Dr. Robert Drake (Columbia University, New York) joins Dr. Dixon and Dr. Berezin to discuss a personal reflection looking back at research conducted at Dartmouth in the 1990s looking at mental health, employment, individual placement, and support.

Transcript

• 00:49     Dartmouth in the 1990s
• 01:59     Failures and successes
• 04:01     “This was really the greatest serendipity of my life”
• 07:05     Employment versus day centers
• 09:11     A pivot point
• 11:07     Assertive Community Treatment (ACT)
• 12:53     Finding a job, and a path
• 16:03     Too sick to work?
• 18:47     Individual Placement and Support (IPS)
• 21:00     Wanting to share this experience
• 22:36     Replicating this program in other environments
• 24:43     The reflection
• 29:36     Building relationships
• 31:17     Building IPS
• 33:35     Advice for employers

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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

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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 

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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

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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 faith-based communities
• 27:39     The multilayered nature of faith-based community participation
• 28:53     Future research

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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

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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

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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

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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

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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

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Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it.

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