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Administration and Policy in Mental Health

Carlos R García-Alonso, Nerea Almeda, José Alberto Salinas-Pérez, Mencía R Gutiérrez-Colosía, Luis Salvador-Carulla
The current prevalence of mental disorders demands improved ways of the management and planning of mental health (MH) services. Relative technical efficiency (RTE) is an appropriate and robust indicator to support decision-making in health care, but it has not been applied significantly in MH. This article systematically reviews the empirical background of RTE in MH services following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Finally, 13 studies were included, and the findings provide new standard classifications of RTE variables, efficiency determinants and strategies to improve MH management and planning...
January 9, 2019: Administration and Policy in Mental Health
Marvin So, Russell F McCord, Jennifer W Kaminski
Policies have potential to help families obtain behavioral healthcare for their children, but little is known about evidence for specific policy approaches. We reviewed evaluations of select policy levers to promote accessibility, affordability, acceptability, availability, or utilization of children's mental and behavioral health services. Twenty articles met inclusion criteria. Location-based policy levers (school-based services and integrated care models) were associated with higher utilization and acceptability, with mixed evidence on accessibility...
January 2, 2019: Administration and Policy in Mental Health
Marianne Storm, Anne Marie Lunde Husebø, Elizabeth C Thomas, Glyn Elwyn, Yaara Zisman-Ilani
Effective coordination as people with serious mental illness (SMI) move between care settings is essential. We aimed to review challenges to care coordination for people with SMI and identify approaches for improving it. Sixteen articles were identified. Two main challenges emerged: people with SMI facing adjustment challenges during transitions and services struggling to provide continuity of care. Effective approaches addressed coordination challenges and resulted in better improvements in service utilization, social functioning and quality of life...
January 2, 2019: Administration and Policy in Mental Health
Shirli Werner, Ira Stern, Dana Roth, Ariel Tenenbaum
This study examined the roles of stigma and of enabling factors in help-seeking by parental caregivers of individuals with intellectual disabilities and dual diagnosis. Questionnaires were completed by 195 family caregivers. Lower family stigma was related to higher personal enabling factors (e.g. knowledge about services and previous experience in seeking help), which in turn was related to higher help-seeking behaviors. Higher professional enabling factors (e.g. attitude of the professional, services in the vicinity) were related to higher intentions to seek help, which were related to higher help-seeking behaviors...
January 2, 2019: Administration and Policy in Mental Health
Eric D A Hermes, Laura Burrone, Alicia Heapy, Steve Martino, Elliottnell Perez, Robert Rosenheck, Michael Rowe, Josef I Ruzek, Carolyn Greene
Behavioral intervention technologies (BITs) are online programs or mobile applications that deliver behavioral health interventions for self-care. The dissemination and implementation of such programs in U.S. healthcare systems has not been widely undertaken. To better understand these phenomena, we explored perspectives on BIT deployment in the Veterans Health Administration. Interviews from 20 providers, administrators, and policy makers were analyzed using qualitative methods. Eight themes were identified including the use of traditional healthcare delivery models, strategies for technology dissemination and implementation, internet infrastructure, leadership, health system structure, regulations, and strategic priorities...
January 2, 2019: Administration and Policy in Mental Health
Lauren Bochicchio, Ana Stefancic, Kristen Gurdak, Margaret Swarbrick, Leopoldo J Cabassa
This qualitative study explored peer specialists' contributions to a healthy lifestyle intervention for obese/overweight individuals with serious mental illness (SMI) living in supportive housing. Intervention participants, peer specialists, and supervisors were interviewed and a grounded model emerged from the data identifying essential interpersonal attributes of the peer specialist-participant relationship. Peer specialists' disclosure of their own experiences making health behaviors changes was critical for building participants' motivation and ability to try lifestyle changes...
December 18, 2018: Administration and Policy in Mental Health
Maria Kent
Globally, health care systems stakeholders have encouraged health systems change that reflects recovery oriented practice. The implementation and integration of Peer Support Workers is one such strategy. Yet, what factors should be considered in the implementation of these roles? How can services be integrated effectively? Recent literature will be reviewed to explore current knowledge about peer support, and offer considerations for effective implementation of peer supports into current health care systems...
December 17, 2018: Administration and Policy in Mental Health
Wang-Sheng Lee, Cathrine Mihalopoulos, Mary Lou Chatterton, Georgina M Chambers, Nicole Highet, Vera A Morgan, Elizabeth A Sullivan, Marie-Paule Austin
This paper helps to quantify the impact of the Australian National Perinatal Depression Initiative (NPDI) on postnatal inpatient psychiatric hospitalisation. Based on individual hospital admissions data from New South Wales and Western Australia, we found that the NPDI reduced inpatient psychiatric hospital admission by up to 50% [0.9% point reduction (95% CI 0.70-1.22)] in the first postnatal year. The greatest reduction was observed for adjustment disorders. The NPDI appears to be associated with fewer post-birth psychiatric disorders hospital admissions; this suggests earlier detection of psychiatric disorders resulting in early care of women at risk during their perinatal period...
December 5, 2018: Administration and Policy in Mental Health
Vincent Lorant, Adeline Grard, Chantal Van Audenhove, Mark Leys, Pablo Nicaise
Mental health and social care services networks aim to provide patients with continuity of care and support their recovery. There is, however, no conclusive evidence of their effectiveness. Since 2011, Belgium has been implementing a nation-wide reform of mental health care by commissioning service networks. Using a case-control design, we assessed the reform's effectiveness for continuity of care, social integration, quality of life, and re-hospitalization for 1407 patients from 23 networks. Greater reform exposure was associated with a slight improvement in continuity of care, but not with other outcomes...
December 4, 2018: Administration and Policy in Mental Health
Michelle P Salyers, Jennifer M Garabrant, Lauren Luther, Nancy Henry, Sadaaki Fukui, Dawn Shimp, Wei Wu, Tim Gearhart, Gary Morse, Mary M York, Angela L Rollins
Clinician burnout is presumed to negatively impact healthcare quality; yet scant research has rigorously addressed this hypothesis. Using a mixed-methods, randomized, comparative effectiveness design, we tested two competing approaches to improve care-one addressing clinician burnout and the other addressing how clinicians interact with consumers-with 192 clinicians and 469 consumers at two community mental health centers. Although qualitative reports were promising, we found no comparative effectiveness for either intervention on burnout, patient-centered processes, or other outcomes...
November 28, 2018: Administration and Policy in Mental Health
Lawrence A Palinkas, Douglas Zatzick
Pragmatic clinical trials of mental health services are increasingly being developed to establish comparative effectiveness, influence sustainable implementation, and address real world policy decisions. However, use of time and resource intensive qualitative methods in pragmatic trials may be inconsistent with the aims of efficiency and cost minimization. This paper introduces a qualitative method known as Rapid Assessment Procedure-Informed Clinical Ethnography (RAPICE) that combines the techniques of Rapid Assessment Procedures with clinical ethnography...
November 28, 2018: Administration and Policy in Mental Health
Juan Chen, Duoduo Xu, Xiaogang Wu
Family members, rather than mental health professionals, are often the first responders for emotional or mental problems, particularly in Chinese societies where family is regarded as the primary care unit. Using data from the third wave of a representative sample of Chinese adults in the Hong Kong Panel Study of Social Dynamics, we investigate how family, and particularly family functioning, is associated with individual mental health help seeking and perceived barriers to professional service use, and how the associations vary across different generations of immigrants and between individuals with high versus low psychological distress...
November 20, 2018: Administration and Policy in Mental Health
Christine M Wienke Totura, Christa D Labouliere, Kim Gryglewicz, Marc S Karver
This study examined the roles that youth involvement and youth trainee-trainer alliance play in school mental health prevention within the context of youth suicide gatekeeper training. Measures included youth involvement in programming, trainee-trainer alliance, and intentions to refer at-risk youth at pre- and post-training. A moderated-mediation design was used to examine associations among these factors. Results show alliance mediating pre- and post-training referral intentions, and involvement moderating the relationship between alliance and post-training intentions...
November 20, 2018: Administration and Policy in Mental Health
David H Sommerfeld, Gregory A Aarons, Jeanean B Naqvi, Jason Holden, Dimitri Perivoliotis, Kim T Mueser, Eric Granholm
This study examined stakeholder perceptions of the "fit" between cognitive-behavioral social skills training (CBSST) and assertive community treatment (ACT) when implementing CBSST into existing community-based ACT teams. Focus group feedback was collected from a diverse set of stakeholders (i.e., clients, providers, supervisors, agency administrators, public sector representatives, and intervention developers). Results identified perceived client and provider benefits for integrating CBSST into ACT while highlighting the importance of purposeful adaptations, training, and implementation tools to facilitate structural and values fit between CBSST and ACT...
November 8, 2018: Administration and Policy in Mental Health
Winnie W S Mak, Randolph C H Chan, Sania S W Yau
Recovery-oriented transformation of mental health service systems not only necessitates changes in mental health policies and practices, it also requires an adoption of recovery-oriented mindset, which includes knowledge and attitudes, among service providers. It is also important that service users are informed about the changes and can fully participate in the process. The present study developed and evaluated the efficacy of a recovery psychoeducation program in enhancing recovery-oriented knowledge and attitudes among mental health service providers and users in Hong Kong...
November 7, 2018: Administration and Policy in Mental Health
Allyson L Dir, Lisa Saldana, Jason E Chapman, Matthew C Aalsma
Despite high rates of mental health problems among juvenile justice-involved youth, mental health stigma among juvenile probation officers (JPOs) is under-studied. This cross-sectional study examined effects of job burnout and workplace participatory atmosphere on mental health stigma among JPOs across Indiana (n = 226). Participatory atmosphere moderated the relationship between JPO burnout-related cynicism and mental health stigma (interaction β = - 0.14, p = .04); burnout was related to greater mental health stigma at low levels of participatory atmosphere...
November 3, 2018: Administration and Policy in Mental Health
Jessica F Saunders, Asia A Eaton, Stacy L Frazier
This qualitative study draws on a photo-elicitation method ("PhotoVoice") and semi-structured interviews to examine the key areas stakeholders (30 young women between the ages of 18 and 35 in eating disorder recovery) identify as meaningful venues of policy-based change. Photography and the accompanying narratives capturing personally-meaningful social, cultural, and systemic influences on recovery were shared with the research team. Photographs and interviews were examined for policy implications using thematic analysis, and six areas of improvement emerged: media, healthcare practice and access, health insurance reform, education, objectification of the female body, and mental health stigma...
October 26, 2018: Administration and Policy in Mental Health
Christopher J Miller, Jennifer L Sullivan, Bo Kim, A Rani Elwy, Karen L Drummond, Samantha Connolly, Rachel P Riendeau, Mark S Bauer
The Collaborative Care Model (CCM) is an evidence-based approach for structuring care for chronic health conditions. Attempts to implement CCM-based care in a given setting depend, however, on the extent to which care in that setting is already aligned with the specific elements of CCM-based care. We therefore interviewed staff from ten outpatient mental health teams in the US Department of Veterans Affairs to determine whether care delivery was consistent or inconsistent with CCM-based care in those settings...
October 23, 2018: Administration and Policy in Mental Health
Edwin S Wong, Matthew L Maciejewski, Paul L Hebert, John C Fortney, Chuan-Fen Liu
Older veterans can obtain care from the Veterans Affairs Health System (VA), Medicare or both. We examined whether their use of mental health care was impacted by capacity effects stemming from younger, uninsured veterans' enrolling in VA to satisfy the individual mandate within Massachusetts Health Reform (MHR). Using administrative data, we applied a difference-in-difference approach to compare pre-post changes in mental health use following MHR implementation. Findings indicated MHR was associated with increases in use through Medicare and the probability of dual VA-Medicare use...
October 20, 2018: Administration and Policy in Mental Health
Karen T G Schwartz, Amanda A Bowling, John F Dickerson, Frances L Lynch, David A Brent, Giovanna Porta, Satish Iyengar, V Robin Weersing
The current study evaluated the interrater reliability of the Child and Adolescent Services Assessment (CASA), a widely used structured interview measuring pediatric mental health service use. Interviews (N = 72) were randomly selected from a pediatric effectiveness trial, and audio was coded by an independent rater. Regressions were employed to identify predictors of rater disagreement. Interrater reliability was high for items (> 94%) and summary metrics (ICC > .79) across service sectors...
November 2018: Administration and Policy in Mental Health
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