Psychiatric Services From Pages to Practice

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  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 website. 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 psjournal@psych.org

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 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 website. 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 psjournal@psych.org

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 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 website. 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 psjournal@psych.org

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 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 website. 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 psjournal@psych.org

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 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 website. 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 psjournal@psych.org

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 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 website. 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 psjournal@psych.org

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 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 website. 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 psjournal@psych.org  

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   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 website. 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 psjournal@psych.org

Gregory E. Simon, M.D., M.P.H. (Kaiser Permanente Washington Health Research Institute, Seattle) join Dr. Dixon and Dr. Berezin to discuss the use of machine learning models to analyze electronic health records to predict antidepressant treatment response. 00:00     Introduction 02:31    Focus on practical research 04:55    Population studied 05:57    Predicting outcomes 07:20    Using diagnostic codes, not personalized notes 08:04    What three data items might be more helpful? 08:49    What key indicators are we missing in clinical care? 11:35    A billing tool, not a clinical tool 12:57    Is suicide a predictable event based on electronic health record data? 14:48    “Machine learning and artificial intelligence”  16:15    Methods 18:59     Can we do a better job clarifying what we mean by depression? 22:32    How can we use a predictive model in clinical practice? 28:20    Predictive models, probability, the weather, and communicating  Transcript 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 website. 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 psjournal@psych.org

Misty C. Richards, M.D., M.S. (University of California, Los Angeles), and Nicole Kozloff, M.D. (University of Toronto), join Dr. Dixon and Dr. Berezin to discuss the need to remodel our systems and provision of mental health services for children and adolescents. 00:00     Introduction 01:18     Impetus 05:45     What constitutes a mental health crisis? 11:14     “Remodeling” 16:21     Differences by location 18:28     Remodeling primary care 21:25     Virtual care 27:19     New service models 32:19     Are we moving in the right direction?   Transcript   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 website. 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 psjournal@psych.org

Andrew D. Carlo, M.D., M.P.H. (Northwestern University Feinberg School of Medicine, Chicago) joins Dr. Dixon and Dr. Berezin to discuss the insurance acceptance rates of psychiatric practitioners compared with other medical disciplines. 00:00     Introduction 01:04     Background and Motivation 02:46     Data Set and Methodology 05:12     Restricted Data Set and Privacy Concerns 06:08     Research Questions and Goals 10:04     Findings: Insurance Acceptance Rates 11:29     Factors Influencing Insurance Acceptance 14:23     Magnitude of the Gap in Insurance Acceptance 15:44     Factors Affecting Insurance Acceptance for Psychiatrists 18:08     Challenges in Enforcing Mental Health Parity 19:27     Market Power of Psychiatrists 22:48     Impact on Other Mental Health Professionals 24:16     Importance and Implications 25:11     Potential Solutions and Policy Changes 29:31     Conclusion   Transcript   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 website. 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 psjournal@psych.org

Eliza Hallett, M.S., (Oregon Health & Science University, Portland, Oregon) joins Dr. Dixon and Dr. Berezin to discuss the challenges faced by staff and behavioral health service providers, including low wages, traumatic work environments, low wages, and physical and administrative infrastructure. Workforce crisis in behavioral health care [01:33] How representative of the country is Oregon? [03:45] Who were you talking to? [05:32] A figure on radio [06:30] Generating a theoretical framework from the responses [08:01] Qualitative methods [09:30] The five factors [10:33] Wages [14:05] Infrastructure [14:40] Are these issues unique to behavioral health services? [19:11] Legislative changes in Oregon [21:25] Feeling supported matters [23:39] Did the pandemic exacerbate the problem? [27:04] Take home [29:08] Access the complete Behavioral Health Workforce Report to the Oregon Health Authority and State Legislature here. Transcript   Figure 1.  Factors influencing turnover and attrition in the public behavioral health system workforce in Oregona a Interviewees identified factors across three levels—system, organizational, and individual—that contribute to the direct drivers of workforce turnover and attrition.   https://ps.psychiatryonline.org/pb-assets/podcasts/transcripts/PS/PS_Chung_August_2023_transcript.pdf   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 website. 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 psjournal@psych.org

Henry Chung, M.D., (Albert Einstein College of Medicine, Bronx, New York City) joins Dr. Dixon and Dr. Berezin to discuss the differences between the collaborative care model and the colocation model, and the impact on Medicaid costs and utilization, for the treatment of patients with depression. Chung interview [00:58] A bridge between clinical and research work [02:32] The colocation model and the collaborative care model [03:44] What populations are you working with? [07:21] Differences in service utilization and cost [10:25] Methodology [10:47] Concentration on depression instead of other psychiatric disorders [13:59] Findings [15:11] Choosing between models [20:21] Impact of COVID [24:06] Final thoughts [28:21] Transcript   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 website. 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 psjournal@psych.org

Joseph Parks, M.D., joins Dr. Dixon and Dr. Berezin to discuss guidelines for clinicians on how to deal with the increased prevalence of drugs adulterated with fentanyl and similar potent fentanyl analogs. MDI publications can be found here. Parks interview [00:53] The National Council for Mental Wellbeing [01:21] Guidelines [03:50] Contemplation [05:02] A back-to-basics approach [07:13] Fentanyl test strips and harm reduction [08:37] Spillover [10:06] Issues with fentanyl [12:05] Incremental behavioral changes [13:44] Things people should know about fentanyl [16:29] Training for professionals [18:03] How things are moving [19:55] See the Psychiatric Services Editor's Choice collection, "Responding to the Opioid Crisis." Transcript 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 website. 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 psjournal@psych.org

Eric P. Slade, Ph.D., joins Dr. Dixon and Dr. Berezin to discuss the complex and often confusing world of dual eligibility for Medicare and Medicaid coverage when it comes to mental health services, in particular Dual Eligible Special Needs Plans (D-SNPs), a type of Medicare Advantage plan designed around those eligible for both programs.   Slade interview [00:59] Medicare and Medicaid [02:24] Eligibility for each, and both [06:36] Dual eligibility [08:09] Who pays for care? [09:51] Managed care [11:13] Trade offs between traditional insurance and HMO plans [15:47] Medicare Advantage [18:17] Dual Eligible Special Needs Plans (D-SNPs) [19:06] D-SNPs from the perspective of consumers [21:34] Provider networks [24:50] Findings [27:07] Why do D-SNPs not have larger psychiatrist networks than traditional Medicare? [30:02] Mental health care and insurance coverage [33:47] What should policymakers take from this? [36:37] What should clinicians take from this? [39:56]   Transcript   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 website.   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 psjournal@psych.org

Lauren Southwick, M.P.H., and Sharath Guntuku, Ph.D., join Dr. Dixon and Dr. Berzin to discuss whether using a digital dashboard maintained by patients to track social media and other digital data usage had an impact on mental health therapy outcomes. •    Southwick and Guntuku interview [01:37] •    What led you to this study design? [03:06] •    What did you think this would look like in a therapy setting? [08:00] •    Amount of data patients contributed varied widely [09:39] •    The dashboard [10:12] •    What were the effects of sharing digital data with therapists? [12:31] •    The Hawthorne effect [15:25] •    What's next for your research? [18:23] •    Recruitment [20:46] •    COVID and people's interactions with digital media and mental health [23:29] •    ChatGPT [26:50] Transcript 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 website. 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 psjournal@psych.org  

Breanna C. Keepers, M.D., M.B.A., and Ish P. Bhalla, M.D., M.S., join Dr. Dixon and Dr. Berezin to discuss the results of a survey of mental healthcare providers and their usage of measurement-based care.  Dr. Keepers is in the Department of Psychiatry at New York-Presbyterian Hospital, and Dr. Bhalla is Medical Director of Behavioral Health Value Transformation at Blue Cross-Blue Shield of North Carolina. •    Keepers and Bhalla interview [00:50] •    Incentivizing provider behavior changes [03:01] •    Measurement instruments [05:30] •    Measurement-based care from the care recipient's perspective [06:27] •    Study design [09:16] •    Clinical utility and measurement-based care [11:31] •    Are we using the right measure? [14:45] •    Heterogeneity in provider perceptions of measurement-based care [16:08] •    Training providers [17:25] •    Providing care is hard [19:36] •    What's next for your research? [22:10] Transcript 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 website. 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 psjournal@psych.org

Navdep Kaur, M.P.H., joins Dr. Dixon and Dr. Berezin to discuss persistent racial and ethnic disparities in mental health treatment access and outcomes prior to and following the passage of the 2010 Affordable Care Act.  Ms. Kaur is a predoctoral fellow at the Columbia University Mailman School of Public Health in New York. Kaur interview [01:01] Connecting your work with your passion [03:09] Affordable Care Act and mental health [05:39] What did you look at to study this? [09:11] What are we talking about when we talk about distress? [10:06] How do you define treatment usage? [11:30] What are your hypotheses for why your findings on mental health treatment usage look the way they do? [13:11] Disaggregating data for disparate groups [14:40] Has the amount of treatment change overall differed between subgroups and the whole population? [17:42] How do you categorize the various levels of stigma and attitudes towards treatment? [19:16] Sources of market failure – lack of providers, insurance, access [21:21] What would a data set that could answer your questions look like? [22:22] What are you working on next? [24:34] Has your passion survived contact with sample sizes, measures, and the nitty gritty of data sets? [25:20] Transcript 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 website. 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 psjournal@psych.org

Howard H. Goldman, M.D., PH.D. (PS emeritus Editor-in-Chief) and Alison Cuellar, Ph.D., (George Mason University, Fairfax, Virginia) joins current PS Editor-in-Chief Dr. Lisa Dixon to discuss the peer review process from the perspective of both reviewers and editors. Transcript 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 website. 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 psjournal@psych.org

Nathaniel P. Morris, M.D., joins Dr. Dixon and Dr. Berezin to discuss an evidence-based approach to involuntary psychiatric hospitalization.  Dr. Morris is an Assistant Professor of Psychiatry in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco. How did you get interested in this topic? [00:51] What is involuntary psychiatric hospitalization? [02:28] How does it vary by state and nationally? [04:46] What don't we know about the evidence behind involuntary psychiatric hospitalization? [05:46] What are the challenges of investigating involuntary hospitalization? [07:32] What is meant by “involuntary” [09:49] Lack of evidence [11:55] How do you approach studying this subject? [14:12] Alternatives to involuntary hospitalization [17:33] Who gets hospitalized? [19:27] Open Forum [21:30] What does public tracking mean? [22:50] How can we manage this if we don't even know anything about the practice across this country? [23:58] Transcript 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 website. 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 psjournal@psych.org

Shalini Lal, Ph.D., joins Dr. Dixon and Dr. Berezin to discuss the perspective of patients related to recovery, treatment, and relapse following first-episode psychosis.  Dr. Lal is the Canada Research Chair in Innovation and Technology for Youth Mental Health Services and an associate professor at the School of Rehabilitation, University of Montreal, Montreal, Canada. How did you get interested in this topic? [01:26] What do we mean by the word “relapse”? [04:33] What's the perspective of an occupational therapist on first episode psychosis? [06:21] Questions for the focus groups [07:55] Moving beyond the relapse binary [09:10] Categorizing and summarizing [12:44] Four factors [14:20] The complications of technology [15:01] Positives and negatives [17:01] Social environment [19:20] Relationships with healthcare providers [21:43] How did participants understand the meaning of relapse [22:12] The value of qualitative research [25:35] What's next [28:52] Transcript 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 website. 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 psjournal@psych.org

Dr. Bonnie Zima, M.D., M.P.H., joins Dr. Dixon and Dr. Berezin to discuss trends in child emergency department discharges, hospitalization, and mental health care utilization before and after statewide school closure orders due to the COVID-19 pandemic.  Dr. Zima is a Professor-in-Residence in the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles. How did you get interested in this topic? [01:06] Study design [02:26] The team [03:25] The data set: Pediatric Health Information System (PHIS) [06:51] What's in the data? [08:06] Looking at data from 2019 and 2020 [09:27] Medical data as a baseline [10:10] Changes are relative [12:07] Stratification by psychiatric disorder [12:35] Untangling the effects of the pandemic [15:53] Examining the co-occurrence of medical and mental health disorders [17:13] What are the important take home lessons [19:12] IS there a correlation between the severity of the outbreak and service utilization? [22:36] What's next for this research? [23:23] Research and COVID [26:08]   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 website. 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 psjournal@psych.org

Dr. George Pro, Ph.D., M.P.H., joins Dr. Dixon and Dr. Berezin to discuss the downward trend in the provision of mental health services in Spanish across the US, despite the rapidly increasing Hispanic population.  Dr. Pro is an Assistant Professor in the College of Public Health at the University of Arkansas for Medical Sciences. https://ps.psychiatryonline.org/doi/10.1176/appi.ps.202100614 How did you get involved in this research? [01:04] What are the demographic challenges and what do we know about services provision in this population? [02:20] The level of mental health care service utilization [04:45] Why focus on language access? [05:39] What did you find? [06:48] The National Mental Health Services Survey [08:25] National results [10:24] The importance of data visualization [12:39] Figures and how they convey information [17:02] Ohio and North Dakota: rate of change, not overall population [20:07] What are the limitations to this approach? [21:43] Communicating data to policy makers [23:26] What's next for your research? [24:45] Figures from the article:  Figure 1 Figure 2 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 website. 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 psjournal@psych.org

Courtney von Hippel, Ph.D., joins Dr. Dixon and Dr. Berezin to discuss burnout and negative job attitudes, and how lived experience might help provide a buffer in mental health workers. Dr. von Hippel is an Associate Professor of Health and Behavioural Sciences at the University of Queensland in Brisbane, Australia. How did you get involved in this research? [01:16] A profession with a huge amount of burnout [03:20] What does burnout lead to? [05:45] Private versus public practice [08:07] How does a provider's lived experience change their experience with the job? [11:03] Who did you look at and what did you ask? [14:57] What did you find? [19:17] Was there anything about your findings that was surprising to you? [20:52] Lived experience versus self-disclosure [22:22] Do different kinds of lived experience translate? [24:03] Next steps for research [25:54] 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 website. 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 psjournal@psych.org

Mark Savill, Ph.D., joins Dr. Dixon and Dr. Berezin to discuss using online psychosis screening data to see what can be learned about the population taking the assessment, what can be done to close the gap between screening and treatment, and to reduce the duration of untreated psychosis.  Dr. Savill is a professor in the Department of Psychiatry and Behavioral Sciences at University of California, Davis. https://ps.psychiatryonline.org/doi/10.1176/appi.ps.202100257 What's your background? [01:17] Prodromal Questionnaire Brief (PQ-B) [03:03] Duration of Untreated Psychosis (DUP) [03:40] What does the beginning of treatment mean? [05:22] How can the internet help to decrease the time from symptoms to treatment? [07:20] What are people looking for and what are they finding? [10:05] Mental Health America screening [11:00] Where does the PQ-B fit? What did you investigate? [14:33] Getting people into treatment – from A to B, or from A to L? [18:53] What did you learn? [19:50] The numbers [25:02] Further research [23:24]   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 website. 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 psjournal@psych.org

Daniel M. Blonigen, Ph.D. joins Dr. Dixon and Dr. Berezin to discuss implementing moral reconation therapy (MRT) in a noncorrectional setting among justice-involved veterans receiving residential mental health treatment in the U.S. Veterans Health Administration with an aim towards reducing criminal recidivism.  Dr. Blonigen is an Associate Director at the Center for Innovation to Implementation, VA Palo Alto Health Care System, in Palo Alto, California.   Blonigen interview [00:55] Veterans Justice programs [02:29] Moral reconation therapy (MRT) [03:18] Treatments for criminal recidivism? [04:24] A group based, cognitive behavioral intervention [05:13] The structure of MRT [06:22] How does MRT avoid implying there's one right way to live? [10:10] MRT in a residential mental health setting [12:58] A hybrid trial design [15:47] Bringing together research and implementation [18:38] What did the participants think of MRT? [19:09] Listening to people who didn't engage [20:34] Barriers to MRT implementation [23:23] Does MRT overlap with other treatments in residential settings? [25:30] What's the next step? [27:16]     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 website. 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 psjournal@psych.org

Margaret E. Balfour, M.D., Ph.D., and Jason Winsky, B.A., join Dr. Dixon and Dr. Berezin to discuss their special article published in Psychiatric Services, “Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies,” looking at collaborations between police and clinicians in the treatment of mental health and behavioral health emergencies.  Dr. Balfour is Chief of Quality & Clinical Innovation at Connections Health Solutions in Tucson, Arizona, and Sgt. Winsky is a police officer and supervisor of the Mental Health Investigative Support Team with the Tucson Police Department.   Balfour and Winsky interview [00:32] How did you get started in this work? [01:22] Police department mental health team [02:44] Crisis Response Center [03:04] Why Arizona? [03:58] Arnold vs Sarn [04:54] Twenty-three hour observation model [05:35] Funding [06:20] How the crisis system works in Tucson [07:44] Easy access for law enforcement [10:11] Crisis management from the law enforcement perspective [10:39] Police training in dealing with mental health crisis [12:41] Who the police bring to the crisis center [14:59] Challenges in providing mental health services for intoxicated and violent patients [16:21] Keeping patients out of the justice system when possible [17:31] “No Wrong Door” policy [18:47] How this works in practice: the lady with the car [21:05] Creating the opportunity for creative solutions to removing barriers to mental health care [23:56] “There can't be a rule for everything in crisis” [24:44] Social justice framing of the paper [26:49] The Technical Assistance Coalition working papers series [29:24] What would you add to enhance the program? Housing, housing, housing [30:07] Collaboration between siloed systems [32:01] Working with stakeholders [32:59] The impact of mental health crisis on people of color [34:41] Other places doing great work [37:13]   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 website. 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 psjournal@psych.org

Cameron Schilling, M.P.H, joins Dr. Dixon and Dr. Berezin to discuss the effects of high deductible health insurance plans on enrollees with mental health conditions and substance use disorder.  Mr. Schilling is a programmer and data analyst from the Center for Mental Health and Addiction Policy at the Johns Hopkins School of Public Health, and an author of an article in the journal.   Health insurance and how it works What is a “high deductible” health insurance plan? Premiums, health care utilization, and planning ahead Employment and insurance Deductibles, premiums, and health savings accounts Co-occurring disorders and high deductible insurance Healthcare utilization and high deductibles: increase and decrease How do people navigate this? The literature: high deductible insurance and bipolar disorder Little change when accessing care, but decrease in likelihood of seeking treatment Prioritization and tradeoffs Do people with a mental health diagnosis and those co-occurring substance use disorders access care differently under high deductible plans? Choice of health care plans provided by employers Let's talk methods Impact of high deductible plans on healthcare utilization   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 website. 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 psjournal@psych.org  

Dr. Debra A. Pinals, M.D., joins Dr. Dixon and Dr. Berezin to discuss two forthcoming articles from Psychiatric Services looking at persons with intellectual and developmental disabilities in mental health systems.  The first paper addresses clinical considerations, and the second looks at policy and systems considerations. Dr. Pinals is a Clinical Professor of Psychiatry and the Director of the Program in Psychiatry, Law, and Ethics at the University of Michigan Medical School in Ann Arbor, Michigan. Topics discussed in this episode: Mental health systems and law enforcement Medicaid-funded and state-funded systems Defining the patient population “Beyond Beds” and the psychiatric continuum of care Seeing the population beyond just crisis Dealing with aggressive behavior and overmedicating the population Restricting individual autonomy as a last resort Applied Behavioral Analysis Overlooked stressors and potential drivers of crisis Role of evidence-based practices in this population Distinguishing between mental illness and intellectual disabilities, and how they interact Encouraging communication across systems Expansion of crisis services Rehabilitation services versus habilitation services Where does neurology fit in? What system does care take place in? How do we improve things from here? 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 website. 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 psjournal@psych.org  

Deborah K. Padgett, Ph.D., M.P.H., and Daniel Herman, M.S.W., Ph.D., join Dr. Dixon and Dr. Berezin to discuss a potentially effective and affordable approach to ending homelessness for many Americans by extending the authorization that U.S. health authorities gave to shelter providers to move residents into hotels. Dr. Padgett is a Professor at New York University's Silver School of Social Work. Dr. Herman is a Professor at Hunter College's Silberman School of Social Work and Director of the Center for the Advancement of Critical Time Intervention.   Topics discussed in this episode: Career trajectories: planned and unplanned transitions Homelessness issue pre-pandemic: 40 years in 4 minutes Structural racism as a contributor SMI: a subset of homelessness issue COVID contagion leading to general agreement on the need to “de-densify” shelters Permanent hotel housing: measurable outcome improvements and qualitative game changer Discussion of Critical Time Intervention   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 website. 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 psjournal@psych.org

Sidney H. Hankerson, M.D., M.B.A., joins Dr. Dixon and Dr. Berezin to discuss efforts to train African American clergy interested in interpersonal counseling in managing major depression among community members, as they are positioned to curb the cultural mistrust and depression stigma that impedes the use of traditional psychiatric services among African Americans. Dr. Hankerson is Assistant Professor of Clinical Psychiatry at Columbia University, College of Physicians and Surgeons, and the New York State Psychiatric Institute. Journey to this area of research  Grady Hospital patients requesting pastor involvement  Importance of NAMI-sponsored suicide prevention program at a large church in Queens  Summary of current paper  Description of and relationship with church involved in the study  Talking with pastors and community members about the intervention  Distrust of institutions  Depression stigma  Future work involving community health workers  How to get involved  Personal connection with mental health  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 website. Be sure to let your colleagues know about the podcast. If you like this podcast please rate and review us on itunes or the platform you prefer. More podcasts from the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

Benjamin G. Druss, M.D., M.P.H., joins Dr. Dixon and Dr. Berezin to discuss two articles: 1) A qualitative study of barriers and facilitators to transitions from the emergency department to outpatient mental health care 2) Supporting the mental health workforce during and after COVID-19. Dr. Druss is a psychiatrist and a professor in the Department of Health Policy and Management at the School of Public Health at Emory University. How research interests and career path have provided expertise on these two seemingly very disparate articles (1:36) Background on interests in emergency department transitions (3:01) Methodology of ED transition study (4:23) Questions asked of subjects (7:52) Client, provider, and system perspectives (8:50) Social determinants of treatment seeking and post-discharge care (12:09) Surprising findings (14:38) How ED visits are often a confluence of factors that are outside of the control of patients (16:35) Structural factors compounding transition difficulties (18:38) How technical assistance supports the adoption and sustainment of evidence-based practices (23:00) Factors affecting successful implementation of evidence-based interventions (26:44) COVID disruption (29:00) COVID's long-term effects on mental health service delivery (33:00) Panoramic view of COVID's effects on the field from adjudicating papers (34:51) 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 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 psjournal@psych.org

Marie Brown, Ph.D., and Nev Jones, Ph.D., join Dr. Dixon and Dr. Berezin to discuss steps to build a pipeline of researchers with significant psychiatric disabilities and intersecting lived experiences and to increase service user participation in the U.S. mental health care system. Dr. Brown is a licensed clinical psychologist, postdoctoral fellow at Columbia University Irving Medical Center, and a cofounder of Hearing Voices Network NYC. Dr. Jones is an assistant professor in the Department of Psychiatry at the University of South Florida. How the authors began their collaboration [1:35] Genesis of the collaboration on the two Open Forum pieces in Psychiatric Services [2:38] Background of advocacy to have people with lived experience in mental health research positions [5:00] A paradigm of what meaningful participation would look like [7:59] Should the same standards of participation and inclusion apply to other research areas? [11:47] Is research disconnected from practice? [16:01] Steps the research community and academia can take to address these issues [22:11] Self-disclosure of psychiatric disability/lived experience [27:30] Deepening engagement of service user participation within the mental health system [31:50] The “radical roots” of the concept of peer support [34:33] What relational psychotherapy has to do with deepening engagement and service user participation [39:18] How Dr. Brown’s experience with the Hearing Voices movement has informed her work [46:31] Activities designed to deepen engagement and help build a diverse lived experience pipeline [48:19] 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 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 psjournal@psych.org

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 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 psjournal@psych.org

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] 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 psjournal@psych.org

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] 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 psjournal@psych.org

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] 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 psjournal@psych.org 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. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

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. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

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 psjournal@psych.org 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 manuscript being discussed has been peer reviewed and accepted for publication but not copyedited or formatted for publication. It is freely available from the Psychiatric Services homepage (https://ps.psychiatryonline.org), in addition to other manuscripts pertaining to the COVID-19 pandemic. 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. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

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. Follow the journal on Twitter. E-mail us at psjournal@psych.org

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 psjournal@psych.org

Patricia E. Deegan, Ph.D., joins Dr. Dixon and Dr. Berezin to discuss the dynamic journey that is learning to use psychiatric medicine optimally to support recovery. It requires more than learning to take pills on schedule. As people recover, as they learn and grow, as they age, and as their concerns and interests evolve, the use of medication as a tool in recovery also evolves. What is Pat Deegan, Ph.D., & Associates? [1:15] Dr. Deegan's personal experience with mental illness [2:48] Recovery as a journey [5:06] Challenges people face when using medication [9:53] The clinician-patient relationship [14:04] Using analogy to understand the use of medication [17:25] Personal motivation for using medication [18:32] The context from which this Personal Accounts column emerged [22:44] Subscribe to the podcast here. Check out Editor's Choice, a new 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 psjournal@psych.org

Natalie Bonfine, Ph.D., joins Dr. Dixon and Dr. Berezin to discuss the reasons why people with serious mental illness are overrepresented in the criminal justice system. Dr. Bonfine also outlines ways to address the multiple factors that contribute to justice involvement for this population. Dr. Bonfine's professional background and research interests [2:05] Development of Dr. Bonfine's article [3:20] What is the criminalization hypothesis? [5:06] What is the criminogenic risk perspective? [10:13] How can the community mental health system address this issue? [12:48] Discussion of the sequential intercept model [17:50] What changes are necessary for the community mental health system to become “intercept 0” [20:41] A counterargument [26:50] Final thoughts [28:55] Check out Editor's Choice, a new 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 psjournal@psych.org

Dr. Dixon and Dr. Berezin discuss substance use among LGBTQ young adults with probable substance use disorders and characteristics and job stressors associated with turnover and turnover intention among community mental health providers. Introduction to article on substance use among LGBTQ populations [1:00] Study design [2:12] Study results [6:32] Introduction to article on turnover at community mental health centers [15:16] Study design [16:06] Study results [18:16] Check out Editor's Choice, a new 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 psjournal@psych.org

Nev Jones, Ph.D., and Christina Mangurian, M.D., M.A.S., join Dr. Dixon and Dr. Berezin to discuss the significant ethical, political, and procedural challenges that affect recruitment and retention of the peer specialist workforce. Introduction to the topic [1:05] Outline of the case study described in the column [6:20] Challenges involved in hiring peer staff [11:28] Tips for helping clients [14:42] Challenges dealing with microaggressions [17:54] What progress has been made? [23:19] Check out Editor's Choice, a new 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. Other articles may be viewed at 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 psjournal@psych.org

Dr. Dixon and Dr. Berezin discuss an innovative model to integrate medication-assisted treatment (MAT) in rural primary care settings for patients with opioid use disorders, and how mental health professionals can prepare and respond to the mental health consequences of increasingly dangerous storms. The barriers and facilitators that affect engagement with Project ECHO (Extension for Community Healthcare Outcomes) to implement MAT in primary care settings [0:58] How mental health professionals can help individuals affected by hurricanes [12:24] We encourage listeners to donate to any trusted charity serving communities affected by Hurricane Dorian. Check out Editor's Choice, a new 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. Other articles may be viewed at 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 psjournal@psych.org

Jonathan Purtle, Dr.P.H., M.Sc., joins Dr. Dixon and Dr. Berezin to discuss state legislators’ opinions about adverse childhood experiences as risk factors for adult behavioral health conditions, as well as how opinions vary between legislators with different characteristics. Dr. Purtle’s research interests [1:35] What are adverse childhood experiences (ACEs)? [3:50] How do the opinions of state legislators align with the body of evidence on ACEs? [6:57] Description of study methods [8:18] Characteristics of the surveyed legislators [13:00] Major findings of the study [14:54] What’s next in this line of research [25:36] Check out Editor's Choice, a new 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. Other articles may be viewed at our web site. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. The podcast is now on Spotify. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

Dr. Dixon and Dr. Berezin discuss psychiatric hospitalization of youths with autism spectrum disorder and whether increasing spending on home and community-based care lowers that risk [1:13], reducing hospitalization through court-ordered assisted outpatient treatment with or without assertive community treatment [11:20], and use of behavioral economics to enhance medication adherence [20:47]. Check out Editor's Choice, a new 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. Other articles may be viewed at our web site. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. The podcast is now on Spotify. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

Dr. Dixon and Dr. Berezin discuss an innovative program to engage patients with early psychosis [1:12], two essays on the legalization of marijuana [11:25], and the aftermath of celebrity suicide [22:30]. Check out Editor's Choice, a new 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. Other articles may be viewed at our web site. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. The podcast is now on Spotify. Follow the journal on Twitter. E-mail us at psjournal@psych.org