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The supply / demand issue in behavioral health care is a well-established fact, and the mental health toll of the COVID-19 pandemic continues to add challenges to an already taxed system. Existing healthcare models are not set up to adequately address the increasing mental health related needs. As such, innovative models are needed to provide patients with access to appropriate, evidence-based behavioral health care within routine clinical care. This paper introduces Precision Behavioral Health (PBH) as an example of such a model. PBH is an innovative, digital first care delivery model that provides an ecosystem of evidence-based digital mental health interventions to patients as a frontline behavioral health treatment within routine care in a large multispecialty group medical center in the United States. This paper describes the implementation of PBH within a practice research network set-up as part of an integrated behavioral health department. We will present how our team leveraged the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance; "What is RE-AIM?," n.d.) implementation science framework, which emphasizes the design, dissemination, and implementation processes at the individual, staff, and organizational levels, to prioritize key implementation constructs to enhance the successful integration of PBH within routine care. We describe how each of these constructs were operationalized to aid data gathering for rapid evaluation and lessons learned. We discuss the benefits of these types of initiatives across multiple stakeholders including patients, providers, organizations, payers, and digital intervention vendors. [ABSTRACT FROM AUTHOR]

Background: Despite disproportionate rates of mental ill-health compared with non-Indigenous populations, few programs have been tailored to the unique health, social, and cultural needs and preferences of young Aboriginal and Torres Strait Islander males. This paper describes the process of culturally adapting the US-based Young Black Men, Masculinities, and Mental Health (YBMen) Project to suit the needs, preferences, culture, and circumstances of Aboriginal and Torres Strait Islander males aged 16–25 years in the Northern Territory, Australia. YBMen is an evidence-based social media-based education and support program designed to promote mental health, expand understandings of gender and cultural identities, and enhance social support in college-aged Black men. Methods: Our adaptation followed an Extended Stages of Cultural Adaptation model. First, we established a rationale for adaptation that included assessing the appropriateness of YBMen's core components for the target population. We then investigated important and appropriate models to underpin the adapted program and conducted a non-linear, iterative process of gathering information from key sources, including young Aboriginal and Torres Strait Islander males, to inform program curriculum and delivery. Results: To maintain program fidelity, we retained the core curriculum components of mental health, healthy masculinities, and social connection and kept the small cohort, private social media group delivery but developed two models: 'online only' (the original online delivery format) and 'hybrid in-person/online' (combining online delivery with weekly in-person group sessions). Adaptations made included using an overarching Aboriginal and Torres Strait Islander social and emotional wellbeing framework and socio-cultural strengths-based approach; inclusion of modules on health and wellbeing, positive Indigenous masculinities, and respectful relationships; use of Indigenous designs and colours; and prominent placement of images of Aboriginal and Torres Strait Islander male sportspeople, musicians, activists, and local role models. Conclusions: This process resulted in a culturally responsive mental health, masculinities, and social support health promotion program for young Aboriginal and Torres Strait Islander males. Next steps will involve pilot testing to investigate the adapted program's acceptability and feasibility and inform further refinement. Keywords: Aboriginal, Torres Strait Islander, Indigenous, Australia, male, cultural adaptation, social media, mental health, masculinities, social support. [ABSTRACT FROM AUTHOR]

Background: More than 20 million children in the United States lack access to primary health care. Practice Learning: Research shows that students with regular access to physical and mental health services have fewer absences, are more social, less likely to participate in risky behaviors, have improved focus and higher test scores. Implication For School Health Policy, Practice, And Equity: School‐based health centers (SBHCs) can be an important, valuable and viable health care delivery option to meet the full‐range of primary health care needs of students where they spend the majority of their wake hours, ie, in school. Children in rural and other underserved communities, as well as those underinsured, non‐insured, economically challenged, underserved, and the most vulnerable among us are especially at risk. Conclusions: This paper discusses the history, value, and importance of SBHCs from myriad perspectives, including physical and emotional wellbeing, academic and social success, and the promotion of a positive transition to adulthood. In addition, the authors' experiences that resulted in building the first SBHC in the Mid‐Hudson Valley Region of New York State are shared. These experiences form the foundation for creating an important roadmap for individuals and school leaders that are interested in bringing a SBHC to their school and district. [ABSTRACT FROM AUTHOR]

With annual point-in-time counts indicating a rise in unsheltered homelessness in the United States, much attention has been paid to how to best provide care to this population. Mobile medical units (MMUs) have been utilized by many programs. However, little is known regarding the evidence behind their effectiveness. A scoping review is conducted of research on MMU provision of medical services for populations experiencing homelessness in the USA to examine the extent and nature of research activity, summarize available evidence, and identify research gaps in the existing literature. Following guidelines for scoping reviews, PubMed and Google Scholar were used to identify an initial 294 papers published from January 1, 1980, to May 1, 2023, using selected keywords, which were distilled to a final set of 50 studies that met eligibility criteria. Eligible articles were defined as those that pertain to the provision of healthcare (inclusive of dental, vision, and specialty services) to populations experiencing homelessness through a MMU in the United States and have been published after peer review. Of the 50 studies in the review, the majority utilized descriptive (40%) or observational methods (36%), with 4 review and 8 controlled studies and no completed randomized controlled trials. Outcome measures utilized by studies include MMU services provided (58%), patient demographics (34%), health outcomes (16%), patient-centered measures (14%), healthcare utilization (10%) and cost analysis (6%). The studies that exist suggest MMUs can facilitate effective treatment of substance use disorders, provision of primary care, and services for severe mental illness among people experiencing homelessness. MMUs have potential to provide community-based healthcare services in settings where homeless populations reside, but the paucity of randomized controlled trials indicates further research is needed to understand if MMUs are more effective than other care delivery models tailored to populations experiencing homelessness. [ABSTRACT FROM AUTHOR]

Mental health challenges have been recognized as one of the most prevalent issues impacting children and families within the United States. Children and families of color are disproportionately affected by this due to lack of access to preventative and ongoing supports, and programs that can help address their overall well-being. These issues are even more severe for those that are at risk or interact with the child welfare system. Social workers use various clinical modalities to assess and support them. In the recent years, child welfare agencies have turned to Evidence based programs (EBPs) as a best practice to meet the needs of children and families. The Title IV-E Prevention Services Clearinghouse, established by the Administration of Children and Families is a landmark effort to review and promote such EBP's that prevents foster care placements, including mental health programs. While the Clearinghouse has reviewed 141 programs and services, out of which 71 have been rated as promising, supported, or well-supported, there is a dearth of culturally responsive programs that have met the Clearinghouse criteria. Given the overrepresentation of African American and Native American Families in the child welfare system, and the critical role of the Clearinghouse in reviewing and promoting EBPs, this paper highlights the philosophical, administrative, cultural and logistical barriers for culturally relevant programs to be accepted into the Clearinghouse. It also provides specific recommendations on how the Clearinghouse and researchers can build EBPs that account for the intersection between mental health, social location and cultural identities of the children and families that social workers serve. [ABSTRACT FROM AUTHOR]

This paper discusses the impact of White supremacy, ableism, and U.S. policing on both the history and current state of psychology and sheds light on ways that psychologists can acknowledge and divest from carceral White supremacist practices in mental healthcare. Because of how oppression and intersectionality function within a White supremacist society, not all Black lives have been equally valued by non-Black Americans. Similarly, White supremacy and ableism have had lasting impacts on the public perception of disabled people. Connecting the historical origins of the U.S. policing system to the current practices of the U.S. police system, this paper argues that the police have always been about controlling "disorder." Similarly, psychology and the larger mental health field have a troubled history of controlling Black, Brown, and disabled bodies. Recommendations for ways therapists can unlearn therapy practices stemming from White supremacy cultural practices (e.g., carceral therapeutic practices and biased mental health care) are provided along with action items for mental health practitioners to maintain a commitment to undoing the harm from these historic and systemic issues. [ABSTRACT FROM AUTHOR]

Presents the results of traditional and ethnographic content analyses of 23 position papers on mental health care reform debate in the United States. Identification of five concrete aspects of mental health service delivery system and eight policy issues; Measure of the quality of policy discussions.

Accessible Summary: What is known on the subject?: International guidelines for trans‐and‐gender‐non‐conforming (TGNC) exists in outpatient settings.Compared to cisgender and heterosexual people, TGNC individuals are at a higher risk of mental health difficulties and have higher rates of inpatient mental health treatment. What does this paper add to existing knowledge?: An international scoping review identifying the lack of guidelines existing for TGNC individuals in inpatient mental health settings. Compared to psychiatrists and psychologists, mental health nursing has the most contact with patients admitted for inpatient psychiatric treatment. The study identifies unaddressed needs in gender affirming policies and outlines preliminary policy recommendations to assist mental health staff in improving TGNC patient quality of care within the United States. What are the implications for practice?: Reforming existing guidelines or creating new guidelines based on the identified themes and gaps to improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings within the United States. Introduction: Access to culturally sensitive care is critical for addressing known mental health disparities among trans‐and gender‐non‐conforming (TGNC) individuals. Although there has been a proliferation of TGNC healthcare guidelines from accrediting bodies, policies have failed to address the needs of TGNC patients in inpatient psychiatric settings. Aim: To identify unaddressed needs in policies and policy recommendations for the care of TGNC patients to inform recommendations for change. Method: A scoping review protocol was developed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 850 articles were reduced to seven relevant articles with six themes identified via thematic analysis. Results: Six themes were identified: lack of consistency in preferred and pronoun use, lack of communication among providers, lack of training in TGNC healthcare, personal bias, lack of formal policies, and housing segregation by sex rather than gender. Discussion: The creation of new guidelines or bolstering of existing guidelines to specifically address identified themes and gaps may improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings. Implications for practice: To provide a foundation for future studies to integrate these identified gaps and inform the future development of comprehensive formal policies that generalize TGNC care in inpatient settings. [ABSTRACT FROM AUTHOR]

This paper presents qualitative data collected from 996 licensed social workers in the United States who reported mental health and/or alcohol and other drug problems and indicated the types of services they used to address these issues. Outpatient therapy was the most commonly accessed modality to treat mental health issues. Regarding problems with alcohol and other drugs, self-help groups were the most frequently utilized intervention. Qualitative findings suggest that behavioral health service use has influenced respondents' work with clients, personal and professional development, and career trajectories. Barriers to service use, such as stigma and limited access to care, were also identified. Implications for social work education and professional practice are discussed. [ABSTRACT FROM AUTHOR]

Applying the behavioral model of health services utilization to data from the United States, this study examined immigrant children's use of physician and dentist visits, hospital care, and prescribed medication. We employed data describing 9759 immigrant parents and children who participated in 2021's National Survey of Children's Health. Logistic regression results negatively linked physician visits to child health, child age, Asian children, fathers, lower parent education, lower family income, uninsured children, and parent's U.S. residence under 5 years. Dentist visits were positively associated with child age, girls, Hispanic children, parent education, family income, public/private health insurance coverage, and U.S.-born children, but such use was associated negatively with Asian children. Hospital use was positively associated with poor child health, Black children, children of "other" race/ethnicity, younger parent age, enrolled in health insurance, and parent's U.S. residence under 5 years. The use of prescribed medication was negatively associated with Asian children, younger child age, lower parent education, uninsured child, and lack of English proficiency. The paper's conclusion suggests policymakers expand Medicaid and CHIP eligibility among immigrant children and suggests community education to foster awareness of children's physical and oral health needs and of Medicaid, CHIP, and prescription assistance programs. The conclusion calls for healthcare providers and social workers to accommodate and respect immigrants' traditional health-related beliefs, showing cultural competence. [ABSTRACT FROM AUTHOR]

Racial and ethnic minorities like Asians in the United States are significantly less likely to receive mental health treatment than Caucasians. Using 2012 Behavioral Risk Factor Surveillance System data, we examined the underutilization of mental health treatment in the US and find that being over 65 or 35–44, being unmarried, and being insured were positively associated with mental health treatment utilization, and as mentally unhealthy days increased, the utilization of treatment also increased. The paper offers a discussion on why there is this underutilization of mental health services amongst Asians and what steps can be taken to improve utilization. [ABSTRACT FROM AUTHOR]

It is now widely accepted that there is a growing discrepancy between demand and access to adequate treatment for behavioral or mental health conditions in the United States. This results in immense personal, societal, and economic costs. One rapidly growing method of addressing this discrepancy is to integrate mental health services into the primary care setting, which has become the de facto service provider for these conditions. In this paper, we describe the development and implementation of a novel integrated care program in a large mid-western university-based healthcare system, drawn from the collaborative care model, and describe the benefits in terms of both health care utilization and depression outcomes. Limitations and proposed future directions are discussed. [ABSTRACT FROM AUTHOR]

Youth in the United States are experiencing mental health concerns at alarming rates. Considering the nation's legacy of racism and growing recognition of the impact of social determinants of health on educational and mental health inequities, it is imperative to re-envision how we approach mental health screening in schools to center equity. A focus on mental health screening for the sole purpose of identifying individual at-risk students ignores key contextual considerations, is ineffective in addressing health and educational inequities, and has the potential to perpetuate oppressive practices in schools. Equity-focused mental health screening requires a shift from individual- and deficit-focused approaches to systems- and holistic-focused approaches that (a) identify strengths and stressors among individuals, groups, and communities; (b) dismantle structural forms of oppression; and (c) promote positive mental health outcomes for minoritized youth. Integrating recommendations from the educational equity literature and critical school mental health frameworks, this paper identifies core considerations for equitable school mental health screening and provides guiding principles for each phase of the screening process, from screening readiness to execution to follow up. To implement these recommendations and transform school-based mental health care, schools should (a) incorporate multiple perspectives; (b) prioritize student, family, and community voices; and (c) build collaborative partnerships to co-construct a vision for equitable school mental health. [ABSTRACT FROM AUTHOR]

In the wake of COVID-19, mental health providers and treatment programs are adapting rapidly to the challenges in engaging people and delivering treatment with limited guidance. This paper will explore the challenges associated with delivering treatment within coordinated specialty care (CSC) programs for people with first episode psychosis. Suggestions for treatment will take into consideration experiences with stress, changes to the pursuit of work and school, and increased time spent with families. Drawing on the experience of several CSC programs in the United States, Israel, and China, we describe the impact and modifications to the core treatment elements in CSC including medication, family interactions, supported employment and education, individual therapy, peer support and the way they are delivered. The paper includes recommendations based on experiences from CSC programs to help staff members, participants, and family members better identify, prepare, cope and respond to the unique new challenges and suggests modifications that can be made during various stages of the coronavirus pandemic. [ABSTRACT FROM AUTHOR]

This article is a reaction paper to the article in this journal issue entitled Human Service Cartels: The Soft Repression of the Mediocracy by David Stoesz. As such, it addresses two significant questions about the Stoesz article. One question is as follows: Are we really talking about a cartel? The other question is as follows: Isn't it the power elite that promotes societal control and repression? [ABSTRACT FROM AUTHOR]

The US South is disproportionately impacted by HIV. Social, cultural, economic, and political characteristics of the South shape access to mental health services leaving adverse impacts on health and wellness outcomes among People Living with HIV. The aim of this paper was to: (a) identify meso factors (at individual, organizational and community-level manifestations) which impact mental health services among People living with HIV in the South of those factors and (b) pose community-articulated recommendation and strategies. Through qualitative interviews with People Living with HIV and service providers, this study found that the meso factors of restricted funding and compounding stigma shaped mental health services in the South. Given the disproportionate rate of HIV, lack of mental health care, and landscape of socio-political factors unique to the region, attention to intervenable meso factors and community-based strategies are needed to enhance mental health services and respond to the HIV epidemic in the US South. [ABSTRACT FROM AUTHOR]

The following research used a paper and pencil survey to assess programming for mental health and wellness in 7742 law enforcement agencies throughout the United States. A total of 465 respondents provided data to two open-ended questions to share several types of programs and services that would be beneficial for agencies to support officers who experience job challenges or stress. The qualitative data was analyzed via constant-comparison method by two independent coders who engaged in several techniques to aid in trustworthiness. The resulting themes included officer wellness initiatives, counseling, and the role of the overall agency culture in order to provide access to support and for reducing the stigma for police seeking services for mental health. Implications include the need for program and policy changes within law enforcement agencies. [ABSTRACT FROM AUTHOR]

Histories of psychiatry in the United States can shed light on current areas of need in mental health research and treatment. Often, however, these histories fail to represent accurately the distinct trajectories of psychiatric care among black and white populations, not only homogenizing the historical narrative but failing to account for current disparities in mental health care among these populations. The current paper explores two parallel histories of psychiatry in the United States and the way that these have come to influence current mental health practices. Juxtaposing the development of psychiatric care and understanding as it was provided for, and applied to, black and white populations, a picture of the theoretic foundations of mental health emerges, revealing the separate history that led to the current uneven state of psychiatric care. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe and discuss both the early implementation of a US mental health intervention for young children in the context of its introduction to a pilot site in a London borough and the progress made in establishing a randomised controlled trial (RCT). Design/methodology/approach: This paper describes an evaluation of a new intervention and the learning that followed in terms of its implementation and future evaluation. Qualitative data were collected from a range of stakeholders and practitioners through interviews and small group discussions. These interviews focussed on both of these issues, with particular reference to the proposal to conduct an RCT. Findings: The findings of this evaluation add to the evidence on how best to support new initiatives that have been introduced from other settings and countries to embed in a receiving site and the optimal timing and feasibility of conducting an RCT. At the end of the feasibility study, which took place within the year of the service being introduced and which was only open to clients for six months of this year the conclusion was that an RCT at that point was neither possible nor desirable. Over the following years, the commitment of the judiciary to examine if there was a way to make an RCT study in respect of this intervention meant that a template was established that may well have broader application. Research limitations/implications: At a time when there is an increasing demand for evidence on effective interventions this paper makes a valuable contribution to the development of RCTs in general and specifically in the family court arena. It also recommends that attention must also be paid to the time, which is needed to implement and establish interventions and then to test them. Practical implications: This paper highlights the need to establish realistic timescales not only around the implementation of initiatives but also for their evaluation. Originality/value: This study breaks new ground in considering implementation challenges in the court and children's services' context. It brings to the fore the important role of the judiciary in approving new processes. [ABSTRACT FROM AUTHOR]

Mass murder, especially involving a firearm, has been a subject of increasing interest among criminologists over the past decade. Lacking an existing and reliable data resource for studying these crimes, several organizations have launched their own database initiatives with, unfortunately, little consensus on definition. As a result, there is confusion regarding the nature and trends of such events. In this paper, we rely on the Associated Press/USA Today/Northeastern University Mass Killing Database, which provides the widest coverage of incidents in the U.S. with four or more victim fatalities, regardless of location, situation, or weapon. First, we present trends in incidents and victimization of mass killings from 2006 through 2020, followed by an examination of various incident, offender, and victim characteristics, distinguishing among the major subtypes. Next, we detail a motivational typology of mass murder and identify the common contributing factors. Finally, we consider the potential effects of certain policy responses related to media coverage, mental health services, and gun restrictions on the prevalence of mass killing. [ABSTRACT FROM AUTHOR]

Nearly half of children meeting criteria for a mental health disorder in the United States (U.S.) do not receive the treatment they need. Unfortunately, lack of access to and engagement in mental health services can be seen at even higher rates for historically marginalized groups, including low-income, racial, and ethnic minority youth. Lay Health Workers (LHWs) represent a valuable workforce that has been identified as a promising solution to address mental health disparities. LHWs are individuals without formal mental health training who oftentimes share lived experiences with the communities that they serve. A growing body of research has supported the mobilization of LHWs to address service disparities around the globe; however, challenges persist in how to scale-up and sustain LHW models of care, with specific barriers in the U.S. In this paper, we describe LHWs' different roles and involvement in the mental health field as well as the current state of the literature around LHW implementation. We integrate the RE-AIM Framework with a conceptual model of how LHWs address disparities to outline future directions in research and practice to enhance equity in the reach, effectiveness, adoption, implementation, and maintenance of LHW models of care and evidence-based practices for historically marginalized communities within the U.S. [ABSTRACT FROM AUTHOR]

Nearly four decades ago, Unclaimed Children documented the gaps in the United States between mental health programs and caregivers' perspectives about those services for their children. This absence of attention to parent or caregiver perspectives, including their satisfaction with these services, was a key finding of the report, which detailed system failure in caring for youth with mental health needs. Since then, the focus on caregiver satisfaction with children's mental health services has been largely overlooked in research, and when examined has been mostly included as an indicator of the feasibility of program implementation. In striking contrast, overall healthcare system reforms have highlighted the importance of improving consumer's direct experience of care. However, caregiver satisfaction remains largely disconnected to these overall health system reforms, even as reforms focus increasingly on value-based, coordinated and integrated care. In this paper, we review literature from 2010 to 2020, revisit the measurement of caregiver satisfaction, identify how and when it is being measured, and delineate a research agenda to both realign it with health system improvements, refine its focus on expectancies and appropriateness, and root it more firmly in the principles of user experience (UX) and human-centered design (HCD). [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has presented a formidable challenge to care continuity for community mental health clients with serious mental illness and for providers who have had to quickly pivot the modes of delivering critical services. Despite these challenges, many of the changes implemented during the pandemic can and should be maintained. These include offering a spectrum of options for remote and in-person care, greater integration of behavioral and physical healthcare, prevention of viral exposure, increased collaborative decision-making related to long-acting injectable and clozapine use, modifying safety plans and psychiatric advance directives to include new technologies and broader support systems, leveraging natural supports, and integration of digital health interventions. This paper represents the authors' collaborative attempt to both reflect the changes to clinical practice we have observed in CMHCs across the US during this pandemic and to suggest how these changes can align with best practices identified in the empirical literature. [ABSTRACT FROM AUTHOR]

BACKGROUND Mental health services in the United States public schools are an important component of the academic success of a student. Not all schools, however, have the necessary personnel and funding to offer such services. METHODS: In this paper, we provide an analysis of data collected from schools in 3 geographic locations. Comparisons were made of the availability of personnel to assess and treat mental health disorders in students enrolled in city, urban, and suburban schools, with over 10,000 schools represented. The data were part of the 2015 to 2016 School Survey on Crime and Safety. RESULTS: Accessibility of mental health practitioners and reasons that limited efforts of a school to provide the services were assessed. Statistically significant differences were identified by school location, demonstrating that those in rural communities were most challenged providing diagnostic assessment and treatment for students by school mental health professionals, for several reasons. CONCLUSIONS: Increased state and county funding to support mental health practitioners in public high schools is one suggestion to address mental health disorders in students. Other strategies are offered for timely and appropriate diagnoses and treatment for mental health disorders that may impact the quality of life of a student for a lifetime. [ABSTRACT FROM AUTHOR]

School-based mental health services are a promising context for evidence-based interventions to promote early socio-emotional development, yet implementation presents significant challenges. This paper describes the rationale, content and format of a school-based intervention, Starting Strong in Kindergarten (Starting Strong). Starting Strong is a 10 week, indicated prevention programme aimed at promoting positive student–teacher relationships and behavioural adjustment during the transition to kindergarten. This parent- and teacher-focused indicated prevention programme targets children with or at risk for disruptive behaviour problems. The paper describes feasibility results of a pilot study of Starting Strong’s parent programme. Twenty-five families participated; rates of enrolment, attendance, retention, session engagement, homework completion, treatment fidelity and participant satisfaction suggest promising feasibility. School-based efforts targeting the transition to kindergarten may be helpful in improving behavioural and relational adjustment, especially for children who begin school with behavioural or relational risk. [ABSTRACT FROM AUTHOR]

This paper discusses methodological issues that emerged during the design and implementation of a large-scale survey of licensed social workers in the USA. Benefits and challenges of survey research are identified. The paper provides recommendations for future workforce studies and surveys that assess behavioral health problems. [ABSTRACT FROM AUTHOR]

The United States spends more money on mental health services than any other country, yet access to effective psychological services remains strikingly low. The need-to-access gap is especially wide among children and adolescents, with up to 80% of youths with mental health needs going without services, and the remainder often receiving insufficient or untested care. Single-session interventions (SSIs) may offer a promising path toward improving accessibility, cost-effectiveness, and completion rates for youth mental health services. SSIs are structured programs that intentionally involve only one visit or encounter with a clinic, provider, or program; they may serve as stand-alone or adjunctive clinical services. A growing body of evidence supports the capacity of SSIs to reduce and prevent youth psychopathology of multiple types. Here, we provide a working definition of SSIs for use in future research and practice; summarize the literature to date on SSIs for child and adolescent mental health; and propose recommendations for the future design, evaluation, and implementation of SSIs across a variety of settings and contexts. We hope that this paper will serve as an actionable research agenda for gauging the full potential of SSIs as a force for youth mental health. [ABSTRACT FROM AUTHOR]

More than 2 million people in the United States are living with some form of aphasia, a communication disorder that has been associated with high incidence of clinical depression. Despite their large numbers, persons with aphasia have received little clinical attention from psychologists and other mental health providers. The life participation interventions and supported communication methods developed and routinely employed by speech–language pathologists could assist mental health professionals in addressing the needs of this underserved population. This paper examines the psychological challenges facing individuals living with aphasia and the factors contributing to depressive symptoms among those with significant communication loss. In addition, it explores the potential compatibility between life participation interventions developed by speech–language pathologists and evidence-based cognitive–behavioral interventions for depression, such as behavioral activation. Specific adaptations to behavioral activation for individuals experiencing aphasia-related depressive symptoms are explored, along with strategies for integrating supported communication in the provision of mental health treatment. [ABSTRACT FROM AUTHOR]

Suicide is a public health problem which will require an integrated cross-sector approach to help reduce prevalence rates. One strategy is to include the legal system in a more integrated way with suicide prevention efforts. Caine (2013) explored a public health approach to suicide prevention, depicting risk factors across the socio-ecological model. The purpose of this paper is to examine laws that impact suicide prevention at the individual, relational, community, and societal levels. These levels are fluid, and some interventions will fall between two, such as a community-level approach to training that enhances provider-patient relationships. At the individual level, we will review laws to improve screening requirements across systems. At the relational level, we note interventions with couples having conflict, such as protection orders and access to attorney consultations, which have been known to be injury prevention mechanisms. At the community level, we discuss legislation that recommends suicide prevention efforts for key individuals working as frontline providers in the medical and educational systems. At the societal level, we explore public awareness campaigns that target stigma reduction for those suffering from mental health burden and enhance linkage to care. The article closes with the discussion that laws are good, but their implementation is essential. [ABSTRACT FROM AUTHOR]

In the United States, the demand for child mental health services is increasing, while the supply is limited by workforce shortages. These shortages are unlikely to be corrected without significant structural changes in how mental health services are provided. One strategy for bridging this gap is task‐shifting, defined as a process by which services that are typically delivered by professionals are moved to individuals with less extensive qualifications or training. Although task‐shifting can increase the size of the workforce, there are challenges related to training new workers. In this paper, we propose Just‐In‐Time Training (JITT) as one strategy for improving task‐shifting efforts. We define JITT as on‐demand training experiences that only include what is necessary, when it is necessary, to promote competent service delivery. We offer a proof of concept from our own work shifting counseling and academic support tasks from school mental health professionals to pre‐baccalaureate mentors, citing lessons learned during our iterative process of JITT development. We conclude with a series of key considerations for scaling up the pairing of task‐shifting and JITT, including expanding the science of JITT and anticipating how task‐shifting and JITT would work within the context of dynamic mental health service systems. Highlights: Task‐shifting refers to redistributing tasks from professionals to workers who have less training.Task‐shifting may be a key strategy in expanding child services in low resource communities.Just‐in‐Time Training (JITT) refers to efficient, on‐demand training experiences.JITT may strengthen task‐shifting efforts.Task‐shifting and JITT involve unique ethical considerations. [ABSTRACT FROM AUTHOR]

Adults released from incarceration are at high risk of death from drug-related causes, pointing to the importance of connecting individuals to healthcare services after release from prison. Though Medicaid plays an important role in financing behavioral health treatments for vulnerable groups, many states terminate individuals' Medicaid coverage during incarceration. A significant risk factor for substance use disorders (SUD) among incarcerated individuals is serious mental illness (SMI). In January 2006, Washington State began a program of expedited Medicaid enrollment for individuals with mental illnesses being discharged from state prisons, jails, and psychiatric hospitals. Prior literature has shown this program to be effective in increasing Medicaid enrollment and use of mental health services for people with SMI. The current paper examined the effect of referral to expedited Medicaid on use of SUD treatment for people with SMI released from prison. Our sample consisted of 3086 individuals with a diagnosis of SMI who were released from prison from January 1, 2006 to December 31, 2007. Of the sample we identified, 871 individuals received referrals for expedited Medicaid and 2215 did not. To control for selection bias on observed characteristics for referral, we used inverse probability weights (IPW) to balance the referred and not-referred groups on more than 50 baseline covariates. We used doubly-robust IPW models to estimate the effect of referral to expedited Medicaid on use of SUD treatments following prison release. Approximately 12% of our sample used any SUD treatment by 3 months after release, with this percentage rising to 28% at 12 months. When controlling for baseline differences, referral to expedited Medicaid enrollment was associated on average with a 6.7 (SE 2.9, p < .05) percentage point increase in the predicted probability of using any SUD treatment in the 3 months following release as compared to those not referred to the program. This effect size represents a 61% increase in the probability of using any treatment by 3 months. The result was similar for the 6-month follow-up period and persisted at the 12-month follow-up though the magnitude of the effect decreased somewhat. Overall, our results suggest that expedited Medicaid enrollment for people with SMI released from prison can increase use of SUD services. [ABSTRACT FROM AUTHOR]

The opioid epidemic is a national emergency in the United States. To meet the needs of individuals diagnosed with Opioid Use Disorder (OUD) office-based opioid treatment programs (OBOT) are quickly expanding. However, social workers roles in OBOT programs are not clearly described. This paper will emphasize three roles social workers may fulfill in OBOT programs to combat the opioid crisis. [ABSTRACT FROM AUTHOR]

Introduction: Under the current payment environment, the challenges to implementing and sustaining integrated behavioral health care are substantial. One key barrier for clinicians, administrators, researchers, and patients/families is a lack of clarity about who pays for integrated health care in the United States, and a lack of consensus about whether bending the health care cost curve is a fundamental goal of integrated care, and for whom. Clinicians caring for patients and families in integrated care settings would benefit from honing their "payment reform literacy skills" in order to advocate for integrated care.Method: This paper offers a primer on the current state of health care spending in the United States, an overview of public and private payers, and the challenges each faces in paying for integrated care.Discussion: Future journal articles in the FSH Policy and Management Department will describe key payment policy and management opportunities for integrated care payment reform. (PsycINFO Database Record (c) 2019 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

What is the role of the arts in healthcare related to young people ’ s mental health and wellbeing ? How do we understand the interconnections of art, therapy and health and describe the projected benefits for young people ’ s mental health and wellbeing ? Responding to these questions, this paper describes a youth arts project and research. Three stakeholder viewpoints, the artists, health workers and young people, are examined to draw out explanations and understandings of art, therapy, and health related to young people’s mental health in an Australian context. A synthesis of arts and health methodologies were used, including thematic analysis of interviews with participants. This paper investigates the ways in which participant descriptions entwined and blurred ideas and possibilities of practice across the art, therapy and health nexus. These viewpoints add up to much more than each one can offer in singularity. They reveal expanded perspectives with which to consider scope of practice, discipline boundaries, and research gaps pertaining to the role of the arts in youth-specific mental health services. [ABSTRACT FROM AUTHOR]

Accessible summary In the Western world, many people who have mental health problems experience poor physical health. Research suggests that those with mental illness often have difficulties in accessing health care services, reporting that when they do, their physical health needs are often overlooked., Nurses are expected to deliver safe and effective care that meets the needs of service users. In order to help mental health nurses address physical health care needs, changes to nurse education, supported by government policy, have been made in the United Kingdom. Despite these changes, mental health nurses still feel less confident and prepared to address physical health needs of service users. However, this same problem is also reported by nurses throughout Europe and in other Western countries, who have undergone different training and education programmes., This paper discusses important factors affecting the mental health nurses' ability to deliver physical care and how they impact on confidence and competence., The paper concludes by highlighting the role of the mental health nurse being key in addressing the physical health needs of those in their care, and how this will only be realized when education and practice provide sufficient opportunity for them to develop and maintain their knowledge and skills., Abstract In the Western world, there is increasing concern regarding the ability of health care professionals to meet the physical health care needs of those diagnosed with mental illness. This discussion paper seeks to explore some of the issues facing mental health nurses in delivering care to those who have both mental and physical illness. Criticism of the National Health Service for failing to meet the physical health needs of people with serious mental illness has generated a number of political strategies aimed at addressing inequalities between mental and physical health care, a consequence being a change in pre-registration nurse education. It is envisaged that such changes will enable all nurses to deliver safe, effective care to service users, with adult and mental health nurses being more adept at meeting both the mental and physical health needs of those in their care. The impact of three key areas identified within the literature will be considered: the impact of co-existing physical and mental illness; the role of mental health nurses and perceptions of service users re physical health care; and education, training and learning from others in the Western world. In conclusion, the complexities of delivering such care will be addressed. [ABSTRACT FROM AUTHOR]

In our collective memory of the 1950s, Frederic Wertham often appears as the spearhead of the conservative anti–comic book campaign. Yet in recent historiography, scholars have championed him as an antiracist who made mental health care more available to African Americans at Harlem’s Lafargue Mental Hygiene Clinic. Named for Karl Marx’s son-in-law, its volunteers provided low-cost care regardless of race from 1946 to 1959. How did someone who might otherwise have been branded a Communist attract white conservative allies at the repressive outset of the Cold War? This paper contends that this leftist was able to keep his subversive clinic open for thirteen years because that white public was unaware its patients and staff were black. The Lafargue Clinic relied on mass media to generate donations. In the 1950s, the clinic’s public image was linked to the anticomics movement. Because Wertham represented the work he did there with children and comics in a race-neutral fashion, white parents thought the clinic was white, flooding it with donations and requests for speakers. Ironically, this radical clinic was forced to close once the anticomics crusade ended, eroding its conservative base. The history of the Lafargue Clinic’s public image highlights the ironies of a postwar United States united by mass media. A carefully crafted public image enabled some subversive institutions to avoid the blacklist and pursue their missions. By generating allies ignorant of their actual activities and ideology, places such as the Lafargue Clinic managed to survive the 1950s—hidden in plain sight. [ABSTRACT FROM AUTHOR]

The primary aim of this paper is to introduce practitioners to the mental health needs of children and families who are under the care and supervision of the child welfare system because of substantiated child maltreatment. Emphasis is placed on children and families who are receiving foster care services. The paper draws attention to the most prevalent mental health conditions that affect foster care children and their families based on type of maltreatment. Given that young children under age 5 are more likely to be placed in out-of-home placements and to spend a significant portion of their lives in foster care, their unique mental health needs are highlighted. Treatment approaches that are informed by both practice wisdom and evidence-based practice--such as ego-supportive intervention and trauma-focused, cognitive-behavioral therapy--are stressed. A case study is presented as a way of illustrating how mental health care may be delivered to families affected by the child welfare system. [ABSTRACT FROM AUTHOR]

Background: The Implementation Research Institute (IRI) provides two years of training in mental health implementation science for 10 new fellows each year. The IRI is supported by a National Institute of Mental Health (NIMH) R25 grant and the Department of Veterans Affairs (VA). Fellows attend two annual week-long trainings at Washington University in St. Louis. Training is provided through a rigorous curriculum, local and national mentoring, a 'learning site visit' to a federally funded implementation research project, pilot research, and grant writing. Methods: This paper describes the rationale, components, outcomes to date, and participant experiences with IRI. Results: IRI outcomes include 31 newly trained implementation researchers, their new grant proposals, contributions to other national dissemination and implementation research training, and publications in implementation science authored by the Core Faculty and fellows. Former fellows have obtained independent research funding in implementation science and are beginning to serve as mentors for more junior investigators. Conclusions: Based on the number of implementation research grant proposals and papers produced by fellows to date, the IRI is proving successful in preparing new researchers who can inform the process of making evidencebased mental healthcare more available through real-world settings of care and who are advancing the field of implementation science. [ABSTRACT FROM AUTHOR]

Purpose: The main purpose of this paper is to examine geographic variation in unmet need for mental health care among racially/ethnically diverse adults with psychiatric disorders in the US.Methods: Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES; 2001-2003), adults with any past year psychiatric disorder diagnosis (n = 3211) from diverse racial/ethnic backgrounds were selected for analyses. Using weighted data, descriptive analyses and logistic regression analyses were conducted.Results: Two-thirds of the total sample had unmet mental health care need, which differed significantly by race/ethnicity (p < .001). Logistic regression analyses show regional variation of the effect of race/ethnicity in unmet need: after adjusting for covariates, Latinos in the South, Blacks and Latinos in the Midwest, and Latinos and Asians in the West had higher unmet need than non-Hispanic Whites, whereas no significant racial/ethnic effects were found in the Northeast.Conclusions: Findings suggest that geographic region plays an important role in the sufficient use of mental health services among racial/ethnic minorities. Further research should elucidate reasons for geographic disparities in mental health care among racial/ethnic minority adults to reduce disparities. [ABSTRACT FROM AUTHOR]

Purpose Advances in military medical care have facilitated a reduction of fatalities in the global war on terror, relative to previous conflicts. The physical and psychological trauma of returning personnel remain a challenge, and poor physical and psychological health have been shown to affect quality of life (QOL). The purpose of this paper is to validate the WHOQOL-BREF questionnaire amongst wounded, injured and ill military personnel, and to determine the characteristics of distinct groups found in this sample.Design/methodology/approach In total, 52 male and female military personnel (34.69+7.63 years, n=51) completed 24 items of the WHOQOL-BREF. Principal component analysis using the direct oblimin rotation was used to determine the factor structure of the WHOQOL-BREF and k-means cluster analysis was used to determine QOL characteristics of the separate groups.Findings The WHOQOL-BREF is a reliable tool for measuring QOL for American military personnel. However, the psychometric structure of the WHOQOL-BREF in this sample differed from the original domains. The first cluster analysis based on the original domains produced two clusters: a group of 12 that had poor QOL, and a group of 40 that had relatively good QOL except for the physical domain. The second cluster analysis differed in independence and access/social support only.Research limitations/implications Although the sample was small for principal component analysis, the investigators chose to proceed with this procedure, because objective indicators such as measures of sampling adequacy and communalities met or exceeded acceptable thresholds.Originality/value Rehabilitation programs for military ill, injured and wounded should contain components that promote independence and self-actualization. [ABSTRACT FROM AUTHOR]

There are calls across America for police to re-imagine themselves as ‘guardians’ rather than ‘warriors’ in the performance of their innumerable duties. The contentious history of police attitudes and practices surrounding encounters with people affected by mental illnesses can be understood through the lens of this wider push towards guardianship. At least as far back as the de-institutionalisation of mental health care and the profound lack of community-based resources to fill service deficits, the role of police as mental health interventionists has been controversial and complex. This paper reviews the first wave of reform efforts designed to re-shape police sensibilities and practices in the handling of mental health-related encounters. We argue that such efforts, centred on specialised training and cooperative agreements with the health care sector, have advanced a guardian mindset through improved knowledge and attitudes about mental health vulnerabilities and needs. Building on the progress made, we suggest there are critical opportunities for a new wave of efforts that can further advance the guardianship agenda. We highlight three such opportunities: (1) enhancing experiences of procedural justice during mental health-related encounters; (2) building the evidence base through integrated data sets; and (3) balancing a ‘case-based’ focus with a ‘place-based’ focus. [ABSTRACT FROM PUBLISHER]

By providing affordable healthcare to many Americans for the first time, the Affordable Care Act increases demand for public mental health services. It is, however, unclear if states' provision standards for supply of mental health services will be able to accommodate this demand increase. Both the demand and supply of public mental health services vary within states; it is necessary to measure both locally. In this paper, we estimate the prevalence of mental illness within 30 geographical regions in the state of Virginia, a representative example of how many states organize their public mental health systems and how mental illness prevalence can be measured locally. Our methodology extends the analysis in Stern (Health Serv. Outcomes Res. Methods 14:109-155, 2014) by covering an entire state and accounting for peoples' insurance status. The latter allows us to compare estimates of demand for public mental health services among those 30 geographical regions. We find that over 66,000 uninsured and Medicaid-insured individuals in Virginia are not provided with public mental health services. The deficit varies locally, with several regions having no deficit and others having 5000 or more untreated people. We also estimate that a large portion of the unserved people with mental illness are uninsured but would be insured for mental health services through Medicaid if Virginia were to accept the Medicaid expansion associated with the Affordable Care Act. These results provide evidence that there is significant variation in the demand for and public health systems' ability to supply mental health services within states. This implies states can better serve populations relying on mental health care by allocating scarce public mental health dollars to localities reflecting their need. [ABSTRACT FROM AUTHOR]

Purpose – Research and experience following a variety of recent disasters has fostered the development of a range of disaster behavioral health interventions that can be used post-disaster. Consensus documents recommend that five guiding principles be used to inform intervention efforts. These five essential elements, a sense of safety, calming, efficacy, connectedness, and hope, appear critical to the fostering of adaptation and resilience in affected communities. This paper aims to examine the use of these principles in practice. Design/methodology/approach – Translating these five evidence-informed principles into practice requires dissemination, delivery and prioritizing and validation of the elements. Scholars identify actions for dissemination, delivery, and prioritization and validation, and this paper expands on the literature to identify processes that actualize the research into a framework for practice. Findings – This article describes how disaster behavioral health professionals in Colorado have advanced these five principles into practice. Originality/value – While literature clearly dictates the importance of addressing the impacts of extreme stress on individuals and communities, there remains a gap to explain how to bridge the research and practice. These strategies included in this paper begin to bridge this gap and can be used by others charged with disaster planning and response to inform their practices. [ABSTRACT FROM AUTHOR]

Raghavan et al. (Implement Sci 3(26):1-9, 2008) proposed that effective implementation of evidence-based practices requires implementation strategies deployed at multiple levels of the 'policy ecology,' including the organizational, regulatory or purchaser agency, political, and social levels. However, much of implementation research and practice targets providers without accounting for contextual factors that may influence provider behavior. This paper examines Philadelphia's efforts to work toward an evidence-based and recovery-oriented behavioral health system, and uses the policy ecology framework to illustrate how multifaceted, multilevel implementation strategies can facilitate the widespread implementation of evidence-based practices. Ongoing challenges and implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to discuss and examine the implications of holding mental health tribunals in public. Design/methodology/approach -- The paper discusses the functioning of tribunals, compares tribunals with other legal processes in the UK and elsewhere, and reviews the legal reasoning for holding tribunal hearings in public. Findings -- The first tribunal hearing has already been held in public and another public hearing is agreed. Public hearings should allow for greater transparency and scrutiny than has thus far been possible, and may change the behaviour of attendees. Originality/value -- Public tribunal hearings have not yet been widely discussed in the academic literature, yet are expected to have implications for all involved. [ABSTRACT FROM AUTHOR]