Publications by authors named "Margaret R Emerson"

There are over 10,000 mental health and wellness apps on the market. Apps offer the opportunity to increase access to mental health care. However, with many apps to choose from and an app landscape that is largely unregulated, it can be difficult to incorporate this technology into clinical practice.

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Article Synopsis
  • Integrated and collaborative care models are effective for managing psychiatric conditions in primary care, but implementations face challenges like financial investment and changes in care delivery approach.* -
  • An APRN-led integrated behavioral health program showed significant improvements in depression and anxiety scores among patients over nine months, highlighting its impact on mental health outcomes.* -
  • Primary care physicians reported increased satisfaction with collaboration and access to behavioral health services, but challenges remain in enhancing program leadership and adapting to virtual psychiatric support.*
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Despite effective treatment options, people who experience mental health conditions often do not receive needed care. E-mental health, for instance the use of mobile apps, is emerging as a way to increase access to and extend care. However, little formal training is available to increase the digital literacy level among behavioral healthcare providers (BHPs), seeking to employ such technology.

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Background: Recent surveys have revealed many adults have basic or below basic health literacy, which is linked to medical errors, increased illness, and compromised public health. Health literacy as a concept is multi-faceted extending beyond the individual to include social structures and the context in which health information is being accessed. Delivering health information via mobile devices (mHealth) expands the amount of information available while presenting challenges to ensuring these materials are suitable for a variety of literacy needs.

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This column describes the initial steps to develop a bidirectional access initiative between outpatient psychiatric and primary care clinics within an academic medical center. The authors analyzed electronic health record data (N=2,837 patients), interviewed psychiatric and primary care providers, assembled a work group, and identified five patient tracks (treatment optimization, psychiatric continuity, specialty clinic, psychotherapy, and community referral). Over 16 months, the number of patients scheduled for new psychiatric diagnostic evaluations with medical services increased from 62.

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The app evaluation framework of the American Psychiatric Association (APA) has emerged as an adaptable tool for those seeking to navigate the ever-growing space of mental health apps. The authors describe a meeting convened in December 2019 to refine the APA framework. The expert panel comprised 16 individuals across health care fields, with representation from psychiatry, psychology, social work, nursing, clinical informatics, peer support specialists, and individuals with lived mental health experience.

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Background: Integration of telehealth preparation for nurse practitioner (NP) students varies across programs.

Problem: Nurse practitioner students had gaps in the preparation for using telehealth technology to deliver care and manage specific disorders.

Approach: The purpose of this article is to describe the development and implementation of a telehealth simulation training experience for NP students to prepare them for practice in rural settings.

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As use and availability of mobile health apps have increased, so too has the need for a thorough, accessible framework for app evaluation. The American Psychiatric Association's app evaluation model has emerged as a way to critically assess an app by considering accessibility, privacy and security, clinical foundation, engagement, and interoperability; however, there is no centralized database where users can view how various health apps perform when assessed via the APA model. In this perspective, we propose and outline our effort to translate the APA's model for the evaluation of health apps into a set of objective metrics that can be published online, making the framework actionable and accessible to a broad audience.

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A quality improvement project was delivered by a federally qualified health center to improve patient access to psychiatric services. The effort was supported by training and technical assistance provided by the American Psychiatric Association Support and Alignment Network. Over a 3-year period, the collaborative care model (CoCM) and other integrated consultative strategies were implemented.

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Introduction: Infant-caregiver attachment is crucial for an infant's immediate and long-term social-emotional development and health. Despite advocacy by the National Institute of Children's Health Quality for infant social-emotional development screening, there is a lack of identified tools for use in primary care. Therefore, we conducted a systematic review to identify caretaker-infant attachment self-report screening tools that would be feasible, reliable, and valid for use in primary care.

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Access to mental health care is a considerable problem for individuals suffering from a mental illness. Of the 44.7 million adults, aged 18 or older, experiencing a mental illness in 2016 only 43.

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Background: Postpartum depression (PPD) is a debilitating emotional experience that can affect mothers and their infants. Screening for PPD is encouraged during pediatric well-child visits (WCVs); however, the frequency, referral process, and documentation relative to screening in clinical practice require further study.

Objectives: There were three purposes to this study: 1) determine prevalence of mothers who scored in the at-risk range using the Edinburgh Postnatal Depression Scale (EPDS) at each of the 2-, 4-, and 6-month WCVs in a pediatric outpatient practice; 2) examine feasibility factors relative to extending the current standard of care for PPD screening; and 3) examine visit documentation for at-risk mothers.

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