Schools' mental health responses after Hurricanes Katrina and Rita.

Objective: After the displacement of students following Hurricanes Katrina and Rita, schools in several states enrolled many students with potential mental health needs. This study sought to understand how schools perceived the mental health needs of these students and what mental health programs they implemented.

Methods: Mental health personnel at 19 public schools or school systems and 11 private or parochial schools in Louisiana, Alabama, Texas, and Mississippi were interviewed at two time points (spring and fall-winter of 2006).

Outpatient mental health utilization among commercially insured individuals: in- and out-of-network care.

Objective: This study examined the rates and correlates of out-of-network outpatient mental health specialty care.

Research Design: Using administrative data from a large insurer, we examine the frequency of out-of-network utilization, analyze demographic and clinical characteristics of individuals receiving out-of-network care, and examine the types of service provided out-of-network.

Results: Out-of-network outpatient mental health care was received by 15.

Terrorism's psychologic effects and their implications for primary care policy, research, and education.

This paper examines primary care physicians' (PCP) roles in helping the nation prepare for, respond to, and recover from the psychologic consequences of chemical, biologic, radiologic, or nuclear (CBRN) terrorism. First, we discuss the psychologic consequences of a CBRN attack and PCPs' roles in responding to these consequences. Second, we analyze these roles in light of the known barriers to delivering high-quality, primary care-based, mental health care.

In their own words: lessons learned from those exposed to anthrax.

Objectives: We evaluated perceptions of workers at the US Postal Service Brentwood Processing and Distribution Center and US Senate employees regarding public health responses to the anthrax mailings of October 2001. We generated recommendations for improving responses to bioterrorism on the basis of the perceptions we recorded.

Methods: Transcripts from focus groups conducted with Brentwood and US Senate employees were examined, and qualitative analysis identified common domains.

A bitter pill to swallow: nonadherence with prophylactic antibiotics during the anthrax attacks and the role of private physicians.

To generate recommendations for improving adherence to public health advice during public health crises, we conducted semi-structured interviews with employees at the Brentwood Road Postal Facility and on Capitol Hill to identify key themes associated with decisions to adhere to recommended antibiotic prophylaxis during the 2001 anthrax attacks. Factors used in deciding to adhere to recommended prophylactic antibiotics and concerns about the official response were similar in Brentwood and Capitol Hill employees, and in adherent and nonadherent participants. All participants used multiple sources of information and support as they weighed the risk from anthrax against the advantages and disadvantages of antibiotics.

Emotional and behavioral consequences of bioterrorism: planning a public health response.

Millions of dollars have been spent improving the public health system's bioterrorism response capabilities. Yet relatively little attention has been paid to precisely how the public will respond to bioterrorism and how emotional and behavioral responses might complicate an otherwise successful response. This article synthesizes the available evidence about the likely emotional and behavioral consequences of bioterrorism to suggest what decision makers can do now to improve that response.

Using the chronic care model to improve treatment of alcohol use disorders in primary care settings.

Objective: Alcohol use disorders (AUDs) are serious and often chronic medical conditions that present a significant public health concern. The Chronic Care Model (CCM), originally designed to improve care for patients with chronic conditions, is also applicable to a broad range of individuals with AUDs. In this article, we describe the CCM and discuss ways it can be adapted in primary care settings to improve care for AUDs.

Comparison of adult and geriatric psychiatric practice patterns: findings from the American Psychiatric Association's Practice Research Network.

Objective: The authors explored diagnostic and treatment patterns for patients under and over age 65 seen by a nationally representative sample of psychiatrists participating in the American Psychiatric Association's Practice Research Network.

Methods: Detailed patient information, including demographic and financial characteristics, diagnoses, service utilization, and treatment, was collected by 383 psychiatrists on 1,026 patients to assess the impact of patient age on pharmacotherapy and psychotherapy service use as well as treatment outcomes.

Results: Approximately 15% of the patient sample was over age 65.