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    1135 results match your criteria Administration and Policy in Mental Health and Mental Health Services Research [Journal]

    1 OF 23

    Characterizing Intervention Strategies Used in Community-Based Mental Health Care for Infants and Their Families.
    Adm Policy Ment Health 2018 Feb 21. Epub 2018 Feb 21.
    Florida International University, Miami, FL, USA.
    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. Read More

    Furthering Our Understanding of Therapist Knowledge and Attitudinal Measurement in Youth Community Mental Health.
    Adm Policy Ment Health 2018 Feb 19. Epub 2018 Feb 19.
    University of Hawai'i at Mānoa, 3627 Kilauea Ave. Room 101, Honolulu, HI, 96816, USA.
    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. Read More

    Measuring Use of Evidence Based Psychotherapy for Posttraumatic Stress Disorder in a Large National Healthcare System.
    Adm Policy Ment Health 2018 Feb 15. Epub 2018 Feb 15.
    White River Junction VA Medical Center, White River Junction, VT, USA.
    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. Read More

    Unintended Consequences of Evidence-Based Treatment Policy Reform: Is Implementation the Goal or the Strategy for Higher Quality Care?
    Adm Policy Ment Health 2018 Feb 14. Epub 2018 Feb 14.
    Department of Psychology, University of California, Box 951563, Los Angeles, CA, 90095, USA.
    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. Read More

    Strategies to Support the Education Goals of Youth and Young Adults with Serious Mental Health Conditions: A Case Study.
    Adm Policy Ment Health 2018 Feb 8. Epub 2018 Feb 8.
    Systems and Psychosocial Advances Research Center, Transitions to Adulthood Center for Research, University of Massachusetts Medical School, 222 Maple Ave, Shrewsbury, MA, 01545, USA.
    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. Read More

    'Recovery' in the Real World: Service User Experiences of Mental Health Service Use and Recommendations for Change 20 Years on from a First Episode Psychosis.
    Adm Policy Ment Health 2018 Feb 6. Epub 2018 Feb 6.
    DETECT Early Intervention in Psychosis Service, Dublin, Ireland.
    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. Read More

    Patient-Centered Values and Experiences with Emergency Department and Mental Health Crisis Care.
    Adm Policy Ment Health 2018 Jan 30. Epub 2018 Jan 30.
    Department of Emergency Medicine, University of North Carolina School of Medicine, Physician's Office Building, 170 Manning Drive, CB #7594, Chapel Hill, NC, 27599-7594, USA.
    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. Read More

    The Effect of Support and Training for Family Members on Access to Outpatient Services for Veterans with Posttraumatic Stress Disorder (PTSD).
    Adm Policy Ment Health 2018 Jan 27. Epub 2018 Jan 27.
    Department of Veterans Affairs, Durham VA Medical Center Health Services Research and Development, Durham, NC, USA.
    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. Read More

    Interventions at the Transition from Prison to the Community for Prisoners with Mental Illness: A Systematic Review.
    Adm Policy Ment Health 2018 Jan 23. Epub 2018 Jan 23.
    Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
    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. Read More

    Web-Based Training Methods for Behavioral Health Providers: A Systematic Review.
    Adm Policy Ment Health 2018 Jan 19. Epub 2018 Jan 19.
    West Virginia University, Morgantown, WV, USA.
    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. Read More

    Enhancing the Delivery of an Empirically-Supported Trauma-Focused Treatment for Adolescents: Providers' Views of the Role of Technology and Web-Based Resources.
    Adm Policy Ment Health 2018 Jan 5. Epub 2018 Jan 5.
    Department of Psychiatry, Indiana University, 355 W. 16th St., Suite 4800, Indianapolis, IN, 46202, USA.
    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. Read More

    Are Randomized Control Trials the Best Method to Assess the Effectiveness of Community Treatment Orders?
    Adm Policy Ment Health 2017 Dec 28. Epub 2017 Dec 28.
    Departments of Family Medicine and Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
    Many jurisdictions have enacted community treatment order (CTO) legislation that requires a person, who suffers from a severe mental disorder, to follow a treatment plan when living in the community. CTOs have been a source of debate because of controversies on whether evidence of effectiveness should only be considered from randomized controlled trials (RCTs). RCTs are considered the "gold standard" method to evaluate effectiveness of simple therapeutic interventions such as medication, but they are problematic for evaluation of complex interventions because valid attribution of causation in complex interventions is not guaranteed with RCTs. Read More

    Where do Peer Providers Fit into Newly Integrated Mental Health and Primary Care Teams? A Mixed Method Study.
    Adm Policy Ment Health 2017 Dec 21. Epub 2017 Dec 21.
    Suzanne Dworak-Peck School of Social Work, University of Southern California, 150 S. Olive Street, Los Angeles, CA, 90015-2211, USA.
    Little is known about the involvement of peer providers in integrated behavioral health teams. This study asks where peer providers fit within integrated care teams in Los Angeles County. Social network analysis combined with qualitative fieldwork was used to understand the network positions of peer providers in 14 integrated pilot programs. Read More

    A Cost-Effectiveness Analysis to Evaluate a System Change in Mental Healthcare in the Netherlands for Patients with Depression or Anxiety.
    Adm Policy Ment Health 2017 Dec 15. Epub 2017 Dec 15.
    Pro Persona Research, Pro Persona, Wolfheze, The Netherlands.
    Over the last decade, the Dutch mental healthcare system has been subject to profound policy reforms, in order to achieve affordable, accessible, and high quality care. One of the adjustments was to substitute part of the specialized care for general mental healthcare. Using a quasi-experimental design, we compared the cost-effectiveness of patients in the new setting with comparable patients from specialized mental healthcare in the old setting. Read More

    Agreement and Discrepancy Between Supervisor and Clinician Alliance: Associations with Clinicians' Perceptions of Psychological Climate and Emotional Exhaustion.
    Adm Policy Ment Health 2017 Dec 11. Epub 2017 Dec 11.
    University of Washington, 1417 NE 42nd St., Box 354875, Seattle, WA, 98105, USA.
    Despite increasing interest in supervision as a leverage point for bolstering public mental health services, the potential influence of supervisory alliance on organizations and direct service providers remains understudied, particularly in the context of supporting evidence-based treatment (EBT) use. This study examined agreement and discrepancy between supervisor and clinician ratings of alliance associated with clinicians' perceptions of psychological climate and emotional exhaustion. Results indicated that discrepancies in alliance ratings were common and associated with clinicians' perceptions of psychological climate. Read More

    Development and Validation of a Japanese Fidelity Scale for Supported Employment.
    Adm Policy Ment Health 2018 Mar;45(2):318-327
    Department of Psychiatric Rehabilitation, National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
    The Individual Placement and Support (IPS) model of supported employment is an evidence based practice. Although several agencies have been trying to implement the IPS-model since 2005 in Japan, there was no tool to assess the quality. This study developed a Japanese version of the 25-item Individualized Supported Employment Fidelity Scale (J-ISEF), a new Japanese fidelity tool for supported employment based on the IPS model. Read More

    Impact of a Usual Source of Care on Health Care Use, Spending, and Quality Among Adults With Mental Health Conditions.
    Adm Policy Ment Health 2017 Nov 30. Epub 2017 Nov 30.
    IBM Watson Health, Bethesda, MD, USA.
    Physical comorbidities associated with mental health conditions contribute to high health care costs. This study examined the impact of having a usual source of care (USC) for physical health on health care utilization, spending, and quality for adults with a mental health condition using Medicaid administrative data. Having a USC decreased the probability of inpatient admissions and readmissions. Read More

    Disruptive Behavior Treatment Progress as a Function of Therapy Focus and Youth Diagnosis in a Community Mental Health Setting.
    Adm Policy Ment Health 2017 Nov 25. Epub 2017 Nov 25.
    Department of Psychology, University of Hawai‛i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI, 96822, USA.
    Monthly disruptive behavior treatment progress for 613 youth ages 7-18 receiving intensive in-home services was examined. Multilevel modeling indicated carrying a depressive mood diagnosis predicted less disruptive behavior progress compared to youth with only externalizing diagnoses. Paradoxically, more monthly focus on disruptive behavior treatment targets predicted lower concurrent progress ratings, while greater focus on depressive mood targets predicted greater disruptive behavior progress for youth with a depressive mood diagnosis. Read More

    Qualitative Evaluation of a Peer Navigator Program for Latinos with Serious Mental Illness.
    Adm Policy Ment Health 2017 Nov 22. Epub 2017 Nov 22.
    Illinois Institute of Technology, Chicago, USA.
    Peer navigator programs (PNP) may help reduce physical health disparities for ethnic minorities with serious mental illness (SMI). However, specific aspects of PNP that are important to peer navigators and their clients are under-researched. A qualitative study explored the perspectives of service users (n = 15) and peer navigators (n = 5) participating in a randomized controlled trial of a PNP for Latinos with SMI. Read More

    Individualized Progress Measures Are More Acceptable to Clinicians Than Standardized Measures: Results of a National Survey.
    Adm Policy Ment Health 2017 Nov 15. Epub 2017 Nov 15.
    Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
    Despite research supporting measurement-based care grounded in standardized progress measures, such measures are underutilized by clinicians. Individualized measures of client-specific targets present an alternative, but little is known about their acceptability or use. We compared attitudes toward and use of standardized and individualized progress measures in a national sample of 504 clinicians. Read More

    Behavioural and Emotional Problems in Children and Educational Outcomes: A Dynamic Panel Data Analysis.
    Adm Policy Ment Health 2017 Nov 11. Epub 2017 Nov 11.
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia.
    This study investigates the effects of behavioural and emotional problems in children on their educational outcomes using data from the Longitudinal Survey of Australian Children (LSAC). We contribute to the extant literature using a dynamic specification to test the hypothesis of knowledge accumulation. Further, we apply the system generalised method of moments (GMM) estimator to minimise biases due to unobserved factors. Read More

    Stepped Care Interpersonal Psychotherapy Treatment for Depressed Adolescents: A Pilot Study in Pediatric Clinics.
    Adm Policy Ment Health 2017 Nov 9. Epub 2017 Nov 9.
    New York State Psychiatric Institute, 1051 Riverside Drive, Unit 74, New York, NY, 10032, USA.
    Adolescents with depression are at risk for negative long-term consequences and recurrence of depression. Many do not receive nor access treatment, especially Latino youth. New treatment approaches are needed. Read More

    What Makes Research Useful for Public School Educators?
    Adm Policy Ment Health 2017 Nov 9. Epub 2017 Nov 9.
    Department of Psychology, Michigan State University, 316 Physics Rd. Rm. 127A, East Lansing, MI, 48824, USA.
    In this study, we explored the extent to which educators discuss and prioritize Rogers' (Diffusion of innovations, The Free Press: New York, 1995) five attributes of innovations-relative advantage, compatibility, complexity, observability, and trialability-in the context of research use. Using a directed content analysis of 54 semi-structured interviews and exemplar quotes, we describe how educators mentioned compatibility most frequently, but also commonly invoked observability and complexity in their discussions of research use. Our results also revealed key differences between educators in executive and non-executive roles. Read More

    Comparing Agency Leader and Therapist Perspectives on Evidence-Based Practices: Associations with Individual and Organizational Factors in a Mental Health System-Driven Implementation Effort.
    Adm Policy Ment Health 2017 Nov 3. Epub 2017 Nov 3.
    Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
    Agency leaders and therapists are essential stakeholders in implementation of evidence-based practices (EBPs) within publicly-funded mental health services. Little is known about how these stakeholders differ in their perceptions of specific EBPs and which individual and organizational factors differentially influence these perceptions. Within the context of a system-driven implementation of multiple EBPs, survey data from 160 leaders and 720 therapists were examined to assess differences in perceptions of six EBPs. Read More

    Promoting Teachers' Implementation of Classroom-Based Prevention Programming Through Coaching: The Mediating Role of the Coach-Teacher Relationship.
    Adm Policy Ment Health 2017 Oct 26. Epub 2017 Oct 26.
    Department of Mental Health, Bloomberg School of Public Health, Baltimore, MD, USA.
    There is growing awareness of the importance of implementation fidelity and the supports, such as coaching, to optimize it. This study examined how coaching activities (i.e. Read More

    Impacting Entry into Evidence-Based Supported Employment: A Population-Based Empirical Analysis of a Statewide Public Mental Health Program in Maryland.
    Adm Policy Ment Health 2018 Mar;45(2):328-341
    IBM Watson Health, Bethesda, MD, USA.
    We use discrete-time survival regression to study two empirical issues relating to take-up of individual placement and support (IPS) supported employment (SE) services for persons with serious mental illness: (1) the influence of client characteristics on take-up probability, and (2) the possible impacts of a major recent initiative in one state (Maryland) to overcome barriers to IPS-SE expansion. Our longitudinal analysis of population-based Medicaid cohorts, during 2002-2010, provides tentative evidence of positive state initiative impacts on SE take-up rates, and evidence of effects on take-up for clients' diagnoses, prior work-history, health and demographic characteristics, and geographic accessibility to SE providers. Read More

    Exploring Provider Use of a Digital Implementation Support System for School Mental Health: A Pilot Study.
    Adm Policy Ment Health 2017 Oct 9. Epub 2017 Oct 9.
    3C Institute, 4364 S Alston Ave, Durham, NC, 27713, USA.
    This pilot study explored provider use of an online system, Centervention, to support the delivery of empirically supported school-based mental health interventions (ESIs); and associations between components of this system [resources, training, technical assistance (TA), feedback loops], implementation indicators, and student outcomes. Multilevel modeling data were collected from 39 providers implementing ESIs with 758 students. Training, TA, and progress monitoring predicted ESI adherence, and perceived value of resources and TA influenced student responsiveness. Read More

    Documentation of Evidence-Based Psychotherapy and Care Quality for PTSD in the Department of Veterans Affairs.
    Adm Policy Ment Health 2017 Sep 30. Epub 2017 Sep 30.
    VA Center for Clinical Management Research, 2800 Plymouth Road, Building 16, Ann Arbor, MI, 48109, USA.
    This study measured the prevalence of evidence-based psychotherapy (EBP) templated notes in VA and tested the hypothesis that template use would be associated with care quality for posttraumatic stress disorder (PTSD). Across 130 facilities, an average of 3.6% of patients with a PTSD diagnosis received at least one EBP template in 2015. Read More

    The REFINEMENT Glossary of Terms: An International Terminology for Mental Health Systems Assessment.
    Adm Policy Ment Health 2018 Mar;45(2):342-351
    Ludwig Boltzmann Institute for Social Psychiatry, Vienna, Austria.
    Comparing mental health systems across countries is difficult because of the lack of an agreed upon terminology covering services and related financing issues. Within the European Union project REFINEMENT, international mental health care experts applied an innovative mixed "top-down" and "bottom-up" approach following a multistep design thinking strategy to compile a glossary on mental health systems, using local services as pilots. The final REFINEMENT glossary consisted of 432 terms related to service provision, service utilisation, quality of care and financing. Read More

    Modeling the Decision of Mental Health Providers to Implement Evidence-Based Children's Mental Health Services: A Discrete Choice Conjoint Experiment.
    Adm Policy Ment Health 2018 Mar;45(2):302-317
    Child and Youth Mental Health Research Unit, The Hospital for Sick Children, Toronto, Canada.
    Using an online, cross sectional discrete choice experiment, we modeled the influence of 14 implementation attributes on the intention of 563 providers to adopt hypothetical evidence-based children's mental health practices (EBPs). Latent class analysis identified two segments. Segment 1 (12%) would complete 100% of initial training online, devote more time to training, make greater changes to their practices, and introduce only minor modifications to EBPs. Read More

    Impact of a Mental Health Based Primary Care Program on Quality of Physical Health Care.
    Adm Policy Ment Health 2018 Mar;45(2):276-285
    New York State Office of Mental Health, 330 5th Ave, 9th floor, New York, NY, 10001, USA.
    We examine the impact of mental health based primary care on physical health treatment among community mental health center patients in New York State using propensity score adjusted difference in difference models. Outcomes are quality indicators related to outpatient medical visits, diabetes HbA1c monitoring, and metabolic monitoring of antipsychotic treatment. Results suggest the program improved metabolic monitoring for patients on antipsychotics in one of two waves, but did not impact other quality indicators. Read More

    Peer-Assisted Social Learning for Diverse and Low-Income Youth: Infusing Mental Health Promotion Into Urban After-School Programs.
    Adm Policy Ment Health 2018 Mar;45(2):286-301
    Department of Psychology, Florida International University, Miami, FL, USA.
    Community-based after-school programs (ASPs) can promote social competence by infusing evidence-based practice into recreation. Through collaborative partnership, we developed and implemented a peer-assisted social learning (PASL) model to leverage natural opportunities for peer-mediated problem-solving. ASP-Staff (n = 5) led elementary-school youth (n = 30) through 21 activities that partnered socially-skilled and less-skilled children; outcomes were compared to children (n = 31) at another site, via quasi-experimental design. Read More

    "It's Not Like Therapy": Patient-Inmate Perspectives on Jail Psychiatric Services.
    Adm Policy Ment Health 2018 Mar;45(2):265-275
    School of Social Welfare, University of California, Berkeley, 120 Haviland Hall, #7400, Berkeley, CA, 94720, USA.
    Jails may serve an important public health function by treating individuals with psychiatric problems. However, scholars debate the service qualities that can best achieve this aim. Some suggest the possibility of comprehensive psychiatric services in jails, while others recommend a narrower focus on basic elements of care (assessments, medication management, and crisis intervention). Read More

    Length of Involuntary Hospitalization Related to the Referring Physician's Psychiatric Emergency Experience.
    Adm Policy Ment Health 2018 Mar;45(2):254-264
    Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Lenggstrasse 31, Postfach 1931, 8032, Zurich, Switzerland.
    Although involuntary commitment (IC) is a serious intervention in psychiatry and must always be regarded as an emergency measure, the knowledge about influencing factors is limited. Aims were to test the hypothesis that duration of involuntary hospitalization and associated parameters differ for IC's mandated by physicians with or with less routine experience in psychiatric emergency situations. Duration of involuntary hospitalization and duration until day-passes of 508 patients with IC at the University Hospital of Psychiatry Zurich were analyzed using a generalized linear model. Read More

    Patient Satisfaction and Quality of Life in People with Schizophrenia-Spectrum Disorders in a Rural Area.
    Adm Policy Ment Health 2018 Mar;45(2):245-253
    Psychiatrische Dienste Graubünden, Plazza Paracelsus 2, 7500 St., Moritz, Switzerland.
    People suffering from schizophrenia-spectrum disorders often endorse a reduced quality of life (QoL) as compared to the general population. There appears to be a lack of studies for rural catchment areas for this patient population. We conducted a cross-sectional study with 94 people with schizophrenia-spectrum disorders in a mainly rural alpine area. Read More

    Treatment Outcome, Duration, and Costs: A Comparison of Performance Indicators Using Data from Eight Mental Health Care Providers in The Netherlands.
    Adm Policy Ment Health 2018 Mar;45(2):212-223
    Department of Care en Quality, GGZ Rivierduinen, Leiden, The Netherlands.
    Assessing performance of mental health services (MHS) providers merely by their outcomes is insufficient. Process factors, such as treatment cost or duration, should also be considered in a meaningful and thorough analysis of quality of care. The present study aims to examine various performance indicators based on treatment outcome and two process factors: duration and cost of treatment. Read More

    A National Study of Veterans Treatment Court Participants: Who Benefits and Who Recidivates.
    Adm Policy Ment Health 2018 Mar;45(2):236-244
    Veterans Justice Programs, Veterans Health Administration, Lexington, KY, USA.
    Although there are now over 400 veterans treatment courts (VTCs) in the country, there have been few studies on participant outcomes in functional domains. Using national data on 7931 veterans in the Veterans Affairs (VA) Veterans Justice Outreach program across 115 VA sites who entered a VTC from 2011 to 2015, we examined the housing, employment, income, and criminal justice outcomes of VTC participants; and identified veteran characteristics predictive of outcomes. VTC participants spent an average of nearly a year in the program and 14% experienced a new incarceration. Read More

    Potentially Inappropriate Antidepressant Prescriptions Among Older Adults in Office-Based Outpatient Settings: National Trends from 2002 to 2012.
    Adm Policy Ment Health 2018 Mar;45(2):224-235
    Department of Pharmaceutical Care and Health Systems, University of Minnesota College of Pharmacy, Minneapolis, MN, USA.
    Using data from 2002 to 2012 National Ambulatory Medical Care Survey, we estimated that the prevalence of overall antidepressant prescriptions increased almost twofold from 5.2% in 2002 to 10.1% in 2012 in office-based outpatient visits made by older adults. Read More

    Mobilizing Community Health Workers to Address Mental Health Disparities for Underserved Populations: A Systematic Review.
    Adm Policy Ment Health 2018 Mar;45(2):195-211
    Department of Psychology, University of California, Los Angeles, CA, USA.
    This systematic review evaluates efforts to date to involve community health workers (CHWs) in delivering evidence-based mental health interventions to underserved communities in the United States and in low- and middle-income countries. Forty-three articles (39 trials) were reviewed to characterize the background characteristics of CHW, their role in intervention delivery, the types of interventions they delivered, and the implementation supports they received. The majority of trials found that CHW-delivered interventions led to symptom reduction. Read More

    Estimating the Economic Value of Information for Screening in Disseminating and Targeting Effective School-based Preventive Interventions: An Illustrative Example.
    Adm Policy Ment Health 2017 Nov;44(6):932-942
    Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
    When candidates for school-based preventive interventions are heterogeneous in their risk of poor outcomes, an intervention's expected economic net benefits may be maximized by targeting candidates for whom the intervention is most likely to yield benefits, such as those at high risk of poor outcomes. Although increasing amounts of information about candidates may facilitate more accurate targeting, collecting information can be costly. We present an illustrative example to show how cost-benefit analysis results from effective intervention demonstrations can help us to assess whether improved targeting accuracy justifies the cost of collecting additional information needed to make this improvement. Read More

    The Role of Practice Research Networks (PRN) in the Development and Implementation of Evidence: The Northern Improving Access to Psychological Therapies PRN Case Study.
    Adm Policy Ment Health 2017 Nov;44(6):919-931
    Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK.
    Practice research networks (PRNs) can support the implementation of evidence based practice in routine services and generate practice based evidence. This paper describes the structure, processes and learning from a new PRN in the Improving Access to Psychological Therapies programme in England, in relation to an implementation framework and using one study as a case example. Challenges related to: ethics and governance processes; communications with multiple stakeholders; competing time pressures and linking outcome data. Read More

    The Impact of Coverage Restrictions on Antipsychotic Utilization Among Low-Income Medicare Part D Enrollees.
    Adm Policy Ment Health 2017 Nov;44(6):943-954
    Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA.
    Prior research demonstrates substantial access problems associated with utilization management and formulary exclusions for antipsychotics in Medicaid, but the use and impact of coverage restrictions for these medications in Medicare Part D remains unknown. We assess the effect of coverage restrictions on antipsychotic utilization in Part D by exploiting a unique natural experiment in which low-income beneficiaries are randomly assigned to prescription drug plans with varying levels of formulary generosity. Despite considerable variation in use of coverage restrictions across Part D plans, we find no evidence that these restrictions significantly deter utilization or reduce access to antipsychotics for low-income beneficiaries. Read More

    The Role of Health Plans in Supporting Behavioral Health Integration.
    Adm Policy Ment Health 2017 Nov;44(6):967-977
    The Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South St., Waltham, MA, USA.
    Health plan policies can influence delivery of integrated behavioral health and general medical care. This study provides national estimates for the prevalence of practices used by health plans that may support behavioral health integration. Results indicate that health plans employ financing and other policies likely to support integration. Read More

    Comparing Strategies for Providing Child and Youth Mental Health Care Services in Canada, the United States, and The Netherlands.
    Adm Policy Ment Health 2017 Nov;44(6):955-966
    Department of Psychology, University of New Brunswick, Fredericton, NB, Canada.
    This paper reviews how child and youth mental health care services in Canada, the United States, and the Netherlands are organized and financed in order to identify systems and individual-level factors that may inhibit or discourage access to treatment for youth with mental health problems, such as public or private health insurance coverage, out-of-pocket expenses, and referral requirements for specialized mental health care services. Pathways to care for treatment of mental health problems among children and youth are conceptualized and discussed in reference to health insurance coverage and access to specialty services. We outline reforms to the organization of health care that have been introduced in recent years, and the basket of services covered by public and private insurance schemes. Read More

    Context Matters: Team and Organizational Factors Associated with Reach of Evidence-Based Psychotherapies for PTSD in the Veterans Health Administration.
    Adm Policy Ment Health 2017 Nov;44(6):904-918
    Executive Division, National Center for PTSD, White River Junction, VT, USA.
    Evidence-based psychotherapies for PTSD are often underused. The objective of this mixed-method study was to identify organizational and clinic factors that promote high levels of reach of evidence-based psychotherapies for PTSD 10 years into their dissemination throughout the Veterans Health Administration. We conducted 96 individual interviews with staff from ten outpatient PTSD teams at nine sites that differed in reach of evidence-based psychotherapies for PTSD. Read More

    Impact of Coordinated Behavioral Health Management on Quality Measures of Antipsychotic Use.
    Adm Policy Ment Health 2018 Jan;45(1):174-185
    Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA.
    A state Care Management Entity (CME) using the wraparound practice model provided intensive care coordination for youth with severe mental illness, those most likely to receive antipsychotics. The model has led to improved clinical/functional outcomes, but little is known about the impact on antipsychotic prescribing and safety monitoring. A pre-post study was conducted to evaluate antipsychotic dosing, concomitant antipsychotic use, and metabolic monitoring among CME-enrolled and non-CME-enrolled comparison groups. Read More

    Using Participatory Action Research to Develop a Working Model That Enhances Psychiatric Nurses' Professionalism: The Architecture of Stability.
    Adm Policy Ment Health 2017 Nov;44(6):888-903
    Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, 801 76, Gävle, Sweden.
    Ward rules in psychiatric care aim to promote safety for both patients and staff. Simultaneously, ward rules are associated with increased patient violence, leading to neither a safe work environment nor a safe caring environment. Although ward rules are routinely used, few studies have explicitly accounted for their impact. Read More

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