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Background: Alzheimer's disease and related dementias (ADRD) is a growing public health challenge. Prior research suggests that non-Hispanic whites (whites), non-Hispanic African Americans (African Americans), and Hispanics have differing risks for ADRD.Objective: To examine the existence of serious psychological distress (SPD) among whites, African Americans, and Hispanics; to calculate the predicted probability of ADRD in whites, African Americans, and Hispanics, and to decompose the differences among ADRD populations, quantifying the burden of higher SPD among African Americans and Hispanics, compared to whites.Data and Method: The authors use nationally representative data from the Medical Expenditure Panel Survey (2007-2015) to estimate the association between ADRD and race, ethnicity, and SPD. Using Blinder-Oaxaca decomposition analysis, the authors estimate to what extent higher SPD among Hispanics and African Americans was associated with higher ADRD rates compared to whites.Results: After controlling for individuals' demographic and socioeconomic characteristics and co-existing medical conditions, the presence of SPD was still significantly associated with a higher likelihood of having ADRD. The model predicted significantly higher likelihood of having ADRD among African Americans (7.1%) and Hispanics (5.7%) compared to whites (4.5%). Higher rates of having SPD among African Americans explained 15% of white-black difference and 40% of the white-Hispanic difference in ADRD rates, respectively.Discussion and Conclusion: Our findings suggest a significant relationship between SPD and ADRD and that the burden of SPD was greater among African Americans and Hispanics with ADRD. Efficient screening using self-reported SPD, compared to simply using diagnoses codes of mental illness, may be more helpful to reduce racial and ethnic disparities in ADRD. [ABSTRACT FROM AUTHOR]

Background: Past research shows that among individuals with substance use disorders, the presence of a co-occurring mental illness can influence the initiation, course, and success of behavioral health treatment, but little research has examined people with opioid use disorder (OUD) specifically.Methods: Using the 2008-2014 National Survey on Drug Use and Health, this study examines the utilization of substance use disorder and mental health treatment among individuals with OUD and different degrees of mental illness severity. The study also examined types of treatment, perceived unmet need for treatment, and barriers to care.Results: 47% of individuals with OUD and co-occurring mild/moderate mental illness did not receive any behavioral health treatment, and 21% of those with co-occurring serious mental illnesses did not receive any behavioral health treatment. Among those with OUD and co-occurring mild/moderate mental illness, 16% reported receiving both substance use disorder and mental health treatment; among those with co-occurring serious mental illness the rate was 32%. The most common form of treatment was prescription medication for mental health, and this was true regardless of whether or not the individual had any mental illness. More than 50% of the study population reported financial difficulties as a barrier to treatment.Conclusion: A high proportion of individuals with OUD and co-occurring mental illness are not receiving needed care. However, nearly one in five of those with OUD but no diagnosed mental illness is receiving prescription medication for mental illness. These findings suggest that there is a need to better facilitate access to and coordinate behavioral health care across settings for individuals with OUD. [ABSTRACT FROM AUTHOR]

The article discusses research on the link between subsyndromal depression among people aged 85 years old and higher monthly healthcare spending, and older people's access to geriatric psychiatric services.

Introduction: Serving as the center of community-engaged health programs, local health departments can play a critical role in promoting community mental health. The objectives of this study were to explore the association between local health department activities and (1) preventable hospitalizations for individuals with mental disorders, and (2) associated racial disparities in preventable hospitalizations.Method: Employing the linked data sets of the 2012-2013 Healthcare Cost and Utilization Project state inpatient discharge file of the State of Maryland, the National Association of County and City Health Officials Profiles Survey, the Area Resource File, and U.S. Census data, the authors estimated the association between local health department activities (i.e., provision of mental health preventive care and community mental health promotion) and the reduction of the preventable hospitalizations for ambulatory care-sensitive conditions and coexisting mental disorders. All the data analyses were conducted during September 2016-August 2017.Results: Multilevel regression showed that local health departments' provision of mental health preventive care (OR=0.76, 95% CI=0.63, 0.92) and mental health promotion activities (OR=0.77, 95% CI=0.62, 0.94) were significantly associated with lower rates of preventable hospitalizations for individuals with ambulatory care-sensitive conditions and coexisting mental disorders. Decomposition results suggested that local health departments' direct provision of mental health preventive care could reduce 9% of the racial disparities.Conclusions: Improving care coordination and integration are essential to meeting the growing demands for healthcare access, while controlling costs and improving quality of service delivery. These results suggest that it will be effective to engage local health departments in the integrated behavioral health system. [ABSTRACT FROM AUTHOR]

State policies pertaining to prenatal substance use have important implications for health outcomes of pregnant women and their infants. However, little is known about the impact of the various types of state-level prenatal substance use policies (i.e., treatment and supportive services; criminal justice initiatives; and health care provider reporting requirements) on substance use disorder treatment admissions. Using data from the 2002-2014 Treatment Episode Data Set - Admissions, we exploited state-level variation in the implementation of different types of policies to assess their impact on pregnant women's admission to substance use disorder treatment. The study found that state-level prenatal substance use policies focused only on the criminal justice sector were negatively associated with the proportion of women of reproductive age who were pregnant upon admission to treatment. Additionally, the implementation of policies that engaged all three sectors was positively associated with the proportion of women of reproductive age who were pregnant upon admission to treatment. These results were consistent across age groups and for both non-Hispanic white women and women of other racial/ethnic groups. The findings imply that states with cross-sector policy engagement around prenatal substance use and policies that take a multifaceted, comprehensive approach are more likely to see an increase in admissions to substance use disorder treatment during pregnancy. [ABSTRACT FROM AUTHOR]