Authors:Rebecca K. Sripada; Kipling M. Bohnert; Dara Ganoczy; Paul N. Pfeiffer Pages: 353 - 361 Abstract: This study measured the prevalence of evidence-based psychotherapy (EBP) templated notes in VA and tested the hypothesis that template use would be associated with care quality for posttraumatic stress disorder (PTSD). Across 130 facilities, an average of 3.6% of patients with a PTSD diagnosis received at least one EBP template in 2015. Among patients receiving psychotherapy for PTSD, an average of 8.5% received an EBP template. In adjusted models, facility-level EBP template use was associated with a greater proportion of PTSD-diagnosed patients treated in specialty clinics, greater facility-level rates of diagnostic assessment, and greater facility-level rates of psychotherapy adequacy. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0828-8 Issue No:Vol. 45, No. 3 (2018)
Authors:Melanie Livet; Mary Yannayon; Kelly Sheppard; Kelly Kocher; James Upright; Janey McMillen Pages: 362 - 380 Abstract: This pilot study explored provider use of an online system, Centervention, to support the delivery of empirically supported school-based mental health interventions (ESIs); and associations between components of this system [resources, training, technical assistance (TA), feedback loops], implementation indicators, and student outcomes. Multilevel modeling data were collected from 39 providers implementing ESIs with 758 students. Training, TA, and progress monitoring predicted ESI adherence, and perceived value of resources and TA influenced student responsiveness. Greater adherence was predictive of better socio-emotional outcomes. Interviews with 15 providers illuminated how they used these four Centervention support strategies. Implications for digital implementation support research are discussed. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0829-7 Issue No:Vol. 45, No. 3 (2018)
Authors:Daiane B. Machado; Flávia Jôse Alves; Davide Rasella; Laura Rodrigues; Ricardo Araya Pages: 381 - 391 Abstract: A sizeable proportion of all suicides have mental health issues in the background. The association between access to mental health care in the community and decreased suicide rates is inconsistent in the literature. Brazil undertook a major psychiatric reform strengthening psychiatric community-based care. To evaluate the impact of the new Brazilian community mental health care units (CAPS-Psychosocial-Community-Centres) on municipal rates of suicide, and hospitalisations by attempted suicide, psychiatric and alcohol problems. We performed robust multivariable negative binomial regression models with fixed effect for panel data from all 5507 Brazilian municipalities. Suicide and hospitalization rates were calculated by sex and standardised by age for each municipality and year from 2008 to 2012. The main variable of interest was municipal CAPS coverage. CAPS municipal coverage was associated with lower suicide rates but this was not statistically significant (RR: 0.981; 95% CI 0.952–1.011). However, increased CAPS coverage was associated with lower hospitalizations for attempted suicide (RR: 0.887; 95% CI 0.841–0.935), psychiatric (RR: 0.841; 95% CI 0.821–0.862), and alcohol problems (RR: 0.882; 95% CI 0.860–0.904). Our results suggest that access to community mental health services seems to reduce hospitalisations due to attempted suicide, psychiatric and alcohol problems but not suicidal rates. Therefore, increased investments in community mental health services in low-middle-income countries might decrease costs associated with potentially avoidable hospitalizations. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0830-1 Issue No:Vol. 45, No. 3 (2018)
Authors:Amanda Jensen-Doss; Ashley M. Smith; Emily M. Becker-Haimes; Vanesa Mora Ringle; Lucia M. Walsh; Monica Nanda; Samantha L. Walsh; Colleen A. Maxwell; Aaron R. Lyon Pages: 392 - 403 Abstract: Despite research supporting measurement-based care grounded in standardized progress measures, such measures are underutilized by clinicians. Individualized measures of client-specific targets present an alternative, but little is known about their acceptability or use. We compared attitudes toward and use of standardized and individualized progress measures in a national sample of 504 clinicians. Clinicians reported neutral to positive attitudes toward both types of measures, but strongly preferred and were more likely to use individualized measures. Clinician attitudes, theoretical orientation, and work setting predicted assessment preferences and practices. Implications for dissemination and implementation of measurement-based care are discussed. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0833-y Issue No:Vol. 45, No. 3 (2018)
Authors:Stacy R. Johnson; Elise T. Pas; Catherine P. Bradshaw; Nicholas S. Ialongo Pages: 404 - 416 Abstract: There is growing awareness of the importance of implementation fidelity and the supports, such as coaching, to optimize it. This study examined how coaching activities (i.e., check-ins, needs assessment, modeling, and technical assistance) related directly and indirectly to implementation dosage and quality of the PAX Good Behavior Game, via a mediating pathway through working relationship. Mediation analyses of 138 teachers revealed direct effects of modeling and working relationship on implementation dosage, whereas needs assessment was associated with greater dosage indirectly, by higher ratings of the working relationship. Understanding how coaching activities promote implementation fidelity elements has implications for improving program effectiveness. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0832-z Issue No:Vol. 45, No. 3 (2018)
Authors:Laura Mufson; Moira Rynn; Paula Yanes-Lukin; Tse Hwei Choo; Karen Soren; Eileen Stewart; Melanie Wall Pages: 417 - 431 Abstract: Adolescents with depression are at risk for negative long-term consequences and recurrence of depression. Many do not receive nor access treatment, especially Latino youth. New treatment approaches are needed. This study examined the feasibility and acceptability of a stepped collaborative care treatment model (SCIPT-A) for adolescents with depression utilizing interpersonal psychotherapy for adolescents (IPT-A) and antidepressant medication (if needed) compared to Enhanced Treatment as Usual (E-TAU) in urban pediatric primary care clinics serving primarily Latino youth. Results suggest the SCIPT-A model is feasible, acceptable and potentially beneficial for urban Latino adolescents. Clinicians delivered the SCIPT-A model with fidelity using supervision successfully implemented in a community setting. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0836-8 Issue No:Vol. 45, No. 3 (2018)
Authors:Jennifer Watling Neal; Zachary P. Neal; Jennifer A. Lawlor; Kristen J. Mills; Kathryn McAlindon Pages: 432 - 446 Abstract: In this study, we explored the extent to which educators discuss and prioritize Rogers’ (Diffusion of innovations, The Free Press: New York, 1995) five attributes of innovations—relative advantage, compatibility, complexity, observability, and trialability—in the context of research use. Using a directed content analysis of 54 semi-structured interviews and exemplar quotes, we describe how educators mentioned compatibility most frequently, but also commonly invoked observability and complexity in their discussions of research use. Our results also revealed key differences between educators in executive and non-executive roles. We discuss the implications of our findings for closing the research-practice gap in school-based mental health services and psychosocial interventions. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0834-x Issue No:Vol. 45, No. 3 (2018)
Authors:Nicole A. Stadnick; Anna S. Lau; Miya Barnett; Jennifer Regan; Gregory A. Aarons; Lauren Brookman-Frazee Pages: 447 - 461 Abstract: Agency leaders and therapists are essential stakeholders in implementation of evidence-based practices (EBPs) within publicly-funded mental health services. Little is known about how these stakeholders differ in their perceptions of specific EBPs and which individual and organizational factors differentially influence these perceptions. Within the context of a system-driven implementation of multiple EBPs, survey data from 160 leaders and 720 therapists were examined to assess differences in perceptions of six EBPs. Findings indicated that leaders and therapists have unique perspectives and preferences regarding EBPs that are shaped by distinct sociodemographic and professional characteristics and aspects of organizational functioning. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0835-9 Issue No:Vol. 45, No. 3 (2018)
Authors:Catherine A. Fullerton; Whitney P. Witt; Clifton M. Chow; Manjusha Gokhale; Christine E. Walsh; Erika L. Crable; Sarah Naeger Pages: 462 - 471 Abstract: Physical comorbidities associated with mental health conditions contribute to high health care costs. This study examined the impact of having a usual source of care (USC) for physical health on health care utilization, spending, and quality for adults with a mental health condition using Medicaid administrative data. Having a USC decreased the probability of inpatient admissions and readmissions. It decreased expenditures on emergency department visits for physical health, 30-day readmissions, and behavioral health inpatient admissions. It also had a positive effect on several quality measures. Results underscore the importance of a USC for physical health and integrated care for adults with mental health conditions. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0838-6 Issue No:Vol. 45, No. 3 (2018)
Authors:Rasheda Khanam; Son Nghiem Pages: 472 - 483 Abstract: This study investigates the effects of behavioural and emotional problems in children on their educational outcomes using data from the Longitudinal Survey of Australian Children (LSAC). We contribute to the extant literature using a dynamic specification to test the hypothesis of knowledge accumulation. Further, we apply the system generalised method of moments (GMM) estimator to minimise biases due to unobserved factors. We find that mental disorders in children has a negative effect on the National Assessment Program—Literacy and Numeracy (NAPLAN) test scores. Among all mental disorders, having emotional problems is found to be the most influential with one standard deviation (SD) increase in emotional problems being associated with 0.05 SD reduction in NAPLAN reading, writing and spelling; 0.04 SD reduction in matrix reasoning and grammar; and 0.03 SD reduction in NAPLAN numeracy. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0837-7 Issue No:Vol. 45, No. 3 (2018)
Authors:Daniel P. Wilkie; David C. Cicero; Charles W. Mueller Pages: 484 - 494 Abstract: Monthly disruptive behavior treatment progress for 613 youth ages 7–18 receiving intensive in-home services was examined. Multilevel modeling indicated carrying a depressive mood diagnosis predicted less disruptive behavior progress compared to youth with only externalizing diagnoses. Paradoxically, more monthly focus on disruptive behavior treatment targets predicted lower concurrent progress ratings, while greater focus on depressive mood targets predicted greater disruptive behavior progress for youth with a depressive mood diagnosis. Findings held when other predictors of disruptive behavior progress were included as covariates, including episode length, youth age, and functional impairment. Treatment and research implications are discussed. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0840-z Issue No:Vol. 45, No. 3 (2018)
Authors:Lindsay Sheehan; The Latino Consumer Research Team; Alessandra Torres; Juana L. Lara; Deysi Paniagua; Jonathon E. Larson; John Mayes; Susan Doig; Patrick W. Corrigan Pages: 495 - 504 Abstract: Peer navigator programs (PNP) may help reduce physical health disparities for ethnic minorities with serious mental illness (SMI). However, specific aspects of PNP that are important to peer navigators and their clients are under-researched. A qualitative study explored the perspectives of service users (n = 15) and peer navigators (n = 5) participating in a randomized controlled trial of a PNP for Latinos with SMI. Results show PN engagement with service users spans diverse areas and that interactions with peers, trust, and accessibility are important from a service user perspective. PNs discussed needs for high-quality supervision, organizational support, and additional resources for undocumented Latinos. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0839-5 Issue No:Vol. 45, No. 3 (2018)
Authors:Jill Locke; Stephanie Violante; Michael D. Pullmann; Suzanne E. U. Kerns; Nathaniel Jungbluth; Shannon Dorsey Pages: 505 - 517 Abstract: Despite increasing interest in supervision as a leverage point for bolstering public mental health services, the potential influence of supervisory alliance on organizations and direct service providers remains understudied, particularly in the context of supporting evidence-based treatment (EBT) use. This study examined agreement and discrepancy between supervisor and clinician ratings of alliance associated with clinicians’ perceptions of psychological climate and emotional exhaustion. Results indicated that discrepancies in alliance ratings were common and associated with clinicians’ perceptions of psychological climate. These findings have important implications for collaboration among supervisors and clinicians within a community mental health organizational context and the provision of EBTs. PubDate: 2018-05-01 DOI: 10.1007/s10488-017-0841-y Issue No:Vol. 45, No. 3 (2018)
Authors:Shereen Hussein Abstract: Social workers (SWs) provide emotional and practical support to vulnerable service users who are likely to suffer from emotional trauma and mental health conditions. Stress and burnout levels are reported to be high among SWs, however, little is known about their relationships with different characteristics. The current article utilises unique and large dataset (n = 3786) on SWs working in adults and children’s services to examine factors associated with burnout. Employing job-demand/resources model and structural equations modelling, we highlight the varying significant impact of work-engagement, administrative support and work experience as moderating factors to burnout across adult and children service specialism in this sample. PubDate: 2018-04-26 DOI: 10.1007/s10488-018-0872-z
Authors:Alene Kennedy-Hendricks; Gail L. Daumit; Seema Choksy; Sarah Linden; Emma E. McGinty Abstract: Despite the proliferation of initiatives to integrate services for people with serious mental illness (SMI), measures of distinct dimensions of integration, such as spatial arrangement and care team expertise, are lacking. Such measures are needed to support organizations’ assessment of progress toward integrated service delivery. We developed measures characterizing integration of behavioral, somatic, and social services to operationalize the integrated care dimensions conceived by the Agency for Healthcare Research and Quality. In a survey fielded to 46 Maryland Medicaid health homes (response rate: 96%) serving adults with SMI during 2015–2016, we found that these measures provided a useful description of variation across dimensions of integration. PubDate: 2018-04-25 DOI: 10.1007/s10488-018-0871-0
Authors:Alex R. Dopp; Cindy M. Schaeffer; Cynthia Cupit Swenson; Jennifer S. Powell Abstract: This study evaluated the economics of Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) by applying the Washington State Institute for Public Policy (WSIPP) cost-benefit model to data from a randomized effectiveness trial with 86 families (Swenson et al. in JFP 24:497–507, 2010b). The net benefit of MST-CAN, versus enhanced outpatient treatment, was $26,655 per family at 16 months post-baseline. Stated differently, every dollar spent on MST-CAN recovered $3.31 in savings to participants, taxpayers, and society at large. Policymakers and public service agencies should consider these findings when making investments into interventions for high-need families involved with child protective services. PubDate: 2018-04-04 DOI: 10.1007/s10488-018-0870-1
Authors:Vanessa Panaite; Racine Brown; Michelle Henry; Amanda Garcia; Gail Powell-Cope; Rodney D. Vanderploeg; Heather G. Belanger Abstract: Population-based post-deployment screening programs within the Departments of Defense and Veterans Affairs have been implemented to assess for mental health conditions and traumatic brain injury. The purpose of this paper is to systematically review the literature on post-deployment screening within this context and evaluate evidence compared to commonly accepted screening implementation criteria. Findings reflected highly variable psychometric properties of the various screens, variable treatment referral rates following screening, low to moderate treatment initiation rates following screening, and no information on treatment completion or long-term outcomes following screening. In sum, the evidence supporting population based post-deployment screening is inconclusive. Implications are discussed. PubDate: 2018-03-30 DOI: 10.1007/s10488-018-0869-7
Authors:Meghan Romanelli; Wenhua Lu; Michael A. Lindsey Abstract: This study examined how experiences of service denial and discrimination in three health care settings—doctors’ offices, emergency rooms, and mental health clinics—might contribute to attempted suicide among transgender adults. Mechanisms of this relationship were examined, including treatment receipt and the use of substances to cope with mistreatment. Perceived emotional social support was also tested as a potential protective factor against the deleterious effects of service denial and discrimination on treatment receipt, substance use, and attempted suicide. The analysis included 4190 respondents from the National Transgender Discrimination Survey. Structural equation modeling was employed to test hypothesized relationships. Being denied a greater number of services and discriminated against in more settings were associated with lower levels of treatment receipt. Service denial was also correlated with increased rates of coping-motivated substance use and elevated rates of attempted suicide. Treatment receipt mediated the relationships between service denial/discrimination and substance use. Substance use mediated the relationship between treatment receipt and attempted suicide. Higher levels of support were protective to treatment receipt when denied services in one setting, but no longer retained protective effects when denied in two or three settings. Results have critical implications for service access and delivery and policies that protect transgender help-seekers in the health care system. PubDate: 2018-03-24 DOI: 10.1007/s10488-018-0868-8
Authors:Emily Velazquez Trask; Kya Barounis; Brandon L. Carlisle; Ann F. Garland; Gregory A. Aarons Abstract: Therapeutic homework is a fundamental skill-building component of the majority of evidence-based therapies and is associated with better treatment outcomes. However, it is rarely utilized in public mental health settings. To determine barriers to homework use and identify predictors of clinicians’ assignment of homework, an online survey was administered to 267 clinicians in a large diverse public mental health system. Clinicians who were younger, licensed, whose supervisors asked about homework and whose clients completed their homework more frequently were predictors of greater homework utilization. The survey results are discussed and a novel idea to increase the use of homework is introduced. PubDate: 2018-03-24 DOI: 10.1007/s10488-018-0867-9
Authors:Sonya J. Leathers; Jill E. Spielfogel; Joan Blakey; Errick Christian; Marc S. Atkins Abstract: The original version of this article unfortunately contained a mistake. PubDate: 2018-02-24 DOI: 10.1007/s10488-018-0859-9
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