Psychiatric services最新文献

Objective: A cohort of certified peer specialists (CPSs) was surveyed to investigate factors affecting postcertification employment and retention.

Methods: Survey data were collected in 2020, 2021, and 2022 from 591 CPSs in four states (North Carolina, Oregon, Pennsylvania, and Texas). The data were analyzed via percentages, means, and multilevel regression models.

Results: Postcertification employment remained high: 76% (N=448 of 591) in 2020, 73% (N=329 of 448) in 2021, and 77% (N=279 of 364) in 2022. However, the proportion working in peer support positions declined significantly-from 73% (N=325 of 448) in 2020 to 63% (N=175 of 279) in 2022-despite the significantly higher job satisfaction, greater access to job benefits, and longer average job tenure reported by those working in peer support versus nonpeer jobs.

Conclusions: Although the individuals who completed certification appeared to remain employed, a significant proportion appeared to leave peer support for other work. These trends should be monitored to evaluate investments in peer certification and service capacity.

Objective: The authors utilized patient-reported outcomes from a large U.S. behavioral health care system to evaluate the strength of improvements in patients' self-perceived recovery during mental health treatment.

Methods: This was a cohort study conducted with electronic health records from 2021-2022 Discovery Behavioral Health patients. Patients were grouped according to their 41-item Recovery Assessment Scale (RAS) scores at admission. Linear regression models accounting for patient characteristics were used to estimate RAS score changes from admission to discharge and RAS score at discharge.

Results: Of 9,441 patients, those belonging to groups with lower RAS scores at admission showed substantial score improvements, although their scores at discharge were still much lower compared with those of patients with higher admission scores. Results were consistent across secondary analyses.

Conclusions: Substantial improvements in recovery were evident during treatment, especially for patients with lower RAS scores at admission. The findings underline the importance of research into enhanced personalized treatment approaches to optimize recovery.

The Vermont Child Psychiatry Access Program (VTCPAP), launched in 2022 to address gaps in youth mental health care access in Vermont, offers same-day consultation to primary care providers (PCPs). Over 16 months, the VTCPAP facilitated 597 patient-specific consultations, including in rural and underserved areas. With VTCPAP's services, PCPs reported being better able to treat patients' mental health as well as enhancement to their own work life. Plans to maximize limited resources and to address the full spectrum of youth mental health care needs include providing asynchronous messaging for consultation initiation and integrating an existing perinatal mental health consultation program.

Joint Commission accreditation helps ensure hospital safety and quality. Accreditation also serves as an independent monitor for payers, the public, and other stakeholders. Evidence-based practices necessarily evolve, and ensuring high-quality care requires an ongoing review of which metrics to prioritize. The Joint Commission has recently introduced new voluntary health care equity certification while acknowledging a need to reduce and eliminate unnecessary requirements. In this Open Forum, an inpatient psychiatrist and administrator reflects on the accreditation survey experience and suggests more closely aligning the reimbursement and reputational incentives associated with accreditation with effective, evidence-based interventions.