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Psychiatric Services: a Journal of the American Psychiatric Association

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https://www.readbyqxmd.com/read/28617212/leveraging-technology-to-address-the-quality-chasm-in-children-s-evidence-based-psychotherapy
#1
Kenneth J Ruggiero, Benjamin E Saunders, Tatiana M Davidson, Danna Lewsky Cook, Rochelle Hanson
The quality of psychosocial treatment delivery is highly variable in community practice settings, even among well-trained providers. This column discusses the potential to improve patient outcomes by targeting two important quality-of-care indicators through technology: provider fidelity and children's engagement. A case example describes one provider's use of numerous tablet-based activities in the context of evidence-based psychotherapy. Providers and families responded favorably to this approach in a recent feasibility study funded by the National Institute of Mental Health...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28617211/-docs-vs-glocks-and-the-regulation-of-physicians-speech
#2
Paul S Appelbaum
Physicians increasingly have recognized the importance of asking patients whether they own firearms and suggesting safe means of storage. Florida's legislature perceived these questions as threats to patients' rights to keep guns and passed a law restricting physicians from making such inquiries. When a number of physicians and their organizations challenged the law in 2011, a six-year odyssey through the courts ensued. In the end, the U.S. 11th Circuit Court of Appeals struck down the statute, recognizing that physicians' free speech rights extend to communications with patients, a decision that may influence other attempts to restrict clinicians' speech...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28617210/antipsychotic-medication-use-among-publicly-insured-pregnant-women-in-the-united-states
#3
Yoonyoung Park, Krista F Huybrechts, Jacqueline M Cohen, Brian T Bateman, Rishi J Desai, Elisabetta Patorno, Helen Mogun, Lee S Cohen, Sonia Hernandez-Diaz
OBJECTIVE: Given the increasing use and broadening of indications for use of antipsychotic medications in the general population, as well as the paucity of information on the safety of this drug class during pregnancy, the study documented patterns of antipsychotic medication use among pregnant women. METHODS: Medicaid Analytic eXtract data (2001-2010) from pregnant women who delivered live-born infants were used. Antipsychotic use at both the class and the individual drug level was defined based on dispensed outpatient prescriptions...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28617209/suicide-risk-assessment-and-prevention-a-systematic-review-focusing-on-veterans
#4
Heidi D Nelson, Lauren M Denneson, Allison R Low, Brian W Bauer, Maya O'Neil, Devan Kansagara, Alan R Teo
OBJECTIVE: Suicide rates in veteran and military populations in the United States are high. This article reviews studies of the accuracy of methods to identify individuals at increased risk of suicide and the effectiveness and adverse effects of health care interventions relevant to U.S. veteran and military populations in reducing suicide and suicide attempts. METHODS: Trials, observational studies, and systematic reviews relevant to U.S. veterans and military personnel were identified in searches of MEDLINE, PsycINFO, SocINDEX, and Cochrane databases (January 1, 2008, to September 11, 2015), on Web sites, and in reference lists...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28617208/nurse-practitioner-independent-practice-authority-and-mental-health-service-delivery-in-u-s-community-health-centers
#5
Bo Kyum Yang, Alison M Trinkoff, Julie Magno Zito, Mehmet Burcu, Daniel J Safer, Carla L Storr, Mary E Johantgen, Shannon Idzik
OBJECTIVE: Little is known about how nurse practitioner independent practice authority (NP-IPA) influences patient care. This study examined the effect of NP-IPA on patterns of mental health-related visits provided by NPs in U.S. community health centers (CHCs). METHODS: State NP regulatory information was linked to National Ambulatory Medical Care Survey data on NP- and physician-provided visits (N=61,457) in CHCs from 2006 through 2011. The proportion of NP-provided versus physician-provided mental health-related visits in states with NP-IPA was compared with the proportion in states without NP-IPA...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28617207/development-and-validation-of-a-scale-assessing-mental-health-clinicians-experiences-of-associative-stigma
#6
Philip T Yanos, Beth Vayshenker, Joseph S DeLuca, Lauren K O'Connor
OBJECTIVE: Mental health professionals who work with people with serious mental illnesses are believed to experience associative stigma. Evidence suggests that associative stigma could play an important role in the erosion of empathy among professionals; however, no validated measure of the construct currently exists. This study examined the convergent and discriminant validity and factor structure of a new scale assessing the associative stigma experiences of clinicians working with people with serious mental illnesses...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28617206/utilization-patterns-at-a-specialized-children-s-comprehensive-psychiatric-emergency-program
#7
Ruth Gerson, Jennifer Havens, Mollie Marr, Amy Storfer-Isser, Mia Lee, Carolena Rojas Marcos, Michelle Liu, Sarah McCue Horwitz
OBJECTIVE: Most youths experiencing a psychiatric crisis present to emergency departments (EDs) that lack the specialized staff to evaluate them, so youths are often discharged without appropriate mental health assessment or treatment. To better understand the needs of this population, this study described clinical details and disposition associated with visits for psychiatric emergencies to a specialized ED staffed 24/7 by child psychiatrists. METHODS: Through retrospective chart review, 1,180 visits to the ED during its first year of operation were reviewed for clinical characteristics, prior service utilization, and demographic characteristics...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28617205/establishing-a-research-agenda-for-understanding-the-role-and-impact-of-mental-health-peer-specialists
#8
Matthew Chinman, D Keith McInnes, Susan Eisen, Marsha Ellison, Marianne Farkas, Moe Armstrong, Sandra G Resnick
Mental health peer specialists are individuals with serious mental illnesses who receive training to use their lived experiences to help others with serious mental illnesses in clinical settings. This Open Forum discusses the state of the research for mental health peer specialists and suggests a research agenda to advance the field. Studies have suggested that peer specialists vary widely in their roles, settings, and theoretical orientations. Theories of action have been proposed, but none have been tested...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28617204/is-the-clinical-high-risk-state-a-valid-concept-retrospective-examination-in-a-first-episode-psychosis-sample
#9
Jai L Shah, Anne Crawford, Sally S Mustafa, Srividya N Iyer, Ridha Joober, Ashok K Malla
OBJECTIVE: One reason for worldwide interest in the clinical high-risk (CHR) state for psychosis is its potential as a target for prevention. However, the feasibility and utility of early intervention initiatives that are focused on this stage involve an untested assumption: that most patients with a first episode of psychosis (FEP) experience earlier CHR symptoms. The objective of this study was to identify and characterize the proportion of FEP patients who had experienced such symptoms prior to the onset of their psychosis...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28566029/trainer-fidelity-as-a-predictor-of-crisis-counselors-behaviors-with-callers-who-express-suicidal-thoughts
#10
Wendi F Cross, Tian Chen, Karen Schmeelk-Cone, Xin Tu, Marjorie Kleinman, Madelyn S Gould
OBJECTIVE: The relationship between trainer fidelity during a two-day suicide prevention program for counselors at crisis centers and counselors' behaviors during calls from individuals with suicidal thoughts was examined. METHODS: The study used two data sets from a randomized control trial of a suicide prevention program delivered by counselors at 17 crisis centers who had previously received training (train-the-trainer [TTT] approach). One data set examined counselors' behaviors by silently monitoring calls (N=764) to the crisis lines, and one assessed adherence to manual content and competence in delivery among trainers (N=34) by coding training videotapes...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28566028/a-randomized-controlled-trial-of-the-rochester-forensic-assertive-community-treatment-model
#11
J Steven Lamberti, Robert L Weisman, Catherine Cerulli, Geoffrey C Williams, David B Jacobowitz, Kim T Mueser, Patricia D Marks, Robert L Strawderman, Donald Harrington, Tara A Lamberti, Eric D Caine
OBJECTIVE: Forensic assertive community treatment (FACT) is an adaptation of the assertive community treatment model and is designed to serve justice-involved adults with serious mental illness. This study compared the effectiveness of a standardized FACT model and enhanced treatment as usual in reducing jail and hospital use and in promoting engagement in outpatient mental health services. METHODS: Seventy adults with psychotic disorders who were arrested for misdemeanor crimes and who were eligible for conditional discharge were recruited from the Monroe County, New York, court system...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28566027/perceived-autonomy-support-in-the-nimh-raise-early-treatment-program
#12
Julia Browne, David L Penn, Daniel J Bauer, Piper Meyer-Kalos, Kim T Mueser, Delbert G Robinson, Jean Addington, Nina R Schooler, Shirley M Glynn, Susan Gingerich, Patricia Marcy, John M Kane
OBJECTIVE: This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28566026/gun-violence-following-inpatient-psychiatric-treatment-offense-characteristics-sources-of-guns-and-number-of-victims
#13
Aaron J Kivisto
OBJECTIVE: This study presents data on the relative contribution to gun violence by people with a history of inpatient psychiatric treatment and on federal efforts to deter presumptively dangerous persons from obtaining firearms, information useful for analyzing the potential public health benefits of gun policies targeting people with serious mental illness. The study also estimates the reduction in gun violence victims that would be expected if individuals with a previous psychiatric hospitalization were prohibited from purchasing firearms...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28566025/management-of-mental-health-crises-among-youths-with-and-without-asd-a-national-survey-of-child-psychiatrists
#14
Luther G Kalb, Elizabeth A Stuart, David S Mandell, Mark Olfson, Roma A Vasa
OBJECTIVE: This study compared management by child psychiatrists of mental health crises among youths with and without autism spectrum disorder (ASD). METHODS: A custom online mental health crisis services survey was administered to members of the American Academy of Child and Adolescent Psychiatry. The survey probed three domains of crisis management: willingness to work with youths with a history of mental health crisis, comfort level in managing a mental health crisis, and availability of external resources during a crisis...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28566024/fostering-activation-among-latino-parents-of-children-with-mental-health-needs-an-rct
#15
Kathleen C Thomas, Gabriela L Stein, Christianna S Williams, Mónica Pérez Jolles, Betsy L Sleath, Maria Martinez, San Juanita García, Linda E Guzman, Charlotte E Williams, Joseph P Morrissey
OBJECTIVE: Latino families raising children with mental health and other special health care needs report greater dissatisfaction with care compared with other families. Activation is a promising strategy to eliminate disparities. This study examined the comparative effectiveness of MePrEPA, an activation intervention for Latino parents whose children receive mental health services. METHODS: A randomized controlled trial (N=172) was conducted in a Spanish-language mental health clinic to assess the effectiveness of MePrEPA, a four-week group psychoeducational intervention to enhance parent activation among Latino parents, compared with a parent-support control group...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28566023/second-generation-antipsychotic-prescribing-patterns-for-pediatric-patients-enrolled-in-west-virginia-medicaid
#16
Kelly E Melvin, Joseph C Hart, Richard D Sorvig
OBJECTIVE: The prescribing of second-generation antipsychotics for young people has increased dramatically. Studies have shown that children enrolled in Medicaid are more likely than those with private insurance to receive antipsychotics, leading many states to require prior authorization (PA) for their use. However, little is known about how PA programs affect prescribing patterns for antipsychotics or other psychotropic medications. This study examined a PA program for second-generation antipsychotic use for children under 18 in West Virginia Medicaid...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28566022/six-month-follow-up-of-recovery-oriented-cognitive-therapy-for-low-functioning-individuals-with-schizophrenia
#17
Paul M Grant, Keith Bredemeier, Aaron T Beck
OBJECTIVE: The study examined six-month follow-up results and the impact of length of illness on treatment outcomes of recovery-oriented cognitive therapy (CT-R). METHODS: Sixty outpatients (mean age 38.4 years, 33% female, 65% African American) with schizophrenia or schizoaffective disorder and elevated negative symptoms were randomly assigned to CT-R or standard treatment. Assessments were conducted at baseline, midtreatment (six and 12 months), end of treatment (18 months), and follow-up (24 months, N=46 after attrition) by assessors blind to treatment condition...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28566021/first-person-perspectives-on-prescriber-service-user-relationships-in-community-mental-health-centers
#18
Annalee Johnson-Kwochka, Elizabeth Carpenter-Song, Ida Griesemer, Cara Nikolajski, Nancy Parrotta, Kim L MacDonald-Wilson
OBJECTIVE: Because of changes in health care, there is a greater focus on brief medication management visits as the primary method of providing psychiatric care in community mental health settings. Research on the first-person perspectives of service users and prescribers in these settings is limited. The objective of this study was to describe first-person perspectives on medication management visits and the service user-prescriber relationship. METHODS: Researchers conducted qualitative interviews as part of a larger comparative effectiveness trial at 15 community mental health centers, researchers interviewed service users (N=44) and prescribers (N=25) about their perspectives on the typical elements of a medication management visit and asked service users about their relationship with their prescriber...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28502249/psychiatric-mental-health-nursing-advanced-practice-workforce-capacity-to-address-shortages-of-mental-health-professionals
#19
Kathleen R Delaney
There is a recognized shortage of mental health professionals licensed to provide the full scope of mental health services, including assessment, diagnosis, and prescribing. Psychiatric mental health advanced practice nurses (PMH APNs) have the education and licensure to provide these services, address provider shortages and increase access to services. Unfortunately, federal reports and mental health workforce studies inaccurately depict important characteristics of PMH APNs, particularly their scope of practice, a situation that creates misunderstanding and impedes workforce planning...
May 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28502248/how-do-private-health-plans-manage-specialty-behavioral-health-treatment-entry-and-continuing-care
#20
Amity E Quinn, Sharon Reif, Elizabeth L Merrick, Constance M Horgan, Deborah W Garnick, Maureen T Stewart
OBJECTIVE: This study examined private health plans' arrangements for accessing and continuing specialty behavioral health treatment in 2010 as federal health reforms were being implemented. These management practices have historically been stricter in behavioral health care than in general medical care; however, the Mental Health Parity and Addiction Equity Act of 2010 required parity in management policies. METHODS: The data source was a nationally representative survey of private health plans' behavioral health treatment management approaches in 2010...
May 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
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