Psychological Services最新文献

Criticisms of police use of force policies and the over policing of communities of color have generated calls to reallocate part of the funding that routinely goes to police departments to fund more social welfare programs. In particular, analysts and policy makers have supported the implementation of alternative crisis response programs, such as the use of unarmed behavioral health workers, to reduce police contact and improve mental health service provision to citizens. The present study examined the extent to which one such civilian-based 911 diversion program in St. Petersburg, Florida, called the Community Assistance and Life Liaison program, provides equitable access to communities in need. Through analysis of contact data (N = 6,653 contacts with residents) and zip code-level Census data of community characteristics, we found that the program diverted 37% of the noncrime crisis calls coming through the emergency communication line. The program additionally engaged in a substantial number of proactive and follow-up contacts, responded to a diverse group of individuals, and disproportionately served communities showing higher drivers of inequity. At the same time, notable disparities were found in that fewer follow-up services and nonlive referrals (e.g., officer or proactive contacts) were provided by Community Assistance and Life Liaison program to communities with higher poverty rates, Black youth were less likely to be diverted from police contact, and communities with more Black and non-U.S. citizen residents were less likely to receive live dispatch contacts from the program. Implications and recommendations for reducing over policing and health disparities are provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Youth Mental Health First Aid (YMHFA) training has been adopted across the United States to teach adults how to identify and respond to youth mental health challenges and crises. Evaluations of YMHFA have yet to be undertaken with law enforcement populations, although agencies and officers are participating in the training. The present study implemented and evaluated YMHFA with law enforcement officers (N = 446) across a southeastern state. A longitudinal survey design (pretest, posttest, 90-day follow-up) was employed to measure training participants' satisfaction with the training and changes to seven constructs: mental health knowledge; confidence to engage in help-seeking behaviors; intentions to intervene; positive attitudes toward youth with mental health needs; negative attitudes toward community responsibility for youth with mental health needs; positive attitudes toward youth with mental health needs living in the community; and preparedness. Results of analyses demonstrated statistically significant improvements among all constructs immediately following training completion, and participants generally reported being satisfied with the training. However, most of the improvements observed immediately following the training disappeared at the 90-day follow-up, with only participants' reported confidence and preparedness continuing to show improvement over pretest scores. The implications of these findings for law enforcement officers, their agencies, and researchers are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Interventions for substance use disorders (SUDs) are typically delivered face-to-face or remotely via telehealth. In recent years, there has been a rapid rise in the number of SUD services delivered using telehealth. However, the literature on which mode of service delivery SUD patients and providers prefer is still emerging, particularly with respect to family-based interventions in Opioid Treatment Programs (OTPs). This study sought to identify/explain preferences for delivering family-based programs among OTP patients and providers. Data collection from a total of 40 participants (20 patients and 20 providers) was conducted from August 2022 to October 2022 at two OTPs in Florida. An online survey was used to collect demographic data, while individual qualitative interviews were conducted to explore preferences for delivering family-based programs. Audiotapes of interviews were transcribed, coded, and thematically analyzed. Analyses revealed that patients and providers had similar preferences, with the most salient being (a) concerns about keeping children engaged during telehealth sessions, (b) concerns about communication barriers when using telehealth, (c) preference for telehealth using live video (as opposed to prerecorded content), and (d) preference for telehealth over face-to-face due to greater convenience for patients. These findings show that preferences for delivering family-based services are varied and may differ somewhat from preferences for delivering traditional individual therapy services. The data presented here can be used to develop and further refine protocols for adapting and delivering family-based interventions in OTP settings, and are especially timely as legislative discussions are currently occurring about expanding telehealth services in these facilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Professional firefighters are routinely exposed to occupational stressors that place them at a higher risk of developing mental health symptoms, including anxiety, depression, and posttraumatic stress. This article discusses findings of the National Wellness Survey for Public Safety Personnel, specifically the stressors that professional firefighters are exposed to on the job and their impact. Results indicated high levels of both occupational and individual stressors in this group. Common occupational and personal stressors and mental health symptomology endorsed by professional firefighters are discussed. Findings also revealed that about 40% of professional firefighters are facing clinically substantial levels of anxiety and depression, and more than 10% are experiencing clinically significant levels of posttraumatic stress disorder in numbers surpassing the general population. Most professional firefighters indicated being adversely impacted by their duties but did not want to utilize services, which is in line with prior research. Suggestions for assisting professional firefighters in mitigating occupational and personal stress are presented, and proposals for future research are provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The U.S. special operations forces (SOF) contribute to a range of complex missions and experience high operational tempo, which may result in heightened professional and personal stressors. Those who are experiencing stressors may be reluctant to seek professional mental health services due to career concerns. The chaplaincy community is at the forefront of bearing and responding to the pain of others including those at risk for suicide. As a formative step to developing a tailored suicide prevention curriculum for the U.S. SOF religious support teams (RSTs), we sought to understand SOF RSTs' common strategies for suicide prevention, intervention, and postvention. We conducted confidential interviews with SOF RSTs via telephone and in person. We used an inductive thematic analysis to code a total of 57 transcripts. SOF RSTs prominently expressed that building relationships with SOF community members was foundational to their suicide prevention, intervention, and postvention practices: (a) Suicide prevention involved being available and cultivating a community of insiders who can provide resources as needed prior to crisis escalation; (b) Suicide intervention involved listening and responding to suicide risk and building autonomy for a suicidal SOF member to seek outside help; (c) Suicide postvention involved reaching out to suicide-loss survivors and grieving together through memorial services. The salient theme of building relationships points to opportunities to capitalize on RSTs' social connections and to enhance skills and resources for military suicide prevention, intervention, and postvention practices. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

FLOW (not an acronym) is a program that aims to improve mental health (MH) access using an algorithm that extracts electronic medical record data to identify recovered or stabilized MH patients who may be eligible to transition to primary care. The purpose of this case study was to describe and understand the factors that contributed to success or struggles in implementing FLOW. We conducted a posthoc evaluation of four health care sites implementing FLOW, using a mixed-method formal case study analysis. Qualitative data included written process notes, teleconference minutes, and interviews with internal facilitators (IF), MH providers, and patients who were transitioned. The external facilitation team also examined the degree to which IF characteristics matched suggested criteria. Quantitative data included discharge percentages and the percentage of providers who transitioned ≥ three patients during implementation. Sites were considered successful if they: (a) discharged ≥ 3% of their unique MH patients and (b) had a preponderance of patients who were satisfied with their MH to primary care transition. This article discusses two successful and two struggling FLOW sites based on these and other criteria and the factors that contributed to these outcomes. These case study findings increased understanding of how to successfully implement FLOW. The importance of shared decision making, selection of the IF, role definition, as well as leadership and organizational support are key elements in fostering appropriate transitions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychologists are well-positioned to take on leadership roles in health care systems as a result of the broad-based skills included in doctoral level, professional training programs. These include knowledge of evidence-based practice, extensive training in applied research and clinical practice, emphasis on critical thinking in scientific methods and hypothesis testing, teaching, supervision, team consultation, and continuous learning (APA Presidential Task Force on Evidence-Based Practice, 2006; Korman, 1974; McFall, 2007). Formal opportunities to learn how to apply these skills in leadership and organizational management roles are, however, limited during graduate training. There have been recent efforts within the American Psychological Association to foster interest and readiness for leadership roles among psychologists. These efforts have included a leadership development fellowship, on-demand webinars, and online learning for continuing education (American Psychological Association, 2023). The content of these training opportunities is typically general in nature so that it can be applied to all types of organizational settings. Psychologists interested in leadership positions within public sector health care organizations are likely to benefit from information that aligns more specifically with the mission and organizational structures of such systems. This article presents a conceptual framework to prepare psychologists aspiring to leadership positions in public sector health care. Leadership theories and models from organizational management science are outlined which capture the context and organizational goals of such programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

African American veterans who use tobacco use evidence-based tobacco-cessation treatment less than other racial/ethnic groups, contributing to higher tobacco-related treatment burden for them. This study aimed to assess barriers and facilitators African American patients face before engaging in Veterans Health Administration behavioral tobacco-cessation treatment services, as an initial step to identify new implementation strategies. African American veterans (N = 30) who use tobacco at a large Veterans Affairs Medical Center completed interviews about perceived barriers and facilitators to behavioral treatment, views on telehealth, and suggested care improvements. We used a combination of deductive and inductive analytic approaches and identified four themes: (1) Ambivalence towards Quitting Tobacco: Patients described how low motivation to quit and intense withdrawal symptoms impede treatment engagement, despite known health risks; (2) Limited Interaction with Health Care System: Patients described how histories of mistrust and stigma toward treatment impact engagement with the health care system, resulting in lack of awareness of treatment options and preference for self-reliance in quitting; (3) Individualized Factors for Engagement: Patients described how persistent providers, access to telehealth modalities, personal health complications exacerbated by tobacco use, and benefits of positive lifestyle change increase motivation for treatment; and (4) Suggestions for Culturally Tailored Treatment Engagement: Patients expressed a desire for more African American group-specific outreach, including targeted advertisement and culturally aware providers to combat mistrust of the health care system. Findings indicate that generating patient-driven implementation strategies such as tailored education and proactive outreach are necessary to increase engagement of African American patients in tobacco-cessation treatment programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Measurement-based care (MBC) comprises collecting patient-reported outcomes data using validated assessments and using that information to support treatment. The Veterans Health Administration (VHA) has developed technology platforms to support MBC, including the Mental Health Checkup (MHC) mobile health application (app). Our objective was to examine VHA mental health provider perspectives on the MHC app. We completed a mixed-methods, sequential explanatory evaluation of MHC. We surveyed 284 VHA mental health providers who used MHC, then conducted semistructured telephone interviews with a purposefully selected subset of survey respondents (n = 20). Approximately half of survey respondents agreed that MHC allowed them to collect assessment data from veterans more frequently than before (51%) and that they more frequently discussed assessment results with veterans because of MHC (50%) and used those results to inform goal-setting discussions (50%) and treatment decision making (51%). Bivariate analyses indicated a positive relationship between frequency of MHC use and the aforementioned impacts on care. Interview data conveyed both advantages (e.g., increased treatment efficiency, improved treatment decision making) and challenges (e.g., limited assessment availability, difficulties engaging veterans in completing assessments through the app) to using MHC. This evaluation demonstrated how MHC supported providers working to implement MBC. The app enhanced their ability to reach and engage veterans and incorporate assessment data into clinical encounters. Still, many did not perceive that MHC was impactful on mental health care delivery; given that providers who used MHC more frequently reported more positive impressions of MHC, this may be related to how frequently they used the app. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Within mental health services, persons in recovery from their own experiences of mental health challenges (peers) are increasingly being trained to provide peer support. This study describes individual and organizational outcomes related to engaging peers in a multisite demonstration project in California that sought to integrate them as cocreators throughout planning and implementation of digital mental health interventions. We collected data from key informants across 11 sites. Quarterly online surveys invited key informants to report perceived outcomes of the peer component. Biannual interviews elicited details regarding survey-reported outcomes. Quantitative data provided indications of outcome prevalence and consistency, and quotes from the interviews illustrated the complex realities underlying survey responses. One hundred three quarterly surveys and 39 biannual interviews were completed between Summer 2020 and Fall 2022. Key informants reported diverse outcomes, including integration of peer input into local decision making, mental health benefits to peers and community members, reduced workplace mental health stigma, and new cross-site collaborations. Five sites reported outcomes with greater consistency compared to the other six sites. Reports of increased peer visibility in the workplace coincided with reports of reduced stigma and increased value of peer input by mental health professionals. This study offers encouragement for the potential positive impact of engaging peers as cocreators of mental health interventions. Data suggest integrating peers does not increase mental health stigma and may instead result in various positive outcomes. The degree to which these outcomes manifest in a specific setting, however, may vary. Future research should seek to identify contextual factors that support actualization of positive outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).