Administration and Policy in Mental Health and Mental Health Services Research最新文献

{"title":"Clinical Supervision Models for Non-specialist Providers Delivering Psychotherapy: A Qualitative Analysis.","authors":"Nicole Andrejek, Paula Ravitz, Kaspars Mikelsteins, Laura La Porte, J Jo Kim, Crystal E Schiller, Mae Lynn Reyes-Rodríguez, Lucy C Barker, Cindy-Lee Dennis, Richard K Silver, Samantha Meltzer-Brody, Daisy R Singla","doi":"10.1007/s10488-025-01450-1","DOIUrl":"https://doi.org/10.1007/s10488-025-01450-1","url":null,"abstract":"<p><p>Trained non-specialist providers (NSPs), with no formal degree in mental healthcare, can deliver effective psychotherapies for task-sharing. Clinical supervision is important in this process to facilitate quality-assured psychotherapy. We explored three group supervision models within a large, multi-site trial that leveraged NSPs to deliver a brief psychotherapy. In-depth, semi-structured interviews with NSPs (n = 15) explored facilitators and barriers of group supervision models in a stepwise approach, that progressed from expert-led to peer-led, with monthly measurement-based supervision throughout. A focus group on measurement-based supervision was also conducted with clinical experts who provided supervision (n = 4). Qualitative data were analyzed using content and thematic analysis. In expert-led supervision, perceived facilitators among NSPs (n = 15) included educational and professional development (n = 14/15, 93.33%), emotional support (n = 11/15, 77.33%), and expert advice in specific delivery techniques (n = 4/15, 26.67%). A barrier was scheduling (n = 6/15, 40.00%). In peer-led supervision, perceived facilitators among participating NSPs (n = 12) included learning opportunities with peers from diverse backgrounds (n = 10/12, 83.33%), fostering peer connections (n = 9/12, 75.00%), and professional growth (n = 6/12, 50.00%). Barriers included reduced structure (n = 6/12, 50.00%) and attendance (n = 3/12, 25.00%). In measurement-based supervision, reported facilitators included listening to peer's audio-recorded sessions (n = 14/15, 93.33%), receiving and providing feedback (n = 13/15, 86.67%), and the supervision model's structure and tools (n = 5/15, 33.33%). Barriers included low self-ratings (n = 12/15, 80.00%) and initial uncertainty on how to provide constructive feedback (n = 6/15, 40.00%). These facilitators and barriers were also reported by the clinical experts (n = 4). Our results highlight the need to produce clear and concrete guidelines to facilitate peer-led and measurement-based supervision, which will support the implementation of task-sharing.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge Access to Action: Care Extender Models to Promote Youth Mental Health in Under-Resourced Schools.","authors":"A C Goodman, K N Bryant, E M Schiavone, R R Ouellette, A S Gutierrez, R Millan, S L Frazier","doi":"10.1007/s10488-025-01449-8","DOIUrl":"https://doi.org/10.1007/s10488-025-01449-8","url":null,"abstract":"<p><p>One school psychologist is recommended for every 500 students; in practice there is ~one school psychologist for every 1,500-2,000 students. Care extenders can help decrease the number of students needing one-on-one support by implementing universal mental health prevention and promotion practices. Their impact and success relies on empirically informed models for workforce support. The present study extends partnership with City Year Miami, an education non-profit that supports students in low-performing public schools to stay on-track and on-time to graduation. We delivered four weekly 1-hour sessions of Cognitive Triangle training (i.e., brief training applying the Triangle to promote staff and youth emotional well-being) to their AmeriCorps Members (ACMs, n = 19) and collected three sources of data: (1) pre-training quantitative survey data (n = 14 to inform qualitative inquiry), (2) training-generated data (e.g., attendance, text nudge replies), and (3) post-training semi-structured interviews with ACMs (n = 13, ~60 min). We used theoretical thematic analysis to explore, \"What will it take to infuse mental health knowledge into routine practice?\" informed by the Consolidated Framework for Implementation Research emphasis on provider characteristics and perceptions of mental health knowledge. Results illustrate the interplay between innovation and individual characteristics for infusing knowledge into student support routines. Discussion points to findings advancing the science of transportability and workforce support.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Capacity to Treat First Episode Psychosis with a Hybrid Telemental Health Delivery Model: A Needs Assessment of Ohio Community Mental Health Centers.","authors":"Brian P O'Rourke, Jennifer L Hefner, Nicholas J K Breitborde, Vicki L Montesano, Kraig Knudsen, Tory H Hogan","doi":"10.1007/s10488-025-01437-y","DOIUrl":"10.1007/s10488-025-01437-y","url":null,"abstract":"<p><p>Coordinated specialty care (CSC) is considered the gold-standard treatment for individuals experiencing first episode psychosis (FEP). However, CSC teams are resource-intensive, motivating the development of a hybrid delivery approach where community mental health centers (CMHCs) collaborate with an academic medical center to deliver a mix of in-person and virtual services. To inform the development of this hybrid approach, a needs assessment was conducted, evaluating the existing capacity of Ohio CMHCs to treat FEP and identifying barriers to expanded use of telemental health. CMHC administrators throughout Ohio whose agencies primarily provide mental health services were surveyed using a novel instrument. A concurrent mixed methods approach combined multivariable analysis of cross-sectional survey data with thematic coding of responses to open-ended questions. The 56 responding CMHCs on average offered 10.96 of 17 services associated with CSC for FEP. Agency size was positively associated with number of service offerings, but rurality was not. Most agencies perceived gaps in their care for patients with FEP, particularly rural CMHCs. 75% believed that telemental health service expansion would benefit patients. Thematic analysis revealed three success factors for expanded telemental health usage: adapting care to virtual assessment, ensuring patient access, and adjusting workflows for virtual delivery. Responding CMHCs generally agreed that care for individuals with FEP could be improved and saw potential in expanded use of virtual services. Hybrid models may represent a valuable opportunity to overcome conventional barriers to CSC availability, but their development must account for current CMHC resource infrastructure and workflows.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":"584-593"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Leaves from Inpatient Care Among Individuals with Traumatic Life Events in Ontario, Canada.","authors":"Danielle Fearon, John P Hirdes, Scott Leatherdale, Christopher M Perlman","doi":"10.1007/s10488-025-01431-4","DOIUrl":"10.1007/s10488-025-01431-4","url":null,"abstract":"<p><p>Psychological trauma is a prevalent mental health concern, with most individuals experiencing at least one traumatic event in their lifetime. Early leaves from inpatient settings are a pertinent challenge among persons who have experienced trauma and may reflect unmet care needs. This study examined patterns of early leaves among persons with trauma from inpatient care in Ontario, Canada. All records for individuals who have experienced trauma with an index admission of over 72 h between January 1, 2015 and December 31, 2019 were included (N = 11,043). Logistic regression using generalized equation estimation was used to assess the association between demographic and clinical characteristics, substance use, social relationships, staff dynamics, and control interventions with the outcome of early leaves. In the final model, alcohol (OR: 1.83, 95% CI: 1.27-2.64), other substances (OR: 2.15, 95% CI: 1.34-3.46), and poly substance use (OR: 2.46, 95% CI: 1.82-3.31) all increased the odds of early leaves after considering possible facility effects, and after adjusting for other demographic and clinical factors. Being older, employed, and having mood disorders reduced odds of early leaves. Early leaves are important within treatment planning, particularly in relation to addressing complex traumas. While challenges related to substance use may be driving some of the early leaves, there may also be challenges to providing complex care within acute mental health settings. Further exploration of policies and practices to prevent early leaves are necessary, including the potential need for longer-term specialized treatment programs.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":"533-541"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Model for Understanding Lived Expertise to Support Effective Recruitment of Peer Roles.","authors":"Louise Byrne, Helena Roennfeldt","doi":"10.1007/s10488-024-01424-9","DOIUrl":"10.1007/s10488-024-01424-9","url":null,"abstract":"<p><p>Peer roles have increased within mental health and alcohol and other drug services. However, there is a lack of understanding about the 'lived experience' necessary for success in these roles and how to recruit effectively. This study explores participants' views on the essential knowledge and skills derived from lived experience to inform the design of peer roles and support effective recruitment. This qualitative study involved 132 participants employed across five multi-disciplinary organizations in the United States. Participants represent three cohorts: designated peer workers, management, and colleagues in other roles. Fourteen focus groups and eight individual interviews were conducted, with separate focus groups for peers, colleagues in non-designated roles, and management. Findings indicate essential aspects of lived experience comprise three domains: life-changing or life-shaping individual experiences (including intersectionality); common impacts of adverse experiences, identification as a peer, and understanding and application of the collective peer thinking and values; and ultimately, Lived Expertise, a unique, experientially developed knowledge base and set of skills that can benefit others. The study identifies Lived Expertise as a unique combination of individual and collectively derived experiential knowledge. Understanding what comprises Lived Expertise can guide the design of roles and improve recruitment strategies, thereby enhancing the effectiveness of roles and support for the peer workforce. This study offers a model for understanding Lived Expertise that can be readily applied in developing recruitment materials, including position descriptions.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":"482-493"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction To: User Satisfaction with Child and Adolescent Mental Health Services: Factor Structure of the Experience of Service Questionnaire (ESQ) in Norway and the UK.","authors":"Yngvild Arnesen, Bjørn Helge Handegård, Børge Mathiassen, Kjersti Lillevoll, Monica Martinussen, Luís Costa da Silva, Jasmine Harju-Seppänen, Abigail Rennick, Jenna Jacob, Julian Edbrooke-Childs","doi":"10.1007/s10488-025-01447-w","DOIUrl":"10.1007/s10488-025-01447-w","url":null,"abstract":"","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":"583"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Youth Peer Advocacy and Support Services: Responding to NASEM Consensus Report on Launching Lifelong Health by Improving Health Care for Children, Youth, and Families (2024).","authors":"Kimberly Hoagwood, Kelly Davis, Trace Terrell, Robert Lettieri, Kelly Kelleher","doi":"10.1007/s10488-024-01428-5","DOIUrl":"10.1007/s10488-024-01428-5","url":null,"abstract":"","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":"455-458"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142919016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Shortfalls: Perceptions of Unmet Needs and Barriers and Facilitators to Receiving Care.","authors":"Olga V Berkout, Emily Barena","doi":"10.1007/s10488-025-01438-x","DOIUrl":"10.1007/s10488-025-01438-x","url":null,"abstract":"<p><p>Understanding the perspectives of individuals with mental health concerns and the influence of barriers and facilitators on treatment access can help mental health professionals ensure that those they serve receive needed care. The current study examined these factors in an online survey among 295 adults self-identifying as diagnosed with a mental health condition, which they felt was uncontrolled by intervention or psychiatric medication and impacted their daily lives. Most participants were not receiving psychotherapy or psychiatric medication, although some were accessing care and indicating unmet needs. A majority expressed a desire for more specialized care. Positive perception of providers, higher distress, and greater stigma tolerance were related to greater openness towards receiving psychotherapy and greater openness to psychotherapy, higher distress, and lower perceived barriers were associated with psychotherapy receipt. The relationship between openness towards psychotherapy and receipt was also stronger for those who perceived lower barriers to care. Advocacy and efforts to promote positive attitudes and reduce barriers by mental health practitioners and professional organizations may help support treatment access.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":"594-602"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Determinants of Effective Implementation of an Innovation Within Health Care: Qualitative Insights from Program Champions on Implementing One-at-a-Time Therapy Within Addictions and Mental Health Services in New Brunswick.","authors":"Natalie R Keeler-Villa, Danie Beaulieu, Laura M Harris-Lane, Stéphane Bérubé, Katie Burke, AnnMarie Churchill, Peter Cornish, Bernard Goguen, Alexia Jaouich, Mylène Michaud, Anne Losier, Nicole Snow, Joshua A Rash","doi":"10.1007/s10488-024-01423-w","DOIUrl":"10.1007/s10488-024-01423-w","url":null,"abstract":"<p><p>Government of New Brunswick implemented One-at-a-Time (OAAT) therapy, a single-session approach to care, within Addiction and Mental Health (A&MH) services. We conducted interviews to understand determinants of implementation from program champions. Champions of the OAAT therapy implementation (N = 19; Child/Youth n = 8, Adult n = 11) working within A&MH services and school districts were recruited through the provincial implementation team. Transcripts were synthesized using thematic analysis. Determinants were organized as facilitators and barriers in accordance with the Consolidated Framework for Implementation Research (CFIR). Thematic analysis resulted in 18 themes and 5 recommendations. Facilitators within the inner setting included: (1) need for change and perceived benefits of OAAT therapy; (2) compatibility of OAAT therapy with previous practice and service processes; and (3) support received from champions and colleagues. Insufficient resources (e.g., staff and physical infrastructure), and a culture that favored long-term therapy were barriers. Navigating age of consent, and implementation around COVID-19 were barriers within the outer setting. Facilitators within the implementation process domain included: (1) interconnected teams across sites, regions and the province; (2) collaborative implementation planning; (3) flexibility to tailor implementation at sites; and (4) mentorship provided by champions. Insufficient standardization of the implementation and limited representation among affected parties (e.g., community partners) were barriers within the implementation process. This study elucidated determinants that influenced implementation of a new service delivery within an Eastern Canadian provincial health care system. Findings can serve as a heuristic for organizations looking to enact similar implementation initiatives.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":"459-481"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges when Combining Expertise to Provide Integrated Care for Youth At-Risk and Their Family: A Qualitative Study.","authors":"Laura C M Veerman, Eva A Mulder, Robert R J M Vermeiren, Lieke van Domburgh, Anne van der Maas, Laura A Nooteboom","doi":"10.1007/s10488-024-01430-x","DOIUrl":"10.1007/s10488-024-01430-x","url":null,"abstract":"<p><p>The needs of youth at-risk and their families, facing multiple problems and serious mental health issues, exceed the expertise and possibilities of a single stakeholder (professional, organization, municipality). These youngsters require care in which the expertise of different professionals and organizations is integrated. However, combining various types of expertise to provide integrated care to youth at-risk is challenging. Therefore, this qualitative study aims to describe how stakeholders approach these challenges when combining different types of expertise to provide integrated care for youth at-risk. In total, 28 in-depth interviews were conducted with stakeholders working in various organizations or municipalities for youth at-risk in The Netherlands. Transcripts were analyzed through reflexive thematic analysis. Reflections from a youth representative were also incorporated. Results reveal challenges at four levels: youth and family, professional, organization, and system. At each level, challenges arise in addressing the exceptional needs and problems of youth at-risk, collaborating with multiple stakeholders, reluctance to apply or involve expertise, and finding sufficient resources to combine expertise. Professionals, organizations, and municipalities approach these challenges with a backward or forward approach: either they accept the situation, focus on their own expertise, leave responsibility to others; or they force their expertise on others, or seek collaboration to combine expertise. Overall, combining different types of expertise to provide integrated care to youth at-risk can be seen as an expertise in itself, and necessitates reflection, awareness, and careful consideration from all stakeholders.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":"520-532"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}