Implementing Quality Improvement Initiatives Within Community Psychiatry: Challenges and Strategies.

Implementation of quality improvement (QI) initiatives within community mental health settings is crucial to addressing equity-related issues affecting mental health services delivery, including for co-occurring substance use disorders. Given the growing recognition of QI interventions as an effective framework to facilitate structural change within systems of care, it is important to equip mental health providers with the knowledge and ability to execute QI initiatives that are feasible, sustainable, and integrate a health equity lens. To demystify the QI process, we describe the design and methodologies of four fellows' capstone projects conducted during the 2022-2023 academic year at the University of California, San Francisco (UCSF) Public Psychiatry Fellowship at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG).

The Provision and Utilization of Telehealth within Academic Mental Health Clinics in North America during the COVID-19 Pandemic.

Objective: To document the experience of 14 academic child and adolescent psychiatry programs in transitioning to and managing telehealth services during the COVID-19 pandemic. The goal was to understand how programs adopted and sustained telehealth during the pandemic. Telehealth was defined as services delivered via videoconferencing and telephony.

Recommendations for the Use of Telepsychology in Psychology-Law Practice and Research: A Statement by American Psychology-Law Society (APA Division 41).

In response to the COVID-19 pandemic and subsequent impact on psychological work, Division 41 of the American Psychological Association convened a taskforce to provide guidance to its membership regarding the use of technology for practice and research at the intersection of psychology and law. Drawing from existing research in psychology-law and beyond, as well as the first-hand experience of taskforce members, this document outlines foundational guidance to apply technology to forensic and correctional work while acknowledging these settings provide unique challenges to ethical practice. The recommendations provide support for psychologists involved in assessment, treatment, training, and research.

Youth recidivism: youth self-report matters.

Introduction: "Recidivism" is used ubiquitously in juvenile justice research and typically describes repeat legal contact; however, researchers, policymakers, and clinicians operationalize it in various ways. Despite assuming each measure is a proxy for continued delinquent behavior leading to further legal contact, few have examined the association between youth delinquent behavior and self-reported and official records of legal contact. Furthermore, systemic bias against ethnoracial and gender minoritized youth often results in more harsh treatment by the legal system, which could influence recidivism measurement.

Implementation Considerations for Family-Based Telehealth Interventions for Youth in Foster Care: Focus Group Study With Child Welfare System Professionals.

Background: Between 2016 and 2020, over 600,000 youth were served annually by the foster care system. Despite approximately half of foster youth struggling with emotional or behavioral challenges, few receive much-needed services to address their mental health concerns. Family-based interventions are efficacious in addressing both youth and caregiver mental health needs; however, foster youth participation in these family-based interventions is limited by many barriers, including out-of-home placement far from their family of origin.

Dialectical Behavior Therapy in Juvenile Correctional and Detention Facilities: A Scoping Review.

Dialectical behavior therapy (DBT) has shown preliminary success in the treatment of youth in forensic settings. However, the implementation of DBT varies considerably from facility to facility. A scoping review was conducted to detail DBT intervention protocols in juvenile correctional and detention facilities.

Risk and Protective Factors Associated with Self-Cutting Behavior Among Adolescents at First Contact with the Juvenile Court.

Adolescents involved in juvenile legal system are at increased risk for self-cutting behavior, however, correlates associated with elevated risk remain underresearched, particularly among youth with first involvement with the court. This study utilized an epidemiological two-year longitudinal study involving 401 adolescents at first contact with the court (M = 14.47; SD = 1.

Psychiatric and Substance-Related Problems Predict Recidivism for First-Time Justice-Involved Youth.

Justice-involved youth with clinically significant co-occurring psychiatric and substance-related problems are at increased risk for recidivism. Less is known about how psychiatric symptoms (i.e.

Comprehensive Dialectical Behavior Therapy for Adolescents in a Juvenile Correctional Treatment Center: A Pilot Evaluation.

Background: Incarcerated youth commonly present with emotion dysregulation, aggression, and comorbid psychiatric disorders, yet often do not receive necessary mental health treatment while confined. It is therefore crucial to expand the evidence base regarding empirically supported mental health interventions which are feasible to implement in secure settings to address incarcerated youth's mental health needs. Through a community-academic partnership, the current pilot study evaluated a comprehensive Dialectical Behavior Therapy program implemented in a juvenile correctional treatment center.

The Association Between Expanded ACEs and Behavioral Health Outcomes Among Youth at First Time Legal System Contact.

A growing body of literature has documented high rates of adverse childhood experiences (ACEs) and their effects on behavioral health among adolescents impacted by the juvenile legal system. Most research with justice-impacted youth assesses the ten standard ACEs, encompassing abuse, neglect, and household dysfunction. This body of work has largely ignored the five expanded ACEs which assess social and community level adversity.

Using Social Media to Engage Justice-Involved Young Adults in Digital Health Interventions for Substance Use: Pilot Feasibility Survey Study.

Background: Young adults involved in the justice system have high rates of substance use disorders and low rates of treatment engagement. Most justice-involved young adults are supervised in the community-not incarcerated in jail or prison-where they have ongoing access to substances and experience significant barriers to care. When they do engage in treatment, they tend to have worse outcomes than justice-involved adolescents and older adults.

Gender Differences in National Institutes of Health Grant Submissions Before and During the COVID-19 Pandemic.

Emerging data suggest that the COVID-19 pandemic has disproportionately impacted women in academic medicine, potentially eliminating recent gains that have been made toward gender equity. This study examined possible pandemic-related gender disparities in research grant submissions, one of the most important criteria for academic promotion and tenure evaluations. Data were collected from two major academic institutions (one private and one public) on the gender and academic rank of faculty principal investigators who submitted new grants to the National Institutes of Health (NIH) during COVID-19 (March 1st, 2020, through August 31, 2020) compared with a matched period in 2019 (March 1st, 2019, through August 31, 2019).

Leveraging Technology to Increase Behavioral Health Services Access for Youth in the Juvenile Justice and Child Welfare Systems: a Cross-systems Collaboration Model.

Behavioral health services access for justice- and child welfare-involved youth is limited despite significant need. Structural interventions to address limited access are nascent. Technology can advance access, but few interventions focus on system-impacted youth and their mental health needs and challenges.

Juvenile Justice, Technology and Family Separation: A Call to Prioritize Access to Family-Based Telehealth Treatment for Justice-Involved Adolescents' Mental Health and Well-Being.

Separating children from families has deleterious effects on children's mental health and well-being, which is highly relevant for youth in juvenile detention and other out-of-home residential placements. Despite growth in the evidence of family-based interventions in mitigating adverse behavioral health outcomes for justice involved adolescents (JIA), gaps remain in intervention dissemination for JIA; this particularly true for those leveraging digital health technologies, a need that has intensified with the COVID-19 pandemic. Use of digital health technologies for JIAs is pressing to address structural barriers in maintaining JIA-family connections, but also to improve treatment access for detained JIAs.

An Ecodevelopmental Framework for Engaging Diverse Youth in Foster Care and Their Families Into Technology-Based Family Intervention Research Trials.

Family-based interventions delivered via telehealth are a promising mode for overcoming barriers to behavioral health treatment among youth in foster care and their families. There is a dearth of research, however, regarding effectiveness of these interventions for youth in foster care, who commonly exhibit complex behavioral health treatment needs. Clinical research in this area directly relates to equity in service access and quality for these youth and families, with numerous barriers and enabling factors to consider in order to improve engagement in clinical trials and bolster the evidence base.

Researchers' Perspectives on Digital Mental Health Intervention Co-Design With Marginalized Community Stakeholder Youth and Families.

Co-design of digital mental health technology with youth and families is a relatively new but growing approach to intervention development. In this perspective article, researchers used collaborative reflexivity through duoethnography methodology to reflect and report on experiences and lessons learned conducting co-designed projects with marginalized youth and families. Researchers engaged in written reflective dialogue regarding projects designed to co-develop technology-based apps and computer programs to support mental health of youth and their families.

Peer, substance use, and race-related factors associated with recidivism among first-time justice-involved youth.

Objectives: Peer deviancy and substance-related consequences are dynamic criminogenic needs associated with increased risk of recidivism for justice-involved youth. Most prior research in this area, however, is based on samples of primarily male youth charged with delinquent offenses. Because identification of dynamic criminogenic needs is essential to delinquency risk reduction efforts, the purpose of this study was to examine the role of peer deviancy and substance-related consequences in a sample of youth at first contact with the juvenile justice system, with relatively equal representation of males and females and youth charged with delinquent and status offenses.

Agreement between Youth Self-Report and Biospecimen-Confirmed Substance Use: A Systematic Review.

ContextBiospecimen analysis may enhance confidence in the accuracy of self-reported substance use among adolescents and transitional age youth (TAY). Associations between biospecimen types and self-reported use, however, are poorly characterized in the existing literature. We performed a systematic review of associations between biospecimen-confirmed and self-reported substance use.

Home-Based Telemental Health: A Proposed Privacy and Safety Protocol and Tool.

To describe the development of a protocol and practical tool for the safe delivery of telemental health (TMH) services to the home. The COVID-19 pandemic forced providers to rapidly transition their outpatient practices to home-based TMH (HB-TMH) without existing protocols or tools to guide them. This experience underscored the need for a standardized privacy and safety tool as HB-TMH is expected to continue as a resource during future crises as well as to become a component of the routine mental health care landscape.

The Ethical Implications of Using Social Media to Engage and Retain Justice-Involved Youth in Behavioral Health Research.

Given its popularity among youth ages 13-17, social media is a promising avenue for engaging and retaining historically hard-to-reach youth in longitudinal research. Social media use in longitudinal research involving youth, however, has preceded development of best practices for ethical use. This article describes the ethical challenges and considerations of using social media to engage and retain youth within the context of a randomized controlled trial of a group-based adolescent substance use intervention.

VOICES: An efficacious trauma-informed, gender-responsive cannabis use intervention for justice and school-referred girls with lifetime substance use history.

Background: Girls have unique developmental pathways to substance use and justice system involvement, warranting gender-responsive intervention. We tested the efficacy of VOICES (a 12-session, weekly trauma-informed, gender-responsive substance use intervention) in reducing substance use and HIV/STI risk behaviors among justice- and school-referred girls.

Methods: Participants were 113 girls (M = 15.

The prospective impact of adverse childhood experiences on justice-involved youth's psychiatric symptoms and substance use.

Objective: Justice-involved youth report high rates of adverse childhood experiences (ACEs; abuse, neglect, household dysfunction) and are at high risk for elevated behavioral health needs (i.e., substance use, psychiatric symptoms).