Racial and Ethnic Differences Among Active-Duty Service Members in Use of Mental Health Care and Perceived Mental Health Stigma: Results From the 2018 Health Related Behaviors Survey.

Introduction: The prevalence of mental health disorders is rising among US service members; however, research is limited on their use of mental health care. The objective of our study was to determine whether racial and ethnic disparities exist in the use of mental health care and perceived mental health stigma among active-duty service members.

Methods: We obtained data from a sample of 17,166 active-duty service members who participated in the 2018 Department of Defense Health Related Behavior Survey (HRBS).

Exploring the Impact of Education Strategies on Individuals' Attitude Towards Telemental Health Service: Findings from a Survey Experiment Study.

While COVID-19 has caused significant mental health consequences, telemental health services have the potential to mitigate this problem. But due to the sensitive nature of mental health issues, such services are seriously underutilized. Based on an integrated variance-process theoretical framework, this study examines the impact of applying different education strategies on individuals' attitude toward telemental health and subsequently their intention to adopt telemental health.

Natural disasters and mental health.

Natural disasters are large-scale adverse events resulting from natural processes of the earth, often associated with death, trauma, and destruction of property. They threaten harm or death to a large group of people; cause disruption of services and social networks and a communal loss of resources; and involve identifiable mental and physical health outcomes, among those affected. While majority of individuals who experience a traumatic event due to natural disasters do not develop psychopathology, natural disasters can threaten our psychological well-being in many ways and they can result in both short and long-term psychological distress and thus create a significant burden of mental health conditions on individuals and the community affected by them.

Study of Impact of Telehealth Use on Clinic "No Show" Rates at an Academic Practice.

Objective: To examine the clinic no-show rate across different modalities of care delivery (Face to Face, Telephone visits and Audio-Video visits).

Methods: Clinic no show data for adult patients was extracted from the electronic health records used by the psychiatry clinic for 10 months before pandemic and 10 months during pandemic. No show rate was analyzed by visits type (new vs return) and across different modalities (face-to-face vs Telephone vs Audio-Video) before and during COVID pandemic.

COVID-19 and its impact on the brain and Mind- A conceptual model and supporting evidence.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel coronavirus that is causing the ongoing coronavirus disease 2019 (COVID-19) pandemic, was first reported in late 2019. Since then, an unprecedented amount of new knowledge has emerged about this virus and its treatment. Although the reported symptoms of COVID-19 are primarily respiratory with acute respiratory distress syndrome, SARS-CoV-2 has also been shown to affect other organs, including brain, and there are growing reports of neuropsychiatric symptoms due to COVID-19.

Investigating the Impact of Covid-19 on Telepsychiatry Use Across Sex and Race: A Study of North Carolina Emergency Departments.

The COVID-19 pandemic and the intervention measures have increased mental health problems among Americans. Telepsychiatry provides a safe and efficient way to serve mental health patients in emergency departments (EDs). The objective of this study is to evaluate the impact of COVID-19 on telepsychiatry consultations in North Carolina (NC) and analyze the differences across sex and race.

The Impact of NC Statewide Telepsychiatry Program (NC-STeP) on Cost Savings by Reducing Unnecessary Psychiatric Hospitalizations During a 6½ Year Period.

Objective: To study the impact of the North Carolina Statewide Telepsychiatry Program in reducing unnecessary psychiatric hospitalizations and cost savings during a 6½ year period.

Methods: Patient encounter data was extracted from the NC-STeP database that captured records of 19,383 patients who received services over a 6½ -years' period. We analyzed the data to calculate the total number of patient encounters, the number of encounters with an IVC, and the number of encounters with an IVC that was overturned.

Disparities in Health Care and the Digital Divide.

Purpose Of Review: Disparities in health outcomes are a well documented and worrisome part of our health care system. These disparities persist in spite of, and are occasionally exacerbated by, new technologies that are intended to improve health care. This results in a "digital divide" in which populations that have poorer health outcomes continue to have poorer health outcomes despite technological improvements.

The Impact of the North Carolina Statewide Telepsychiatry Program (NC-STeP) on Patients' Dispositions From Emergency Departments.

Objective: The number of patients seeking treatment in emergency departments (EDs) for mental health reasons is rising, and these patients are often kept in the ED until they can be treated or discharged, leading to overcrowding. Telepsychiatry may alleviate overcrowding by increasing the rate of discharges home.

Methods: ED discharge records for 86,931 patients with psychiatric symptoms were examined to compare patient disposition and length of stay (LOS) between times when the North Carolina Statewide Telepsychiatry Program (NC-STeP) program was available or unavailable.

Past Epidemics, Natural Disasters, COVID19, and Mental Health: Learning from History as we Deal with the Present and Prepare for the Future.

As cases of the coronavirus disease (COVID-19) continue to rise, psychological endurance is a challenge many people will face. For mental health, heightened stress responses to the pandemic, is likely to manifest in three ways: 1) development of a new episode of a disorder in those with a predisposition to a major psychiatric disorder or an acute exacerbation in those who already have such a disorder, 2) development of a trauma or stressor related disorder, such as acute stress disorder, Post Traumatic Stress Disorder (PTSD), or adjustment disorders, and 3) development of a symptomatic stress response that does not meet the diagnostic criteria of a psychiatric disorder. The authors reviewed existing literature on past epidemics, natural disasters, and COVID-19 with a focus on psychiatry and mental health.

Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation.

Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety disorders. As an adjunctive treatment, exercise seems most helpful for treatment-resistant depression, unipolar depression, and posttraumatic stress disorder.

Successfully Navigating Multiple Electronic Health Records When Using Telepsychiatry: The NC-STeP Experience.

Telepsychiatry is a viable option for providing psychiatric care to those who are currently underserved or who lack access to services, but barriers to its widespread utilization remain. Use of different electronic health record systems (EHRs) by various health care systems is one such barrier. Utilization of different EHRs makes it difficult for providers to review patient data and to document clinical encounters.

Tower of Babel Problem in Telehealth: Addressing the Health Information Exchange Needs of the North Carolina Statewide Telepsychiatry Program (NC-STeP).

Telepsychiatry is a viable option for providing psychiatric care to those who are currently underserved or who lack access to services. While the current technology is adequate for most uses, and continues to advance, there remain barriers to its widespread utilization. One such barrier when working with different healthcare systems is that they utilize different electronic medical record systems (EMRs).

Psychiatric Management, Administration, and Leadership: a Continuum or Distinct Concepts?

To clarify the relationship between the concepts of management, administration, and leadership in psychiatry. The authors provide a review of the conceptual evolution of administrative psychiatry and develop operational definitions of these three domains. Based upon their experiences, they discuss relevant core competencies and personal attributes.

Bright Light Therapy as Augmentation of Pharmacotherapy for Treatment of Depression: A Systematic Review and Meta-Analysis.

Background: Bright light therapy has demonstrated efficacy and is an accepted treatment for seasonal depression. It has been suggested that bright light therapy may have efficacy in nonseasonal depressions. Also, there is evidence that bright light therapy may improve responsiveness to antidepressant pharmacotherapy.

Training Residents in the Use of Telepsychiatry: Review of the Literature and a Proposed Elective.

Many regions in the United States are deficient in mental health services, especially those in rural areas. As a result of these deficiencies, many patients in need of psychiatric services are often left untreated. Although it is clear that telepsychiatry has great potential in improving patient access to mental health care in areas where psychiatric services are deficient, the lack of familiarity with the technology and inadequate training are current barriers to expanding the use of telepsychiatry.

Training Psychiatry Residents in Psychotherapy: The Role of Manualized Treatments.

Evidence-based treatment and manualized psychotherapy have a recent but rich history. As interest and research have progressed, defining the role of treatment manuals in resident training and clinical practice has become more important. Although there is not a universal definition of treatment manual, most clinicians and researchers agree that treatment manuals are an essential piece of evidence-based therapy, and that despite several limitations, they offer advantages in training residents in psychotherapy.

The Changing World of Psychiatric Education: Challenges and Opportunities.

This special section of the journal focuses on the expanding horizons, challenges, and opportunities for the psychiatric educators. In the six papers that comprise this special section, the authors have covered a broad range of topics in both undergraduate medical education and graduate medical education including topics such as accreditation, technology, how providers can locate education resources, how trainees are taught about professionalism in the digital age, telepsychiatry, manualized psychotherapy treatments, and cultural competence. We hope that psychiatric educators, and others interested in this field, will find these papers helpful.

Use of Telepsychiatry in Psychodynamic Psychiatry.

This article reviews the organization, infrastructure basics, applications, effectiveness, outreach, and implementation barriers related to telepsychiatry. We highlight the tremendous potential and promise that this technology holds and also discuss the importance that telepsychiatry may play in the field of psychodynamic psychiatry. Given the growing effectiveness evidence base for therapy delivered over the Internet, telepsychiatry holds a large unexplored territory to help psychodynamically minded patients connect with psychodynamically oriented psychiatrists.

Career Paths and Trends: How Does One Become a Leader in Psychiatric Administration? Implications for Residency Training.

In the changing landscape of healthcare the number of psychiatrists entering leadership positions has declined steadily over the years. One factor contributing to this appears to be lack of leadership training during residency training. International competency frameworks have addressed this and some programs, both national and international, have designed innovative curricula to provide didactic and experiential learning in administration during and after residency.

Role of Leadership in Narrowing the Gap between Science and Practice: Improving Treatment Outcomes at the Systems Level.

It's been well documented that health care does not reliably transfer what we know from science into clinical practice. As a result, Americans do not always receive the care suggested by the scientific evidence. Despite the best intentions of a dedicated and skilled healthcare workforce, this can often lead to poor clinical outcomes.

Ethical Challenges in Psychiatric Administration and Leadership.

As with all professional ethical principles, those in psychiatry have to evolve over time and societal changes. The current ethical challenges for psychiatric administration and leadership, especially regarding for-profit managed care, need updated solutions. One solution resides in the development by the American Association of Psychiatric Administrators (AAPA) of the first set of ethical principles designed specifically for psychiatric administrators.

An update on mindfulness meditation as a self-help treatment for anxiety and depression.

In recent years, complementary and alternative medicine (CAM) treatments have increased in popularity. This is especially true for treatments that are related to exercise and mindfulness-based interventions (MBIs) in the treatment of both mental and physical illness. MBIs, such as Mindfulness-based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR), which are derived from ancient Buddhist and Yoga philosophies, have become popular treatments in contemporary psychotherapy.