Psychiatric Services From Pages to Practice

Milton L. Wainberg, M.D., joins Dr. Dixon and Dr. Berezin to discuss protocols for studies implementing comprehensive mental health services in low- and middle-income countries.

Dr. Wainberg is a professor of clinical psychiatry at Columbia University and the New York State Psychiatric Institute and director of the Global Mental Health Implementation Science program at Columbia University.

• Development of the author's partnership with Psychiatric Services to publish protocols to address the gap between global mental health research and treatment [1:59]
• Applying lessons learned in low- and middle-income countries to the United States [11:17]
• Overriding themes of the published protocols [15:41]
• Key advantages, challenges, and design solutions of these programs [20:15]
• Overview of what related studies are doing at other sites [21:35]
• A call to be bold in engaging with complex problems in mental health care [28:11]

List of published Global Mental Health Implementation Science Protocols:

• Adaptation and Implementation of the Multiple-Family Group Intervention in Ghana
• The Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity-Building Scale-Up Trial: Study Design and Protocol
• Technology-Assisted Teachers' Training to Promote Socioemotional Well-Being of Children in Public Schools in Rural Pakistan
• Youth Functioning and Organizational Success for West African Regional Development (Youth FORWARD): Study Protocol
• Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence-Based Practices (PRIDE) in Mozambique

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Leopoldo J. Cabassa, Ph.D., M.S.W., and Ana Stefancic, Ph.D., join Dr. Dixon to discuss the effectiveness of the Peer-led Group Lifestyle Balance intervention, a 12-month manualized healthy lifestyle intervention delivered by peer specialists, in a sample of persons with serious mental illness who were overweight or obese and living in supportive housing.

Dr. Cabassa is an associate professor at the Brown School at Washington University in St. Louis. He also is director of the NIMH T-32 Training Program and co-director of the Center for Mental Health Services Research at the university. His work aims to improve care for underserved communities, with a focus on disparities among racial-ethnic minorities with serious mental illness.

Dr. Stefancic is an associate research scientist in the Department of Psychiatry at Columbia University. Her research interests focus on evaluating housing and support services for individuals who have experienced homelessness, psychiatric disabilities, and other medical conditions.

• How the authors became interested in this field [2:08]
• Summary of study findings [6:20]
• Details of the supportive housing sites [10:05]
• Description of the peer-led program intervention [14:04]
• Work of the peer specialists within the program [16:35]
• Discussion of usual care [19:16]
• Details of the main outcomes [21:27]
• Differences between peer-led and usual care [22:31]
• Discussion of fidelity [27:02]
• Discussion of patient-level randomization [28:22]
• Remembering peer specialist Kelli Adams [33:41]
• One key takeaway from the work [36:44]

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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.

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Wanda G. Wright, D.D.S., M.S.D., joins Dr. Dixon and Dr. Berezin to explore barriers and facilitators in addressing the oral health needs of individuals with mental illness from the perspectives of patients, psychiatrists, and dentists.

Dr. Wright is affiliated with the School of Dental Medicine at East Carolina University, where she is Assistant Dean for Diversity, Equity, and Inclusion; Assistant Professor; and Division Director of Dental Public Health.

• Introduction to the field of dental public health [1:39]
• Issues of diversity, equity, and inclusion in dentistry and dental health [2:50]
• How Dr. Wright became interested in this area, and the type of collaboration that is involved [4:44]
• Details of the research [6:40]
• Did any results from the research stand out to Dr. Wright? [10:26]
• Key findings of the research [11:58]
• Description of public sector funding for dental services [12:44]
• Examples of integrated dental and mental health clinics, training, and hospital care [14:57]
• Discussion of stigma [19:18]
• Challenges around referring patients for dental care and around access [21:10]
• The one policy Dr. Wright would change, and what mental health providers should know about oral health in general [23:19]
• The next phase of this research [26:12]

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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 web site.

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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Michael F. Hogan, Ph.D., joins Dr. Dixon and Dr. Berezin to discuss the challenges and opportunities for nationwide reform in systems of care for individuals in psychiatric crisis in the United States.

Dr. Hogan has served as commissioner of the New York State Office of Mental Health, director of the Ohio Department of Mental Health, and commissioner of the Connecticut Department of Mental Health and Addiction Services. He was chair of the President's New Freedom Commission on Mental Health under President George W. Bush. He has been appointed to the board of The Joint Commission and as a member of the National Action Alliance for Suicide Prevention.

• How Dr. Hogan became interested in this area of research [2:10]
• How an ideal crisis system would operate, and what aspects of such a system are currently missing [7:10]
• How widespread is this model throughout the United States? [16:02]
• Other recommendations the article makes to improve crisis services [23:22]
• Efforts to improve the National Suicide Prevention Lifeline [29:12]
• How has nonsuicidal crisis been incorporated into the new three-digit (988) hotline? [32:11]
• Examples of larger structural changes in crises services [36:30]
• How issues of race and social injustice tie in to this conversation [38:56]
• Dr. Hogan's thoughts on what the future holds [44:38]

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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 web site.

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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This article is part of the Think Bigger, Do Good series commissioned by the Thomas Scattergood Behavioral Health Foundation, Peg's Foundation, the Patrick P. Lee Foundation, and the Peter & Elizabeth Tower Foundation. The full series can be viewed at www.ThinkBiggerDoGood.org.

John Torous, M.D., M.B.I., joins Dr. Dixon and Dr. Berezin to discuss the expanded access to smartphone apps for mental health on college campuses as well as issues regarding the privacy, efficacy, and quality of mental health apps.

Dr. Torous is the director of the digital psychiatry division at Beth Israel Deaconess Medical Center and an instructor in psychiatry at Harvard Medical School.

• How Dr. Torous became interested in this area of research [1:27]
• What does it mean to be a director of digital psychiatry? [2:27]
• Why colleges are a good place to study digital psychiatry [3:47]
• A sense of the landscape of digital mental health or digital psychiatry on college campuses [5:20]
• Pros and cons of digital mental health tools [7:25]
• Major findings of the study [12:39]
• Key conclusions of the study [16:42]
• Evidence base for mental health apps [18:34]
• Recommendations for college mental health organizations [20:35]
• Questions surrounding legal liability [22:57]
• Emerging issues in the field [25:08]
• Final thoughts from Dr. Torous [27:05]

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 web site.

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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Ayana Jordan, M.D., Ph.D., joins Dr. Dixon and Dr. Berezin to discuss disparities in initiation of and engagement in mental health care among persons from racial-ethnic minority groups. This topic formed the basis of an Editor's Choice collection assembled by Dr. Jordan.

Dr. Jordan is the associate program director of the adult psychiatry training program and an assistant professor of psychiatry at the Yale University School of Medicine. She also is a member of the Psychiatric Services Early-Career Psychiatrist Advisory Committee.

• Dr. Jordan's career interests [2:11]
• Development of the Editor's Choice collection on mental health disparities by race and ethnicity of adults [6:44]
• Dr. Jordan's perspectives in the area of mental health disparities [10:50]
• Dr. Dixon's statement on racism and creation of an advisory group to address racism as it relates to the journal [17:37]
• Dr. Jordan's plans to update the Editor's Choice collection [20:21]
• Dr. Berezin's take on the Editor's Choice collection [23:08]
• How health care systems can engage with policy, historical, and structural issues involving racism [24:37]
• Interventions required to address racism in health care and in scientific research [28:33]
• How funding priorities in scientific research affect racism [36:16]
• Final thoughts on the subject [38:38]

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 web site.

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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Erik Messamore, M.D., Ph.D., joins Dr. Dixon and Dr. Berezin to discuss suggestions for informing the public more effectively about the potential benefits and risks of marijuana in state medical marijuana programs.

Dr. Messamore is Associate Professor of Psychiatry at Northeast Ohio Medical University and Medical Director of the university's Best Practices in Schizophrenia Treatment Center.

• How Dr. Messamore became interested in medical marijuana policy [2:33]
• Points raised by patients regarding the benefits and risks of medical marijuana [5:57]
• A history of the legalization of medical marijuana in the United States [7:54]
• The difference between the authorization of marijuana for medical use relative to recreational use [10:24]
• Discrepancies between the approval processes of regular medicines and medical marijuana [12:32]
• The role of industry and lobbying [18:09]
• Recommendations for what state governments should be doing [19:22]
• Side effects of cannabis [20:43]
• Arguments for the continued loosening of cannabis policies [24:40]
• Response to cannabis advocates [27:28]

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 web site.

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 [email protected]

This article is part of the Think Bigger, Do Good series commissioned by the Thomas Scattergood Behavioral Health Foundation, Peg's Foundation, the Patrick P. Lee Foundation, and the Peter & Elizabeth Tower Foundation. The full series can be viewed at www.ThinkBiggerDoGood.org.

Matthew Goldman, M.D., M.S., joins Dr. Dixon and Dr. Berezin to discuss the significant changes in mental health policy prompted by the COVID-19 crisis across five major areas: legislation, regulation, financing, accountability, and workforce development. Special considerations for mental health policy are discussed, including social determinants of health, innovative technologies, and research and evaluation.

The article was authored by the members of the Psychiatric Services Policy Advisory Group, which aims to guide the journal on how to maximize its relevance and impact on mental health policy.

• Dr. Goldman's research interests, and how his responsibilities have changed during the COVID-19 pandemic [3:29]
• What is mental health policy, and how is policy evolving during the pandemic? [6:35]
• Differences between legislative and regulatory frameworks [9:13]
• Discussion of changes involving financing, accountability, and workforce development [14:14]
• Discussion of changes involving state licensing [17:41]
• Umbrella issues that affect policy [19:57]

Dr. Goldman is a Public Psychiatry Fellow at the University of California, San Francisco, and is a clinical instructor in the Department of Psychiatry at UCSF.

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 web site.

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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Mark Munetz, M.D., and Elizabeth Ford, M.D., join Dr. Dixon and Dr. Berezin to discuss their work in the field of providing services to individuals who have criminal justice contact and serious mental illness.

Articles discussed:

Black Robe/White Coat: Mental Health Providers Must Reclaim the Role of Caring Clinician

Clinical Outcomes of Specialized Treatment Units for Patients With Serious Mental Illness in the New York City Jail System

• How each author became interested in the field in general and the topic of their article [2:14]
• Take-home messages from Dr. Ford's work [9:07]
• Dr. Munetz's experience with mental health courts [9:38]
• Areas of overlap between the articles [12:41]
• How to approach these areas of research [18:29]
• How unusual are the examples featured in the articles? [21:28]
• With improved funding, would individuals be more empathic toward people involved with criminal justice? [24:39]
• How the personal reflections discussed in these articles may interact with the field generally [26:40]
• What advice do the authors have for younger professionals? [30:42]

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 web site.

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.

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Delbert G. Robinson, M.D., joins Dr. Dixon and Dr. Berezin to discuss barriers to the use of long-acting injectable (LAI) antipsychotic medication.

• Dr. Robinson's path to this particular area of research [1:43]
• How have people traditionally viewed LAIs? [3:32]
• A different approach to LAIs [4:13]
• The trend to use qualitative methods to understand perspectives of different stakeholders [7:28]
• Scope of the study [8:13]
• What the barriers are to more uptake of the use of LAIs [14:18]
• Barriers stemming from the individual level (interactions between a clinician and a patient) and the systems level (clinics not having appropriate infrastructure) [19:48]
• What is the next step in this line of research? [22:20]

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 web site.

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 [email protected]