Group items tagged

"unless states carefully regulate the plans that compete in the exchanges and the benefits that they offer, people with mental illness, who typically have higher health care costs, are at risk of receiving poorer quality care."

"Major depressive disorder is a common global disease that causes a significant societal burden. Most interventional studies of depression provide a limited assessment of the interventions on mortality and suicide risks. This study utilizes data from an observational registry of patients with major depressive disorder to determine the impact of intervention (vagus nerve stimulation or standard pharmacological/non-pharmacological therapy) and a latent factor, patient trajectory toward response, on mortality, suicide and suicidal ideation. A total of 636 patients were available for an intent-to-treat analysis of all-cause mortality, suicide and suicidal ideation. Patients treated with vagus nerve stimulation in addition to standard therapies experienced lower, but not statistically significant, all-cause mortality (vagus nerve stimulation 4.93 per 1,000 person-years vs. 10.02 per 1,000 patient years for treatment as usual) and suicide rates (vagus nerve stimulation 0.88 per 1,000 person-years vs. 1.61 per 1,000 patient years for treatment as usual). Treatment with vagus nerve stimulation produced a statistically lower relative risk of suicidal ideation 0.80, 95% confidence interval (0.68,0.95). Further, patients that responded to either treatment saw a 51% reduction in relative risk of suicidal behavior; relative risk and 95% confidence interval of 0.49 (0.41,0.58). In summary, we find that treatment with adjunctive vagus nerve stimulation can potentially lower the risk of all-cause mortality, suicide and suicide attempts."

The program also connects patients to other community resources and addresses health, social, and logistical barriers to care. The program significantly enhanced access to appropriate care and improved client understanding of their medical condition, resulting in enhanced health functioning and a significant decline in emergency department use and costs for nonemergent conditions.

From the abstract: "We conducted systematic literature searches in PubMed, PsycINFO, and Embase up to November 2012, and identified additional studies through earlier meta-analyses and the references of included studies. We identified 198 studies, including 15,118 adult patients with depression, and coded moderator variables. Each of the seven psychotherapeutic interventions was superior to a waitlist control condition with moderate to large effects (range d = −0.62 to d = −0.92). Relative effects of different psychotherapeutic interventions on depressive symptoms were absent to small (range d = 0.01 to d = −0.30). Interpersonal therapy was significantly more effective than supportive therapy (d = −0.30, 95% credibility interval [CrI] [−0.54 to −0.05]). Moderator analysis showed that patient characteristics had no influence on treatment effects, but identified aspects of study quality and sample size as effect modifiers. Smaller effects were found in studies of at least moderate (Δd = 0.29 [−0.01 to 0.58]; p = 0.063) and large size (Δd = 0.33 [0.08 to 0.61]; p = 0.012) and those that had adequate outcome assessment (Δd = 0.38 [−0.06 to 0.87]; p = 0.100). Stepwise restriction of analyses by sample size showed robust effects for cognitive-behavioural therapy, interpersonal therapy, and problem-solving therapy (all d>0.46) compared to waitlist. Empirical evidence from large studies was unavailable or limited for other psychotherapeutic interventions."

From the abstract: "the current study provides a n analysis of homeless and runaway youths' attitudes towards mental health servic es in order to identify possible factors t hat can assist service providers with understanding and increasing service engagement . V ariables examined included help seeking propensity, psychological openness , concern for mental health stigma, parental maltreat ment, street victimization and services n eeds assessment. The current study also examines the relationship between social support and attitudes toward mental health services. A comparison sample of housed youth was obtained in order to de termine if mental health attitudes are unique to homeless y outh. Fifty - six youth who identified as homeless were recruited through youth drop - in centers and a shelter in Northern California , and 97 housed youth were recruited from alternative community continuation schools in the same region . A nalys is of v ariance iii showed that homeless and housed groups did not differ significant ly on attitudes toward mental health services, help seeking propensity, psychological openness, and concern for mental health stigma . Additional f indings revealed that , for homeless youth, t he more perceived friend support , the more their concern for mental health stigma decreased and the more supportive individuals available , the more positive attitudes toward mental health services and help seeking propensity increased . Comparison of correl ations between homeless and housed groups revealed only one significant difference; the association between perceived family support and help seeking propensity was strongest for the housed group than for the homeless group . Results demonstrate d that home less youth and housed youth share similar attitudes toward mental health services , help seeking propensity, psychological openness, and c o ncern for mental health stigma. Mean scores obtained on these measures were comparable to the only existing study on