Dr. Dixon and Dr. Berezin discuss what policy makers can do regarding fentanyl and the evolving opioid epidemic, explore communication strategies to counter stigma and improve mental illness and substance use disorder policy, and document how the concept of multimorbidity is making its way into clinical practice. Articles may be viewed online at ps.psychiatryonline.org.  We are conducting a listener survey. Please go to ps.psychiatryonline.org/podcast and select the link to the survey. It won’t take more than a few minutes to complete, and your feedback will remain anonymous. We appreciate your responses. Thank you.

05: Fentanyl and the Opioid Epidemic, Strategies to Counter Stigma, and the Concept of Multimorbidity

Editor Lisa Dixon, M.D., M.P.H., and Podcast Editor and Co-Host Josh Berezin, M.D., M.S., discuss key aspects of research recently published by Psychiatric Services (https://ps.psychiatryonline.org/), a journal of the American Psychiatric Association. Tune in to Psychiatric Services From Pages to Practice to learn about the latest mental health services research and why it is relevant. Topics include community-based treatment programs, collaborative care, evidence-based treatment and service delivery, criminal and social justice, policy analysis, and more.

Medicine

Science & Medicine

Science

Health & Fitness

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 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

67: Addressing Mental Health Disability in Unsheltered Homelessness: Outpatient Conservatorship in Los Angeles

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, 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

66: Predicting Outcomes of Antidepressant Treatment in Community Practice Settings

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 journal on Twitter.   E-mail us at psjournal@psych.org

65: Remodeling Broken Systems: Addressing the National Emergency in Child and Adolescent Mental Health

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 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

64: Acceptance of Insurance by Psychiatrists and Other Physicians, 2007–2016

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 behavioral health system workforce in Oregona  a  Interviewees identified factors across three levels—system, organizational, and individual—that contribute to the direct drivers of workforce turnover and attrition.     https://ps.psychiatryonline.org/pb-assets/podcasts/transcripts/PS/PS_Chung_August_2023_transcript.pdf     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

05: Fentanyl and the Opioid Epidemic, Strategies to Counter Stigma, and the Concept of Multimorbidity

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