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Brown TR, Jansen MO, Rolin SA, Liu SA, Xu KY. The misuse of malingering diagnoses in individuals with sickle cell disease. Gen Hosp Psychiatry 2024; 87:157-158. [PMID: 38102021 PMCID: PMC10982992 DOI: 10.1016/j.genhosppsych.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Affiliation(s)
- Tashalee R Brown
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, United States of America; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, United States of America; Health and Behavior Research Center, Department of Psychiatry, Washington University School of Medicine, 4940 Children's Place, Saint Louis, MO 63110, United States of America.
| | - Madeline O Jansen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, United States of America; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, United States of America
| | - Stephanie A Rolin
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, United States of America
| | - Shiyuan Anabeth Liu
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, United States of America
| | - Kevin Y Xu
- John T. Milliken Department of Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, United States of America; Health and Behavior Research Center, Department of Psychiatry, Washington University School of Medicine, 4940 Children's Place, Saint Louis, MO 63110, United States of America.
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Xu KY, Gold JA, Szlyk HS, Rolin SA, Shields MC. Mental Illness and Violence Among People Experiencing Homelessness: An Evidence-Based Review. Mo Med 2024; 121:14-20. [PMID: 38404439 PMCID: PMC10887459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Affiliation(s)
- Kevin Y Xu
- Health and Behavior Research Center, Division of Addiction Science, Prevention, and Treatment, Washington University, and in the Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Jessica A Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Hannah S Szlyk
- Health and Behavior Research Center, Division of Addiction Science, Prevention, and Treatment, Washington University, and in the Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Stephanie A Rolin
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
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Lawrence RE, Rolin SA, Looney DV, Birt AR, Stevenson EM, Dragatsi D, Appelbaum PS, Dixon LB. Physical Assault in the Psychiatry Emergency Room. Focus (Am Psychiatr Publ) 2023; 21:89-99. [PMID: 37205038 PMCID: PMC10172533 DOI: 10.1176/appi.focus.23022004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Previous studies of physical assaults in hospitals focused primarily on inpatient psychiatric units, leaving unanswered questions about the extent to which findings generalize to psychiatric emergency rooms. Assault incident reports and electronic medical records from one psychiatric emergency room and two inpatient psychiatric units were reviewed. Qualitative methods were used to identify precipitants. Quantitative methods were used to describe characteristics of each event, as well as demographic and symptom profiles associated with incidents. During the five-year study period, there were 60 incidents in the psychiatric emergency room and 124 incidents on the inpatient units. Precipitating factors, incident severity, means of assault, and interventions were similar in both settings. Among patients in the psychiatric emergency room, a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder with manic symptoms (Adjusted Odds Ratio (AOR) 27.86) and presenting with thoughts to harm others (AOR 10.94) were associated with an increased likelihood of having an assault incident report. Similarities between assaults in the psychiatric emergency room and inpatient psychiatric units suggest that the broader literature from inpatient psychiatry can be generalized to the psychiatric emergency room setting, although some differences exist. Reprinted from J Am Acad Psychiatry Law 2020; 48:484-495, with permission from The American Academy of Psychiatry and the Law. Copyright © 2020.
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Salehi B, Rolin SA, Dixon LB. Refugee Mental Health. Psychiatr Serv 2022; 73:1196. [PMID: 36181325 DOI: 10.1176/appi.ps.22073011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rolin SA, Scodes J, Dambreville R, Nossel IR, Bello I, Wall MM, Scott Stroup T, Dixon LB, Appelbaum PS. Feasibility and Utility of Different Approaches to Violence Risk Assessment for Young Adults Receiving Treatment for Early Psychosis. Community Ment Health J 2022; 58:1130-1140. [PMID: 34981276 PMCID: PMC8723812 DOI: 10.1007/s10597-021-00922-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/17/2021] [Indexed: 12/24/2022]
Abstract
This pilot study examined violence risk assessment among a sample of young adults receiving treatment for early psychosis. In this study, thirty participants were assessed for violence risk at baseline. Participants completed follow-up assessments at 3, 6, 9 and 12 months to ascertain prevalence of violent behavior. Individuals were on average 24.1 years old (SD = 3.3 years) and predominantly male (n = 24, 80%). In this sample, six people (20%) reported engaging in violence during the study period. Individuals who engaged in violence had higher levels of negative urgency (t(28) = 2.21, p = 0.035) This study sought to establish the feasibility, acceptability, and clinical utility of violence risk assessment for clients in treatment for early psychosis. Overall, this study found that most individuals with early psychosis in this study (who are in treatment) were not at risk of violence. Findings suggest that violent behavior among young adults with early psychosis is associated with increased negative urgency.
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Affiliation(s)
- Stephanie A Rolin
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, Suite 1300, New York, NY, 10032, USA.
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Jennifer Scodes
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Renald Dambreville
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Ilana R Nossel
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, Suite 1300, New York, NY, 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Iruma Bello
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, Suite 1300, New York, NY, 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Melanie M Wall
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, Suite 1300, New York, NY, 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - T Scott Stroup
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, Suite 1300, New York, NY, 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Lisa B Dixon
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, Suite 1300, New York, NY, 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Paul S Appelbaum
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, Suite 1300, New York, NY, 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
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Rolin SA, Jackson DS, Swartz MS. The Bridge Between Racial Justice and Clinical Practice. Psychiatr Serv 2021; 72:1369. [PMID: 34847704 DOI: 10.1176/appi.ps.721204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Stephanie A Rolin
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Rolin); Department of Psychiatry, Rutgers University-Robert Wood Johnson Medical School, Piscataway, New Jersey (Jackson); Psychiatry and Behavioral Sciences, Duke School of Medicine, and Wilson Center for Science and Justice, Duke University School of Law, Durham, North Carolina (Swartz)
| | - Danielle S Jackson
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Rolin); Department of Psychiatry, Rutgers University-Robert Wood Johnson Medical School, Piscataway, New Jersey (Jackson); Psychiatry and Behavioral Sciences, Duke School of Medicine, and Wilson Center for Science and Justice, Duke University School of Law, Durham, North Carolina (Swartz)
| | - Marvin S Swartz
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Rolin); Department of Psychiatry, Rutgers University-Robert Wood Johnson Medical School, Piscataway, New Jersey (Jackson); Psychiatry and Behavioral Sciences, Duke School of Medicine, and Wilson Center for Science and Justice, Duke University School of Law, Durham, North Carolina (Swartz)
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Rolin SA, Bareis N, Bradford JM, Rotter M, Rosenfeld B, Pauselli L, Compton MT, Stroup TS, Appelbaum PS, Dixon LB. Violence risk assessment for young adults receiving treatment for early psychosis. Int J Law Psychiatry 2021; 76:101701. [PMID: 33887604 PMCID: PMC8140412 DOI: 10.1016/j.ijlp.2021.101701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 03/22/2021] [Accepted: 04/11/2021] [Indexed: 06/12/2023]
Abstract
AIM Although the absolute risk of violence is small for individuals with mental illnesses, a specific subgroup of individuals who appear to be at increased risk for violence includes young people experiencing emerging or early psychosis. Prior research has identified risk factors for violence in this population, though no prior studies using a formal risk assessment tool have been identified. This study used the Historical Clinical Risk Management-20, version 3 (HCR-20) to identify risk of future violence among a sample of young adults with early psychosis and relevant predictors of risk unique to this population. METHODS The HCR-20 was administered to a sample of young adults with early psychosis (N = 53) enrolled at one OnTrackNY site, part of a statewide program providing early intervention services to young adults presenting with a first episode of non-affective psychosis. A Confirmatory Factor Analysis (CFA) was conducted to explore the relative importance of the HCR-20 items for this population. RESULTS The average age of participants was 21.9 years (SD 3.6 years) and most were male (69.8%, n = 37). Most patients were assessed to be at low risk for future violence based on the Case Prioritization summary risk rating (67.9%, n = 36). The CFA identified 4 items that were not of relative predictive value in identifying the risk of violence in this sample: history of substance use (item H5), history of major mental disorder (item H6), living situation (item R2), and personal support (item R3). CONCLUSION This study presents a formal approach to assessing violence risk in a population at elevated risk of violence, demonstrates the feasibility of using a standardized risk assessment tool in early intervention services, and identifies factors of particular importance associated with predicting violence in this population. Future research should implement violence risk assessment with a structured tool such as the HCR-20 and assess its accuracy in predicting future violent behavior in this setting.
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Affiliation(s)
- Stephanie A Rolin
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Natalie Bareis
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Jean-Marie Bradford
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Merrill Rotter
- Department of Psychiatry, Albert Einstein College of Medicine, New York, NY, USA
| | - Barry Rosenfeld
- Department of Psychology, Fordham University, NY, New York, USA
| | - Luca Pauselli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside/West, New York, NY, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - T Scott Stroup
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Paul S Appelbaum
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Lisa B Dixon
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
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Abstract
ABSTRACT Violence is a serious concern in the psychiatric inpatient and emergency setting. Much of the research on victims of inpatient violence has focused on identifying and supporting staff who are at risk of being victimized when working in psychiatric settings. This article presents an analysis of 72 patients who were targeted during incidents of patient-on-patient physical aggression in hospital-based psychiatric settings (both inpatient and emergency) from 2014 to 2018. Results suggest that patients who are at risk of being targeted by another patient while in the hospital tend to be younger, are more likely to be male, and present with manic symptoms and recent cannabis use. These variables have all been identified as risk factors for perpetration of violence by patients with mental illness. This study adds to a literature demonstrating a consistent overlap between individuals with mental illness who are victimized and those who initiate violence.
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Affiliation(s)
- Stephanie A Rolin
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, New York, New York
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Rolin SA, Richards MC. Closing the Gap: Better Health Care for Young Adults With First-Episode Psychosis. Psychiatr Serv 2021; 72:241. [PMID: 33641353 DOI: 10.1176/appi.ps.72305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Stephanie A Rolin
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, New York City (Rolin); Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Richards)
| | - Misty C Richards
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, New York City (Rolin); Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Richards)
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Lawrence RE, Rolin SA, Looney DV, Birt AR, Stevenson EM, Dragatsi D, Appelbaum PS, Dixon LB. Physical Assault in the Psychiatry Emergency Room. J Am Acad Psychiatry Law 2020; 48:484-495. [PMID: 33077638 PMCID: PMC8048140 DOI: 10.29158/jaapl.200022-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Previous studies of physical assaults in hospitals focused primarily on inpatient psychiatric units, leaving unanswered questions about the extent to which findings generalize to psychiatric emergency rooms. Assault incident reports and electronic medical records from one psychiatric emergency room and two inpatient psychiatric units were reviewed. Qualitative methods were used to identify precipitants. Quantitative methods were used to describe characteristics of each event, as well as demographic and symptom profiles associated with incidents. During the five-year study period, there were 60 incidents in the psychiatric emergency room and 124 incidents on the inpatient units. Precipitating factors, incident severity, means of assault, and interventions were similar in both settings. Among patients in the psychiatric emergency room, a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder with manic symptoms (Adjusted Odds Ratio (AOR) 27.86) and presenting with thoughts to harm others (AOR 10.94) were associated with an increased likelihood of having an assault incident report. Similarities between assaults in the psychiatric emergency room and inpatient psychiatric units suggest that the broader literature from inpatient psychiatry can be generalized to the psychiatric emergency room setting, although some differences exist.
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Affiliation(s)
- Ryan E Lawrence
- Dr. Lawrence is Assistant Professor of Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Rolin is Research Fellow, Division of Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Ms. Looney is Administrator for Psychiatry, Department of Psychiatry, New York Presbyterian Hospital, New York, NY. Dr. Birt is Assistant Professor of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Stevenson is Associate Professor of Psychiatry and Director of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Dragatsi is Associate Professor of Psychiatry, Columbia University and Associate Clinical Director, Department of Psychiatry, Rockland Psychiatric Center, Orangeburg, NY. Dr. Appelbaum is the Dollard Professor of Psychiatry, Medicine, and Law, and Directory of the Center for Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Dixon is the Edna L. Edison Professor of Psychiatry and Director, Division of Behavioral Health Services and Policy Research, Department of Psychiatry, New York State Psychiatric Institute, New York, NY.
| | - Stephanie A Rolin
- Dr. Lawrence is Assistant Professor of Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Rolin is Research Fellow, Division of Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Ms. Looney is Administrator for Psychiatry, Department of Psychiatry, New York Presbyterian Hospital, New York, NY. Dr. Birt is Assistant Professor of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Stevenson is Associate Professor of Psychiatry and Director of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Dragatsi is Associate Professor of Psychiatry, Columbia University and Associate Clinical Director, Department of Psychiatry, Rockland Psychiatric Center, Orangeburg, NY. Dr. Appelbaum is the Dollard Professor of Psychiatry, Medicine, and Law, and Directory of the Center for Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Dixon is the Edna L. Edison Professor of Psychiatry and Director, Division of Behavioral Health Services and Policy Research, Department of Psychiatry, New York State Psychiatric Institute, New York, NY
| | - Diane V Looney
- Dr. Lawrence is Assistant Professor of Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Rolin is Research Fellow, Division of Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Ms. Looney is Administrator for Psychiatry, Department of Psychiatry, New York Presbyterian Hospital, New York, NY. Dr. Birt is Assistant Professor of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Stevenson is Associate Professor of Psychiatry and Director of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Dragatsi is Associate Professor of Psychiatry, Columbia University and Associate Clinical Director, Department of Psychiatry, Rockland Psychiatric Center, Orangeburg, NY. Dr. Appelbaum is the Dollard Professor of Psychiatry, Medicine, and Law, and Directory of the Center for Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Dixon is the Edna L. Edison Professor of Psychiatry and Director, Division of Behavioral Health Services and Policy Research, Department of Psychiatry, New York State Psychiatric Institute, New York, NY
| | - Adriane R Birt
- Dr. Lawrence is Assistant Professor of Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Rolin is Research Fellow, Division of Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Ms. Looney is Administrator for Psychiatry, Department of Psychiatry, New York Presbyterian Hospital, New York, NY. Dr. Birt is Assistant Professor of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Stevenson is Associate Professor of Psychiatry and Director of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Dragatsi is Associate Professor of Psychiatry, Columbia University and Associate Clinical Director, Department of Psychiatry, Rockland Psychiatric Center, Orangeburg, NY. Dr. Appelbaum is the Dollard Professor of Psychiatry, Medicine, and Law, and Directory of the Center for Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Dixon is the Edna L. Edison Professor of Psychiatry and Director, Division of Behavioral Health Services and Policy Research, Department of Psychiatry, New York State Psychiatric Institute, New York, NY
| | - Ellen M Stevenson
- Dr. Lawrence is Assistant Professor of Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Rolin is Research Fellow, Division of Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Ms. Looney is Administrator for Psychiatry, Department of Psychiatry, New York Presbyterian Hospital, New York, NY. Dr. Birt is Assistant Professor of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Stevenson is Associate Professor of Psychiatry and Director of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Dragatsi is Associate Professor of Psychiatry, Columbia University and Associate Clinical Director, Department of Psychiatry, Rockland Psychiatric Center, Orangeburg, NY. Dr. Appelbaum is the Dollard Professor of Psychiatry, Medicine, and Law, and Directory of the Center for Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Dixon is the Edna L. Edison Professor of Psychiatry and Director, Division of Behavioral Health Services and Policy Research, Department of Psychiatry, New York State Psychiatric Institute, New York, NY
| | - Dianna Dragatsi
- Dr. Lawrence is Assistant Professor of Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Rolin is Research Fellow, Division of Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Ms. Looney is Administrator for Psychiatry, Department of Psychiatry, New York Presbyterian Hospital, New York, NY. Dr. Birt is Assistant Professor of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Stevenson is Associate Professor of Psychiatry and Director of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Dragatsi is Associate Professor of Psychiatry, Columbia University and Associate Clinical Director, Department of Psychiatry, Rockland Psychiatric Center, Orangeburg, NY. Dr. Appelbaum is the Dollard Professor of Psychiatry, Medicine, and Law, and Directory of the Center for Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Dixon is the Edna L. Edison Professor of Psychiatry and Director, Division of Behavioral Health Services and Policy Research, Department of Psychiatry, New York State Psychiatric Institute, New York, NY
| | - Paul S Appelbaum
- Dr. Lawrence is Assistant Professor of Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Rolin is Research Fellow, Division of Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Ms. Looney is Administrator for Psychiatry, Department of Psychiatry, New York Presbyterian Hospital, New York, NY. Dr. Birt is Assistant Professor of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Stevenson is Associate Professor of Psychiatry and Director of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Dragatsi is Associate Professor of Psychiatry, Columbia University and Associate Clinical Director, Department of Psychiatry, Rockland Psychiatric Center, Orangeburg, NY. Dr. Appelbaum is the Dollard Professor of Psychiatry, Medicine, and Law, and Directory of the Center for Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Dixon is the Edna L. Edison Professor of Psychiatry and Director, Division of Behavioral Health Services and Policy Research, Department of Psychiatry, New York State Psychiatric Institute, New York, NY
| | - Lisa B Dixon
- Dr. Lawrence is Assistant Professor of Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Rolin is Research Fellow, Division of Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Ms. Looney is Administrator for Psychiatry, Department of Psychiatry, New York Presbyterian Hospital, New York, NY. Dr. Birt is Assistant Professor of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Stevenson is Associate Professor of Psychiatry and Director of Psychiatry, Department of Psychiatry, Columbia University, New York, NY. Dr. Dragatsi is Associate Professor of Psychiatry, Columbia University and Associate Clinical Director, Department of Psychiatry, Rockland Psychiatric Center, Orangeburg, NY. Dr. Appelbaum is the Dollard Professor of Psychiatry, Medicine, and Law, and Directory of the Center for Law, Ethics, and Psychiatry, Department of Psychiatry, New York State Psychiatric Institute, New York, NY. Dr. Dixon is the Edna L. Edison Professor of Psychiatry and Director, Division of Behavioral Health Services and Policy Research, Department of Psychiatry, New York State Psychiatric Institute, New York, NY
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Cunningham C, Dixon LB, Sawhney R, Robitz R, Richards M, Rodríguez Penney AT, Jordan A, Colon-Rivera H, Goldman ML, Zingman MA, Rolin SA. 2019 Editor's Choice Collections. Psychiatr Serv 2020; 71:105-107. [PMID: 31892287 DOI: 10.1176/appi.ps.71103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Carrie Cunningham
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Lisa B. Dixon
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Rishi Sawhney
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Rachel Robitz
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Misty Richards
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Alan Tomás Rodríguez Penney
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Ayana Jordan
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Héctor Colon-Rivera
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Matthew L. Goldman
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Michael A. Zingman
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Stephanie A. Rolin
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
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Talley RM, Rolin SA, Trejo BN, Goldman ML, Alves-Bradford JME, Dixon LB. Perspectives of Individuals With Serious Mental Illness on a Reverse-Colocated Care Model: A Qualitative Study. Psychiatr Serv 2019; 70:793-800. [PMID: 31109264 PMCID: PMC6718316 DOI: 10.1176/appi.ps.201800480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Individuals with serious mental illness experience excess mortality related to general medical comorbidities. Reverse-integrated and reverse-colocated models of care have been proposed as a system-level solution. Such models integrate primary care services within behavioral health settings. Further understanding of consumer perspectives on these models is needed to ensure that models adequately engage consumers on the basis of their expressed needs. This qualitative study examined the perspectives of English- and Spanish-speaking individuals with serious mental illness on their current experience with the management of their medical care and on a hypothetical reverse-colocated care model. METHODS Semistructured interviews were conducted in a purposive sample of 30 individuals with serious mental illness recruited from two outpatient mental health clinics affiliated with a comprehensive community-based program. The interview assessed the participant's current experience with the management of their health care, followed by a vignette describing a reverse--colocated care model and questions to elicit the participant's reaction to the vignette. An inductive thematic analysis was employed. RESULTS Consumers expressed positive views of the potential for working with trusted staff, increased communication, and access to care through reverse colocation. Reflections on current health management experience were notable for an emphasis on self-efficacy and receipt of support for self-management strategies from mental health clinicians. CONCLUSIONS Study findings add to prior literature indicating support for assistance with management of general medical health in the mental health setting among individuals with serious mental illness. Key themes similar to those in previous studies generate hypotheses for further evaluation.
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Affiliation(s)
- Rachel M Talley
- Department of Psychiatry, Columbia University Irving Medical Center, New York (Talley, Rolin, Goldman, Alves-Bradford, Dixon); New York State Psychiatric Institute, New York (Talley, Rolin, Alves-Bradford, Dixon); Vagelos College of Physicians and Surgeons, Columbia University, New York (Trejo). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Stephanie A Rolin
- Department of Psychiatry, Columbia University Irving Medical Center, New York (Talley, Rolin, Goldman, Alves-Bradford, Dixon); New York State Psychiatric Institute, New York (Talley, Rolin, Alves-Bradford, Dixon); Vagelos College of Physicians and Surgeons, Columbia University, New York (Trejo). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Barbara N Trejo
- Department of Psychiatry, Columbia University Irving Medical Center, New York (Talley, Rolin, Goldman, Alves-Bradford, Dixon); New York State Psychiatric Institute, New York (Talley, Rolin, Alves-Bradford, Dixon); Vagelos College of Physicians and Surgeons, Columbia University, New York (Trejo). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Matthew L Goldman
- Department of Psychiatry, Columbia University Irving Medical Center, New York (Talley, Rolin, Goldman, Alves-Bradford, Dixon); New York State Psychiatric Institute, New York (Talley, Rolin, Alves-Bradford, Dixon); Vagelos College of Physicians and Surgeons, Columbia University, New York (Trejo). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Jean-Marie E Alves-Bradford
- Department of Psychiatry, Columbia University Irving Medical Center, New York (Talley, Rolin, Goldman, Alves-Bradford, Dixon); New York State Psychiatric Institute, New York (Talley, Rolin, Alves-Bradford, Dixon); Vagelos College of Physicians and Surgeons, Columbia University, New York (Trejo). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Lisa B Dixon
- Department of Psychiatry, Columbia University Irving Medical Center, New York (Talley, Rolin, Goldman, Alves-Bradford, Dixon); New York State Psychiatric Institute, New York (Talley, Rolin, Alves-Bradford, Dixon); Vagelos College of Physicians and Surgeons, Columbia University, New York (Trejo). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
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13
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Rolin SA, Marino LA, Pope LG, Compton MT, Lee RJ, Rosenfeld B, Rotter M, Nossel I, Dixon L. Recent violence and legal involvement among young adults with early psychosis enrolled in Coordinated Specialty Care. Early Interv Psychiatry 2019; 13:832-840. [PMID: 29740953 PMCID: PMC6226380 DOI: 10.1111/eip.12675] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/09/2018] [Accepted: 03/13/2018] [Indexed: 12/18/2022]
Abstract
AIM Individuals with serious mental illnesses have a small increased risk of engaging in violence or legal involvement compared to the general population. This seems to be particularly true for young adults experiencing early stages of psychosis. This study analysed the prevalence of and risk factors for reports of violence and legal involvement in a sample of young adults receiving Coordinated Specialty Care for early non-affective psychosis. METHODS A total of 373 young adults (ages 16-30) within 2 years of the onset of non-affective psychosis were enrolled in 10 Coordinated Specialty Care sites in New York State from October 2013 to August 2016. Baseline violent ideation or behaviour and legal involvement was described and predictors identified. RESULTS Approximately one-quarter of individuals had either recent violent ideation or behaviour at baseline (n = 90, 24.6%); nearly one-tenth of the sample reported recent legal involvement (n = 33, 9.0%). Individuals with violent ideation or behaviour had lower levels of education and were less likely to be working. Those with recent legal involvement were more likely to be male and more likely to have substance use (alcohol, cannabis and other drugs). CONCLUSIONS The overall rate of recent violent ideation or behaviour is similar to other studies; up to one-third of individuals experiencing a first-episode of psychosis (FEP) report violence. Recent legal involvement was strongly associated with substance use. This study presents insight into violence and legal involvement among individuals with FEP and indicates the need for further research.
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Affiliation(s)
- Stephanie A Rolin
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.,Office of Mental Health, New York State Psychiatric Institute, New York, New York
| | - Leslie A Marino
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.,Office of Mental Health, New York State Psychiatric Institute, New York, New York
| | - Leah G Pope
- Vera Institute of Justice, New York, New York
| | - Michael T Compton
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.,Office of Mental Health, New York State Psychiatric Institute, New York, New York
| | - Rufina J Lee
- Silberman School of Social Work, Hunter College, City University of New York, New York, New York
| | | | | | - Ilana Nossel
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.,Office of Mental Health, New York State Psychiatric Institute, New York, New York
| | - Lisa Dixon
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.,Office of Mental Health, New York State Psychiatric Institute, New York, New York
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Pincus HA, Rolin SA. Evidence-based science policy for mental health in a post-truth era. Lancet Psychiatry 2017; 4:270-272. [PMID: 28185900 PMCID: PMC5967405 DOI: 10.1016/s2215-0366(17)30050-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Harold Alan Pincus
- Department of Psychiatry at Columbia University, New York State Psychiatric Institute, New York City, NY 10032, USA; NewYork-Presbyterian Hospital, New York City, NY 10032, USA.
| | - Stephanie A Rolin
- Department of Psychiatry at Columbia University, New York State Psychiatric Institute, New York City, NY 10032, USA; NewYork-Presbyterian Hospital, New York City, NY 10032, USA
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DeFlavio JR, Rolin SA, Nordstrom BR, Kazal LA. Analysis of barriers to adoption of buprenorphine maintenance therapy by family physicians. Rural Remote Health 2015; 15:3019. [PMID: 25651434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Opioid abuse has reached epidemic levels. Evidence-based treatments such as buprenorphine maintenance therapy (BMT) remain underutilized. Offering BMT in primary care settings has the potential to reduce overall costs of care, decrease medical morbidity associated with opioid dependence, and improve treatment outcomes. However, access to BMT, especially in rural areas, remains limited. This article will present a review of barriers to adoption of BMT among family physicians in a primarily rural area in the USA. METHODS An anonymous survey of family physicians practicing in Vermont or New Hampshire, two largely rural states, was conducted. The survey included both quantitative and qualitative questions, focused on BMT adoption and physician opinions of opioids. Specific factors assessed included physician factors, physicians' understanding of patient factors, and logistical issues. RESULTS One-hundred and eight family physicians completed the survey. Approximately 10% were buprenorphine prescribers. More than 80% of family physicians felt they regularly saw patients addicted to opiates. The majority (70%) felt that they, as family physicians, bore responsibility for treating opiate addiction. Potential logistical barriers to buprenorphine adoption included inadequately trained staff (88%), insufficient time (80%), inadequate office space (49%), and cumbersome regulations (37%). Common themes addressed in open-ended questions included lack of knowledge, time, or interest; mistrust of people with addiction or buprenorphine; and difficult patient population. CONCLUSIONS This study aims to quantify perceived barriers to treatment and provide insight expanding the community of family physicians offering BMT. The results suggest family physicians are excellent candidates to provide BMT, as most report regularly seeing opioid-addicted patients and believe that treating opioid addiction is their responsibility. Significant barriers remain, including inadequate staff training, lack of access to addiction experts, and perceived efficacy of BMT. Addressing these barriers may lower resistance to buprenorphine adoption and increase access to BMT in rural areas.
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Affiliation(s)
| | - Stephanie A Rolin
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
| | - Benjamin R Nordstrom
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
| | - Louis A Kazal
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
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Aschbrenner KA, Pepin R, Mueser KT, Naslund JA, Rolin SA, Faber MJ, Bartels SJ. A mixed methods exploration of family involvement in medical care for older adults with serious mental illness. Int J Psychiatry Med 2014; 48:121-33. [PMID: 25377153 PMCID: PMC4825808 DOI: 10.2190/pm.48.2.e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received little attention. This study explored family involvement in medical care for older adults with SMI. METHODS This mixed methods study involved analysis of quantitative data collected from older adults with SMI and cardiovascular risk (n = 28) participating in a pilot study of an intervention designed to improve patient-centered primary care augmented by qualitative interviews with their relatives (n = 13) to explore family involvement in medical care. RESULTS Approximately 89% of older adults with SMI reported family involvement in at least one aspect of their medical care (e.g., medication reminders, medical decision making). However, many family members reported that they were rarely involved in their relative's medical visits, and most did not perceive a need to be involved during routine care. Family members identified obesity as their relative's primary health concern and many wanted guidance from providers on effective strategies for supporting weight loss. CONCLUSIONS Although many family members did not perceive a need to be involved in their relative's routine medical visits, they expressed interest in talking with providers about how to help their relative change unhealthy behaviors. Educating patients, families, and providers about the potential benefits of family involvement in medical care, including routine medical visits for persons with SMI and cardiovascular health risk may promote patient- and family-centered collaboration in this high-risk population.
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Affiliation(s)
- Kelly A. Aschbrenner
- Dartmouth Centers for Aging Research, 46 Centerra Parkway, Suite 200, Lebanon NH 03766
| | - Renee Pepin
- Dartmouth Centers for Aging Research, 46 Centerra Parkway, Suite 200, Lebanon NH 03766
| | - Kim T. Mueser
- Boston University Center for Psychiatric Rehabilitation, 940 Commonwealth Avenue West, Boston , MA 02215
| | - John A. Naslund
- Dartmouth Centers for Aging Research, 46 Centerra Parkway, Suite 200, Lebanon NH 03766
| | - Stephanie A. Rolin
- Dartmouth Centers for Aging Research, 46 Centerra Parkway, Suite 200, Lebanon NH 03766
| | - Marjan J. Faber
- Dartmouth Centers for Aging Research, 46 Centerra Parkway, Suite 200, Lebanon NH 03766
| | - Stephen J. Bartels
- Dartmouth Centers for Aging Research, 46 Centerra Parkway, Suite 200, Lebanon NH 03766
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Bartels SJ, Aschbrenner KA, Rolin SA, Hendrick DC, Naslund JA, Faber MJ. Activating older adults with serious mental illness for collaborative primary care visits. Psychiatr Rehabil J 2013; 36:278-88. [PMID: 24219769 PMCID: PMC4994809 DOI: 10.1037/prj0000024] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Persons with serious mental illness frequently receive inadequate medical care and are more likely to experience difficulty navigating the health care system compared with the general population. To address this gap in quality, we developed a program of peer co-led collaborative activation training for primary care (CAT-PC) designed to improve "patient activation" and person-centered care in primary care visits for middle-aged and older adults with serious mental illness and cardiovascular risk. This report presents pilot study feasibility and participant outcomes for CAT-PC. METHOD A pre-post pilot evaluation of CAT-PC included N = 17 adults (age ≥ 50) with serious mental illness and cardiovascular health risk conditions, and N = 6 primary care providers. CAT-PC consists of 9 weekly peer co-led patient education and skills training sessions and a 45-min video-based training for primary care providers. Pre-post measures included the Patient Activation Measure (PAM), Perceived Efficacy in Patient-Physician Interactions (PEPPI), Autonomy Preference Index (API) for preferred role in primary care encounters, and Social Skills Performance Assessment (SSPA) role-play test for medical visits. RESULTS All 17 participants attended 5 or more sessions. Post-intervention improvement was found for patient activation and simulated performance of medical visit communication skills. Trends were observed for improved self-efficacy in provider interactions and greater preference for a more collaborative role in decision-making. CONCLUSIONS AND IMPLICATIONS CAT-PC is a brief, peer co-led education and skills training intervention potentially improving patient activation in primary care encounters and providing an important missing component in emerging models of "patient-centered behavioral health homes" for this high-risk group.
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Rolin SA, Waine DJ. P22 Yield of Microbiology Samples Taken During Bronchoscopy Performed For the Diagnosis of Lung Cancer. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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