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

{"title":"Trauma on the Front Lines: Violence Exposure Across Disciplines in an Inpatient Psychiatric Hospital.","authors":"Stephanie Emhoff, Kelly Kearney, Sarah Hernandez, Calvary Fielden, Ana Ruiz, Elaheh Ashtari","doi":"10.1176/appi.ps.20250602","DOIUrl":"https://doi.org/10.1176/appi.ps.20250602","url":null,"abstract":"<p><strong>Objective: </strong>Inpatient psychiatric health care workers are at high risk for exposure to workplace violence, with nurses and psychiatric technicians particularly vulnerable because of frequent direct patient contact. Despite growing awareness of this issue, limited research has examined how violence exposure differs across professional disciplines and how such exposure affects staff members' well-being. This study aimed to compare rates of violence exposure across staff disciplines in an inpatient psychiatric hospital and examine associations between trauma exposure and staff psychological well-being.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted at a 274-bed inpatient psychiatric hospital in Texas. Using a modified version of the Staff Workplace Experiences Questionnaire, 142 staff members reported their experiences of workplace violence and related emotional impacts. Participants were grouped by level of patient contact (high, moderate, or low direct care), and multiple regression analyses were used to assess relationships between discipline and trauma exposure and well-being indicators (e.g., helplessness or perceived support).</p><p><strong>Results: </strong>Staff in high direct care roles (nurses and psychiatric technicians) reported significantly higher rates of trauma exposure (total, witnessed, and experienced) than those in moderate or low direct care roles. High direct care staff also reported increased feelings of fear, helplessness, and being very upset and decreased perceptions of safety and support. Across disciplines, higher trauma exposure was associated with increased psychological distress and lower perceived support.</p><p><strong>Conclusions: </strong>These findings highlight the disproportionate burden of trauma on direct care psychiatric staff and underscore the need for trauma-responsive organizational strategies and specific interventions to reduce violence exposure and support staff well-being.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682061","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":"Intersection of Race and Ethnicity With Social Determinants of Health in Access to Treatment for Alcohol Use Disorder in 2023.","authors":"Alyssa Burnett, Bryant Shuey, Stephanie Argetsinger, Matthew Lakoma, Emily C Williams, Benjamin G Druss, J Franklin Wharam, Hefei Wen","doi":"10.1176/appi.ps.20250157","DOIUrl":"10.1176/appi.ps.20250157","url":null,"abstract":"<p><strong>Objective: </strong>The COVID-19 pandemic exacerbated health disparities and increased alcohol use and its health consequences. Although prepandemic research identified racial and ethnic disparities in receipt of alcohol use disorder treatment, few studies have described postpandemic disparities or have assessed the role social determinants of health (SDOHs) may play in these inequities. The authors examined how rates of treatment for alcohol use disorder differ by race and ethnicity, SDOHs, and at the intersection of both.</p><p><strong>Methods: </strong>In this cross-sectional analysis, the authors used a nationally representative sample of 5,785 U.S. adults with past-year alcohol use disorder from the 2023 National Survey on Drug Use and Health (NSDUH). Multivariable logistic regression models were used to estimate the probability of any past-year alcohol use disorder treatment overall, by the intersection of race and ethnicity with 20 SDOH subcategories, and across treatment settings.</p><p><strong>Results: </strong>Only 9.6% of adults with alcohol use disorder in the NSDUH received any treatment in 2023. Compared with other racial and ethnic groups, non-Hispanic Black or African American adults had the lowest probability of receiving treatment for alcohol use disorder overall and in the stratified analyses of nine of 20 SDOH subcategories.</p><p><strong>Conclusions: </strong>These findings highlight significant disparities in the receipt of treatment for alcohol use disorder among non-Hispanic Black or African American adults, generally concentrated within the more vulnerable SDOH categories. These results underscore a critical need for clinically and culturally nuanced policies and practices tailored to specific populations with health disparities.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682021","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":"Prescription Contraception Use Among Psychiatric Inpatients.","authors":"Kierstin S Utter, Bronwyn L Marques, Jonathan Leung, Kathryn M Schak, Melanie T Gentry, Katherine M Moore, Hannah K Betcher","doi":"10.1176/appi.ps.20250282","DOIUrl":"10.1176/appi.ps.20250282","url":null,"abstract":"<p><strong>Objective: </strong>Mental health symptoms are known to affect contraceptive behavior. Psychiatrically hospitalized patients-those with severe symptoms-are a unique population that may have distinct patterns of contraception use; however, relevant data are currently lacking. This data paucity is notable, given the complex considerations of this population-including potential exposure to medications that are teratogens or interact with contraception. This study aimed to assess patterns of prescription contraception (PC) use and help guide contraceptive counseling in inpatient psychiatric settings.</p><p><strong>Methods: </strong>The study was a retrospective chart review that included all biologically female patients ages 18-45 years who were admitted to inpatient behavioral health care from 2017 to 2023 (N=1,258). Patients were separated into PC users and nonusers. Data regarding diagnoses, medications, demographic characteristics, and general medical health were abstracted. The authors measured odds ratios (ORs) of PC use for variables of interest.</p><p><strong>Results: </strong>PC, used by 42% of included patients, was significantly positively associated with younger age (OR=1.60, p<0.01), single marital status (OR=1.56, p<0.01), lithium (OR=1.53, p=0.02) and antidepressant (OR=1.48, p=0.03) use, and borderline personality disorder diagnosis (OR=1.42, p<0.01). The most prescribed form of PC was an oral contraceptive pill, followed by an intrauterine device.</p><p><strong>Conclusions: </strong>This study identified distinct PC use patterns among psychiatrically hospitalized patients. These findings emphasize the importance of psychiatrists providing contraceptive counseling and prescribing contraception, both during hospitalization and at discharge-particularly for patients receiving teratogenic medications such as valproic acid.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"739-744"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978522","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":"Integrating Mental Health and Social Care in Transitional Housing: Horizon Health and Housing Partnership.","authors":"Ericka Agostini, Nicolas Franck, Guillaume Barbalat","doi":"10.1176/appi.ps.20250517","DOIUrl":"10.1176/appi.ps.20250517","url":null,"abstract":"<p><p>Horizon Health and Housing is an innovative partnership in Lyon, France, that addresses the needs of homeless individuals experiencing mental illness and living in transitional housing centers. This partnership involves close collaboration between social workers and mental health specialists working onsite. Together, these providers deliver coordinated care for homeless people discharged from the local psychiatric hospital, as well as for residents with unmet mental health needs. Since its launch in 2019, the partnership has yielded valuable lessons for improving psychiatric care and has had positive impacts on mental health and social outcomes for individuals in this marginalized population.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"798-801"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702005","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":"Neighborhood Opportunity and Mental Health-Related Hospitalization Rates Among Children and Youths in 12 U.S. States.","authors":"Ankita T Gupta, Matthew Hall, Mert Sekmen, Derek J Williams, Alison R Carroll, Sabrina E Carro, Heather Kreth, David P Johnson, Kelsey A B Gastineau, James W Antoon, Katherine S Spencer, Alison Herndon, Stephanie K Doupnik","doi":"10.1176/appi.ps.20250548","DOIUrl":"10.1176/appi.ps.20250548","url":null,"abstract":"<p><strong>Objective: </strong>Using the Child Opportunity Index (COI) 3.0 and mental health-related hospitalization rates among children and youths, the authors examined whether hospitalization rates were significantly associated with neighborhood conditions.</p><p><strong>Methods: </strong>In this cross-sectional, population-based study, the authors analyzed mental health-related hospitalizations among children and youths (5-24 years) from 12 U.S. states by using data from the 2021 State Inpatient Databases and U.S. Census. The exposure was ZIP code-level COI 3.0, with an outcome of mental health hospitalization incidence rate per 10,000 population. Mental health hospitalizations included a primary psychiatric diagnosis indexed in the <i>DSM-5</i>. Hospitalization rates were estimated overall, by state, and by 10 psychiatric diagnosis categories. Differences across COI quintiles were examined with negative binomial regression models.</p><p><strong>Results: </strong>Among 21,156,318 children and youths, 157,641 were hospitalized for mental health problems, corresponding to an incidence rate of 74.5 per 10,000 population. The hospitalization rate (per 10,000 children and youths) was highest in the very low-COI quintile (incidence rate=76.9, 95% CI=73.4-80.5) and lowest in the very high-COI quintile (incidence rate=67.3, 95% CI=64.8-69.9). Trends were consistent within psychiatric diagnosis categories, except for anxiety disorders, which showed a positive correlation between COI level and hospitalization rates. Hospitalization rates varied significantly among states (ranging from 34 to 135 per 10,000 youths, in Oregon and Kentucky, respectively).</p><p><strong>Conclusions: </strong>Children and youths residing in lower-opportunity neighborhoods had higher mental health-related hospitalization rates, which varied by state and psychiatric diagnosis. Future research to understand the reasons for these variations across COI levels could inform programs to avoid mental health-related hospitalizations.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"745-751"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849219","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 Impact of a Psychiatric Home Care Program on Mental Health Services Utilization and Costs in Spain.","authors":"Ana María Besoaín-Cornejo, Ignacio Aznar-Lou, Luisa Baladón Higueras, Maria Rubio-Valera","doi":"10.1176/appi.ps.20240578","DOIUrl":"10.1176/appi.ps.20240578","url":null,"abstract":"<p><p>Crisis resolution and home treatment (CRHT) is a home-based alternative to acute psychiatric hospitalization. A retrospective cohort study in Spain measured the impact of CRHT on mental health resource utilization, comparing emergency department (ED) visits, acute admissions, and length of stay. The authors compared three CRHT catchment areas (N=298,935 adults) with three control areas without CRHT (N=157,334 adults). The mean cost of CRHT was compared with that of inpatient hospitalization. Results showed that CRHT models may be associated with a reduction in ED visits and potentially lower mean costs per stay; however, these findings were not statistically significant. Further research is needed to confirm the long-term benefits of CRHT.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"802-806"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038962","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":"Psychiatric Hospitalization Among Adults With Intellectual and Developmental Disability.","authors":"Ellie K Kogan, Hillary Samples, Elizabeth M Stone","doi":"10.1176/appi.ps.20250585","DOIUrl":"10.1176/appi.ps.20250585","url":null,"abstract":"<p><strong>Objective: </strong>The authors examined psychiatric hospitalizations among adults with mental illness, by intellectual and developmental disability (IDD) diagnosis.</p><p><strong>Methods: </strong>MarketScan Multi-State Medicaid Database claims from 2016 to 2023 were used in measuring annual rates of psychiatric hospitalization among adults with mental illness with and without IDD and by IDD diagnosis. The authors made comparisons using generalized estimating equation models.</p><p><strong>Results: </strong>A total of 2,718,432 adults with mental illness were identified in claims from 2016 to 2023; 5.1% (N=137,916) had IDD. Annual rates of psychiatric hospitalization were higher among those with IDD. In adjusted models, adults with IDD had decreased odds of psychiatric hospitalization (adjusted odds ratio=0.80, 95% CI=0.79-0.81, p<0.001). Factors associated with psychiatric hospitalization were consistent across groups.</p><p><strong>Conclusions: </strong>Despite higher rates of psychiatric hospitalization, adults with IDD are less likely to be hospitalized than other adults with the same clinical and demographic characteristics.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"772-775"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221740","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":"When Treatment Becomes Fate.","authors":"Michael Elwan","doi":"10.1176/appi.ps.20260292","DOIUrl":"10.1176/appi.ps.20260292","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"784-785"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221715","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":"When Billing Codes Fall Short: Unbillable Time in Collaborative Care for Co-occurring Opioid Use and Mental Health Conditions.","authors":"Rebecca L Weir, Lia Pak, Colleen M McCullough, Grace M Hindmarch, Sapna J Mendon-Plasek, Beth Ann Griffin, Katherine E Watkins, Alex R Dopp","doi":"10.1176/appi.ps.20250715","DOIUrl":"10.1176/appi.ps.20250715","url":null,"abstract":"<p><strong>Objective: </strong>Considerable time spent on delivering the collaborative care model (CoCM) for patients with co-occurring opioid use and mental health conditions is not billable under relevant billing codes for Medicare or Medicaid behavioral health integration. In this follow-up study, the authors explored associations between patients' characteristics and the likelihood of receiving unbillable services.</p><p><strong>Methods: </strong>Billable time was estimated by applying billing code rules to documentation of CoCM delivery from a clinical trial (N=381 patients). Multivariate logistic regressions revealed patient characteristics associated with receiving >15 minutes in ≥1 months of unbillable outreach before CoCM engagement or care time that exceeded code maxima.</p><p><strong>Results: </strong>Overall, 43% of the patients received unbillable outreach, and 59% exceeded billable time. Health system, age, stimulant use, and worry about housing were significantly or marginally associated with exceeding billable time; health system also predicted unbillable outreach.</p><p><strong>Conclusions: </strong>Policymakers should consider modifying CoCM billing codes to adequately reimburse efforts to engage and serve this complex patient population.</p>","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"767-771"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795742","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 Blessings and Curses of Medications.","authors":"Sarah M Gunther","doi":"10.1176/appi.ps.20260288","DOIUrl":"10.1176/appi.ps.20260288","url":null,"abstract":"","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"782-783"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153066","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}