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Objective: The Clear Answers to Louisiana Mental Health (CALM) campaign's objective is to reduce the duration of untreated psychosis (DUP) of patients experiencing first-episode psychosis in the New Orleans community., Methods: CALM used mass transit and digital marketing and local community engagement strategies to reduce DUP in referrals to the Early Psychosis Intervention Clinic-New Orleans. DUP measures were collected for clinic referrals pre- and post-CALM launch (N=116). Analytics from marketing strategies were used to evaluate campaign success., Results: In the first 12 months of CALM, the mean DUP from onset of psychotic symptoms to clinic entry decreased from a median of 6.6 (interquartile range [IQR]=2.5-14.9) to 2.1 (IQR=1.1-10.7) months. Time from onset of psychotic symptoms to first antipsychotic treatment decreased from a median of 2.0 (IQR=0.5-8.6) to 0.2 (IQR=0.0-0.7) months., Conclusions: The CALM campaign produced promising results for reducing DUP in referrals to a coordinated specialty care program., Competing Interests: Dr. Mojtabai reports receiving royalties and consulting fees from UpToDate, Medscape, and MindMed, as well as providing consultation regarding social media litigation on behalf of plaintiffs. The other authors report no financial relationships with commercial interests.

Objective: The authors sought to quantify the proportion of U.S. postsecondary institutions that offer any on-campus mental health services to their students., Methods: In this cross-sectional study, data about the availability and descriptions of mental health services were gathered from websites of a main sample of 200 postsecondary institutions other than community colleges and a sample of 50 community colleges. Both samples were selected through a stratified sampling process. Descriptive statistics, weighted (main sample) and unweighted percentages, and confidence intervals were calculated., Results: In the main sample, 191 institutions (95%, 95% CI=91%-98%) offered mental health services. Among community colleges, 40 (80%, 95% CI=69%-91%) offered such services. In both the main and community college samples, most institutions (92% and 75%, respectively) used "counseling" to describe the services offered., Conclusions: Extrapolation of these results suggests that >1,700 U.S. postsecondary institutions offer mental health services, making campus services a sizeable mental health services sector.

Objective: Up to 2 million college students in the United States have been diagnosed as having attention-deficit hyperactivity disorder (ADHD), a condition associated with negative academic, social, and psychiatric outcomes. The authors investigated the online availability and content of policies governing ADHD services at college clinics., Methods: Using a stratified sample of 200 colleges and universities, the authors reviewed clinic websites and invited clinical staff to participate in a survey. They weighted percentages to account for oversampling and used regression modeling to examine associations with policy availability., Results: Only 70 institutions (32%, weighted percentage) provided information about ADHD services online. Institutions with <1,000 students had significantly lower odds of providing information online (adjusted odds ratio [AOR]=0.04, 95% CI=0.01-0.26), as did institutions that accepted >67% of applicants (AOR=0.18, 95% CI=0.07-0.48). After merging data from the Web review and survey, the authors noted that 14% (N=11 of 75 institutions with data available for this variable) facilitated neuropsychological assessments on campus, 49% (N=33 of 72) did not allow stimulant medications to be prescribed, 73% (N=43 of 61) did not offer clinical evaluations for ADHD, and 89% (N=32 of 35) required a neuropsychological assessment to receive prescription stimulants., Conclusions: Information about the assessment and management of ADHD is rarely available online, and ADHD services on U.S. college campuses appear to be limited., Competing Interests: Dr. Aluri reports receiving research funding from the American Foundation for Suicide Prevention. Dr. Mojtabai reports receiving royalties from UpToDate and Medscape and providing expert consultation regarding social media litigation on behalf of plaintiffs. The other authors report no financial relationships with commercial interests.

The COVID-19 pandemic caused disruption to health services. It is unclear if there were inequalities in the continuity of mental health care in the years around the COVID-19 pandemic. We used electronic health records (EHR) to detect mental health care gaps of more than six months in psychiatric appointments across demographic and socioeconomic characteristics among patients with depression. The analysis included patients with depression who were seen at one of two mental health clinics every year of 2018, 2019, 2021, and 2022 (n = 783 patients). First, we found that the odds of mental health care gaps significantly decreased in the post-pandemic period (2021-2022) relative to the pre-pandemic period (2018-2019). Second, in the pre-pandemic period, patients who lived in areas in the highest tertile of deprivation had greater odds of gaps in mental health care relative to those in the lowest tertile (aOR: 2.18 [95 % CI: 1.02, 4.68]). Males had higher odds of gaps in care than females in the post-pandemic period (aOR: 2.22 [1.13, 4.37]) and the pooled pre- and post-pandemic study period (aOR: 1.58 [1.04, 2.40]). Third, interactions between patient characteristics and time were not significant, suggesting that the change in the odds of gaps of mental health care before relative to after the COVID-19 pandemic did not differ significantly based on patient characteristics. Overall, gaps in care decreased in the post-pandemic period relative to the pre-pandemic period among almost all patient groups., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Dr. Mojtabai reports having received royalties and consulting fees from UpToDate, Medscape, and MindMed and providing expert consultation regarding social media litigation on behalf of the plaintiffs. The other authors report no financial relationships with commercial interests., (Copyright © 2025. Published by Elsevier B.V.)

Introduction: Medications for opioid use disorder (MOUD) are considered the first line treatment for opioid use disorder. As states expanded Medicaid beginning in 2014 under the Affordable Care Act, policymakers and public health officials were interested in the potential for expansion to increase access to MOUD. This study examined whether there were changes in MOUD use within outpatient admissions to specialty treatment facilities in Medicaid expansion states beyond the initial expansion period., Methods: Analyses were conducted using 2010-2020 data from the Treatment Episode Data Set - Admissions. For states that expanded Medicaid prior to 2015, a difference-in-differences analysis was conducted to evaluate whether expansion was associated with an increased proportion of MOUD treatment comparing the initial 2014-2017 period and the 2018-2020 period to 2010-2013. We then conducted a difference-in-differences analysis to examine the overall effect of Medicaid expansion on outpatient MOUD using all states that passed expansion at any point during the study period., Results: Among outpatient treatment episodes for OUD in states that expanded Medicaid in 2014, there was a 9.5 percentage point (95 % CI: 0.7-18.2) increase in the probability of receiving MOUD during the initial expansion period from 2014 to 2017 compared to 2010-2013 period, and a 7.5 percentage point (95 % CI: -8.1 -23.1) increase in 2018-2020 (compared to the 2010-2013 period) after adjusting for individual-level covariates. After incorporating states that expanded Medicaid between 2015 and 2020, there was a 6.4 percentage point (95 % CI: -0.01-13.0) increase in the probability of receiving MOUD among individuals receiving care after expansion (compared to the pre-expansion period). During the study period, there was variability among states in the change in probability of receiving MOUD from prior to after Medicaid expansion from an almost 30 percentage point increase in New York to an almost 20 percentage point decrease in Washington, DC., Conclusions: Medicaid expansion increased the probability of receiving MOUD in outpatient settings across states from initial expansion through 2020. However, these results were not statistically significant. Additionally, significant variability between states warrants further study and suggests that improving access to MOUD will require additional state and local strategies., Competing Interests: Declarations of interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Little is known about how race and ethnicity influence the association between college enrollment and past-year suicide attempts. In this brief report, the relationship between college enrollment and past-year suicide attempts varied across racial groups in a nationally representative sample of 12,474 full-time college enrolled and unenrolled young adults. Only White students displayed a protective association between enrollment and past-year suicide attempts (aOR, 0.32; 95% CI, 0.17, 0.62). Race and ethnicity significantly moderated the relationship between enrollment and past-year suicide attempts for Black/African American (P = 0.003) and multiracial (P = 0.03) compared to White young adults., Competing Interests: Declarations. Ethics Approval: Approval for the activities conducted as part of this study was granted by the Institutional Review Board (IRB) of the Johns Hopkins Bloomberg School of Public Health. This secondary data analysis was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki. Consent to Participate: Informed consent was obtained from all individual participants included in the studies from which the data were obtained. Conflict of Interest: Dr. Aluri reports consulting for the Maryland Collaboration to Reduce College Drinking and Related Problems. Dr. Mojtabai has received royalties and consulting fees from UpToDate, Medscape, and MindMed. Dr. Wilcox receives funding from the National Institute of Mental Health, Patient-Centered Outcomes Research Institute, and the Robert Wood Johnson Foundation for projects unrelated to this paper. Dr. Wilcox also serves on the National Board of the American Foundation for Suicide Prevention (uncompensated)., (© 2025. Society for Prevention Research.)