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Characterizing Schizophrenia Spectrum Disorders: Results of the U.S. Mental and Substance Use Disorders Prevalence Study. 精神分裂症谱系障碍的特征:美国精神和物质使用障碍流行率研究结果》。
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 Epub Date: 2024-09-23 DOI: 10.1176/appi.ps.20240138
Natalie Bareis, Mark Edlund, Heather Ringeisen, Heidi Guyer, Lisa B Dixon, Mark Olfson, Thomas E Smith, Lydia Chwastiak, Maria Monroe-DeVita, Marvin Swartz, Jeffrey Swanson, Elizabeth Sinclair Hancq, Paul Geiger, Noah T Kreski, T Scott Stroup

Objective: Current information on treatment and clinical characteristics of U.S. adults with schizophrenia spectrum disorders (i.e., schizophrenia, schizoaffective, and schizophreniform disorders) may help inform public health policy and service development for this population.

Methods: Data were from the U.S. Mental and Substance Use Disorders Prevalence Study, conducted from October 2020 to October 2022. Clinicians administered the Structured Clinical Interview for the DSM-5 for past-year psychiatric and substance use disorder diagnoses among adults ages 18-65 years. Using sampling weights, the authors examined clinical and treatment characteristics among those with schizophrenia spectrum disorders and compared sociodemographic characteristics and comorbid behavioral health conditions of individuals with or without such disorders (N=4,764).

Results: Among 114 adults with schizophrenia spectrum disorders, the most common comorbid conditions were major depressive episode (52%, 95% CI=34%-69%) and alcohol use (23%, CI=3%-43%), cannabis use (20%, 95% CI=1%-39%), and posttraumatic stress (17%, 95% CI=5%-30%) disorders. Global Assessment of Functioning scores were lower among people with than among those without schizophrenia spectrum disorders (mean±SE=44.8±2.0 vs. 77.2±0.5, p<0.01, respectively), indicating worse functioning. In the past year, 71% (95% CI=55%-87%) of adults with schizophrenia spectrum disorders received at least some mental health treatment, and 26% (95% CI=13%-38%) received minimally adequate treatment.

Conclusions: Individuals with schizophrenia spectrum disorders face substantial challenges in the United States, including high rates of comorbid mental health conditions and substance use; few received adequate treatment. A strong social safety net and active clinical interventions are required to address the socioeconomic challenges and unmet mental health service needs of this population.

目的:有关美国成人精神分裂症谱系障碍(即精神分裂症、情感分裂症和精神分裂症)患者的治疗和临床特征的现有信息可能有助于为该人群的公共卫生政策和服务发展提供参考:数据来自 2020 年 10 月至 2022 年 10 月进行的美国精神和物质使用障碍流行率研究。临床医生对 18-65 岁的成年人进行了 DSM-5 结构化临床访谈,以了解他们过去一年的精神病和药物使用障碍诊断情况。作者使用抽样加权法检查了精神分裂症谱系障碍患者的临床和治疗特征,并比较了有无此类障碍患者的社会人口特征和合并行为健康状况(N=4,764):在114名患有精神分裂症谱系障碍的成年人中,最常见的合并症是重度抑郁发作(52%,95% CI=34%-69%)、酗酒(23%,CI=3%-43%)、吸食大麻(20%,95% CI=1%-39%)和创伤后应激障碍(17%,95% CI=5%-30%)。精神分裂症谱系障碍患者的功能全面评估得分低于非精神分裂症谱系障碍患者(平均值±SE=44.8±2.0 vs. 77.2±0.5,p结论:在美国,精神分裂症谱系障碍患者面临着巨大的挑战,包括精神健康状况和药物使用的高并发率;很少有人能得到充分的治疗。要解决这一人群面临的社会经济挑战和未得到满足的精神健康服务需求,需要一个强大的社会安全网和积极的临床干预措施。
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引用次数: 0
Implementation of Community Health Worker Support for Tobacco Cessation: A Mixed-Methods Study. 实施社区卫生工作人员戒烟支持:混合方法研究。
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 Epub Date: 2024-08-09 DOI: 10.1176/appi.ps.20240044
Cheryl Y S Foo, Kevin Potter, Lindsay Nielsen, Aarushi Rohila, Melissa Culhane Maravic, Kristina Schnitzer, Gladys N Pachas, Douglas E Levy, Sally Reyering, Anne N Thorndike, Corinne Cather, A Eden Evins

Objective: Adults with serious mental illness have high rates of tobacco use disorder and underuse pharmacotherapy for tobacco cessation. In a previous randomized controlled trial, participants receiving community health worker (CHW) support and education for their primary care providers (PCPs) had higher tobacco abstinence rates at 2 years, partly because of increased initiation of tobacco-cessation pharmacotherapy. The authors aimed to determine the association between CHW-participant engagement and tobacco abstinence outcomes.

Methods: The authors conducted a secondary, mixed-methods analysis of 196 participants in the trial's intervention arm. Effects of the number and duration of CHW visits, number of smoking-cessation group sessions attended, and number of CHW-attended PCP visits on initiation of tobacco-cessation pharmacotherapy and tobacco abstinence were modeled via logistic regression. Interviews with 12 CHWs, 17 patient participants, and 17 PCPs were analyzed thematically.

Results: Year 2 tobacco abstinence was significantly associated with CHW visit number (OR=1.85, 95% CI=1.29-2.66), visit duration (OR=1.51, 95% CI=1.00-2.28), and number of group sessions attended (OR=1.85, 95% CI=1.33-2.58); effects on pharmacotherapy initiation were similar. One to three CHW visits per month across 2 years were optimal for achieving abstinence. Interviews identified CHW-patient engagement facilitators (i.e., trust, goal accountability, skills reinforcement, assistance in overcoming barriers to treatment access, and adherence). Training and supervision facilitated CHW effectiveness; barriers included PCPs' and care teams' limited understanding of the CHW role.

Conclusions: Greater CHW-participant engagement, within feasible dose ranges, was associated with tobacco abstinence among adults with serious mental illness. Implementation of CHW interventions may benefit from further CHW training and integration within clinical teams.

目的:患有严重精神疾病的成年人烟草使用障碍的发病率很高,而且对戒烟药物疗法的使用不足。在之前的一项随机对照试验中,接受社区健康工作者(CHW)支持和初级保健提供者(PCP)教育的参与者在2年后的戒烟率较高,部分原因是戒烟药物治疗的启动率提高了。作者旨在确定CHW参与者的参与与戒烟结果之间的关联:作者对试验干预组的 196 名参与者进行了二次混合方法分析。通过逻辑回归模拟了CHW访问次数和持续时间、参加的戒烟小组会议次数以及CHW参加的初级保健医生访问次数对开始戒烟药物治疗和戒烟的影响。对 12 名社区保健工作者、17 名患者参与者和 17 名初级保健医生的访谈结果进行了专题分析:结果:第 2 年的戒烟率与 CHW 访视次数(OR=1.85,95% CI=1.29-2.66)、访视持续时间(OR=1.51,95% CI=1.00-2.28)和参加小组活动的次数(OR=1.85,95% CI=1.33-2.58)显著相关;对药物治疗启动的影响相似。在两年时间里,每月进行一至三次社区保健员访视是实现戒断的最佳方式。访谈确定了社区保健工作者与患者接触的促进因素(即信任、目标责任、技能强化、协助克服获得治疗的障碍以及坚持治疗)。培训和监督促进了社区保健工作者的有效性;障碍包括初级保健医生和护理团队对社区保健工作者角色的理解有限:结论:在可行的剂量范围内,CHW-参与者更多的参与与重症精神病成人患者戒烟有关。对社区保健工作者进行进一步培训并将其纳入临床团队,可能会有利于社区保健工作者干预措施的实施。
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引用次数: 0
Digital Terror: Its Striking Impact on Public Mental Health. 数字恐怖:数字恐怖:对公众心理健康的惊人影响》(Digital Terror: Its Striking Impact on Public Mental Health)。
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.ps.20240169
David Roe, Eva Gilboa-Schechtman, Amit Baumel

Digital terror refers to the use of digital technology to disseminate graphic images of acts of violence to frighten the public. On October 7, 2023, militants of the Palestinian organization Hamas launched a brutal attack on Israel and used digital terror to magnify their acts. Although the purposeful spreading of terror via digital means is not new, the Hamas attack was significant for the scope, immediacy, and widespread dissemination of its digital content. This column aims to describe and analyze the psychological significance of this new form of terror, the public mental health challenges raised, and the interventions needed to assist those exposed to digital terror.

数字恐怖是指利用数字技术传播暴力行为的图像,以恐吓公众。2023 年 10 月 7 日,巴勒斯坦组织哈马斯(Hamas)的武装分子对以色列发动了野蛮袭击,并利用数字恐怖手段放大了他们的行为。尽管通过数字手段有目的地传播恐怖并不是什么新鲜事,但哈马斯的这次袭击因其数字内容的范围、即时性和广泛传播而意义重大。本专栏旨在描述和分析这种新恐怖形式的心理意义、引发的公共心理健康挑战,以及帮助那些受到数字恐怖袭击的人所需的干预措施。
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引用次数: 0
Implementing a Grief Support Program in a Black Church to Support the Mental Health Needs of People in Bereavement. 在黑人教堂实施悲伤支持计划,为丧亲之痛者的心理健康需求提供支持。
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 Epub Date: 2024-10-23 DOI: 10.1176/appi.ps.20240259
Kimberly T Arnold, David S Mandell, Sidney H Hankerson
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引用次数: 0
Evaluating Partnerships Between Faith Communities and the Mental Health Sector. 评估宗教团体和精神卫生部门之间的伙伴关系。
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 DOI: 10.1176/appi.ps.25076002
Sidney H Hankerson, Catherine T Squirewell, Mavis Flowers
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引用次数: 0
Electroconvulsive Therapy, Manufacturers' Liability, and Learned Intermediaries. 电休克疗法、制造商责任和博学的中间人。
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 Epub Date: 2024-11-19 DOI: 10.1176/appi.ps.20240518
Paul S Appelbaum

Manufacturers of drugs or devices that are prescribed by physicians are protected by the "learned intermediary rule" from having to disclose risks directly to patients. Instead, they must inform physicians of these risks. But when a company fails to disclose a known risk, how can a patient gain compensation for any resulting harm? The California Supreme Court considered this question in a case involving alleged memory impairment from electroconvulsive therapy. By broadening the ways by which plaintiffs can demonstrate that the absence of a warning caused their injury, the court made it easier for patients to recover compensation for the consequences.

由医生处方的药品或器械的制造商受 "博学的中间人规则 "的保护,不必直接向患者披露风险。相反,他们必须将这些风险告知医生。但是,当一家公司未能披露已知风险时,患者该如何就由此造成的伤害获得赔偿呢?加州最高法院在一起指控电休克疗法导致记忆受损的案件中考虑了这个问题。通过拓宽原告证明缺乏警告导致其受到伤害的途径,法院使患者更容易获得后果赔偿。
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引用次数: 0
An Observational Study of a Digital Substance Use and Recovery Program. 数字药物使用与康复计划的观察研究。
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 Epub Date: 2024-07-10 DOI: 10.1176/appi.ps.20230427
Bilal Noreen Khan, Cherry Chu, Janette Brual, Marlena Dang-Nguyen, Adetola Oladimeji, Altea Kthupi, Blanca Bolea-Alamañac, Mina Tadrous, Anne O'Riordan, Donna Rubenstein, Kathleen Carlin, Philip Longum, Daryn Gibson, Ibukun-Oluwa Omolade Abejirinde

Objective: Digital substance use treatment programs present an opportunity to provide nonresidential care for people with problematic substance use. In June 2021, the provincial government in Ontario provided free access to Breaking Free Online (BFO), a digital behavioral change program for people with substance use disorders.

Methods: An observational study was conducted with retrospective data to characterize clients' use and engagement patterns in BFO and examine changes in self-reported outcomes.

Results: In total, 6,370 individuals registered for BFO between June 2021 and October 2022, of whom 3,650 completed the intake assessment. Most of these clients were self-referred (64%), with 37% having been referred by health service providers. More than one-half of the clients (52%) resided in Ontario West or East regions. Support for addressing problematic alcohol use was the most requested program (40%). By October 2022, about 44% of the clients had completed between one and four of 12 program strategies. Analysis revealed significant changes in pre-post scores across four validated scales (p<0.001), indicating a decrease in anxiety and depression, an increase in quality of life, an improvement in recovery progression, and a decrease in severity of symptoms associated with substance use disorders.

Conclusions: BFO clients with higher completion rates had the most improvement across the scales used; however, clients with lower and medium completion rates also had improvements. Because of the shame and stigma associated with substance use, digital supports with low barriers to entry can help support the autonomy, privacy, and preferences of individuals seeking help for problematic substance use.

目标:数字药物使用治疗项目为有药物使用问题的人提供了一个非住院治疗的机会。2021 年 6 月,安大略省政府为药物使用障碍患者提供了免费的 "打破束缚在线"(Breaking Free Online,BFO)数字行为改变项目:方法:我们利用回顾性数据开展了一项观察研究,以描述客户使用和参与 BFO 的模式,并检查自我报告结果的变化:在2021年6月至2022年10月期间,共有6370人注册了BFO,其中3650人完成了入院评估。其中大部分人是自我转介的(64%),37%是由医疗服务提供者转介的。超过一半的客户(52%)居住在安大略省西部或东部地区。支持解决酗酒问题是客户要求最多的项目(40%)。截至 2022 年 10 月,约 44% 的客户完成了 12 项计划策略中的 1 到 4 项。分析表明,在四项有效量表中,前后评分发生了重大变化(p结论:在所使用的量表中,完成率较高的《生物多样性公约》受助者的进步最大;然而,完成率较低和中等的受助者也有所改善。由于与药物使用相关的羞耻感和耻辱感,进入门槛低的数字支持有助于支持寻求帮助解决药物使用问题的个人的自主性、隐私性和偏好。
{"title":"An Observational Study of a Digital Substance Use and Recovery Program.","authors":"Bilal Noreen Khan, Cherry Chu, Janette Brual, Marlena Dang-Nguyen, Adetola Oladimeji, Altea Kthupi, Blanca Bolea-Alamañac, Mina Tadrous, Anne O'Riordan, Donna Rubenstein, Kathleen Carlin, Philip Longum, Daryn Gibson, Ibukun-Oluwa Omolade Abejirinde","doi":"10.1176/appi.ps.20230427","DOIUrl":"10.1176/appi.ps.20230427","url":null,"abstract":"<p><strong>Objective: </strong>Digital substance use treatment programs present an opportunity to provide nonresidential care for people with problematic substance use. In June 2021, the provincial government in Ontario provided free access to Breaking Free Online (BFO), a digital behavioral change program for people with substance use disorders.</p><p><strong>Methods: </strong>An observational study was conducted with retrospective data to characterize clients' use and engagement patterns in BFO and examine changes in self-reported outcomes.</p><p><strong>Results: </strong>In total, 6,370 individuals registered for BFO between June 2021 and October 2022, of whom 3,650 completed the intake assessment. Most of these clients were self-referred (64%), with 37% having been referred by health service providers. More than one-half of the clients (52%) resided in Ontario West or East regions. Support for addressing problematic alcohol use was the most requested program (40%). By October 2022, about 44% of the clients had completed between one and four of 12 program strategies. Analysis revealed significant changes in pre-post scores across four validated scales (p<0.001), indicating a decrease in anxiety and depression, an increase in quality of life, an improvement in recovery progression, and a decrease in severity of symptoms associated with substance use disorders.</p><p><strong>Conclusions: </strong>BFO clients with higher completion rates had the most improvement across the scales used; however, clients with lower and medium completion rates also had improvements. Because of the shame and stigma associated with substance use, digital supports with low barriers to entry can help support the autonomy, privacy, and preferences of individuals seeking help for problematic substance use.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"41-48"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Racial-Ethnic Differences in Lack of Treatment Among Care-Seeking People With Substance Use Disorders. 寻求治疗的物质使用障碍患者缺乏治疗的种族差异
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 Epub Date: 2024-12-06 DOI: 10.1176/appi.ps.20240159
Carol A Lee, Mark A Ilgen, Lara N Coughlin
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引用次数: 0
Mental Health Agency Officials' Perceived Priorities for Youth Mental Health and Factors That Influence Priorities. 心理健康机构官员对青少年心理健康的优先考虑以及影响优先考虑的因素。
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 Epub Date: 2024-08-02 DOI: 10.1176/appi.ps.20230430
Blanche Wright, Katherine L Nelson, Kimberly E Hoagwood, Jonathan Purtle

Objective: This study aimed to characterize the perceived priorities of state and county policy makers for youth mental health services and the factors that influence those priorities.

Methods: Mental health agency officials (N=338; N=221 state officials, N=117 county officials) representing 49 states completed a Web-based survey in 2019-2020. On 5-point scales, respondents rated the extent to which 15 issues were priorities for their agency in providing youth mental health services and the extent to which nine factors influenced those priorities.

Results: Suicide was identified as the highest priority (mean±SD rating=4.38±0.94), followed by adverse childhood experiences and childhood trauma and then increasing access to evidence-based treatments. Budget issues (mean=4.27±0.92) and state legislative priorities (mean=4.01±0.99) were perceived as having the greatest influence on setting priorities.

Conclusions: These findings provide insights into youth mental health policy priorities and can be used to guide implementation and dissemination strategies for research and program development within state and county systems.

研究目的本研究旨在了解州和县决策者对青少年心理健康服务的优先考虑以及影响这些优先考虑的因素:代表 49 个州的心理健康机构官员(N=338;N=221 名州级官员,N=117 名县级官员)于 2019-2020 年完成了一项基于网络的调查。受访者用 5 点量表对 15 个问题在多大程度上是其机构提供青少年心理健康服务的优先事项以及 9 个因素对这些优先事项的影响程度进行评分:自杀被认为是最优先考虑的问题(平均值±SD=4.38±0.94),其次是不良童年经历和童年创伤,然后是增加循证治疗的可及性。预算问题(平均值=4.27±0.92)和州立法优先事项(平均值=4.01±0.99)被认为对优先事项的确定影响最大:这些研究结果提供了有关青少年心理健康政策优先事项的见解,可用于指导州和县系统内研究和项目开发的实施和传播策略。
{"title":"Mental Health Agency Officials' Perceived Priorities for Youth Mental Health and Factors That Influence Priorities.","authors":"Blanche Wright, Katherine L Nelson, Kimberly E Hoagwood, Jonathan Purtle","doi":"10.1176/appi.ps.20230430","DOIUrl":"10.1176/appi.ps.20230430","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to characterize the perceived priorities of state and county policy makers for youth mental health services and the factors that influence those priorities.</p><p><strong>Methods: </strong>Mental health agency officials (N=338; N=221 state officials, N=117 county officials) representing 49 states completed a Web-based survey in 2019-2020. On 5-point scales, respondents rated the extent to which 15 issues were priorities for their agency in providing youth mental health services and the extent to which nine factors influenced those priorities.</p><p><strong>Results: </strong>Suicide was identified as the highest priority (mean±SD rating=4.38±0.94), followed by adverse childhood experiences and childhood trauma and then increasing access to evidence-based treatments. Budget issues (mean=4.27±0.92) and state legislative priorities (mean=4.01±0.99) were perceived as having the greatest influence on setting priorities.</p><p><strong>Conclusions: </strong>These findings provide insights into youth mental health policy priorities and can be used to guide implementation and dissemination strategies for research and program development within state and county systems.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"82-85"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterizing Crisis Services Offered by Certified Community Behavioral Health Clinics: Results From a National Survey. 认证社区行为健康诊所提供的危机服务特点:全国调查结果。
IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2025-01-01 Epub Date: 2024-08-14 DOI: 10.1176/appi.ps.20240152
Amanda I Mauri, Saba Rouhani, Jonathan Purtle

Objective: The authors aimed to examine how certified community behavioral health clinics (CCBHCs) fulfill crisis service requirements and whether clinics added crisis services after becoming a CCBHC.

Methods: National survey data on CCBHC crisis services were paired with data on clinic features and the demographic and socioeconomic characteristics of the counties within a CCBHC service area. The dependent variables were whether CCBHCs provided the three categories of CCBHC crisis services (i.e., crisis call lines, mobile crisis response, and crisis stabilization) directly or through another organization and whether these services were added after becoming a CCBHC. Descriptive statistics and multivariable logistic regression analyses were performed with data about clinics and the counties they served. In total, 449 CCBHCs were surveyed in the summer of 2022, with a response rate of 56%. The final sample comprised 247 clinics.

Results: The number of CCBHC employees per 1,000 people within a CCBHC service area was significantly and positively associated with clinics providing some crisis services directly (mobile crisis response: adjusted OR [AOR]=1.46, 95% CI=1.08-1.98; crisis stabilization services: AOR=1.60, 95% CI=1.17-2.19). Compared with clinics that did not receive a CCBHC Medicaid bundled payment, clinics that received this payment had higher odds of adding mobile crisis response (AOR=2.52, 95% CI=1.28-4.97) and crisis stabilization services (AOR=3.19, 95% CI=1.51-6.72) after becoming a CCBHC.

Conclusions: CCBHC initiatives, particularly CCBHC Medicaid bundled payments, may provide opportunities to increase the availability of behavioral health crisis services, but the sufficiency of this increase for meeting crisis care needs remains unknown.

目的作者旨在研究经认证的社区行为健康诊所(CCBHC)如何满足危机服务要求,以及诊所在成为 CCBHC 后是否增加了危机服务:关于社区行为健康诊所危机服务的全国调查数据与诊所特征数据以及社区行为健康诊所服务区内各县的人口和社会经济特征数据配对。因变量为:CCBHC 是直接提供还是通过其他组织提供三类 CCBHC 危机服务(即危机呼叫热线、移动危机响应和危机稳定),以及成为 CCBHC 后是否增加了这些服务。对诊所及其服务县的数据进行了描述性统计和多变量逻辑回归分析。2022 年夏季共调查了 449 家 CCBHC,回复率为 56%。最终样本包括 247 家诊所:CCBHC服务区域内每千人中CCBHC员工的数量与诊所直接提供某些危机服务有显著正相关(移动危机响应:调整OR [AOR]=1.46,95% CI=1.08-1.98;危机稳定服务:调整OR [AOR]=1.60,95% CI=1.98):AOR=1.60,95% CI=1.17-2.19)。与未获得 CCBHC 医疗补助捆绑付款的诊所相比,获得该付款的诊所在成为 CCBHC 后增加移动危机响应(AOR=2.52,95% CI=1.28-4.97)和危机稳定服务(AOR=3.19,95% CI=1.51-6.72)的几率更高:CCBHC倡议,尤其是CCBHC医疗补助捆绑支付,可能会为增加行为健康危机服务的可用性提供机会,但这种增加是否足以满足危机护理需求仍是未知数。
{"title":"Characterizing Crisis Services Offered by Certified Community Behavioral Health Clinics: Results From a National Survey.","authors":"Amanda I Mauri, Saba Rouhani, Jonathan Purtle","doi":"10.1176/appi.ps.20240152","DOIUrl":"10.1176/appi.ps.20240152","url":null,"abstract":"<p><strong>Objective: </strong>The authors aimed to examine how certified community behavioral health clinics (CCBHCs) fulfill crisis service requirements and whether clinics added crisis services after becoming a CCBHC.</p><p><strong>Methods: </strong>National survey data on CCBHC crisis services were paired with data on clinic features and the demographic and socioeconomic characteristics of the counties within a CCBHC service area. The dependent variables were whether CCBHCs provided the three categories of CCBHC crisis services (i.e., crisis call lines, mobile crisis response, and crisis stabilization) directly or through another organization and whether these services were added after becoming a CCBHC. Descriptive statistics and multivariable logistic regression analyses were performed with data about clinics and the counties they served. In total, 449 CCBHCs were surveyed in the summer of 2022, with a response rate of 56%. The final sample comprised 247 clinics.</p><p><strong>Results: </strong>The number of CCBHC employees per 1,000 people within a CCBHC service area was significantly and positively associated with clinics providing some crisis services directly (mobile crisis response: adjusted OR [AOR]=1.46, 95% CI=1.08-1.98; crisis stabilization services: AOR=1.60, 95% CI=1.17-2.19). Compared with clinics that did not receive a CCBHC Medicaid bundled payment, clinics that received this payment had higher odds of adding mobile crisis response (AOR=2.52, 95% CI=1.28-4.97) and crisis stabilization services (AOR=3.19, 95% CI=1.51-6.72) after becoming a CCBHC.</p><p><strong>Conclusions: </strong>CCBHC initiatives, particularly CCBHC Medicaid bundled payments, may provide opportunities to increase the availability of behavioral health crisis services, but the sufficiency of this increase for meeting crisis care needs remains unknown.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"13-21"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Psychiatric services
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