Psychiatric services : a journal of the American Psychiatric Association
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Depression screening is a required part of an initial annual wellness visit (AWV), a benefit for Medicare Part B beneficiaries. It is uncertain whether AWVs will increase depression screening. This study assessed whether patients with an AWV were more likely to be screened for depression than those with a primary care visit. ⋯ Overall, depression screening during the index AWV was uncommon. By itself, the AWV benefit does not appear to be a strong enough incentive to increase depression screening.
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Randomized Controlled Trial
Job Offers to Individuals With Severe Mental Illness After Participation in Virtual Reality Job Interview Training.
Individuals with severe mental illness have low employment rates, and the job interview presents a critical barrier for them to obtain competitive employment. Prior randomized controlled trials (RCTs) indicated that virtual reality job interview training (VR-JIT) improved job interviewing skills among trainees. This study assessed whether VR-JIT participation was associated with greater odds of receiving job offers in the six-months after completion of training. ⋯ Results provide preliminary support that VR-JIT is a promising intervention associated with enhanced vocational outcomes among individuals with severe mental illness. Given that participants had minimal access to standardized vocational services, future research could evaluate the effectiveness of VR-JIT among individuals with and without access to standardized vocational services as well as evaluate strategies to implement VR-JIT within a large community mental health service provider.
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Prescription opioid medications are the most commonly implicated substances in unintentional overdoses. Outpatient health care encounters represent a potential opportunity to intervene to reduce opioid overdose risk. This study assessed the timing and type of outpatient provider contacts prior to death from unintentional prescription opioid overdose. ⋯ Most patients who died by unintentional prescription opioid overdose were seen in outpatient settings within a month of their overdose. These settings may provide an opportunity to prevent patients from dying from prescription opioid overdoses. Interventions to reduce risk should not be limited to visits during which an opioid is prescribed.
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Multicenter Study
Impact of a Telepsychiatry Program at Emergency Departments Statewide on the Quality, Utilization, and Costs of Mental Health Services.
This study estimated the impact of a statewide, centralized telepsychiatry service provided in nonpsychiatric emergency departments (EDs) on use of mental health services. ⋯ Telepsychiatry delivered in the ED through a centralized coordinated program has great promise for improving linkage with outpatient mental health services while reducing inpatient utilization and hospital costs.
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A substantial proportion of people shot by police have mental disorders, and many of these killings appear to have been avoidable. One tool to encourage better police training and more cautious behavior is the Americans with Disabilities Act (ADA). ⋯ Supreme Court appears to favor that view. When the Court declined a recent opportunity to decide the question, it left open a window of opportunity during which the ADA can be leveraged to improve how police officers deal with persons with mental illness.