Psychiatric services : a journal of the American Psychiatric Association
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This study assessed the prevalence of general medical problems, stress or emotional problems, and alcohol problems reported by members of the armed forces of the United Kingdom after deployment in Iraq or Afghanistan. The study also identified types of help seeking and factors associated with help seeking. ⋯ Medical help seeking for stress or emotional problems was uncommon and was related to meeting criteria for two or more mental health problems. Commissioned officers were reluctant to seek medical help for stress or emotional problems. Help seeking for alcohol problems increased if personnel were experiencing additional mental health problems.
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The Centers for Medicare and Medicaid Services (CMS) is promoting formation of accountable care organizations (ACOs). In these population-based models, CMS aligns a Medicare beneficiary population to an ACO with associated expenditure and quality targets, transitioning away from purely volume-based revenue of fee-for-service Medicare. ⋯ In addressing the needs of high-cost, high-risk patients to meet quality and expenditure targets, an ACO should examine the quality of mental health care it provides as well as medical quality for patients with mental illness. In addition, federal agencies should invest to ensure understanding of the impact of population-based initiatives on patients with mental illness.
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Comparative Study
Disengagement from care: perspectives of individuals with serious mental illness and of service providers.
This study sought to describe reasons for disengagement from services and practical guidelines to enhance engagement among individuals with serious mental illness and high need for treatment. ⋯ Individuals with serious mental illness and providers often do not agree on reasons for seeking care. The framework of acceptable, accessible, and available services identifies opportunities for providers to adjust practices and maximize engagement in services among individuals with serious mental illness who are in high need of treatment.
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Randomized Controlled Trial Comparative Study
Clinically significant improved fitness and weight loss among overweight persons with serious mental illness.
The objective of this study was to evaluate the effectiveness of a fitness health mentor program (In SHAPE) in improving physical fitness and weight loss among overweight and obese adults with serious mental illness. ⋯ The In SHAPE program achieved clinically significant reduction in cardiovascular risk for almost one-half of participants at 12 months. Although the intervention showed promise in improving fitness, optimizing weight loss may require additional intensive, multicomponent dietary interventions.