Attending to Persons with Intellectual and/or Other Developmental Disorders in Crisis Settings.

Crisis response is growing across the United States with increasingly broad phone, text, and chat response systems that lead to triaging callers who may be in need of further outreach. This might include deploying a mobile crisis response team and/or referring a caller to a crisis stabilization unit. The information set forth earlier aims to help advance the field and individual practices to ensure that persons with intellectual and/or other developmental disorders receive equivalent care and treatment with information that helps focus on this population's unique features and needs.

Examining the Impact of State-Level Factors on HIV Testing for Medicaid Enrollees With Schizophrenia.

Background: People with schizophrenia experience unique barriers to routine HIV testing, despite increased risk of HIV compared with the general US population. Little is known about how health care delivery system factors affect testing rates or whether there are testing differences for people with schizophrenia.

Setting: Nationally representative sample of Medicaid enrollees with and without schizophrenia.

A legal dispute resolution intervention for patients with substance use disorders: a study protocol for a randomized controlled trial.

Background: Substance use disorders (SUDs) represent major public health concerns and are linked to enhanced risk of legal consequences. Unresolved legal issues may prevent individuals with SUD from completing treatment. Interventions aimed at improving SUD treatment outcomes are limited.

Examining Perceived Coercion in Drug Treatment Courts.

While perceptions of voluntary consent have been studied among participants in Mental Health Courts (MHC), little is known about coercion among participants in Drug Treatment Courts (DTC), the most common type of specialty court. The purpose of the present study was to examine perceptions of coercion at enrollment among participants (N = 85) in two Massachusetts DTCs. Results indicated that, on average, participants reported low levels of perceived coercion (M = 1.

Racial and ethnic differences in behavioral health, criminal legal system involvement, and service needs among mental health court participants: Implications for service delivery.

Mental Health Courts (MHCs), an alternative to incarceration, aim to address behavioral health, social needs, and criminal recidivism and serve many adults with co-occurring mental health and substance use disorder (COD). Despite the growth in MHCs, little research has examined ethnic/racial differences in behavioral health and service needs of individuals with COD. This study used data from behavioral health and social assessments administered to 146 adults with COD entering a Massachusetts MHC.

A 20-year follow-up survey of police officers' experience with Tarasoff warnings: How law enforcement reacts to clinicians' duty to protect.

Since the Tarasoff case of 1976, mental health professionals are recognized to have a "duty to protect" third-party targets from violence-threatening patients, but little is known about what happens after clinicians warn law enforcement. In 2000, Huber et al. published a study that surveyed Michigan police about "Tarasoff warnings.

Data on Evaluations as a Foundation for States Rethinking Competency to Stand Trial.

Competency to stand trial policies and processes vary significantly across jurisdictions, and, increasingly, state policymakers are looking for ways to improve their efficiency, equity, and effectiveness. This commentary describes the importance of certain data, including the number of evaluations ordered, to inform state policymaking, drawing on the strategies highlighted in a recently released guide for policymakers, .

Persons With Intellectual and Developmental Disabilities in the Mental Health System: Part 1. Clinical Considerations.

Individuals with intellectual and developmental disabilities (IDD) are at high risk of co-occurring mental health conditions, including major depressive disorder, bipolar disorder, anxiety disorders, psychotic illnesses, impulse control disorders, and others. Because of symptoms associated with these illnesses and with the disabilities themselves, these individuals are often served in a mental health service system framework. However, treatment for them in these settings has typically not been sufficiently nimble, knowledgeable, or adept.

Persons With Intellectual and Developmental Disabilities in the Mental Health System: Part 2. Policy and Systems Considerations.

Individuals with intellectual and developmental disabilities (IDD) are at high risk of co-occurring mental health conditions, including major depressive disorder, bipolar disorder, psychotic disorders, anxiety disorders, impulse control disorders, and others. Because of symptoms associated with these illnesses and with the disabilities themselves, these individuals are often served in a mental health service system framework. In this second of two articles on care for persons with IDD in the mental health system, the authors focus on policy and systems considerations to assist practitioners and administrators to provide high-quality mental health services for these individuals by recognizing existing infrastructures of support.

Risk-need-responsivity and its application in behavioral health settings: A feasibility study of a treatment planning support tool.

The risk-need-responsivity (RNR) model suggests several key practices for justice-involved populations under correctional supervision. Behavioral health treatment planning aligned with RNR principles for offender populations with co-occurring mental health and substance use disorders (CODs) could be one method for integrating RNR into clinical care. To explore a unique approach to working with behavioral health and RNR principles, the authors implemented a mixed-methods feasibility study of the acceptability, usability, and utility of a newly developed RNR treatment planning support tool (RNR TST).

The Behavioral Health System and Its Response to COVID-19: A Snapshot Perspective.

The global experience of the COVID-19 pandemic is unprecedented. The magnitude, pace, and uncertainty of the pandemic have taxed systems and catalyzed innovation in many fields, including behavioral health. Behavioral health leaders have absorbed changing information about regulations and laws, proper use of personal protective equipment, isolation and quarantine, telepsychiatry practices (broadly defined here as the use of virtual and telephonic means to provide behavioral health care), and financial opportunities and challenges while attending to the mental health needs of local populations.

The Vital Role of a Full Continuum of Psychiatric Care Beyond Beds.

The authors make the case for expanding the national discussion of inpatient psychiatric beds to recognize and incorporate other vital components of the continuum of care in order to improve outcomes for individuals with serious mental illness. They review the varied terminology applied to psychiatric beds and describe how the location of these beds has changed from primarily state hospitals to the criminal justice system, emergency departments, inpatient units, and the community. The authors propose 10 recommendations related to beds or to contextual issues regarding them.

Challenges to Reforming the Competence to Stand Trial and Competence Restoration System.

Many mental health and justice professionals have noted that the system that manages both competence to stand trial (CST) evaluation and competence restoration (CR) processes in criminal cases is in crisis. Public mental health services often are inundated with court referrals and are challenged to address them in a timely manner, resulting in waits for competence-related services for people in jail as well as substantial risks to criminal defendants for whom competence issues are raised. In this review, the authors describe the current CST-CR system and offer preliminary solutions to its challenges.

Evaluation and Restoration of Competence to Stand Trial: Intercepting the Forensic System Using the Sequential Intercept Model.

The sequential intercept model (SIM) is used to reduce the penetration of persons with mental illness and substance use disorders in the criminal legal system. Its framework recommends identifying individuals with mental illness at various decision points of criminal case processing, from arrest to return from incarceration, so that they can be diverted toward treatment rather than permeate deeper into the criminal justice system. Communities frequently use the model to augment and inform jail diversion services.

Resource Document on Risk-Based Gun Removal Laws.

(Reprinted with permission from , June 2018).

Embedding a Co-occurring Disorders Rehabilitation Intervention in Veterans Courts: A Pilot Study with Male Veterans.

Veterans treatment courts (VTCs) have expanded dramatically despite their limited empirical base. This pilot study examined MISSION-Criminal Justice (CJ), a co-occurring disorders wraparound intervention, delivered alongside two VTCs. Baseline data from 26 male veterans enrolled in two VTCs and MISSION-CJ, and 6-month follow-up data for 18 of the 26 veterans, are presented.

Psychiatry and Fitness to Fly After Germanwings.

In March 2015, a co-pilot flying Germanwings Flight 9525 deliberately pointed his airplane into a descent, killing himself, five other crew members, and 144 passengers. Subsequent investigation and review teams examined the incident and considered potential lessons to maximize air safety. In this article, aviation industry clinical leaders, including the U.

Implementation of MISSION-Criminal Justice in a Treatment Court: Preliminary Outcomes Among Individuals With Co-occurring Disorders.

Objective: Mental health courts provide an alternative to incarceration and address both mental health and criminal justice needs. Many individuals within these treatment courts also have co-occurring substance use disorders. This pilot study examined the preliminary effectiveness of Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking-Criminal Justice (MISSION-CJ), an intervention that targets co-occurring disorders and criminal justice risk factors within a mental health court.

Evaluating the implementation of a prisoner re-entry initiative for individuals with opioid use and mental health disorders: Application of the consolidated framework for implementation research in a cross-system initiative.

Given the interrelated nature of opioid use, criminal justice interaction, and mental health issues, the current opioid crisis has created an urgent need for treatment, including medication assisted treatment, among justice-involved populations. Implementation research plays an important role in improving systems of care and integration of evidence-based practices within and outside of criminal justice institutions. The current study is a formative qualitative evaluation of the implementation of a cross-system (corrections and community-based) opioid use treatment initiative supported by Opioid State Targeted Response (STR) funding.

AAPL Practice Resource for the Forensic Psychiatric Evaluation of Competence to Stand Trial.

Full Document: Wall BW, Ash P, Keram E, et al: AAPL Practice Resource for the Forensic Psychiatric Evaluation of Competence to Stand Trial Update 2018. Journal of the American Academy of Psychiatry and the Law Online Supplement 2018, 46 (3). Available at: http://www.

Integrating a Co-occurring Disorders Intervention in Drug Courts: An Open Pilot Trial.

Little research has focused on systematically integrating clinical treatment within existing drug court procedures. This could be particularly useful for clients with substance use disorders, who comprise those on court dockets and often have co-existing mental health issues. This article reports on the preliminary outcomes of integrating MISSION-Criminal Justice (MISSION-CJ), a co-occurring mental health and substance use wraparound intervention, within two Massachusetts drug courts.