State Strategies for Enhancing Access and Quality in Systems of Care for Youth with Complex Behavioral Health Needs
The objective was to characterize diverse strategies states employed to enhance funding for, access to, and quality and effectiveness of home and community-based services (HCBS) for these youth. States report using a wide variety of creative solutions while navigating the unique needs and constraints of their political and economic environments. Findings can benefit public officials, researchers, and advocates by advancing knowledge-sharing of public policy-making and resourceful problem-solving. (Source: Administration and Policy in Mental Health and Mental Health Services Research)
Source: Administration and Policy in Mental Health and Mental Health Services Research - July 6, 2020 Category: Psychiatry Source Type: research

Assessing Stakeholder Perceptions of the Utility of Genetic Information for the Clinical Care of Mental Health Disorders: We Have a Will but Need to See the Way
AbstractAcademic stakeholders ’ (primarily mental health researchers and clinicians) practices and attitudes related to the translation of genetic information into mental health care were assessed. A three-part survey was administered at two large, urban universities. Response frequencies were calculated. Participants (N = 64) reported moderate levels of translational practice, adequate levels of genetic knowledge, and variable levels of genetic competence. They held positive attitudes toward translating genetic information about mental health broadly but negative attitudes about the impact that such informatio n wou...
Source: Administration and Policy in Mental Health and Mental Health Services Research - June 19, 2020 Category: Psychiatry Source Type: research

Predictors of Hospitalization in a Cohort of Children with Elevated Symptoms of Mania
AbstractDescribe hospitalization rates in children with elevated symptoms of mania and determine predictors of psychiatric hospitalizations during  the 96 month follow-up. Eligible 6–12.9 year olds and their parents visiting 9 outpatient mental health clinics were invited to be screened with the Parent General Behavior Inventory 10-item Mania Scale. Of 605 children with elevated symptoms of mania eligible for follow-up, 538 (88.9%) had  ≥ 1 of 16 possible follow-up interviews and are examined herein. Multivariate Cox regression indicated only four factors predicted hospitalizations: parental mental health proble...
Source: Administration and Policy in Mental Health and Mental Health Services Research - June 15, 2020 Category: Psychiatry Source Type: research

Therapist-Observer Concordance in Ratings of EBP Strategy Delivery: Challenges and Targeted Directions in Pursuing Pragmatic Measurement in Children ’s Mental Health Services
AbstractPragmatic measures of therapist delivery of evidence-based practice (EBP) are critical to assessing the impact of large-scale, multiple EBP implementation efforts. As an initial step in the development of pragmatic measurement, the current study examined the concordance between therapist and observer ratings of items assessing delivery of EBP strategies considered essential for common child EBP targets. Possible EBP-, session-, and therapist-levels factors associated with concordance were also explored. Therapists and independent observers rated the extensiveness of therapist (n = 103) EBP strategy delivery in ...
Source: Administration and Policy in Mental Health and Mental Health Services Research - June 7, 2020 Category: Psychiatry Source Type: research

Definitions of Community for Individuals with Serious Mental Illnesses: Implications for Community Integration and Recovery
AbstractWhile recent work on community integration for individuals with serious mental illnesses (SMIs) has focused on the multi-dimensionality of community integration, it has not been fully rooted in how consumers define and experience communitiesfor themselves. Guided by symbolic interactionism theory, the goal of the present study is to explore definitions of community as provided by individuals with SMIs, and to incorporate those definitions into a theoretical framework of community to inform community integration efforts in the context of mental health services and recovery. Semi-structured interviews were conducted ...
Source: Administration and Policy in Mental Health and Mental Health Services Research - June 4, 2020 Category: Psychiatry Source Type: research

Fidelity Scale: From Black Box to Holy Grail
In conclusion, fidelity assessment, both at the level of interventions and systems, contributes to a highly desirable transparency in practice variations within the field of mental healthcare. (Source: Administration and Policy in Mental Health and Mental Health Services Research)
Source: Administration and Policy in Mental Health and Mental Health Services Research - June 3, 2020 Category: Psychiatry Source Type: research

Where Does It Begin? Community-Based Therapists ’ Intentions for Treating Non-comorbid Youth
This study examined patterns and predictors of 79 public sector therapists ’ practice element (PE) intentions for treating hypothetical single problem area youth with either anxiety or disruptive behavior problems. Analyses of intention profiles suggested that PE intentions varied by diagnosis and included both a majority of practices derived from the evidence base (PDEB s) and a large number of practices with minimal evidence support (PMESs) for each problem area. Hierarchical multiple regression results indicated the only significant predictor of higher PDEB intentions for both problem areas was reporting more PMES int...
Source: Administration and Policy in Mental Health and Mental Health Services Research - May 26, 2020 Category: Psychiatry Source Type: research

Applying NUDGE to Inform Design of EBP Implementation Strategies in Community Mental Health Settings
AbstractWe demonstrate the application of NUDGE (Narrow, Understand, Discover, Generate, Evaluate), a behavioral economics approach to systematically identifying behavioral barriers that impede behavior enactment, to the challenge of evidence-based practice (EBP) use in community behavioral health. Drawing on 65 clinician responses to a system-wide crowdsourcing challenge about EBP underutilization, we applied NUDGE to discover, synthesize and validate specific behavioral barriers to EBP utilization that directly inform the design of tailored implementation strategies. To our knowledge, this is the first study to apply beh...
Source: Administration and Policy in Mental Health and Mental Health Services Research - May 18, 2020 Category: Psychiatry Source Type: research

Are There Performance Advantages Favoring Federally Qualified Health Centers in Medical Home Care for Persons with Severe Mental Illness?
This study suggests that no one ty pe of medical practice setting—whether FQHC, other group, or individual—consistently outperforms the others in providing medical home services to people with severe mental illness. (Source: Administration and Policy in Mental Health and Mental Health Services Research)
Source: Administration and Policy in Mental Health and Mental Health Services Research - May 17, 2020 Category: Psychiatry Source Type: research

Towards Integrated Youth Care: A Systematic Review of Facilitators and Barriers for Professionals
AbstractTo overcome fragmentation in support for children and their families with multiple and enduring problems across life domains, professionals increasingly try to organize integrated care. However, it is unclear what facilitators and barriers professionals experience when providing this integrated care. Our systematic review, including 55 studies from a broad variety of settings in Youth Care, showed that integrated care on a professional level is a multi-component entity consisting of several facilitators and barriers. Findings were clustered in seven general themes: ‘Child’s environment’, ‘Preconditions’, ...
Source: Administration and Policy in Mental Health and Mental Health Services Research - May 17, 2020 Category: Psychiatry Source Type: research

An Examination of the Association Between Patient Experience and Quality of Mental Health Care Among Women Veterans
This study sought to examine: (1) the proportion of women veterans who obtained a PTD of mental health treatment; and (2) the association between women ’s experiences with Veterans Health Administration (VHA) mental health services and obtaining a PTD of mental health treatment. We assessed patient experience via a survey that measured experiences with gender-sensitive care, ease of getting care, perceived quality of care, and extent to which car e met needs. We used VHA administrative data to determine mental health utilization across a national sample of 2109 women veterans with episodes of mental health care that incl...
Source: Administration and Policy in Mental Health and Mental Health Services Research - May 14, 2020 Category: Psychiatry Source Type: research

Leveraging Machine Learning to Identify Predictors of Receiving Psychosocial Treatment for Attention Deficit/Hyperactivity Disorder
This study aimed to identify factors associated with receiving psychosocial treatment for ADHD in a nationally representative sample. Participants were 6630 youth with a parent-reported diagnosis of ADHD from the 2016 –2017 National Survey of Children’s Health. Machine learning analyses were performed to identify factors associated with receipt of psychosocial treatment for ADHD. We examined potentially associated factors in the broad categories of variables hypothesized to affect problem recognition (e.g., s everity, mental health comorbidities); the decision to seek treatment; service selection (e.g., insurance cover...
Source: Administration and Policy in Mental Health and Mental Health Services Research - May 12, 2020 Category: Psychiatry Source Type: research

Pre-implementation Evaluation of PARTNER-MH: A Mental Healthcare Disparity Intervention for Minority Veterans in the VHA
AbstractTo design PARTNER-MH, a peer-led, patient navigation program for implementation in Veterans Health Administration (VHA) mental health care settings, we conducted a pre-implementation evaluation during intervention development to assess stakeholders ’ views of the intervention and to explore implementation factors critical to its future adoption. This is a convergent mixed-methods study that involved qualitative semi-structured interviews and survey data. Data collection was guided by the Consolidated Framework for Implementation Research (CF IR). We interviewed and administered the surveys to 23 peers and 10 supe...
Source: Administration and Policy in Mental Health and Mental Health Services Research - May 11, 2020 Category: Psychiatry Source Type: research

Measurement Strategies for Evidence-Based Antidepressants for Posttraumatic Stress Disorder Delivery: Trends and Associations with Patient-Reported Outcomes
AbstractWe sought to develop a quality standard for the prescription of antidepressants for posttraumatic stress disorder (PTSD) that is both consistent with the underlying evidence supporting antidepressants as a treatment for PTSD and associated with the best levels of symptom improvement. We quantified antidepressant initiation during the first year of PTSD treatment in a 10-year national cohort of Department of Veterans Affairs (VA) users, and compared outcomes in a subgroup who completed patient-reported outcome measurement (PROM) as part of routine practice. We added progressively stringent measurement requirements. ...
Source: Administration and Policy in Mental Health and Mental Health Services Research - May 10, 2020 Category: Psychiatry Source Type: research

Mobilization of Telepsychiatry in Response to COVID-19 —Moving Toward 21 st Century Access to Care
AbstractThe COVID-19 pandemic threatens to disrupt the provision of mental health services. In response, policymakers, administrators, and providers have taken bold steps toward enabling telepsychiatry to bridge this sudden gap in care for our most vulnerable populations. With rapid deregulation and adoption of this modality of care, careful consideration of issues related to policy and implementation is essential to maximize its effectiveness and mitigate unintended consequences. Though the crisis places the healthcare system under strain, it sets the stage for a lasting shift in not only how care is delivered, but also o...
Source: Administration and Policy in Mental Health and Mental Health Services Research - April 23, 2020 Category: Psychiatry Source Type: research