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Tran QD. Going Beyond Waitlists in Mental Healthcare. Community Ment Health J 2024; 60:629-634. [PMID: 38324069 DOI: 10.1007/s10597-024-01233-2] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/26/2023] [Indexed: 02/08/2024]
Abstract
Managing waitlists for outpatient mental health services particularly in community health settings is difficult to standardize, poses an administrative burden, and are barriers rather than gateways to access to care particularly for low-income communities. While telehealth has initially expanded access to mental healthcare at the onset of the COVID-19 pandemic, it has not resolved the challenges associated with the increasing demand for services and the shortage of available providers. This commentary explores the intricate interconnections between wait times, readiness for and appropriateness of therapy, and engagement in treatment. Drawing on insights from waiting line theory to question the attachment to and utility of waitlists for non-emergency, outpatient mental healthcare, this commentary questions the utility and efficacy of waitlists. Alternative solutions that capitalize on community resources and collaboration and harness patients' agency for change are discussed.
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Affiliation(s)
- Quang D Tran
- Health Equity Research Lab, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA, USA.
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, MA, USA.
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Axelrod DA, Ince D, Harhay MN, Mannon RB, Alhamad T, Cooper M, Josephson MA, Caliskan Y, Sharfuddin A, Kumar V, Guenette A, Schnitzler MA, Ainapurapu S, Lentine KL. Operational challenges in the COVID era: Asymptomatic infections and vaccination timing. Clin Transplant 2021; 35:e14437. [PMID: 34297878 PMCID: PMC8420523 DOI: 10.1111/ctr.14437] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 11/28/2022]
Abstract
The coronavirus disease 2019 (COVID‐19) pandemic has created unprecedented challenges for solid organ transplant programs. While transplant activity has largely recovered, appropriate management of deceased donor candidates who are asymptomatic but have positive nucleic acid testing (NAT) for SARS‐CoV‐2 is unclear, as this result may reflect active infection or prolonged viral shedding. Furthermore, candidates who are unvaccinated or partially vaccinated continue to receive donor offers. In the absence of robust outcomes data, transplant professionals at US adult kidney transplant centers were surveyed (February 13, 2021 to April 29, 2021) to determine community practice (N: 92 centers, capturing 41% of centers and 57% of transplants performed). The majority (97%) of responding centers declined organs for asymptomatic NAT+ patients without documented prior infection. However, 32% of centers proceed with kidney transplant in NAT+ patients who were at least 30 days from initial diagnosis with negative chest imaging. Less than 7% of programs reported inactivating patients who were unvaccinated or partially vaccinated. In conclusion, despite national recommendations to wait for negative testing, many centers are proceeding with kidney transplant in patients with positive SARS‐CoV‐2 NAT results due to presumed viral shedding. Furthermore, few centers are requiring COVID‐19 vaccination prior to transplantation at this time.
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Affiliation(s)
| | - Dilek Ince
- University of Iowa/Transplant Institute, Iowa City, IA, USA
| | - Meera N Harhay
- Drexel University Tower Health Transplant Institute, Philadelphia, USA
| | | | | | - Matthew Cooper
- Medstar Georgetown Transplant Institute, Washington, DC, USA
| | | | - Yasar Caliskan
- Saint Louis University Center for Abdominal Transplantation, St. Louis, MO, USA
| | | | - Vineeta Kumar
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alexis Guenette
- Saint Louis University Center for Abdominal Transplantation, St. Louis, MO, USA
| | - Mark A Schnitzler
- Saint Louis University Center for Abdominal Transplantation, St. Louis, MO, USA
| | - Sruthi Ainapurapu
- Saint Louis University Center for Abdominal Transplantation, St. Louis, MO, USA
| | - Krista L Lentine
- Saint Louis University Center for Abdominal Transplantation, St. Louis, MO, USA
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