Barriers to metabolic care for adults with serious mental illness: provider perspectives.

This study assessed barriers to metabolic care for persons with serious mental illness (SMI) by surveying experienced healthcare providers. Sixty-eight medical, mental health, and other stakeholders who care for patients with SMI attended a CME conference focused on medical management of SMI patients in 2007. They completed a 27-item survey assessing barriers to and systemic responsibility for metabolic care.

Consistency of psychiatric crisis care with advance directive instructions.

Objectives: Psychiatric advance directives document clients' treatment preferences in advance of periods of diminished capacity for decision making. This article presents the first empirical data regarding rates and predictors of whether crisis care is consistent with psychiatric advance directives.

Methods: Participants were 106 community mental health outpatients who had completed a directive.

Competency for creation, use, and revocation of psychiatric advance directives.

Psychiatric advance directives help promote patient involvement in treatment and expedite psychiatric care. However, clinicians are unsure of how to use directives, partly due to poor clarity regarding standards for capacity to create, use, and revoke them. This article recommends possible capacity standards.

The content and clinical utility of psychiatric advance directives.

Objective: This paper provides the first systematic examination of the content and clinical utility of psychiatric advance directives, which are documents that specify treatment preferences in advance of periods of compromised decision making.

Methods: Directives were completed by 106 community mental health center outpatients with at least two psychiatric hospitalizations or emergency department visits within two years. Participants used AD-Maker software in groups of up to six people led by peer trainers.

Geriatric patients improve as much as younger patients from hospitalization on general psychiatric units.

Objectives: To determine whether geriatric patients aged 65 and older on general adult psychiatric units improve as much as younger patients, over what duration their improvement occurs, and their risk of readmission.

Design: Cohort study.

Setting: Inpatient psychiatric unit of an urban, university-affiliated, county hospital from January 1993 through August 1999.

Unlinking disability income, substance use and adverse outcomes in dually diagnosed, severely mentally ill outpatients.

The goals of the current study were to determine whether incorporating disability benefit management into combined outpatient psychiatric/addiction treatment was feasible and clinically useful for managing severely mentally ill, substance-abusing patients over time, and then if patients in this program would demonstrate the first-week-of-the-month increased substance abuse and hospitalizations shown in other studies. Forty-four patients were studied for an average of forty weeks, with little treatment or study dropout. There was no evidence in either the schizophrenic/cocaine abuser or the broader diagnostic sample of the cyclic first-of-the-month pattern of substance use and hospitalizations observed in other studies.

Interest in psychiatric advance directives among high users of crisis services and hospitalization.

Objectives: This study examined rates of interest in creating psychiatric advance directives among individuals at risk of psychiatric crises in which these directives might be used and variables associated with interest in the directives.

Methods: The participants were 303 adults with serious and persistent mental illnesses who were receiving community mental health services and who had experienced at least two psychiatric crises in the previous two years. Case managers introduced the concepts of the directives and assessed participants' interest.

Psychometric properties and utility of the problem severity summary for adults with serious mental illness.

Objective: The authors studied the psychometric properties and utility of the Problem Severity Summary (PSS), a 13-item instrument that assesses symptom severity and functioning among adults with severe and persistent mental illness.

Methods: Case managers rated the PSS among more than 1,000 adults with severe and persistent mental illness who were receiving services at either mainstream community mental health centers or specialty community mental health centers (serving various minority groups) in one county in Washington State. A subsample of clients was used to assess the concurrent validity of the PSS with the Psychiatric Symptom Assessment Scale.

Initial findings from Parent Party Patrol: an intervention to reduce adolescent substance use through reduced involvement in unchaperoned parties.

This article presents preliminary evaluation findings from Parent Party Patrol (PPP). PPP is a two-hour single-session intervention that provides information to parents about ways to increase monitoring and improve communication and family guidelines regarding substance use, with the goal of reducing adolescent involvement in unsupervised activities and associated substance use. Seventy-three attendees from 15 PPP sessions completed baseline and three- to six-month follow-up information.