Psychiatric services : a journal of the American Psychiatric Association
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This study assessed trends in days' supply for opioid prescriptions filled by adolescents with commercial insurance and Medicaid. ⋯ The 2-3 days' supply decreased from 50.5% (2005) to 36.7% of fills (2016), while 4-5 days' supply increased from 30.2% to 37.7%. Fills of 6-7 and 8-15 days increased slightly. Fills of over 30 days remained near 0.0%, and one-day fills remained at 1.0-2.0% until 2016, when they increased to 3.6% Conclusions: For adolescents, fills of prescription opioids generally exceeded three days. Efforts to reduce opioid prescribing through guidelines, prescription drug monitoring programs, and limits on days' supply do not appear to have affected prescribing for adolescents as much as desired.
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The U. S. Department of Veterans Affairs (VA) is shifting its focus from ending veteran homelessness to preventing veteran suicides. ⋯ S. veterans in 2015 shows that veterans with a history of homelessness attempted suicide in the previous two years at a rate >5.0 times higher compared with veterans without a history of homelessness (6.9% versus 1.2%), and their rates of two-week suicidal ideation were 2.5 times higher (19.8% versus 7.4%). Because the majority of veterans who die by suicide are not engaged in VA care, VA services for the homeless that include outreach efforts to engage new veterans may be reaching some of these veterans. Thus continued federal support for VA homelessness services not only may help address homelessness but also may help prevent suicide of veterans.
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This study measured Americans' willingness to pay an additional $50 in taxes to improve health care and social services for individuals with serious mental illness. ⋯ Many Americans are willing to pay additional taxes to improve health care and social services for individuals with serious mental illness.
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This analysis quantified and assessed the projected workforce of psychiatrists in the United States through 2050 on the basis of population data. ⋯ Because of steady population growth and the retirement of more than half the current workforce, the psychiatrist workforce will continue to contract through 2024 if no interventions are implemented, leading to a significant shortage of psychiatrists. Despite an expected workforce expansion beginning in 2025, it is unclear whether the shortage will completely resolve by 2050. Future research should focus on developing strategies to address this quantified shortage in an effort to curb the worsening shortage through 2024 and over the coming decades.
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Randomized Controlled Trial
Peer-Led Self-Management of General Medical Conditions for Patients With Serious Mental Illnesses: A Randomized Trial.
Individuals with serious mental illnesses have high rates of general medical comorbidity and challenges in managing these conditions. A growing workforce of certified peer specialists is available to help these individuals more effectively manage their health and health care. However, few studies have examined the effectiveness of peer-led programs for self-management of general medical conditions for this population. ⋯ The HARP program was associated with improved physical health- and mental health-related quality of life among individuals with serious mental illness and comorbid general medical conditions, suggesting the potential benefits of more widespread dissemination of peer-led disease self-management in this population.