Psychiatric services最新文献

Program development and evaluation that promote health equity are driven by community-based participatory research and led by people from select communities to adhere to the principles of diversity, equity, inclusion, and accessibility (DEIA). This process is enriched when these communities represent intersections within DEIA, such as, for example, Korean American women with depression. Research shows that culture-specific adaptations of services are significantly more effective for these communities than is the standard of care for the broader population. However, cultural specificity decreases generalizability of findings and scalability of interventions. Decisions about intersectionality are affected by implications for science as well as real-world benefits for individuals participating in this process.

Objective: Stigma toward individuals with schizophrenia and psychosis has been widely studied in the general population, but research on Spanish-language news media coverage of these mental disorders in the Latinx population is limited. The authors aimed to examine how schizophrenia and psychosis are commonly presented in U.S. Spanish-language news media, focusing on stigmatizing stereotypes, recovery themes, and the use of best practices for reporting on mental health issues.

Methods: A content analysis was conducted of reports from two leading U.S. Spanish-language news outlets, Univision and Telemundo, and from the newspaper database U.S. Hispanic Newsstream. The searches included articles published from August 1, 2012, to August 1, 2022, and included keywords related to schizophrenia and psychosis.

Results: In total, 108 news articles were identified and coded. Several types of stigmatizing stereotypes were observed, including portraying a person with schizophrenia or psychosis as violent, suicidal, incompetent, or weak. Only 20 news articles included at least one recovery theme, with educational information about schizophrenia or psychosis being the most common. Most articles used person-first language when referring to people with these conditions, but few articles included information about treatment options or where and how to seek mental health care.

Conclusions: More studies should emphasize the importance of U.S. Spanish-language news outlets offering linguistically and culturally appropriate information on treatment options and where and how to access mental health care. Studies focusing on recovery and treatment for schizophrenia and psychosis are needed to combat public mental health stigma in the Latinx population.

Objective: Mental health lived experience organizations (LEOs) and their lived experience workforce are increasingly recognized as invaluable. However, a deeper understanding of the elements that enhance or inhibit LEOs' efficacy is required to learn how to sustain LEOs and support their workforce. Rapid international expansion has resulted in significant LEO growth and change, challenging many LEOs to adapt. With this rapid expansion, the field is evolving faster than many LEOs can keep pace with. This review, codesigned and coproduced in partnership with a LEO to draw on both lived experience and academic perspectives, aims for a deeper understanding of which elements within a LEO enhance or inhibit its efficacy, growth, and support for its lived experience workforce.

Methods: A systematic search of peer-reviewed and non-peer-reviewed literature, following the PRISMA-ScR guidelines and JBI methodology, identified 60 records published in English between 2000 and 2022.

Results: The results indicate general agreement regarding which LEO elements are important (e.g., culture, leadership, board composition, organizational structure, financial arrangements, and professionalization). However, considerable disagreements exist regarding the relative influence of several of these elements, especially funding arrangements, in which funder and LEO values often diverge; training for increased lived experience professionalization; and partnerships with medical model-focused mental health services.

Conclusions: Organizational disagreements relate to managing future LEO growth and advancing the lived experience workforce while preserving LEOs' unique characteristics that make them valued mental health services. Further research should examine community differences among LEOs, including hybrid LEOs within services and non-LEO mental health organizations.

Objective: Certified community behavioral health clinics (CCBHCs) are designed to provide comprehensive care for individuals with co-occurring mental and substance use disorders. The authors classified outpatient mental health treatment facilities on the basis of provision of services for clients with co-occurring disorders and assessed whether CCBHCs differed from other outpatient mental health facilities in services provided.

Methods: The authors used latent class analysis to identify distinct services for clients with co-occurring disorders in 5,692 outpatient mental health facilities in the 2021 National Substance Use and Mental Health Services Survey. Nine indicators were included: treatment for clients with substance or alcohol use disorder co-occurring with serious mental illness or serious emotional disturbance, specialized programs or groups for such clients, medication-assisted treatment (MAT) for alcohol use disorder, MAT for opioid use disorder, detoxification, individual counseling, group counseling, case management, and 12-step groups. A multinomial logistic regression was used to estimate whether CCBHCs were associated with any identified classes after analyses controlled for facility characteristics.

Results: A four-class solution provided a model with the best fit, comprising comprehensive services (23.4%), case management services (17.7%), counseling and self-help services (58.6%), and professional services (4.3%). Regressing class membership on facility type and covariates, the authors found that compared with community mental health clinics (CMHCs), CCBHCs were more likely to belong to the comprehensive services class than to the case management services, counseling and self-help services, and professional services classes.

Conclusions: CCBHCs were more likely than other outpatient programs to offer comprehensive care, and CCBHC status of a CMHC facilitated enhanced service provisions.