Parenting With and Beyond Cancer: A Photo-Elicitation Study.

The purpose of this study was to understand the occupational performance of parents with cancer and to understand if photo-elicitation would provide new insights into these experiences. In a semi-structured photo-elicitation interview, 36 participants living with and beyond cancer who had children under 18 years old shared and discussed photographs related to their parenting experiences. Transcribed interviews were analyzed using thematic analysis.

Demystifying treatment disposition patterns for psychiatrically high-risk youth referred for intensive outpatient psychiatric services: The role of demographics and telehealth.

Intensive outpatient (IOP) psychiatric treatment is increasingly deployed to meet the needs of psychiatrically high-risk youth; however, documentation of treatment disposition for in-person and/or telehealth modalities following treatment referral is largely unknown. The current study examined psychiatrically high-risk youth baseline treatment disposition patterns and explored variations according to treatment modality (telehealth vs. in-person).

A Roadmap for Measurement-based Care Implementation in Intensive Outpatient Treatment Settings for Children and Adolescents.

Measurement-based care (MBC), the routine collection and use of patient-reported data to monitor progress and tailor treatment, has been predominantly studied in adult treatment settings. Although growing evidence supports MBC effectiveness with youth in outpatient settings and university training clinics, there is a substantial dearth of findings about successful implementation of MBC in "real world" youth treatment settings, particularly intensive settings offering group-based treatment. The current manuscript provides a foundational model of MBC implementation for "real world" intensive outpatient programs (IOP) for youth using the organizational framework of the Consolidated Framework for Implementation Research (CFIR).

Developing and Aligning a Safety Event Taxonomy for Inpatient Psychiatry.

Objective: The aim of this project was to develop and align an inpatient psychiatric safety event taxonomy that would blend well-established safety events with psychiatry-specific concerns.

Methods: A hybrid inductive-deductive thematic analysis was used to generate novel descriptive safety event categories for inpatient psychiatry and align these categories with an established taxonomic framework. In the inductive phase, an initial taxonomy was developed by describing the semantic subject and context of reported safety concerns.

Characteristics of Assaultive Patients Whom Inpatient Psychiatric Staff Report to Law Enforcement.

Objective: The authors sought to identify factors that affect hospital staff's decision to pursue criminal charges against patients who assault staff on inpatient psychiatric units.

Methods: Data on assaults occurring on inpatient psychiatric units in one hospital system were collected over 32 months, from November 1, 2016, to July 1, 2019. The events were grouped by whether staff pursued criminal charges after the incident.

Showing Up Is Half the Battle: The Impact of Telehealth on Psychiatric Appointment Attendance for Hospital-Based Intensive Outpatient Services During COVID-19.

The COVID-19 pandemic accelerated telehealth to deliver psychiatric services. Continuation of psychiatric services for individuals with high clinical acuity was critical. This study examined attendance to rapidly deployed telehealth services for psychiatrically high-risk individuals receiving intensive outpatient program (IOP), primarily group-based psychotherapy services for adults and adolescents by race/ethnicity, insurance, and clinical treatment program within a large hospital-based outpatient psychiatric setting.

Validating Psychometric Properties of a Revised Patient Version of the Combined Assessment of Psychiatric Environments (CAPE).

Background: Measuring patient experience is an essential challenge in the inpatient behavioral health population.

Aim: This initiative analyzed the psychometric properties of a revised version of the patient Combined Assessment of Psychiatric Environments (p-CAPE-R) survey.

Methods: The p-CAPE was revised to encompass the interdisciplinary treatment team and implemented on five inpatient psychiatric units at an academic medical center.

Management of Complex Co-occurring Psychiatric Disorders and High-Risk Behaviors in Adolescence.

Adolescents often present to treatment with multiple psychiatric diagnoses. The presence of certain co-occurring mental health conditions can significantly affect an individual's treatment course. Adolescence is also a time of developmentally appropriate risk taking and experimenting with novel behaviors.

Emergency conversion to telehealth in hospital-based psychiatric outpatient services: Strategy and early observations.

Balancing public health physical distancing guidelines and the need to provide critical mental health services for risky and psychiatrically complex patient populations without disruption, many systems swiftly pivoted to telehealth to provide care during COVID-19. Leveraging technology, Yale New Haven Psychiatric Hospital's ambulatory services designed and deployed virtual intensive outpatient (IOP) and outpatient (OP) group-based services rapidly. Strategies for rapid deployment of group-based services, including action steps transitioning to telehealth, clinical protocols, and remote workforce training, early observations and challenges to implementation are described as helpful tools for clinical settings with similar needs to prevent infectious spread while addressing the mental health needs of patients.

Rapid design and deployment of intensive outpatient, group-based psychiatric care using telehealth during coronavirus disease 2019 (COVID-19).

COVID-19 has demanded unprecedented actions in the delivery of outpatient psychiatric services, including the rapid shift of services from in-person to telehealth in response to public health physical distancing guidelines. One such shift was to convert group-level intensive outpatient psychiatric (IOP) interventions to telehealth. Historically, telehealth in psychiatric care has been studied in provider-patient interactions, but has not been as well studied for group telehealth service delivery.

Challenges and Priorities in Responding to COVID-19 in Inpatient Psychiatry.

This Open Forum focuses on specific challenges, contingency planning considerations, and downstream impacts of COVID-19 on inpatient psychiatric care. COVID-19 is a novel coronavirus that has been declared a pandemic. Challenges for inpatient psychiatry include risky close contact among staff and patients, space constraints, and structural barriers in care delivery.

A Qualitative Study of Implementation Challenges of Mental Health Clubhouse Rehabilitation Services in China's Hunan Province.

Objective: Psychosocial rehabilitation has been established as a critical component of client-centered recovery-oriented services for people with serious mental illness. Despite its importance, the implementation of mental health rehabilitation services in low- or middle-income countries has not been well studied. In this study, the authors document the regional challenges of planning and implementing mental health rehabilitation services in clubhouses in Hunan Province in the People's Republic of China.

Using instrumentation in psychiatric nursing to assess documentation of the nursing process for emergent non-psychiatric patient events.

Ongoing education of experienced psychiatric nurses is imperative given the historically complex health presentations of psychiatric patients. Psychiatric patients tend to have medical co-morbidities and often do not have the financial resources for preventative health care. The hospitalization for acute psychiatric stabilization, is an opportunity for psychiatric nurses to teach and advocate for patients' physiological and psychological health.

Ketamine: A Review for Clinicians.

A growing series of clinical trials and case series now suggest that ketamine-originally used as an anesthetic agent-potentially offers an exciting new treatment option for severe depression. Increasing numbers of studies show that ketamine can provide prompt relief for many depressed patients, including those with severe treatment-refractory depression. Although the effects of a single treatment are commonly short-lived, multiple infusion protocols may offer sustained relief.

Making it fit.

A new NP on a psych unit finds her professional identity must be redefined.

Studying hallucinations within the NIMH RDoC framework.

We explore how hallucinations might be studied within the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) framework, which asks investigators to step back from diagnoses based on symptoms and focus on basic dimensions of functioning. We start with a description of the objectives of the RDoC project and its domains and constructs. Because the RDoC initiative asks investigators to study phenomena across the wellness spectrum and different diagnoses, we address whether hallucinations experienced in nonclinical populations are the same as those experienced by people with psychotic diagnoses, and whether hallucinations studied in one clinical group can inform our understanding of the same phenomenon in another.

Qualitative study of high-cost patients in an urban primary care centre.

Objectives: We examined patient accounts of illness and care among primary care patients whose medical services costs were high in order to illuminate factors associated with high cost.

Methods: Thirty-three primary care patients with multiple chronic illnesses in an urban clinic serving a resource poor neighbourhood were selected from a range of high medical cost patients. Participants were interviewed with open-ended questions to investigate experiences of illnesses and care; their responses were examined for prominent themes using qualitative analysis methodology.

Elevated functional connectivity along a corticostriatal loop and the mechanism of auditory/verbal hallucinations in patients with schizophrenia.

Background: Higher levels of inter-region functional coordination can facilitate emergence of neural activity as conscious percepts. We consequently tested the hypothesis that auditory/verbal hallucinations (AVHs) arise from elevated functional coordination within a speech processing network.

Methods: Functional coordination was indexed with functional connectivity (FC) computed from functional magnetic resonance imaging data.

A systematic review of off-label uses of memantine for psychiatric disorders.

Recent data points to glutamatergic dysfunction in mood disorders, anxiety disorders, obsessive-compulsive disorder, and schizophrenia. Memantine, a drug approved by the FDA for the treatment of moderate to severe Alzheimer's disease that acts at the N-methyl-d-aspartate receptor, has been used off-label for various psychiatric disorders. Although promising, the available data for the use of memantine in these disorders is limited.

Psychiatric issues in multiple sclerosis.

MDD and anxiety disorders are highly prevalent among persons who have MS and have been associated with decreased adherence to MS treatment and poorer functional status and quality of life. Effective treatment is available for MDD, but this disorder continues to be underdetected and undertreated by MS providers. Treatment with pharmacotherapy is particularly challenging in this patient population, given the somatic symptom overlap between MS and depression and the increased burden of side effects.

Extracting spurious messages from noise and risk of schizophrenia-spectrum disorders in a prodromal population.

Atendency to extract spurious, message-like meaning from meaningless noise was assessed as a risk factor leading to schizophrenia-spectrum disorders by assessing word length of speech illusions elicited by multispeaker babble in 43 people with prodromal symptoms. These individuals were randomised to olanzapine v. placebo groups during year 1 followed by no pharmacological treatment for those with no disorder conversion during year 2.