Strategies to Improve Mental Health Care for Children and Adolescents: Research Review

The Agency for Healthcare Research and Quality review assesses the effectiveness of quality improvement, implementation, and dissemination strategies that seek to improve the mental health care of children and adolescents.

Approximately one in five children and adolescents living in the United States has one or more mental, emotional, or behavioral health disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria in any given year. These disorders contribute to problems with family, peers, and academic functioning; comorbidity (including other mental and substance use disorders and chronic health conditions); and reduced quality of life; they also increase the risk of involvement with the criminal justice system and other risk-taking behaviors and suicide. The evidence base for pediatric mental health interventions that target mood disorders, anxiety disorders, disruptive behavior disorders, psychotic disorders, eating disorders, and substance use disorders continues to grow. Despite advances in the evidence base, outcomes for children with mental health problems remain suboptimal because of issues with access to care, failure of systems and providers to adopt interventions with proven efficacy (e.g., evidence-based practices [EBPs]), and variability in the quality of mental health care received. Studies using nationally representative data on U.S. adolescents show that only approximately one in five children with mental health problems receives services, and only one-third of treatment episodes are considered minimally adequate (at least four visits with psychotropic medication or at least eight visits without psychotropic medication). The current health care system continues to provide fragmented care to children in numerous uncoordinated systems, rendering inefficient delivery of needed services. Other issues include providers not having the time available or knowledge/training to identify mental health problems and treat or refer accordingly.

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HHS selects eight states for new demonstration program to improve access to high quality behavioral health services

HHS announced the selection of eight states for participation in a two-year Certified Community Behavioral Health Clinic (CCBHC) demonstration program designed to improve behavioral health services in their communities. This demonstration is part of a comprehensive effort to integrate behavioral health with physical health care, increase consistent use of evidence-based practices, and improve access to high-quality care for people with mental and substance use disorders. The eight states HHS selected for this demonstration program include Minnesota, Missouri, New York, New Jersey, Nevada, Oklahoma, Oregon, and Pennsylvania.

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Chantix and Zyban: Drug Safety Communication – Mental Health Side Effects Revised, FDA

Based on a Food and Drug Administration (FDA) review of a large clinical trial that FDA required the drug companies to conduct, FDA determined the risk of serious side effects on mood, behavior, or thinking with the stop-smoking medicines Chantix (varenicline) and Zyban (bupropion) is lower than previously suspected. The risk of these mental healthRead More

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Adding Better Mental Health Care to Primary Care

Many people visit a primary health care provider to treat physical diseases and injuries; however, it is also common for patients to see a primary care provider because of brain health issues, including such as depression, anxiety, alcohol use and might be the first contact for schizophrenia prodrome. The primary care provider can treat someRead More

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SERIOUS MENTAL ILLNESS AMONG ADULTS BELOW THE POVERTY LINE

The challenges that adults with mental illness face are made more difficult if they are living in poverty. For example, adults with mental illness who are living in poverty may face higher health care costs, decreased productivity, and poor general health. According to the National Survey of Drug Use and Health (NSDUH), an estimated 9.8 million adultsRead More

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As Some States Implement New Marijuana Laws, Science Should Guide Public Health Policy

After the election on November 8, marijuana is now or will soon be legal for adult recreational use in eight states plus the District of Columbia. These states, and those that may join them in the future, will have choices to make in how they enact and implement their policies. Careful thought should be givenRead More

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Metabolic Changes in Schizophrenia May Predate Antipsychotic Use

By the time a person with schizophrenia presents at the onset of the illness, he or she may already be experiencing glucose dysregulation—increasing the risk of type 2 diabetes, a meta-analysis published today in JAMA Psychiatry reports. The findings highlight the importance of prescribing antipsychotics at a dose that limits the metabolic impact and educatingRead More

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NIMH Director’s Message, Neural Circuits Research: How and Why

Yes, schizophrenia spectrum disorders are neuro-circuitry disorder and NIMH is focused on discovering which neuro-circuits and how to manage them to alleviate symptoms. It would be amazing if this could lead to eradicating schizophrenia spectrum illnesses. Read NIMH Director, Dr. Joshua Gordon’s message. By Joshua Gordon I wrote in my welcome message about my priorities.Read More

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Can Mental Illness Be Prevented In The Womb?

Every day in the United States, millions of expectant mothers take a prenatal vitamin on the advice of their doctor. The counsel typically comes with physical health in mind: folic acid to help avoid fetal spinal cord problems; iodine to spur healthy brain development; calcium to be bound like molecular Legos into diminutive babyRead More

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New Way of Studying DNA as it’s Bundled in Cells Reveals New Schizophrenia Risk Genes, Daniel Geschwind, Ph.D.

A new study implicates two cellular pathways in schizophrenia risk that haven’t been well supported by genetic evidence before. They involve processes related to the birth of new nerve cells, called neurogenesis, and cell-to-cell signaling by a neurotransmitter called acetylcholine. The study, published October 19 in Nature, characterized interactions between genome segments that regulate genes,Read More

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