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Creating residencies that produce psychiatrists who are skilled and interested in working in under resourced areas, especially in community and rural settings is challenging. State and private agency collaboration can be an effective approach to enhancing such training. These resources for education have the goals of improving access and services, addressing workforce shortages and improving physician retention. They can provide flexibility to implement innovations that enhance training and address community needs. This article describes the implementation of a psychiatry residency at the University of Texas Rio Grande Valley School of Medicine. Funding was obtained from state and private initiatives. This paper describes the implementation. Feedback was positive at all levels. This program illustrates some of the advantages of utilizing alternate funding in creating high quality residencies that are integral to the community, produce skilled collaborative physicians, provide necessary care that addresses specific community needs and potentially address workforce issues in underserved areas. [ABSTRACT FROM AUTHOR]

Transition-age youth (TAY, ages 14–26) diagnosed with serious mental health conditions are at high risk for vocational struggles. This paper examines the implementation and process evaluation of Individual Placement and Support (IPS) and Supported Employment enhanced to better meet developmental needs of TAY. Enhancements include the integration of a TAY development focus, engagement best-practices, Supported Education and Peer Support. Community mental health providers participated in a process evaluation to explore the feasibility of a larger scale implementation. Common organizational barriers were encountered across provider sites including: leadership support, agency structures and funding mechanisms; compounded by the complexity of bridging child and adult systems. Findings have implications for both child and adult community mental health providers as they adapt and integrate programming for TAY. [ABSTRACT FROM AUTHOR]

When faced with experiences of mental struggle, Americans often turn to faith leaders as their first recourse. Although studies have explored religious leaders' mental health literacy, few studies have investigated how religious leaders believe faith communities and mental health professionals should collaborate. The data gathered for this research is from in-depth and focus group interviews with faith leaders from Christian, Jewish, Buddhist, and Sikh communities in South Texas and the Mid-Atlantic region between 2017-2019 (n=67). This research analyzed faith leaders' response to the question "How can mental health professionals and faith communities better work together" by utilizing the flexible coding approach (Deterding and Waters 2018). Four distinct themes emerged from the faith leaders' responses: education, relationship building, external factors, and dismissal. By learning about how faith leaders believe they can better work together with mental health professionals we can help bridge the gap between religion and mental health further by fostering a much-needed dialogue between these two groups. [ABSTRACT FROM AUTHOR]

This study qualitatively explored the past treatment experiences of uninsured young adults who sought public emergency psychiatric care. Qualitative interviews were conducted with a racially diverse sample of 55 young adults (ages 18-25) using a semi-structured interview guide, and analyzed using a team-based open coding approach. Findings emerged in three broad areas-provider-related factors, treatment-related factors, and environmental factors. Young adults talked about the importance of providers respecting and listening to them, the perceived advantages and disadvantages of therapy and medication treatment, and aspects of the environment that resulted in positive and negative experiences, particularly in inpatient settings. Providers need to convey respect and caring that transcends job duties and provide tangible skills and supports. [ABSTRACT FROM AUTHOR]

This study examines results from three mental health screening measures in a cohort of adolescent public school students in seven public schools in Southeast Texas affiliated with the Dating it Safe study. We estimated the odds of receiving professional mental health treatment in the previous year given results from different mental health screening batteries: the CES-D 10 battery for depression screening, the Screen for Child Anxiety Related Disorders, and the Primary Care Posttraumatic Stress Disorder screen. Overall, students with higher scores on screening instruments for depression, posttraumatic stress disorder, and combinations of screening instruments were more likely to have sought past-year professional mental health treatment than non-symptomatic youth. However, the proportion of students screening positive and receiving professional treatment was low, ranging from 11 to 16 %. This study emphasizes the need for broader evaluation of population-based mental health screening among adolescents. [ABSTRACT FROM AUTHOR]

As veterans disproportionately experience higher rates of mental illness than civilians, conflicting results surround the impact of race/ethnicity on treatment utilization. This study utilized the CDC's Texas Behavioral Risk Factor Surveillance System data, a random-digit dialed telephone survey of non-institutionalized adults. A subset of Texas respondents ( n = 8563) were asked questions related to mental health treatment, stigma, help-seeking attitudes and emotional support. While no differences were found in health care utilization between non-Hispanic white veterans and non-veterans, there were distinct patterns among racial/ethnic minority veterans and non-veterans. Black and Latino non-veterans reported significantly lower health care utilization compared to non-Hispanic white non-veterans. Among veterans, there were no differences in reported utilization rates comparing non-Hispanic whites and Latinos and also non-Hispanic whites and Blacks. Our study adds to the literature by examining health care utilization among a diverse group of veterans by focusing on Veterans Administration (VA) and non-VA services to veterans. [ABSTRACT FROM AUTHOR]

This study assessed the psychosocial needs of Hurricane Katrina evacuees temporarily residing in Dallas, TX, after sheltering but prior to their permanent resettlement. Common trauma exposures were physical exposure to flood water, seeing corpses, witnessing death, and loss of family, friends, or home. Fewer than 10 % met symptom criteria for disaster-related posttraumatic stress disorder (PTSD). More than one-fourth met major depressive disorder (MDD) symptom criteria post-disaster but only 15 % had a new (incident) MDD episode after the disaster. Specific trauma exposures and some hurricane-related stressors contributed to risk for both Katrina-related PTSD symptom criteria and incident MDD, but other hurricane-related stressors were uniquely associated with incident MDD. Referral to mental health services was associated with meeting symptom criteria for PTSD and with incident MDD, but only about one-third of these individuals received a referral. Understanding the needs of disaster-exposed population requires assessing trauma exposures and identifying pre-disaster and post-disaster psychopathology. [ABSTRACT FROM AUTHOR]

While there are state and national estimates of serious psychological distress (SPD), these are not useful for targeting local mental health interventions or for addressing the needs of sub-populations at increased risk for SPD. This cross-sectional study uses data from the population-based 2010 Health of Houston Survey (n = 5,116) to examine (1) the prevalence of SPD and its determinants in Houston area and (2) predictors of the utilization of mental health services among people with SPD. The prevalence of SPD among the Houston area adult population was 7 %, more than twice the national average. Correlates of SPD included: being female, under 65, lacking emotional support, smoking, having poor health status and financial distress. The odds of utilizing health services by those with SPD were affected by financial distress, insurance, employment and perceived need for services, among other factors. Interventions should be tailored to mitigate risk factors for SPD and to improve access to mental health services in the SPD sub-population. [ABSTRACT FROM AUTHOR]

Peer specialists are people in recovery employed to share their experiences to promote the recovery of others affected by mental illness. Examining workplace integration indicators that predict the job satisfaction of peer specialists employed in a variety of behavioral health settings is critical to ensure the retention and effectiveness of this viable workforce. A survey of Texas Certified Peer Specialists (n = 86) examined workplace integration indicators. Results suggest that supervisor's understanding of the peer specialist job role has a significant impact on job satisfaction. Better workforce integration may be achieved through targeted efforts to educate supervisors about peer specialist job roles. [ABSTRACT FROM AUTHOR]

Mental health problems are disproportionately represented in the community corrections system with limited information on the epidemiology of mental health and correlated factors such as suicide among probationers. This study recruited 2,077 probationers who completed screeners for mental health and substance disorders and suicide risk. Results found 13 % of probationers were at high risk of suicide. Those who screened positive for a mental health condition were between 2 and 8 times more likely to screen positive for suicide risk. Allocation of additional resources to mental health in the criminal justice system and to effectively coordinate existing mental health services is needed. [ABSTRACT FROM AUTHOR]

We developed an intervention to improve compliance with guidelines for monitoring metabolic syndrome and compared compliance prior to intervention and three times post-intervention at three community mental health clinics in Texas. One test clinic received intervention and two other clinics served as controls. Fifty random charts were reviewed from each clinic for three specific, 1-2 weeks periods over the course of 18 months. There were significant improvements in the ordering of labs, the presence of lab results in the chart, and documentation of blood pressure, body mass index and waist circumference in the intervention clinic over time in comparison to the control clinics. Documented evidence of physician action with respect to out of range values remained low. Metabolic monitoring is a multi-step process. Removing barriers, creating specific procedures, and dedicating staff resources can improve compliance with monitoring. [ABSTRACT FROM AUTHOR]

Psychiatry residents at the University of Texas Southwestern Medical Center were surveyed to investigate their attitudes towards inmates, towards various aspects of correctional psychiatry and whether rotating at the local jail is associated with these attitudes. The overall opinion towards correctional psychiatry was fairly neutral though significantly more negative than towards inpatient psychiatry. While citing a high need for psychiatrists at correctional facilities, residents reported they are not likely to work there when they complete residency. No statistical differences were found between those residents who had rotated at the local jail and those who had not. Given the severe shortage of mental health providers in correctional facilities it is important to expose residents to this and understand ways to promote correctional psychiatry as a career. [ABSTRACT FROM AUTHOR]

This paper describes a novel approach to engaging psychiatric patients in care after discharge from inpatient or ER treatment. The Access Group model provides rapid, flexible, high-volume intake for up to 20 patient referrals per day. Patients are scheduled for intake by referring hospital clinicians using an online scheduling software and can be seen within 1-3 days of hospital discharge. Access allows flexibility, easy rescheduling, and limited wait time. At intake, patients and family members participate in a structured group intake procedure from which they are scheduled for follow-up psychiatry, therapy, and social work appointments. Same-day appointments are available for urgent needs. Initial evidence suggests that the Access Group model is effective at providing rapid access to and engagement in care, and is acceptable to patients. Generalizability and funding approaches for the model are discussed.