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Administration and Policy in Mental Health

Emily B H Treichler, William D Spaulding
Despite the strengths of routine outcome monitoring (ROM) in community mental health settings, there are a number of barriers to effective implementation of ROM, including measurement error due to provider factors (e.g., training level) and non-target client factors (i.e., client characteristics which have no meaningful relationship to the outcome of interest). In this study, ROM data from 80 client-provider dyads were examined for sources of variance due to provider factors and non-target client factors. Results indicated that provider factors and non-target client factors accounted for between 9...
March 17, 2018: Administration and Policy in Mental Health
Ricardo Araya, Pedro Zitko, Niina Markkula
Universal health care programmes have the potential to reduce treatment gaps. We explored the potential impact of an equity-oriented universal health care programme on access to care for depression, hypertension and diabetes using data from two nationally representative health surveys in Chile. The likelihood a depressed individual had accessed health care appears to have increased significantly after the programme was introduced whereas those for hypertension and diabetes remained unchanged. Depressed women seem to have benefited mostly from the programme...
March 14, 2018: Administration and Policy in Mental Health
Jacqueline Horan Fisher, Emily Lichvar, Aaron Hogue, Sarah Dauber
This study examines clinical and family predictors of perceived need for treatment and engagement in mental health treatment services among community-referred racial/ethnic minority adolescents and their primary caregivers. Findings indicated that the majority of families perceived a need for treatment, but that perceived need was not associated with treatment engagement. Family factors (i.e., low cohesion and high conflict within the family) predicted perceived need for treatment among adolescents, whereas clinical factors (i...
March 10, 2018: Administration and Policy in Mental Health
Kathleen Biebel, Amy Ryder-Burge, Shums Alikhan, Heather Ringeisen, Marsha Ellison
The original version of this article unfortunately contained a mistake. The spelling of the fifth author's name was incorrectly published as Masha Ellison.
March 9, 2018: Administration and Policy in Mental Health
Tim Kaiser, Lisa Schmutzhart, Anton-Rupert Laireiter
While monitoring systems in psychotherapy have become more common, little is known about the attitudes that mental health practitioners have towards these systems. In an online survey among 111 Austrian psychotherapists and trainees, attitudes towards therapy monitoring were measured. A well-validated questionnaire measuring attitudes towards outcome monitoring, the Outcome Measurement Questionnaire, was used. Clinicians' theoretical orientations as well as previous knowledge and experience with monitoring systems were associated with positive attitudes towards monitoring...
March 8, 2018: Administration and Policy in Mental Health
Jennifer L A Tran, Rena Sheng, Allyson Beaulieu, Miguel Villodas, Keith McBurnett, Linda J Pfiffner, Leslie Wilson
We conducted a cost-effectiveness analysis (CEA) of two behavioral psychosocial interventions for children with ADHD-inattentive type: Child Life and Attention Skills (CLAS) program and parent-focused treatment (PFT) compared to community-based treatment as usual (TAU). The CEA evaluated cost per ADHD case resolved measured by parent and teacher reports of ADHD inattentive symptoms. Total cost per patient for CLAS, PFT, and TAU were $1559, $710, and $0. CLAS, the costliest treatment, was more effective than PFT and TAU...
February 26, 2018: Administration and Policy in Mental Health
Sonya J Leathers, Jill E Spielfogel, Joan Blakey, Errick Christian, Marc S Atkins
The original version of this article unfortunately contained a mistake.
February 24, 2018: Administration and Policy in Mental Health
Mir M Ali, Judith Teich, Sean Lynch, Ryan Mutter
There is increasing recognition that some preschool-aged children suffer from mental health conditions, but little is known about the treatment they receive. Using the 2014 MarketScan Commercial Claims and Encounters database (N = 1,987,759) the study finds that only a small proportion of preschool-aged children receive any behavioral interventions, including psychotherapy, in conjunction with having a filled psychiatric prescription. Nearly all of the preschool-aged children who had psychotropic prescriptions filled had no other claims for treatment, and among those children who had prescriptions for psychotropic medication filled, the vast majority did not have a mental health diagnosis on a claim...
February 23, 2018: Administration and Policy in Mental Health
Mir M Ali, Sara Lackey, Ryan Mutter, Richard McKeon
This study utilizes data from the National Survey of Drug Use and Health (NSDUH) to analyze the relationship between perceived unmet mental health care needs and suicidal ideation and attempt. Estimates from multivariable logistic regression models suggest that individuals who report perceived unmet mental health care needs have higher probability of experiencing suicidal ideation and attempt. Perceived unmet mental health care need has an important association with suicidal ideation and attempt, and efforts aimed at improving access to care are needed to address this issue...
February 23, 2018: Administration and Policy in Mental Health
Gabriela M Rodríguez, Dainelys Garcia, Angela Blizzard, Nicole E Barroso, Daniel M Bagner
Mental health interventions for infants typically target high-risk groups and can prevent long-term negative outcomes. Despite federal initiatives promoting early intervention, minimal research has examined usual care services for infants, which is important to improve routine care. The current study characterized usual care practices in infant mental health through the adaptation and administration of a provider survey. Providers (n = 126) reported using a wide range of intervention strategies and few intervention programs with varied evidence...
February 21, 2018: Administration and Policy in Mental Health
Kelsie H Okamura, Puanani J Hee, David Jackson, Brad J Nakamura
Examining therapist evidence-based practice (EBP) knowledge seems an important step for supporting successful implementation. Advances in implementation science suggest a distinction between practice specific (i.e., knowing which practices are derived from the evidence base) and EBP process (i.e., integrating research evidence, clinical experience, client characteristics, and monitoring outcomes) knowledge. An examination of how these knowledge types are measured and relate to attitudes appears warranted. In our sample of 58 youth community therapists, both practice specific and EBP process knowledge accounted for EBP attitude scores, which varied by therapist demographic variables...
February 19, 2018: Administration and Policy in Mental Health
Shira Maguen, Erin Madden, Olga V Patterson, Scott L DuVall, Lizabeth A Goldstein, Kristine Burkman, Brian Shiner
To derive a method of identifying use of evidence-based psychotherapy (EBP) for post-traumatic stress disorder (PTSD), we used clinical note text from national Veterans Health Administration (VHA) medical records. Using natural language processing, we developed machine-learning algorithms to classify note text on a large scale in an observational study of Iraq and Afghanistan veterans with PTSD and one post-deployment psychotherapy visit by 8/5/15 (N = 255,968). PTSD visits were linked to 8.1 million psychotherapy notes...
February 15, 2018: Administration and Policy in Mental Health
Alayna L Park, Katherine H Tsai, Karen Guan, Bruce F Chorpita
This study examined patterns of evidence-based treatment (EBT) delivery following a county-wide EBT reform initiative. Data were gathered from 60 youth and their 21 providers, who were instructed to deliver therapy as they normally would under the EBT initiative. Results showed limited applicability of county-supported EBTs to this service sample, and that most youth did not receive traditional delivery of EBTs. Findings suggest that it may be unrealistic to expect providers to deliver EBTs with fidelity with all clients, and that EBT implementation may be best thought of as a strategy for improving mental health services rather than a goal...
February 14, 2018: Administration and Policy in Mental Health
Kathleen Biebel, Amy Ryder-Burge, Shums Alikhan, Heather Ringeisen, Masha Ellison
This manuscript describes efforts to support youth and young adults living with serious mental health conditions (SMHC) as they pursue their education goals. Case studies were conducted with three supported education initiatives across the US. Data were collected through individual interviews and focus groups. Key ingredients exist across various settings (e.g., mental health, post-secondary education) to support the pursuit of education goals for students living with SMHC, while individual settings have unique circumstances to address...
February 8, 2018: Administration and Policy in Mental Health
Donal O'Keeffe, Ann Sheridan, Aine Kelly, Roisin Doyle, Kevin Madigan, Elizabeth Lawlor, Mary Clarke
Little is known about how recovery oriented policy and legislative changes influence service users' perceptions of mental health care over time. Although the recovery approach is endorsed in many countries, qualitative research examining its impact on service use experiences has been lacking. This study aimed to explore this impact as well as experiences of service utilisation and suggestions for change with people diagnosed with a First Episode Psychosis between 1995 and 1999. Participants had used services during the 10 year period prior to, and 10 years post, policy and legislative shifts to the recovery approach...
February 6, 2018: Administration and Policy in Mental Health
Kathleen C Thomas, Hillary Owino, Sana Ansari, Leslie Adams, Julianne M Cyr, Bradley N Gaynes, Seth W Glickman
Little is known about what patients value in psychiatric crisis services or how they compare community-based services with those received in the emergency department. Three focus groups (n = 27) were held of participants who had received psychiatric crisis services in emergency departments or a community mental health center. Participants described care experiences and preferences. Focus groups were audio recorded, transcribed, and coded using a value-based lens. Themes included appreciation for feeling respected, basic comforts, and shared decision-making as foundations of quality care...
January 30, 2018: Administration and Policy in Mental Health
Megan Shepherd-Banigan, Valerie A Smith, Matthew L Maciejewski, Karen M Stechuchak, Susan Nicole Hastings, G Darryl Wieland, Katherine E M Miller, Margaret Kabat, Jennifer Henius, Margaret Campbell-Kotler, Courtney Harold Van Houtven
The VA Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides landmark support for family caregivers of post-9/11 veterans. This study examines PCAFC support for veterans with and without PTSD and assesses whether program effect differs by PTSD status using a pre-post, non-equivalent, propensity score weighted comparison group design (n = 24,280). Veterans with and without PTSD in PCAFC accessed more mental health, primary, and specialty care services than weighted comparisons. PCAFC participation had stronger effects on access to primary care for veterans with PTSD than for veterans without PTSD...
January 27, 2018: Administration and Policy in Mental Health
G Hopkin, S Evans-Lacko, A Forrester, J Shaw, G Thornicroft
Prisoners have high rates of mental illness and the transition from prison to the community is a problematic time for the provision of mental health services and a range of negative outcomes have been identified in this period. A systematic review was conducted to identify interventions for prisoners with diagnosed mental health conditions that targeted this transition period. Fourteen papers from 13 research studies were included. The interventions identified in this review were targeted at different stages of release from prison and their content differed, ranging from Medicaid enrolment schemes to assertive community treatment...
January 23, 2018: Administration and Policy in Mental Health
Carrie B Jackson, Lauren B Quetsch, Laurel A Brabson, Amy D Herschell
There has been an increase in the use of web-based training methods to train behavioral health providers in evidence-based practices. This systematic review focuses solely on the efficacy of web-based training methods for training behavioral health providers. A literature search yielded 45 articles meeting inclusion criteria. Results indicated that the serial instruction training method was the most commonly studied web-based training method. While the current review has several notable limitations, findings indicate that participating in a web-based training may result in greater post-training knowledge and skill, in comparison to baseline scores...
January 19, 2018: Administration and Policy in Mental Health
Rosaura E Orengo-Aguayo, Rochelle F Hanson, Angela D Moreland, Lisa Jobe-Shields, Zachary W Adams
This mixed-methods study assessed providers' views of the use of technology in the delivery of an empirically supported mental health treatment for adolescents (Trauma-Focused Cognitive Behavioral Therapy; TF-CBT). Thematic qualitative interviews were conducted with nine experienced providers. Emerging themes served as the basis for the creation of a quantitative web-based survey, completed by 56 TF-CBT experts, to assess the perceived helpfulness of the recommendations. Technology was perceived as a useful, appealing, and familiar tool that could greatly enhance the delivery of this treatment modality with adolescents...
January 5, 2018: Administration and Policy in Mental Health
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