose large language models-are increasingly used by individuals to disclose suicidal thoughts. Although these platforms can assess suicide risk with growing accuracy, they are not reliably equipped to respond effectively and often even provide harmful or unsafe guidance. Current AI systems fail to motivate disclosure of suicide risk to another person, a necessary step for safety and support. The authors draw attention to this gap and argue for the need to integrate disclosure-focused interventions into AI tools, offering an empirically grounded direction for developers and policymakers to advance suicide prevention in the context of this rapidly evolving technology.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"891-893"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261311","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 Missing Partners in Measurement-Based Care.","authors":"David Wiercigroch, Matthew E Hirschtritt","doi":"10.1176/appi.ps.26077021","DOIUrl":"https://doi.org/10.1176/appi.ps.26077021","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":"77 9","pages":"808"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868968","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":"Inpatient Hospital Admissions for Mental Health in the United States: Medicaid Compared With Private Insurance.","authors":"Chenyu Sun, Li Liu, Qiyang Pan, Laura E Billstein, Tuan Vinh, Abigail Fickel, Youyou Cheng, Jay-Sheree A Akambase, Kodjo M Bossou, Elizabeth H Lees","doi":"10.1176/appi.ps.20250725","DOIUrl":"10.1176/appi.ps.20250725","url":null,"abstract":"<p><strong>Objective: </strong>Differences in mental health services covered by U.S. insurance payers are a public health concern. Mental health benefits are required under the Affordable Care Act, and parity laws have long aimed to ensure equitable access across insurance types. The authors examined the association between insurance coverage (Medicaid or private), hospitalization for a principal psychiatric diagnosis, and patient outcomes.</p><p><strong>Methods: </strong>A retrospective cross-sectional analysis was conducted by using the 2017-2019 Nationwide Inpatient Sample for adults ages 18-64 with Medicaid or private insurance. Mental disorders, length of stay (LOS), hospital charges, and in-hospital mortality rates were analyzed. Survey-weighted multivariable regressions adjusted for demographic characteristics, hospital characteristics (i.e., region and size as number of beds), and somatic comorbid conditions were performed.</p><p><strong>Results: </strong>Among 7,428,110 unweighted hospital discharges (weighted=37.1 million), 11.9% of Medicaid and 5.5% of privately insured hospitalizations (610,394 unweighted and 3,051,969 weighted discharges) involved a principal psychiatric diagnosis (adjusted OR=2.35, 95% CI=2.25-2.44, p<0.001). Compared with private insurance, Medicaid was associated with a longer LOS and higher charges among hospitalizations for a principal psychiatric diagnosis. Subgroup analyses revealed longer LOS and higher charges for major depressive, substance use, and posttraumatic stress disorders. For anxiety disorders, longer LOS under Medicaid was not associated with higher charges. No differences in in-hospital mortality rate were identified.</p><p><strong>Conclusions: </strong>Compared with private insurance, Medicaid was found to cover a higher proportion of hospitalizations for a principal psychiatric diagnosis, longer LOS, and higher cost. These findings likely reflect differences in patient needs but may also be due to programmatic differences.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"816-823"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261294","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":"Discharge From Coordinated Specialty Care: Timing, Reasons, and Predictors in a National Early Psychosis Network.","authors":"Sümeyra N Tayfur, Jenifer L Vohs, Serena Chaudhry, Zhiqian Song, Fangyong Li, Nicholas J K Breitborde, John Cahill, Stephan Heckers, Audrey Satchivi, Steve Silverstein, Stephan F Taylor, Ivy F Tso, Ashley Weiss, Alan Breier, Vinod H Srihari","doi":"10.1176/appi.ps.20260106","DOIUrl":"10.1176/appi.ps.20260106","url":null,"abstract":"<p><strong>Objective: </strong>Retention in coordinated specialty care (CSC) is critical for optimizing outcomes of first-episode psychosis, yet discharge from CSC is heterogeneous and poorly characterized. This study aimed to examine the timing of, reasons for, and predictors of discharge in a large early psychosis intervention network.</p><p><strong>Methods: </strong>Data were drawn from the Academic-Community Early Psychosis Intervention Network. Participants (N=701) were followed for up to 36 months after CSC admission. Discharges were classified as positive, ambiguous, or adverse. Kaplan-Meier and competing-risk Cox models were used to examine time to discharge and baseline predictors, respectively.</p><p><strong>Results: </strong>Over 36 months, 44% of participants were discharged. Ambiguous discharges were most common (55% of discharges), followed by adverse (28%) and positive (17%) discharges. Twenty-five percent of participants were discharged by 10 months. Positive discharge was associated with commercial insurance (hazard ratio [HR]=3.48, p=0.001) and weekly family contact (HR=3.96, p=0.02). A longer duration of untreated psychosis (HR=1.18, p=0.002), prior hospitalization (HR=1.66, p=0.03), and cannabis use (HR=1.81, p=0.005) increased the risk for ambiguous discharge, whereas living with family (HR=0.51, p=0.03) and older age (HR=0.93, p=0.008) were protective. Legal involvement increased the risk for adverse discharge (HR=2.40, p=0.02), whereas antipsychotic use at admission was protective (HR=0.55, p=0.02).</p><p><strong>Conclusions: </strong>Discharge from CSC programs reflects distinct clinical and structural pathways. Findings from this study highlight the need for early engagement strategies, improved discharge documentation, and strong transition supports to promote continuity of care in early psychosis services.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20260106"},"PeriodicalIF":3.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148836032","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":"The Recovery Mindset: Psychosocial Rehabilitation Education for Psychiatric Residents With Peer Specialists as Coeducators.","authors":"Wonyun Lee, Ali Imam Awan, Vivian Nguyen, Bhagyashree Patil, Eslam Elhossieny, Nikesh Shah, Maria Bodic","doi":"10.1176/appi.ps.20250691","DOIUrl":"https://doi.org/10.1176/appi.ps.20250691","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the impact of a targeted educational intervention on psychiatric residents' knowledge, attitudes, and behaviors related to psychosocial rehabilitation (PSR), as well as peer support referral rates.</p><p><strong>Methods: </strong>This quality improvement project used the plan-do-study-act framework to deliver five didactic sessions on PSR and peer support over 1 academic year, including two sessions co-led by certified peer specialists. Pre- and postintervention surveys captured changes in residents' knowledge, attitudes, and behaviors. Referral data were obtained from administrative records for equivalent 2-month periods before and after the intervention. Chi-square tests were used to evaluate differences in referral rates.</p><p><strong>Results: </strong>Peer support referrals increased from 6% to 19% (χ²=17.63, N=484, df=1, p<0.001). Resident-reported referrals increased from 9% to 60%. Confidence discussing PSR increased from 48% to 76%.</p><p><strong>Conclusions: </strong>A brief educational intervention incorporating peer specialist collaboration improved residents' referral practices, knowledge, and attitudes toward recovery-oriented care.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250691"},"PeriodicalIF":3.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148836046","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":"An Evidence-Informed Framework for Treating National Mass Trauma During Ongoing War.","authors":"Rony Kapel Lev-Ari, Doron Amsalem, Milton Wainberg, John C Markowitz, Shilat Haim-Nachum, Maja Bergman, Lisa A Brener, Alexandra Klein Rafaeli, Nitsa Nacasch, Dana Tzur Bitan, Omer Sedoff, Dana Alberg, Hila Almagor Attias, David Roe, Dana Katsoty, Yossi Levy-Belz, Ido Lurie, Yuval Neria, Shlomo Mendlovic","doi":"10.1176/appi.ps.20250643","DOIUrl":"https://doi.org/10.1176/appi.ps.20250643","url":null,"abstract":"<p><p>The October 7, 2023, attack on Israel and the ensuing war created widespread distress and an urgent need for trauma-informed mental health care. This article describes \"Homiyah,\" a nationwide Israeli initiative led by local and international psychiatry, psychology, and trauma care experts to promote evidence-based treatment during ongoing mass trauma. The framework, developed in response to unprecedented events, began with nationwide training of public-sector mental health professionals (N=153) in evidence-based, trauma-informed care. Subsequently, experts refined training, expanded initial workshops into semiweekly clinical meetings, used a train-the-trainer model, and identified clinical leaders to guide teams with biweekly online peer consultation. Next, the initiative focused on developing evidence-based guidelines for trauma care centers and screening protocols to support a personalized approach to trauma care, integrating routine outcome monitoring to inform treatment decisions and improve effectiveness through patient-reported outcome measures and measurement-based care. Finally, national stakeholder engagement was achieved through a 2-day consensus conference and the dissemination and implementation of guidelines across the mental health system. This scalable, evidence-informed model demonstrates how interdisciplinary collaboration, rapid mobilization, and implementation science can translate research into practical clinical responses to strengthen recovery, resilience, and mental health system readiness under mass trauma conditions.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"appips20250643"},"PeriodicalIF":3.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762445","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}