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Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies

August 25, 2014 Comments off

Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies
Source: Substance Abuse and Mental Health Services Administration

Summarizes the evidence base on the clinical and cost effectiveness of different types of crisis services, and presents cases studies of different approaches states are using to coordinate, consolidate, and blend funding sources to provide robust crisis services.

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Emergency department visits for drug-related suicide attempts rise over six year period

August 11, 2014 Comments off

Emergency department visits for drug-related suicide attempts rise over six year period
Source: Substance Abuse and Mental Health Services Administration

Two new reports highlight the rise in drug-related suicide attempt visits to hospital emergency departments especially among certain age groups. The reports by the Substance Abuse and Mental Health Services Administration (SAMHSA) show that overall there was a 51 percent increase for these types of visits among people 12 and older — from 151,477 visits in 2005 to 228,277 visits in 2011.

One report analyzed the increase in emergency department visits by age and found that the overall rise resulted from increases in visits by people aged 18 to 29 and people aged 45 to 64. Visits involving 18 to 29 year olds increased from 47,312 in 2005 to 75,068 — a 58 percent increase. Visits involving people aged 45 to 64 increased from 28,802 in 2005 to 58,776 visits in 2011 — a 104 percent increase. In 2011, these two age groups comprised approximately 60 percent of all drug-related emergency department visits involving suicide attempts.

The other SAMHSA report focused on the 45 to 64 age group, which had the largest increase in emergency department visits involving drug related suicide attempts, and characterized these visits. The report found that the majority (96 percent in 2011) of these visits involved the non-medical use of prescription drugs and over-the-counter-medications. In 2011, these drugs included anti-anxiety and insomnia medications (48 percent), pain relievers (29 percent) and antidepressants (22 percent).

Other substances involved in these drug-related suicide attempt emergency department visits during the same year included alcohol (39 percent) and illicit drugs (11 percent).

The report also found that these visits by patients aged 45 to 64 doubled for both men and women during this time period.

Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update (August 6, 2014)

August 6, 2014 Comments off

Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update (PDF)
Source: Agency for Healthcare Research and Quality

Objective
We updated a prior systematic review of interventions for children (0–12 years) with autism spectrum disorder (ASD), focusing on recent studies of behavioral interventions.

Data sources
We searched the MEDLINE® (PubMed®), PsycInfo, and Educational Resources Information Clearinghouse (ERIC) databases as well as the reference lists of included studies and recent systematic reviews. We conducted the search in December 2013.

Methods. We included comparative studies (with treatment and comparison groups) of behavioral interventions with at least 10 participants with ASD in the update, and made our conclusions based on the cumulative comparative evidence across the original report and update. Two investigators independently screened studies against predetermined inclusion criteria and independently rated the quality of included studies.

Results
We included 65 unique studies comprising 48 randomized trials and 17 nonrandomized comparative studies (19 good, 39 fair, and 7 poor quality) published since the prior review. The quality of studies improved compared with that reported in the earlier review; however, our assessment of the strength of evidence (SOE), our confidence in the stability of effects of interventions in the face of future research, remains low for many intervention/outcome pairs. Early intervention based on high-intensity applied behavior analysis over extended timeframes was associated with improvement in cognitive functioning and language skills (moderate SOE for improvements in both outcomes) relative to community controls in some groups of young children. The magnitude of these effects varied across studies, potentially reflecting poorly understood modifying characteristics related to subgroups of children. Early intensive parent training programs modified parenting behaviors during interactions; however, data were more limited about their ability to improve developmental skills beyond language gains for some children (low SOE for positive effects on language). Social skills interventions varied in scope and intensity and showed some positive effects on social behaviors for older children in small studies (low SOE for positive effects on social skills). Studies of play/interaction-based approaches reported that joint attention interventions may demonstrate positive outcomes in preschool-age children with ASD when targeting joint attention skills (moderate SOE); data on the effects of such interventions in other areas were limited (low SOE for positive effects on play skills, language, social skills). Studies examining the effects of cognitive behavioral therapy on anxiety reported positive results in older children with IQs ≥70 (high SOE for improvements in anxiety in this population). Smaller short-term studies of other interventions reported some improvements in areas such as sleep and communication, but data were too sparse to assess their overall effectiveness.

Conclusions
A growing evidence base suggests that behavioral interventions can be associated with positive outcomes for children with ASD. Despite improvements in the quality of the included literature, a need remains for studies of interventions across settings and continued improvements in methodologic rigor. Substantial scientific advances are needed to enhance our understanding of which interventions are most effective for specific children with ASD and to isolate elements or components of interventions most associated with effects.

What does the Research Tell us about Services for Children in Therapeutic/Treatment Foster Care with Behavioral Health Issues?

July 18, 2014 Comments off

What does the Research Tell us about Services for Children in Therapeutic/Treatment Foster Care with Behavioral Health Issues?
Source: Substance Abuse and Mental Health Services Administration

Reports on a technical expert panel convened to assess the research about services for foster care children in therapeutic or treatment care. Reviews the scientific evidence and expert panel input to identify actions to be taken and further research needs.

Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies

June 8, 2014 Comments off

Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies
Source: Substance Abuse and Mental Health Services Administration

Summarizes the evidence base on the clinical and cost effectiveness of different types of crisis services, and presents cases studies of different approaches states are using to coordinate, consolidate, and blend funding sources to provide robust crisis services.

Mayors’ Resource Guide on Behavioral Health Issues

May 27, 2014 Comments off

Mayors’ Resource Guide on Behavioral Health Issues
Source: Substance Abuse and Mental Health Services Administration

The term “behavioral health” refers to both mental health and substance use, and recognizes how the two are often inter‐related. Behavioral health problems include the misuse of alcohol or drugs, mental and substance use disorders, and suicide. Mental and substance use disorders include conditions such as schizophrenia, bipolar disorder, depression, and addiction to alcohol or prescription drugs. Preventing, treating, and supporting recovery from behavioral health problems is essential for communities to be healthy, safe, and successful. You can help ensure that everyone in your community has the best chance to succeed by addressing the behavioral health needs of your communities. You can do this by supporting the prevention and treatment of mental illness and supporting recovery from mental illness. Mayors and municipal leaders like you can have an important role in providing leadership and support to address the behavioral health needs of children, adults, and families in their communities.

Unaddressed behavioral health problems may have a negative effect on the economy for cities, towns, and counties. Costs may increase across systems including health care, emergency and social services, special education, services for homelessness, law enforcement, criminal justice system, and health insurance for municipal employees. They may impact the productivity of local businesses and health care costs, impede the ability of children and youth to succeed in school, and lead to family and community disruption.

Fortunately, many people with behavioral health problems can recover from these conditions and live healthy and productive lives. Many effective prevention, treatment, and recovery programs are available for mental and substance use disorders. Many mental and substance use disorders can be prevented and if symptoms do appear, and the severity of many of these problems can be reduced through programs focused on health promotion, illness prevention, and early treatment intervention.

Guidelines for the Successful Transition of People with Behavioral Health Disorders from Jail and Prison

April 28, 2014 Comments off

Guidelines for the Successful Transition of People with Behavioral Health Disorders from Jail and Prison (PDF)
Source: Substance Abuse and Mental Health Services Administration

Despite the significant number of individuals with behavioral disorders in the criminal justice system, 2010 marked the first time in nearly 40 years that the number of state prisoners in the United States declined. To achieve better outcomes, policymakers and researchers agree that a shift away from a reliance on incarceration to an emphasis on expanding capacity to supervise and treat individuals in the community is necessary. This shift has focused attention on the importance of cross-system approaches to providing effective criminal justice and behavioral health treatment interventions with the dual goals of reducing recidivism and promoting recovery. A critical component of cross-system work occurs at the transition from jail or prison to the community. Reentry into the community is a vulnerable time, marked by difficulties adjusting, increased drug use and a 12-fold increased risk of death in the first two weeks after release. Effective transition planning and implementation can minimize the risk of these hazards, enhance public safety by increasing the possibility that individuals will participate in and complete supervision and treatment requirements, and improve individual outcomes.

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