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The future of California's mental health system

Marina Tolou-Shams, Juliet Yonek, Katharine Galbraith, Eraka Bath
BACKGROUND: Mental health and substance use disorders are highly prevalent in justice-involved youth, yet only 8% of court-involved, nonincarcerated (CINI) youth in need of treatment receive it. Dual diagnosis (co-occurring psychiatric and substance use disorders) in justice-involved youth is highly predictive of recidivism. Identifying novel approaches, such as the use of mobile health (mHealth) technologies, to close this gap between need and receipt of behavioral health treatment for the CINI population could potentially offset rates of reoffending into adulthood...
April 5, 2019: JMIR MHealth and UHealth
Anusha Kumar, Kathryn J Azevedo, Adam Factor, Elon Hailu, Jeremy Ramirez, Steven E Lindley, Shaili Jain
Veterans returning from recent conflicts present with increased rates of posttraumatic stress disorder (PTSD), and veterans from prior service eras continue to seek trauma-based services. Peer support for veterans with PTSD has the potential to resolve ongoing challenges in access and engagement in mental health care. Assessing the value of peer support services requires a thorough understanding of the expected role and the empirical mechanisms of peer support participation in PTSD recovery. To better understand these mechanisms, this study interviewed 29 veteran participants from an established peer support program (PSP), located in the Central Valley of the Veterans Affairs (VA) Palo Alto Health Care System (VAPAHCS) in Northern California...
November 8, 2018: Psychological Services
Suzanna M Martinez, Edward A Frongillo, Cindy Leung, Lorrene Ritchie
This study examined the relationships between food insecurity, mental health, and academic performance among college students in a California public university system ( N = 8705). Structural equation modeling was performed to examine a direct path from food insecurity to student grade point average and an indirect path through mental health, controlling for demographic characteristics. Food insecurity was related to lower student grade point average directly and indirectly through poor mental health. These findings support the need for future interventions and policy on the importance of providing students with the basic needs to succeed both academically and in the future...
June 1, 2018: Journal of Health Psychology
Cynthia S Osborne, Anne A Lawrence
Gender dysphoria (GD), a feeling of persistent discomfort with one's biologic sex or assigned gender, is estimated to be more prevalent in male prison inmates than in nonincarcerated males; there may be 3000-4000 male inmates with GD in prisons in the United States. An increasing number of U.S. prison systems now offer gender dysphoric inmates diagnostic evaluation, psychotherapy, cross-sex hormone therapy, and opportunities, albeit limited, to enact their preferred gender role. Sex reassignment surgery (SRS), however, has not been offered to inmates except in response to litigation...
October 2016: Archives of Sexual Behavior
Michael J Penkunas, Stephen Hahn-Smith
This study investigated the demographic and clinical predictors of psychiatric hospitalization during the first 2 years of treatment for adults participating in the full-service partnership (FSP) program, based on Assertive Community Treatment, in a large county in northern California. Clinical and demographic characteristics, data on prior hospitalizations, length of enrollment, and living situation for 328 FSP participants were collected from the county's internal billing system and the California Department of Health Care Services...
August 2016: Community Mental Health Journal
Emilie Bhe, Scott Summers, Murat Pakyurek, Matthew Soulier, Jessica Ferranti
OBJECTIVE: The authors assessed the ways in which primary care physicians (PCPs) utilize outpatient psychiatric documentation that has recently become accessible to non-psychiatric providers in the UC Davis Healthcare System electronic medical record (EMR). METHODS: The authors distributed a nine-question paper survey to 71 PCPs on the UC Davis Medical Center Campus in Sacramento, California. Questions addressed awareness of changes in accessibility of psychiatric documentation, which parts of the psychiatric note were most useful, and ways in which reviewing psychiatric notes changed providers' practice and perception of patients with mental illness...
December 2015: Academic Psychiatry
Gelareh Z Gabayan, Benjamin C Sun, Steven M Asch, Stefan Timmermans, Catherine Sarkisian, Sau Yiu, Elizabeth M Lancaster, K Trudy Poon, Arthur L Kellermann, Gery Ryan, Nicholas J Miniel, Drew Flansbaum, Jerome R Hoffman, Stephen F Derose
OBJECTIVES: Early death after emergency department (ED) discharge may signal opportunities to improve care. Prior studies are limited by incomplete mortality ascertainment and lack of clinically important information in administrative data. The goal in this hypothesis-generating study was to identify patient and process of care themes that may provide possible explanations for early postdischarge mortality. METHODS: This was a qualitative analysis of medical records of adult patients who visited the ED of any of six hospitals in an integrated health system (Kaiser Permanente Southern California [KPSC]) and died within 7 days of discharge in 2007 and 2008...
August 2013: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Eric R Pedersen, Jeremy N V Miles, Sarah B Hunter, Karen Chan Osilla, Brett A Ewing, Elizabeth J D'Amico
OBJECTIVE: There has been limited research examining the association between mental health symptoms, perceived peer alcohol norms, and alcohol use and consequences among samples of adolescents. The current study used a sample of 193 at-risk youths with a first-time alcohol and/or other drug offense in the California Teen Court system to explore the moderating role of perceived peer alcohol norms on the association between mental health symptoms and drinking outcomes. METHOD: Measures of drinking, consequences, mental health symptoms, and perceived peer alcohol norms were taken at baseline, with measures of drinking and consequences assessed again 6 months later...
September 2013: Journal of Studies on Alcohol and Drugs
Erick G Guerrero, Ahraemi Kim
Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce...
October 2013: Evaluation and Program Planning
Jennifer C Hunter, Adam W Crawley, Michael Petrie, Jane E Yang, Tomás J Aragón
UNLABELLED: Background On Friday March 11, 2011 a 9.0 magnitude earthquake triggered a tsunami off the eastern coast of Japan, resulting in thousands of lives lost and billions of dollars in damage around the Pacific Rim. The tsunami first reached the California coast on Friday, March 11th, causing more than $70 million in damage and at least one death. While the tsunami's impact on California pales in comparison to the destruction caused in Japan and other areas of the Pacific, the event tested emergency responders' ability to rapidly communicate and coordinate a response to a potential threat...
2012: PLoS Currents
Todd P Gilmer, Victoria D Ojeda, Kya Fawley-King, Barbara Larson, Piedad Garcia
OBJECTIVES: This study examined changes in service use associated with providing age-specific services for youths in their transitional years, ages 18–24. METHODS: A quasi-experimental, difference-in-difference design with propensity score weighting was used to compare mental health service utilization (use of outpatient, inpatient, emergency, and justice system services) among 931 youths enrolled in outpatient programs specifically for transition-age youths and 1,574 youths enrolled in standard adult outpatient programs in San Diego County, California, from July 2004 through December 2009...
June 2012: Psychiatric Services: a Journal of the American Psychiatric Association
Neda Ratanawongsa, Jesse C Crosson, Dean Schillinger, Andrew J Karter, Chandan K Saha, David G Marrero
PURPOSE: The purpose of this cross-sectional study is to explore primary care providers' (PCPs) perceptions about barriers to initiating insulin among patients. Studies suggest that many patients with poorly controlled type 2 diabetes do not receive insulin initiation by PCPs. METHODS: As part of the Translating Research Into Action for Diabetes study, the authors conducted structured interviews in health systems in Indiana, New Jersey, and California, asking PCPs about the importance of insulin initiation and factors affecting this decision...
January 2012: Diabetes Educator
Carole A Shea
Accessibility is a major impediment to nursing education, whether you live in densely populated southern California or rural upstate New York. During the past 10 years, there have been scientific advances, technological breakthroughs, new reimbursement mechanisms and regulatory practices, and shifts in society's priorities. Consequently, the focus of master's programs and the role of graduates has adapted to the needs of the mental health care delivery system. What has not changed much is the way we offer psychiatric nursing education...
March 2008: Journal of the American Psychiatric Nurses Association
Patricia Chamberlain, Rosemarie Roberts, Helen Jones, Lynne Marsenich, Todd Sosna, Joseph M Price
The current paper describes three models of research-practice collaboration to scale-up evidence-based practices (EBP): (1) the Rolling Cohort model in England, (2) the Cascading Dissemination model in San Diego County, and (3) the Community Development Team model in 53 California and Ohio counties. Multidimensional Treatment Foster Care (MTFC) and KEEP are the focal evidence-based practices that are designed to improve outcomes for children and families in the child welfare, juvenile justice, and mental health systems...
July 2012: Administration and Policy in Mental Health
Mistique C Felton, Cheryl E Cashin, Timothy T Brown
The need to move mental health systems toward more recovery-oriented treatment modes is well established. Progress has been made to define needed changes but evidence is lacking about the resources required to implement them. The Mental Health Services Act (MHSA) in California was designed to implement more recovery-oriented treatment modes. We use data from county funding requests and annual updates to examine how counties budgeted for recovery-oriented programs targeted to different age groups under MHSA...
October 2010: Community Mental Health Journal
Gregory A Aarons, Rebecca S Wells, Karen Zagursky, Danielle L Fettes, Lawrence A Palinkas
OBJECTIVES: We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. METHODS: Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers...
November 2009: American Journal of Public Health
Janet Black, Teresa Morris, Anita Harbert, Christine Mathias
This article describes an innovative statewide collaboration between schools of social work and public mental health departments to transform social work curriculum and address the workforce crisis in public mental health service systems. The collaborative partnership has fostered the development of a Mental Health Initiative that has developed a set of mental health competencies offered in each of the participating master's in social work (MSW) programs in California. These competencies identify critical skills and knowledge necessary to support recovery, resiliency, evidence-based practice, and psychosocial rehabilitation principles...
2008: Journal of Social Work in Disability & Rehabilitation
Karl A Sporer, Nicholas J Johnson, Clement C Yeh, Glen M Youngblood
OBJECTIVE: The Medical Priority Dispatch System is an emergency medical dispatch (EMD) system that is widely used to categorize 9-1-1 calls and optimize resource allocation. This study evaluates the ability of EMD and non-EMD codes (calls not processed by EMD) to predict prehospital use of medications and procedures. METHODS: All transported prehospital patients placed in an EMD or non-EMD category that exceeded 500 total calls from January 1, 2004, to December 31, 2006, in a suburban California county were matched with their prehospital electronic patient care record...
October 2008: Prehospital Emergency Care
Raymond F Patterson, Kerry Hughes
OBJECTIVE: The purpose of this extended review is to assist health care managers, clinicians, prison administrators, and custody staff in identifying and responding effectively to prisoners who present a substantial risk of suicide in the foreseeable future. METHODS: The California Department of Corrections and Rehabilitation (CDCR) is the largest state-operated prison system in the country, with a census range of 155,365 to 163,346 prisoners between 1999 and 2004...
June 2008: Psychiatric Services: a Journal of the American Psychiatric Association
Yih-Ing Hser, Elizabeth Evans
Using administrative data to evaluate health care outcomes has become increasingly common, but the reliability and validity of outcome measures based on cross-system data linkage have been little scrutinized. Applying a deterministic data matching methodology, we linked 6545 Californians admitted to 43 substance abuse treatment programs between 2000 and 2001 to administrative data acquired from three state agency databases. We compared self-reported treatment outcome measures to equivalent measures derived from official records on motor vehicle driving incidents, criminal history, and mental health services utilization...
May 2008: Evaluation and Program Planning
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