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Introduction: Implementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high‐impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, "grey areas," or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research. Discussion: A group of IS experts affiliated with NIMH‐funded ARCs convened to identify common and challenging grey areas. The group generated a preliminary list of 19 grey areas in HIV/MH‐related IS. From the list, the authors developed a survey which was distributed to all ARCs to prioritize grey areas to address in this paper. ARC members across the United States (N = 60) identified priority grey areas requiring clarification. This commentary discusses topics with 40% or more endorsement. The top grey areas that ARC members identified were: (1) Differentiating implementation strategies from interventions; (2) Determining when an intervention has sufficient evidence for adaptation; (3) Integrating recipient perspectives into HIV/MH implementation research; (4) Evaluating whether an implementation strategy is evidence‐based; (5) Identifying rigorous approaches for evaluating the impact of implementation strategies in the absence of a control group or randomization; and (6) Addressing innovation in HIV/MH IS grants. The commentary addresses each grey area by drawing from the existing literature (when available), providing expert guidance on addressing each in the context of HIV/MH research, and providing domestic and global HIV and HIV/MH case examples that address these grey areas. Conclusions: HIV/MH IS is key to achieving domestic and international goals for ending HIV transmission and mitigating its impact. Guidance offered in this paper can help to overcome challenges to rigorous and high‐impact HIV/MH implementation research. [ABSTRACT FROM AUTHOR]

In the United States, nearly 13 million adults are incarcerated in prisons and jails annually with significant negative public health consequences. Incarcerated individuals have disproportionate rates of behavioral health disorders (BHDs); untreated BHD symptoms bring people into incarceration settings and are associated with re‐arrest after release. Although lack of treatment motivation is often used to explain these outcomes, individuals may have limited knowledge about BHDs and their symptoms, when and why treatment is warranted, and how to access treatment during custody and in the community. We propose a new construct called behavioral health literacy to facilitate linkage between individuals with BHDs and appropriate treatment options. In this paper, we define behavioral health literacy, review extant literature, describe why behavioral health literacy is needed, and explore how behavioral health literacy interventions may be developed to expand knowledge and guide policy and practice, ultimately improving both behavioral health outcomes and reduce criminal legal system involvement. [ABSTRACT FROM AUTHOR]

The current paper examined the temporal linkage of internalizing symptoms among parent‐adolescent dyads during the beginning of the COVID‐19 pandemic, and whether COVID‐19‐related concerns were associated with parent‐adolescent linkage of symptoms. Using a 5‐week survey‐based study, parent‐adolescent dyads filled out weekly surveys measuring COVID‐19 concerns and internalizing symptoms. Parent and adolescent depressive symptoms did not change over time; however, adolescents experienced decreases in anxiety. Parent‐adolescent dyads exhibited linkage in depressive symptoms but not anxiety symptoms. However, linkage in anxiety symptoms varied by parent's COVID‐related stress. Study findings provide insight into how COVID‐19 disruptions impacted family well‐being during adolescence. [ABSTRACT FROM AUTHOR]

As the necessity of meeting state regulations has continued to mount in the public mental health sector, and insurance companies limit the number of therapy sessions covered in a year, the emphasis on evidence‐based treatments, most often in the guise of some form of Cognitive Behavioral Therapy, continues unabated. Meanwhile, knowledge about and the ability to practice psychodynamically have all but vanished from most community mental health clinics in the United States. With shrinking funds, increasing demand for services, and increasing costs, therapists and their supervisors in these settings are expected to meet productivity and documentation requirements imposed by state and federal regulations and by the clinics themselves. These demands leave little time for therapists to discuss actual cases with their supervisors, to reflect on their experiences with patients and to wonder about the patient's experience with them, skills that are in themselves among the essential tools of psychodynamic clinical training and are crucial to patient care. This paper summarizes the qualitative data collected at the conclusion of a pilot study in which a dozen staff therapists in a community mental health center met weekly individually with psychodynamic supervisor/consultant volunteers to discuss their ongoing cases. [ABSTRACT FROM AUTHOR]

Reflective supervision/consultation (RS/C) is a relationship for learning that embraces reflection and reflective practice strategies. It is considered best practice within the infant and early childhood mental health (IECMH) field. Based on research with supervisors, essential components of RS/C have been operationalized and used to develop evaluative tools. Little is known, however, about the essential components that supervisees find most useful. This paper, part I of a two‐part series, describes the essential components that supervisees identify as fundamental and ways they believe their work is supported by participation in RS/C. Fifty IECMH professionals located in the United States who received RS/C participated in focus groups or individual interviews. Data were analyzed using a Grounded Theory approach. Essential components of RS/C from the supervisee perspective included supervisee feelings of safety, the development of trust, holding a non‐judgmental stance, being available and present, and consistency and predictability. Additionally, supervisees identified outcomes of RS/C that included components of professional wellness, personal growth, and infant and family engagement. This study adds the supervisee's voice to the identification and operationalization of essential RS/C components and elucidates outcomes of RS/C that supervisees view as connected to their professional role. [ABSTRACT FROM AUTHOR]

BACKGROUND Mental health services in the United States public schools are an important component of the academic success of a student. Not all schools, however, have the necessary personnel and funding to offer such services. METHODS: In this paper, we provide an analysis of data collected from schools in 3 geographic locations. Comparisons were made of the availability of personnel to assess and treat mental health disorders in students enrolled in city, urban, and suburban schools, with over 10,000 schools represented. The data were part of the 2015 to 2016 School Survey on Crime and Safety. RESULTS: Accessibility of mental health practitioners and reasons that limited efforts of a school to provide the services were assessed. Statistically significant differences were identified by school location, demonstrating that those in rural communities were most challenged providing diagnostic assessment and treatment for students by school mental health professionals, for several reasons. CONCLUSIONS: Increased state and county funding to support mental health practitioners in public high schools is one suggestion to address mental health disorders in students. Other strategies are offered for timely and appropriate diagnoses and treatment for mental health disorders that may impact the quality of life of a student for a lifetime. [ABSTRACT FROM AUTHOR]

The notion of 'wise mother and good wife (WMGW)' (Hyonmo Yangcho) is the traditional idealized image of Korean womanhood as one who serves her country and others through her roles as a mother and wife. This ideology may continue to have some significance in the lives of many first‐generation Korean immigrant women, but its potential role in the adjustment challenges these women may face while acculturating to the immigrant context in the United States has received little attention. In this paper, we briefly review the historical background of the WMGW ideology and discussed the significance of focusing research attention on the role of this notion in contemporary first‐generation Korean immigrant women in the United States. We focus on the intersecting influences of gender, ethnicity, and immigrants' generation status, which may further marginalize some first‐generation Korean immigrant mothers. We then outline possible unique challenges faced by some of these mothers due to the WMGW gender ideology, highlighting potential immigration‐related difficulties including changes in their social support networks, parenting burden, mental health, and language issues. Finally, we provide suggestions for researchers and practitioners working with U.S. Korean immigrant women. [ABSTRACT FROM AUTHOR]

Background and aims: The focus of this paper is on the improvement of substance use disorder (SUD) screening and measurement. Using a multi‐dimensional item response theory model, the bifactor model, we provide a psychometric harmonization between SUD, depression, anxiety, trauma, social isolation, functional impairment and risk‐taking behavior symptom domains, providing a more balanced view of SUD. The aims are to (1) develop the item‐bank, (2) calibrate the item‐bank using a bifactor model that includes a primary dimension and symptom‐specific subdomains, (3) administer using computerized adaptive testing (CAT) and (4) validate the CAT‐SUD in Spanish and English in the United States and Spain. Design Item bank construction, item calibration phase, CAT‐SUD validation phase. Setting: Primary care, community clinics, emergency departments and patient‐to‐patient referrals in Spain (Barcelona and Madrid) and the United States (Boston and Los Angeles). Participants/cases: Calibration phase: the CAT‐SUD was developed via simulation from complete item responses in 513 participants. Validation phase: 297 participants received the Composite International Diagnostic Interview (CIDI) and the CAT‐SUD. Measurements A total of 252 items from five subdomains: (1) SUD, (2) psychological disorders, (3) risky behavior, (4) functional impairment and (5) social support. CAT‐SUD scale scores and CIDI SUD diagnosis. Findings Calibration: the bifactor model provided excellent fit to the multi‐dimensional item bank; 168 items had high loadings (> 0.4 with the majority > 0.6) on the primary SUD dimension. Using an average of 11 items (four to 26), which represents a 94% reduction in respondent burden (average administration time of approximately 2 minutes), we found a correlation of 0.91 with the 168‐item scale (precision of 5 points on a 100‐point scale). Validation: strong agreement was found between the primary CAT‐SUD dimension estimate and the results of a structured clinical interview. There was a 20‐fold increase in the likelihood of a CIDI SUD diagnosis across the range of the CAT‐SUD (AUC = 0.85). Conclusions: We have developed a new approach for the screening and measurement of SUD and related severity based on multi‐dimensional item response theory. The bifactor model harmonized information from mental health, trauma, social support and traditional SUD items to provide a more complete characterization of SUD. The CAT‐SUD is highly predictive of a current SUD diagnosis based on a structured clinical interview, and may be predictive of the development of SUD in the future. [ABSTRACT FROM AUTHOR]

Low‐income Latinas/os are exposed to widespread mental health disparities in the United States. Most recently, a resurgence of anti‐immigration narratives has led vulnerable Latina/o immigrants to experience considerable contextual stressors with multiple deleterious consequences for their overall well‐being, including significant disruptions to their parenting practices. Within this context of adversity and despite the multiple benefits associated with parent training (PT) prevention interventions, the availability of contextually and culturally relevant PT interventions remains limited in underserved Latina/o communities. This paper constitutes a contribution to this gap in knowledge by presenting a model of intervention delivery utilized in the dissemination of culturally adapted versions of the evidence‐based intervention known as GenerationPMTO.© The proposed model also describes a process of change that we have documented in empirical research with low‐income Latina/o immigrant parents who have been exposed to the adapted interventions. The manuscript is organized in four sections. First, an overview of the model is discussed, along with a brief summary of major theories. Next, the core components of the model are described, complemented by the presentation of a case study. Finally, implications for prevention and clinical intervention are discussed. [ABSTRACT FROM AUTHOR]

Using a national sample of youth from the U.S., this paper examines incidents of bias-based harassment by peers that include language about victims' perceived sexual orientation, race/ethnicity, religion, weight or height, or intelligence. Telephone interviews were conducted with youth who were 10-20 years old (n = 791). One in six youth (17%) reported at least one experience with bias-based harassment in the past year. Bias language was a part of over half (52%) of all harassment incidents experienced by youth. Perpetrators of bias-based harassment were similar demographically to perpetrators of non-biased harassment. However, bias-based incidents were more likely to involve multiple perpetrators, longer timeframes and multiple harassment episodes. Even controlling for these related characteristics, the use of bias language in incidents of peer harassment resulted in significantly greater odds that youth felt sad as a result of the victimization, skipped school, avoided school activities, and lost friends, compared to non-biased harassment incidents. [ABSTRACT FROM AUTHOR]

Objectives: To examine: (1) what elements of patient-centered medical homes (PCMHs) are typically provided to low-income populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for low-income groups.Data Sources/study Setting: Existing literature on PCMH utilization among health care organizations serving low-income populations.Study Design: Systematic review and meta-analysis.Data Collection/extraction Methods: We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low-income populations. A total of 434 studies were reviewed. Thirty-three articles met eligibility criteria.Principal Findings: Patient-centered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range -0.965 to 1.42). PCMH patients had better clinical outcomes (d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms (d = -0.248), but there were apparent limitations in study quality.Conclusions: Evidence shows that the PCMH model can increase health outcomes among low-income populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed. [ABSTRACT FROM AUTHOR]

Abstract: With increasing rates of obesity in the United States, attention to life chances and psychological consequences associated with weight stigma and weight‐based discrimination has also intensified. While research has demonstrated the negative effects of weight‐based discrimination on mental health, little is known about whether different social groups are disproportionately vulnerable to these experiences. Drawing on the modified labelling theory, the focus of this paper is to investigate the psychological correlates of body weight and self‐perceived weight‐based discrimination among American women at the intersection of race/ethnicity and socioeconomic status (SES). Analyses use data from the National Health Measurement Study (NHMS), a national multi‐stage probability sample of non‐institutional, English‐speaking adults, ages 35 to 89 in 2005–2006. Our findings demonstrate that the effect of weight‐based discrimination on psychological well‐being is highly contingent on social status. Specifically, the psychological consequences of discrimination on Hispanic women and women in the lowest household income group is significantly greater relative to White women and women with higher household income, controlling for obesity status and self‐rated health. These results suggest that higher social status has a buffering effect of weight stigma on psychological well‐being. [ABSTRACT FROM AUTHOR]