Psychiatric Services From Pages To Practice

Dr. Benjamin Brody (Weill Cornell Medicine, New York) joins Dr. Dixon and Dr. Berezin to discuss how Joint Commission accreditation can be evolved to ensure that it is aligned with best incentives to for high-quality behavioral health care. Transcript 00:52     Brody background 02:51     Inpatient work 03:42     The tension of inpatient psychiatric care 05:28     The Joint Commission 07:39     What the Joint Commission is doing well 09:04     Best practices 11:02     Who ordered what, when, and where 13:33     Including the patient as a stakeholder 20:23     Comprehensive treatment plans 22:25     What would you do if you were CEO? 24:34     Ensuring that the things the Joint Commission focuses on are the things that improve patients’ lives. 25:14     A vision for quality improvement that engages stakeholders 30:12     Shared decision making Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up

Dr. Judith Cook (University of Illinois Chicago) joins Dr. Dixon and Dr. Berezin to discuss an intervention designed to help improve financial literacy and competency and reduce economic strain for people receiving services for psychiatric disorders. Transcript 00:57     Psychiatric services research 02:05     Clinical work and Thresholds 03:46     Current role 04:23     Why does financial wellness matter for this population? 06:43     Psych rehab 08:05     Spending triggers 10:59     A psych rehab framework 12:53     Financial wellness 14:10     Beyond trans-diagnostic 16:24     The curriculum 20:10     Receiving a good financial education 21:32     Top line findings of the trial 25:07     The emotional context of financial wellness 25:55     Trained peer instructors 27:34     Policymaker takeaways 30:30     Financial literacy does not imply financial wellness 32:07     Small goals towards financial wellness  Subscribe to the podcast here. Check out Editor's Choice, a set of curated collec

Dr. Kevin Simon (Harvard Medical School and Boston Public Health Commission) joins Dr. Dixon and Dr. Berezin to discuss the processes behind and concerns surrounding involuntary psychiatric hospitalization. Transcript 01:03     Career path 03:42     Boston Public Health Commission 09:28     Collaborators 13:09     Section 12 16:14     Transportation 17:17     Rates of involuntary transport 22:29     Requests that don’t end in transport 23:42     Police involvement Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

Eunice Wong, Ph.D., (RAND, Santa Monica, Calif.) joins Dr. Dixon and Dr. Berezin to discuss a review taking a look at the interactions of faith communities and the mental health sector in the provision of mental health care. Transcript 00:56     How did you arrive at this field of study? 02:58     What is RAND and what do they do? 04:11     How are works for a think tank evaluated? 05:21     The interaction of faith communities and mental health service provision 07:38     Types of collaboration – PSFPTP Hankerson episode 09:57     Why look at the literature now? 11:12     What kinds of questions are you asking? 12:57     The complexity of different faiths, and different organizations 15:56     Topline findings 18:12     Does the research paradigm work in situations like this? 22:03     Discussing a patient and provider’s religiosity 23:20     Assumptions and characterizations of faith-based organizations 24:55     Destigmatizing conversations about mental health and behavioral health in fait

Dr. Mette Ødegaard Nielsen (Unit for Complicated Schizophrenia, Glostrup, Denmark) joins Dr. Dixon and Dr. Berezin to discuss patient motivations and experiences of antipsychotic medication tapering at a clinic in Denmark. Transcript 01:02     Nielsen interview 02:22     Tapering medication 04:09     Controversies around tapering 07:07     Debilitating effects of side effects 09:09     The tension between medication and side effects for the clinician 12:47     Top line findings 15:28     Psychotic symptom relapse 17:38     Differences by medication 19:43     Expectations from patients 21:47     Shared decision making 24:44     Mixed expectations and reality 27:20     Relapse 29:50     Close contact between patients and clinic staff Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to l

Maggi A. Price, Ph.D., M.A. (School of Social Work, Boston College) joins Dr. Dixon and Dr. Berezin to discuss gender-affirming psychotherapy (GAP), a comprehensive, evidence-informed, and human-centered set of practices focusing on the treatment of transgender youth developed by Dr. Price and colleagues. The training discussed in the podcast is available to the public at a reduced cost at https://www.affirmlab.org/gaptraining with the discount code “psychserv50." Transcript 01:27     How did you end up on this project? 04:20     Gaps in care for transgender youths 05:47     Methods 08:47     Human-centered design 09:28     Stakeholders and focus groups 12:32     Domains 15:22     Key themes 18:17     Can you separate out gender identity from other goals of therapy? 20:38     Bringing in providers who are less supportive of potentially hostile 23:40     Providers who work in areas of transgender discrimination 26:03     First steps Subscribe to the podcast here. Check out Editor's Choice, a set o

Dr. Sharon Hoover (University of Maryland School of Medicine, Baltimore) joins Dr. Dixon and Dr. Berezin to discuss the provision of mental health services in schools: why it matters, who it touches, how it’s funded, and how it’s doing. 01:15     Background 02:46     Provision of school mental health 09:56     How mental health services differ between ages and grades 11:08     COVID pandemic and youth mental health 15:29     Federal funding mechanisms 18:39     Using the funding while it’s still available 22:10     Partnerships in school mental health 23:00     Medicaid 27:11     Medicaid billing and complications for school systems 28:47     Technical assistance for schools 30:07     Data systems 33:49     Temperature check Transcript Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your

Simon Graham, M.B.Ch.B., M.R.C.Psych., and Kathy Curtis (Spring House Psychotherapy and Personality Disorder Service) join Dr. Dixon and Dr. Berezin to discuss the use of a local case management team and a combined day treatment and crisis service for patients with borderline personality disorder in Liverpool, United Kingdom. Transcript Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org  

Elizabeth Bromley, M.D., Ph.D. (University of California, Los Angeles) joins Dr. Dixon and Dr. Berezin to discuss the use of outpatient conservatorship in the effort to address mental health disability among unsheltered homeless persons in Los Angeles County, California. 00:00    Introduction 03:04     Homelessness in Los Angeles County, California 09:04     The paper and services 11:39     Lanterman-Petris-Short (LPS) conservatorship 13:44     Outpatient conservatorship (OPC) pilot program 15:54     Skepticism 18:48     Beyond conservatorship: other aspects of the program 22:34     Initial evaluation 25:21     Quantitative measures 28:33     Coordination Transcript   Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it whe

Gregory E. Simon, M.D., M.P.H. (Kaiser Permanente Washington Health Research Institute, Seattle) join Dr. Dixon and Dr. Berezin to discuss the use of machine learning models to analyze electronic health records to predict antidepressant treatment response. 00:00     Introduction 02:31    Focus on practical research 04:55    Population studied 05:57    Predicting outcomes 07:20    Using diagnostic codes, not personalized notes 08:04    What three data items might be more helpful? 08:49    What key indicators are we missing in clinical care? 11:35    A billing tool, not a clinical tool 12:57    Is suicide a predictable event based on electronic health record data? 14:48    “Machine learning and artificial intelligence”  16:15    Methods 18:59     Can we do a better job clarifying what we mean by depression? 22:32    How can we use a predictive model in clinical practice? 28:20    Predictive models, probability, the weather, and communicating  Transcript Subscribe to the podcast here. Check out Editor's Choice,

Misty C. Richards, M.D., M.S. (University of California, Los Angeles), and Nicole Kozloff, M.D. (University of Toronto), join Dr. Dixon and Dr. Berezin to discuss the need to remodel our systems and provision of mental health services for children and adolescents. 00:00     Introduction 01:18     Impetus 05:45     What constitutes a mental health crisis? 11:14     “Remodeling” 16:21     Differences by location 18:28     Remodeling primary care 21:25     Virtual care 27:19     New service models 32:19     Are we moving in the right direction?   Transcript   Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. Listen to other podcasts produced by the American Psychiatric Association. Follow the jo

Andrew D. Carlo, M.D., M.P.H. (Northwestern University Feinberg School of Medicine, Chicago) joins Dr. Dixon and Dr. Berezin to discuss the insurance acceptance rates of psychiatric practitioners compared with other medical disciplines. 00:00     Introduction 01:04     Background and Motivation 02:46     Data Set and Methodology 05:12     Restricted Data Set and Privacy Concerns 06:08     Research Questions and Goals 10:04     Findings: Insurance Acceptance Rates 11:29     Factors Influencing Insurance Acceptance 14:23     Magnitude of the Gap in Insurance Acceptance 15:44     Factors Affecting Insurance Acceptance for Psychiatrists 18:08     Challenges in Enforcing Mental Health Parity 19:27     Market Power of Psychiatrists 22:48     Impact on Other Mental Health Professionals 24:16     Importance and Implications 25:11     Potential Solutions and Policy Changes 29:31     Conclusion   Transcript   Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich

Eliza Hallett, M.S., (Oregon Health & Science University, Portland, Oregon) joins Dr. Dixon and Dr. Berezin to discuss the challenges faced by staff and behavioral health service providers, including low wages, traumatic work environments, low wages, and physical and administrative infrastructure. Workforce crisis in behavioral health care [01:33] How representative of the country is Oregon? [03:45] Who were you talking to? [05:32] A figure on radio [06:30] Generating a theoretical framework from the responses [08:01] Qualitative methods [09:30] The five factors [10:33] Wages [14:05] Infrastructure [14:40] Are these issues unique to behavioral health services? [19:11] Legislative changes in Oregon [21:25] Feeling supported matters [23:39] Did the pandemic exacerbate the problem? [27:04] Take home [29:08] Access the complete Behavioral Health Workforce Report to the Oregon Health Authority and State Legislature here. Transcript   Figure 1.  Factors influencing turnover and attrition in the public beh

Henry Chung, M.D., (Albert Einstein College of Medicine, Bronx, New York City) joins Dr. Dixon and Dr. Berezin to discuss the differences between the collaborative care model and the colocation model, and the impact on Medicaid costs and utilization, for the treatment of patients with depression. Chung interview [00:58] A bridge between clinical and research work [02:32] The colocation model and the collaborative care model [03:44] What populations are you working with? [07:21] Differences in service utilization and cost [10:25] Methodology [10:47] Concentration on depression instead of other psychiatric disorders [13:59] Findings [15:11] Choosing between models [20:21] Impact of COVID [24:06] Final thoughts [28:21] Transcript   Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagu

Joseph Parks, M.D., joins Dr. Dixon and Dr. Berezin to discuss guidelines for clinicians on how to deal with the increased prevalence of drugs adulterated with fentanyl and similar potent fentanyl analogs. MDI publications can be found here. Parks interview [00:53] The National Council for Mental Wellbeing [01:21] Guidelines [03:50] Contemplation [05:02] A back-to-basics approach [07:13] Fentanyl test strips and harm reduction [08:37] Spillover [10:06] Issues with fentanyl [12:05] Incremental behavioral changes [13:44] Things people should know about fentanyl [16:29] Training for professionals [18:03] How things are moving [19:55] See the Psychiatric Services Editor's Choice collection, "Responding to the Opioid Crisis." Transcript Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your coll

Eric P. Slade, Ph.D., joins Dr. Dixon and Dr. Berezin to discuss the complex and often confusing world of dual eligibility for Medicare and Medicaid coverage when it comes to mental health services, in particular Dual Eligible Special Needs Plans (D-SNPs), a type of Medicare Advantage plan designed around those eligible for both programs.   Slade interview [00:59] Medicare and Medicaid [02:24] Eligibility for each, and both [06:36] Dual eligibility [08:09] Who pays for care? [09:51] Managed care [11:13] Trade offs between traditional insurance and HMO plans [15:47] Medicare Advantage [18:17] Dual Eligible Special Needs Plans (D-SNPs) [19:06] D-SNPs from the perspective of consumers [21:34] Provider networks [24:50] Findings [27:07] Why do D-SNPs not have larger psychiatrist networks than traditional Medicare? [30:02] Mental health care and insurance coverage [33:47] What should policymakers take from this? [36:37] What should clinicians take from this? [39:56]   Transcript   Subscribe to the podcast he

Lauren Southwick, M.P.H., and Sharath Guntuku, Ph.D., join Dr. Dixon and Dr. Berezin to discuss whether using a digital dashboard maintained by patients to track social media and other digital data usage had an impact on mental health therapy outcomes. •    Southwick and Guntuku interview [01:37] •    What led you to this study design? [03:06] •    What did you think this would look like in a therapy setting? [08:00] •    Amount of data patients contributed varied widely [09:39] •    The dashboard [10:12] •    What were the effects of sharing digital data with therapists? [12:31] •    The Hawthorne effect [15:25] •    What’s next for your research? [18:23] •    Recruitment [20:46] •    COVID and people’s interactions with digital media and mental health [23:29] •    ChatGPT [26:50] Transcript Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. B

Breanna C. Keepers, M.D., M.B.A., and Ish P. Bhalla, M.D., M.S., join Dr. Dixon and Dr. Berezin to discuss the results of a survey of mental healthcare providers and their usage of measurement-based care.  Dr. Keepers is in the Department of Psychiatry at New York-Presbyterian Hospital, and Dr. Bhalla is Medical Director of Behavioral Health Value Transformation at Blue Cross-Blue Shield of North Carolina. •    Keepers and Bhalla interview [00:50] •    Incentivizing provider behavior changes [03:01] •    Measurement instruments [05:30] •    Measurement-based care from the care recipient’s perspective [06:27] •    Study design [09:16] •    Clinical utility and measurement-based care [11:31] •    Are we using the right measure? [14:45] •    Heterogeneity in provider perceptions of measurement-based care [16:08] •    Training providers [17:25] •    Providing care is hard [19:36] •    What’s next for your research? [22:10] Transcript Subscribe to the podcast here. Check out Editor's Choice, a set of curated col

Navdep Kaur, M.P.H., joins Dr. Dixon and Dr. Berezin to discuss persistent racial and ethnic disparities in mental health treatment access and outcomes prior to and following the passage of the 2010 Affordable Care Act.  Ms. Kaur is a predoctoral fellow at the Columbia University Mailman School of Public Health in New York. Kaur interview [01:01] Connecting your work with your passion [03:09] Affordable Care Act and mental health [05:39] What did you look at to study this? [09:11] What are we talking about when we talk about distress? [10:06] How do you define treatment usage? [11:30] What are your hypotheses for why your findings on mental health treatment usage look the way they do? [13:11] Disaggregating data for disparate groups [14:40] Has the amount of treatment change overall differed between subgroups and the whole population? [17:42] How do you categorize the various levels of stigma and attitudes towards treatment? [19:16] Sources of market failure – lack of providers, insurance, access [21:21] Wha

Howard H. Goldman, M.D., PH.D. (PS emeritus Editor-in-Chief) and Alison Cuellar, Ph.D., (George Mason University, Fairfax, Virginia) joins current PS Editor-in-Chief Dr. Lisa Dixon to discuss the peer review process from the perspective of both reviewers and editors. Transcript Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org