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Rolin SA, Caffrey D, Flores MG, Pope LG, Mootz J, Bello I, Nossel I, Compton MT, Stanley B, Wainberg M, Dixon LB, Appelbaum PS. An open pilot trial of a behavioural intervention to reduce violence by young adults with early psychosis receiving treatment in an early intervention services setting: A protocol. Early Interv Psychiatry 2024. [PMID: 38705578 DOI: 10.1111/eip.13543] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024]
Abstract
AIMS Despite the public health impact of violence among young adults with psychosis, behavioural interventions to reduce the risk of engaging in violence remain rare. For young adults with early psychosis, cognitive behavioural therapy (CBT)-based psychotherapy has efficacy in reducing impairment and improving functioning. However, no CBT-based intervention to reduce violence has been formally adapted for young adults with early psychosis. This protocol outlines the first clinical trial of a behavioural intervention to reduce violence for young adults with early psychosis. This study is set in an early intervention services (EIS) setting and seeks to adapt and pilot Psychological Intervention for Complex PTSD and Schizophrenia-Spectrum Disorder (PICASSO), a CBT-based intervention, through an iterative process utilizing mixed-methods assessments. METHODS All research will occur at OnTrackNY, the largest EIS program in the United States. This study will consist of an open pilot trial, with four EIS clinicians delivering the intervention to one to two EIS participants per round. In this mixed-methods study, both quantitative measures (acceptability, feasibility and hypothesized mediators of target outcome collected on a weekly basis) and qualitative interviews (with EIS clinicians at weeks 4, 8 and 12) will be conducted. Transcripts will be analyzed using thematic content analysis. Two to three rounds of iterative modifications are anticipated (n = 10-16 EIS participants total). RESULTS Recruitment began in February 2024 and is expected to continue over a 9-12-month period. CONCLUSIONS Because violent behaviour causes interpersonal disruptions such as incarceration and increased caregiver burden, an innovative intervention to reduce violence risk could have broader health impact for this vulnerable population. Adapting the PICASSO intervention to the EIS setting will optimize its acceptability and feasibility by the intended target population.
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Affiliation(s)
- Stephanie A Rolin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Deirdre Caffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Megan G Flores
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Leah G Pope
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Jennifer Mootz
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Iruma Bello
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Ilana Nossel
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Barbara Stanley
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Milton Wainberg
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Lisa B Dixon
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Paul S Appelbaum
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
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Compton MT, Tan de Bibiana J, Pope LG. Identifying Individuals With Early Psychosis in Jail: Lessons Learned for Coordinated Specialty Care Services. Psychiatr Serv 2024; 75:470-476. [PMID: 38204371 DOI: 10.1176/appi.ps.20230125] [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] [Indexed: 01/12/2024]
Abstract
OBJECTIVE This study sought to establish the feasibility of a two-component intervention embedded within a jail setting that would detect detainees with early psychosis and connect them to coordinated specialty care (CSC) in the community upon release. METHODS The two components of the intervention were a targeted educational campaign for correction officers and a specialized early engagement support service to facilitate jail discharge planning. Jail detainees with early psychosis were referred to the project and assessed for positive and negative symptoms, substance use, and duration of untreated psychosis (DUP). During a 24-month period, 25 individuals were referred, of whom eight were eligible and interviewed. RESULTS The sociodemographic and clinical characteristics of the jail detainees were similar to those of individuals in hospital settings. The median DUP was 36 weeks. One of the eight detainees with early psychosis was successfully referred to CSC; for the other detainees, social or criminal legal factors precluded referral. CONCLUSIONS A targeted educational campaign for correction officers and a specialized early engagement support service can be implemented in a jail setting, and referrals can be facilitated. Success of the campaign may depend on having dedicated liaisons within the jail setting (e.g., among correctional health staff) as well as liaisons in local CSC programs and leadership. Changes in the law and policy environments (e.g., criminal legal system reform) and changes in organizational practices and processes for corrections, correctional health, and local CSC programs (such as those made during the COVID-19 pandemic) require ongoing collaborations.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Compton, Pope); Vera Institute of Justice, New York City (Tan de Bibiana)
| | - Jason Tan de Bibiana
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Compton, Pope); Vera Institute of Justice, New York City (Tan de Bibiana)
| | - Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Compton, Pope); Vera Institute of Justice, New York City (Tan de Bibiana)
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Pope LG, Patel A, Watson AC, Compton MT. Making Decisions About Calling 988 Versus 911: Understanding End-User Views Before the Launch of 988. Psychiatr Serv 2024:appips20230016. [PMID: 38410036 DOI: 10.1176/appi.ps.20230016] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
OBJECTIVE The 988 telephone number was implemented in July 2022 as an easily accessible way to reach the National Suicide Prevention Lifeline and has been envisioned as one step in building a more robust crisis care continuum in the United States. This study aimed to describe how various stakeholders anticipated using 988 compared with the most widely known crisis line: 911. METHODS Focus groups (N=15, with 76 total participants) were conducted in three counties in New York State between October and November 2021, before the launch of 988. Five stakeholder groups were included: mental health services consumers, family members of consumers, community members, mental health providers, and crisis call takers. Thematic analysis was used to code and analyze all focus group transcripts. RESULTS Participants anticipated that key uses for 988 would be accessing support during a crisis, obtaining connections to local resources and services, and receiving alternatives to law enforcement response. However, participants continued to articulate uses for 911 during a mental health crisis, especially for situations involving "safety concerns." CONCLUSIONS The broad expectations for 988 suggest that the line must be flexible and responsive to a range of needs and that communities should clearly define what is available through 988. More implementation research is needed to ensure a detailed understanding of those whom 988 is serving, how the line meets callers' needs, and the line's potential for connecting people to needed services.
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Affiliation(s)
- Leah G Pope
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Pope, Patel, Compton); School of Social Work, Wayne State University, Detroit (Watson)
| | - Ashnee Patel
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Pope, Patel, Compton); School of Social Work, Wayne State University, Detroit (Watson)
| | - Amy C Watson
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Pope, Patel, Compton); School of Social Work, Wayne State University, Detroit (Watson)
| | - Michael T Compton
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Pope, Patel, Compton); School of Social Work, Wayne State University, Detroit (Watson)
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Ku BS, Ren J, Compton MT, Druss BG, Guo S, Walker EF. The association between neighborhood-level social fragmentation and distressing psychotic-like experiences in early adolescence: the moderating role of close friends. Psychol Med 2024:1-9. [PMID: 38362835 DOI: 10.1017/s0033291724000278] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Early exposure to neighborhood social fragmentation has been shown to be associated with schizophrenia. The impact of social fragmentation and friendships on distressing psychotic-like experiences (PLE) remains unknown. We investigate the relationships between neighborhood social fragmentation, number of friends, and distressing PLE among early adolescents. METHODS Data were collected from the Adolescent Brain Cognitive Development Study. Generalized linear mixed models tested associations between social fragmentation and distressing PLE, as well as the moderating role of the number of total and close friends. RESULTS Participants included 11 133 adolescents aged 9 to 10, with 52.3% being males. Greater neighborhood social fragmentation was associated with higher levels of distressing PLE (adjusted β = 0.05; 95% CI: 0.01-0.09). The number of close but not total friends significantly interacted with social fragmentation to predict distressing PLE (adjusted β = -0.02; 95% CI: -0.04 to <-0.01). Among those with fewer close friends, the association between neighborhood social fragmentation and distressing PLE was significant (adjusted β = 0.07; 95% CI: 0.03-0.11). However, among those with more close friends, the association was non-significant (adjusted β = 0.03; 95% CI: -0.01 to 0.07). CONCLUSIONS Greater neighborhood social fragmentation is associated with higher levels of distressing PLE, particularly among those with fewer close friends. Further research is needed to disentangle aspects of the interaction between neighborhood characteristics and the quality of social interactions that may contribute to psychosis, which would have implications for developing effective interventions at the individual and community levels.
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Affiliation(s)
- Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jiyuan Ren
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York, NY, USA
| | - Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shuyi Guo
- Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
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Compton MT, Frimpong EY, Ehntholt A, Zhu H, Chaudhry S, Ferdousi W, Rowan GA, Radigan M, Smith TE, Rotter M. Associations between Social Adversities and Chronic Medical Conditions in a Statewide Sample of Individuals in Treatment for Mental Illnesses. Community Ment Health J 2024; 60:251-258. [PMID: 37395820 DOI: 10.1007/s10597-023-01165-3] [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: 11/28/2022] [Accepted: 06/24/2023] [Indexed: 07/04/2023]
Abstract
Individuals with mental illnesses experience disproportionately high rates of social adversities, chronic medical conditions, and early mortality. We analyzed a large, statewide dataset to explore associations between four social adversities and the presence of one or more, and then two or more, chronic medical conditions among individuals in treatment for mental illnesses in New York State. In Poisson regression models adjusting for multiple covariates (e.g., gender, age, smoking status, alcohol use), the presence of one or more adversities was associated with the presence of at least one medical condition (prevalence ratio (PR) = 1.21) or two or more medical conditions (PR = 1.46), and two or more adversities was associated with at least one medical condition (PR = 1.25) or two or more medical conditions (PR = 1.52) (all significant at p < .0001). Greater attention to primary, secondary, and tertiary prevention of chronic medical conditions is needed in mental health treatment settings, especially among those experiencing social adversities.
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Affiliation(s)
- Michael T Compton
- New York State Psychiatric Institute, New York, NY, USA.
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
| | | | - Amy Ehntholt
- New York State Psychiatric Institute, New York, NY, USA
- New York State Office of Mental Health, Albany, NY, USA
| | - Huilin Zhu
- New York State Office of Mental Health, Albany, NY, USA
| | | | | | - Grace A Rowan
- New York State Office of Mental Health, Albany, NY, USA
| | | | - Thomas E Smith
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- New York State Office of Mental Health, Albany, NY, USA
| | - Merrill Rotter
- New York State Office of Mental Health, Albany, NY, USA
- Albert Einstein College of Medicine, New York, NY, USA
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Ehntholt A, Fu E, Pope LG, Rotter M, Compton MT. Introducing the Staff-Administered Meal Independence Rating Scale for Use Among Patients With Serious Mental Illnesses. J Nerv Ment Dis 2024; 212:71-75. [PMID: 37788339 DOI: 10.1097/nmd.0000000000001732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
ABSTRACT For individuals living with serious mental illnesses (SMIs), inadequate meal preparation skills can hinder the ability to live independently; yet rating scales tailored for this population are lacking. We describe development, item analysis, and initial reliability and validity of the Staff-Administered Meal Independence Rating Scale (SAMIRS). After item development involving expert consultation, two rounds of pilot testing ( n = 188, n = 293) were conducted in inpatient and residential settings (transitional living residences [TLRs] and community residences [CRs]). For initial testing of convergent validity, Pearson correlations with Specific Levels of Functioning (SLOF) scale items were computed. Exploratory factor analysis revealed a single factor; Cronbach's alpha was high (0.98). The mean SAMIRS score varied by setting: CR residents scored higher than those in TLRs or inpatient units. Scores were highly correlated with SLOF items measuring community living skills. Although further study is warranted, the SAMIRS could be a useful tool in rating functional needs pertaining to meal independence among individuals with SMI.
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Affiliation(s)
| | - En Fu
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
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Compton MT. Food and Nutrition Insecurity: A Social Determinant Hungry for Attention by Mental Health Professionals. Psychiatr Serv 2023; 74:1303-1306. [PMID: 37221887 DOI: 10.1176/appi.ps.20220511] [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] [Indexed: 05/25/2023]
Abstract
Food and nutrition security-healthy food being available and households being able to access and use it-is necessary for mental and overall health but is a neglected social determinant of mental health. Mental health professionals should address food and nutrition insecurity by weighing in on federal and state legislation and policies related to food and nutrition; promoting food banks and pantries, "food is medicine" initiatives, and programs offering better opportunities to afford and access whole foods and fresh produce; and addressing food and nutrition insecurity at the individual level in the clinical setting through screening, assessment, treatment, and follow-up.
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Affiliation(s)
- Michael T Compton
- New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York City
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Ku BS, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Compton MT, Cornblatt BA, Druss BG, Gülöksüz S, Mathalon DH, Perkins DO, Tsuang MT, Walker EF, Woods SW, Carrión RE. Associations Between Childhood Area-Level Social Fragmentation, Maladaptation to School, and Social Functioning Among Healthy Youth and Those at Clinical High Risk for Psychosis. Schizophr Bull 2023; 49:1437-1446. [PMID: 37358832 PMCID: PMC10686327 DOI: 10.1093/schbul/sbad093] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
BACKGROUND AND HYPOTHESIS Although studies have identified social fragmentation as an important risk factor for schizophrenia and other psychotic disorders, it is unknown whether it may impact social functioning. This study investigates whether social fragmentation during childhood predicts maladaptation to school as well as social functioning during childhood and adulthood. STUDY DESIGN Data were collected from the North American Prodrome Longitudinal Study. Participants included adults at clinical high risk for psychosis (CHR-P) and healthy comparisons (HC). Maladaptation to school and social functioning during childhood were assessed retrospectively and social functioning in adulthood was assessed at baseline. STUDY RESULTS Greater social fragmentation during childhood was associated with greater maladaptation to school (adjusted β = 0.21; 95% CI: 0.02 to 0.40). Social fragmentation was not associated with social functioning during childhood (unadjusted β = -0.08; 95% CI: -0.31 to 0.15). However, greater social fragmentation during childhood predicted poorer social functioning in adulthood (adjusted β = -0.43; 95% CI: -0.79 to -0.07). Maladaptation to school mediated 15.7% of the association between social fragmentation and social functioning. The association between social fragmentation and social functioning was stronger among adults at CHR-P compared to HC (adjusted β = -0.42; 95% CI: -0.82 to -0.02). CONCLUSIONS This study finds that social fragmentation during childhood is associated with greater maladaptation to school during childhood, which in turn predicts poorer social functioning in adulthood. Further research is needed to disentangle aspects of social fragmentation that may contribute to social deficits, which would have implications for the development of effective interventions at the individual and community levels.
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Affiliation(s)
- Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | | | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York, NY, USA
| | - Barbara A Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sinan Gülöksüz
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Ming T Tsuang
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Ricardo E Carrión
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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Pope LG, Patel A, Fu E, Zingman M, Warnock A, Ellis S, Ashekun O, Watson A, Wood J, Compton MT. Crisis Response Model Preferences of Mental Health Care Clients With Prior Misdemeanor Arrests and of Their Family and Friends. Psychiatr Serv 2023; 74:1163-1170. [PMID: 37070262 DOI: 10.1176/appi.ps.20220363] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
The overrepresentation of people with serious mental illnesses in the criminal legal system has spurred the development of crisis response models to improve or reduce police response to a mental health crisis. However, limited research has explored preferences for crisis response, and no research in the United States has examined the responses desired by mental health care clients or their family members. This study aimed to understand the experiences of people with serious mental illnesses interacting with police and to learn about their preferences for crisis response models. The authors interviewed 50 clients with serious mental illnesses and a history of arrest who were enrolled in a randomized controlled trial of a police-mental health linkage system, as well as 18 of their family members and friends. Data were coded with deductive and inductive approaches and were grouped into larger themes. Clients and family or friends described needing a calm environment and empathy during a crisis. They selected a nonpolice response as their first choice and response from a crisis intervention team as their last choice among four options, highlighting the importance of trained responders and past negative interactions with police. However, they also noted concerns about safety and the shortcomings of a nonpolice response. These findings build understanding about clients' and family members' preferences for crisis response and highlight concerns that are relevant for policy makers.
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Affiliation(s)
- Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Ashnee Patel
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - En Fu
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Michael Zingman
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Amanda Warnock
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Samantha Ellis
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Oluwaytoyin Ashekun
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Amy Watson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Jennifer Wood
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
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Compton MT, Frimpong EY, Fu E, Ehntholt A, Chaudhry S, Ferdousi W, Rowan GA, Swetnam H, Radigan M, Smith TE, Rotter M. Associations Between Cumulative Social Adversities and Substance Use Comorbidity in a Statewide Sample of Individuals in Treatment for Mental Illnesses. J Nerv Ment Dis 2023; 211:814-818. [PMID: 37552046 DOI: 10.1097/nmd.0000000000001703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
ABSTRACT We sought to investigate associations of cumulative social adversities in four areas (low education, unemployment, homelessness, and criminal/legal involvement) with presence of comorbid alcohol and drug use disorders among individuals in treatment for mental illnesses. Using data from 103,416 adults in mental health treatment, generalized estimating equation modified Poisson models were used to estimate increased risk of having comorbid substance use disorders based on individual and/or cumulative number of social adversities present. Controlling for effects of sex, race/ethnicity, and region (New York City vs . the rest of the State), as well as for the other social adversities, each of four social adversities was associated with presence of substance use comorbidity. Relative to having none of the social adversities, the presence of one, two, three, or four was associated with an increased prevalence ratio (PR) of having substance use comorbidity: 1.44, 2.10, 2.66, and 2.92; all p 's < 0.0001. PRs were greater among female patients, and among Hispanics and those classified as other or multiracial compared with non-Hispanic Whites or non-Hispanic Blacks. Findings indicate substantial associations between four social adversities and presence of substance use comorbidity; the strength of association with the four social adversities is cumulative.
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Affiliation(s)
| | | | - En Fu
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | - Sahil Chaudhry
- New York State Office of Mental Health, Albany, New York
| | | | - Grace A Rowan
- New York State Office of Mental Health, Albany, New York
| | - Hannah Swetnam
- New York State Office of Mental Health, Albany, New York
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Compton MT, Cohen DE, Farland G, En Fu, Gerstler C, Pope LG, Rotter M. Improving Nutrition Security for Individuals With Serious Mental Illnesses: A Partnership of Public and Nonprofit Agencies. Psychiatr Serv 2023; 74:1092-1095. [PMID: 36916058 DOI: 10.1176/appi.ps.20220436] [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] [Indexed: 03/16/2023]
Abstract
In conjunction with multiple partners (state agencies, nonprofits, a university, and key stakeholders and content experts), the authors are implementing and evaluating an intervention intended to enable individuals with serious mental illnesses living in community residences (i.e., group homes) and supportive housing apartments to-with support from residential staff-access, purchase, prepare, and enjoy healthy, local produce. The three-component intervention makes fresh produce more accessible; improves its affordability; and conveys knowledge and skills related to purchasing, preparing, and eating healthy foods, especially vegetables. The intervention is being evaluated in preparation for possible larger-scale implementation and potential dissemination to other populations experiencing nutrition insecurity.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Dana E Cohen
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Gabriella Farland
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - En Fu
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Cheryl Gerstler
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Leah G Pope
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Merrill Rotter
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
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Snow JC, Gomez MA, Compton MT. Human memory for real-world solid objects is not predicted by responses to image displays. J Exp Psychol Gen 2023; 152:2703-2712. [PMID: 37079829 PMCID: PMC10587360 DOI: 10.1037/xge0001387] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
In experimental psychology and neuroscience, computerized image stimuli are typically used as artificial proxies for real-world objects to understand brain and behavior. Here, in a series of five experiments (n = 165), we studied human memory for objects presented as tangible solids versus computerized images. We found that recall for solids was superior to images, both immediately after learning, and after a 24-hr delay. A "realness advantage" was also evident relative to three-dimensional (3-D) stereoscopic images, and when solids were viewed monocularly, arguing against explanations based on the presence of binocular depth cues in the stimulus. Critically, memory for solids was modulated by physical distance, with superior recall for objects positioned within versus outside of observers' reach, whereas recall for images was unaffected by distance. We conclude that solids are processed quantitatively and qualitatively differently in episodic memory than are images, suggesting caution in assuming that artifice can always substitute for reality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Michael A. Gomez
- The University of Nevada Reno, Reno, Nevada, USA
- Clovis Community College, Fresno, CA
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Ashekun O, Zern A, Langlois S, Compton MT. Adverse Childhood Experiences and Arrest Rates among Individuals with Serious Mental Illnesses. J Am Acad Psychiatry Law 2023; 51:329-336. [PMID: 37277161 DOI: 10.29158/jaapl.220096-22] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Adverse childhood experiences (ACEs) are linked to both poor mental health and adverse social outcomes, including arrest and incarceration. Furthermore, individuals with serious mental illnesses (SMI) are known to have high rates of childhood adversity and are overrepresented in all facets of the criminal justice system. Few studies have examined the associations between ACEs and arrests among individuals with SMI. We examined the impact of ACEs on arrest among individuals with SMI while controlling for age, gender, race, and educational attainment. In a combined sample from two separate studies in different settings (N = 539), we hypothesized that ACE scores would be associated with prior arrest, as well as rate of arrests. The prevalence of prior arrest was very high (415, 77.3%) and was predicted by male gender, African American race, lower educational attainment, and mood disorder diagnosis. Arrest rate (number of arrests per decade, which thus accounted for age) was predicted by lower educational attainment and higher ACE score. Diverse clinical and policy implications include improving educational outcomes for individuals with SMI, reducing and addressing childhood maltreatment and other forms of childhood or adolescent adversity, and clinical approaches that help clients reduce the likelihood of arrest while addressing trauma histories.
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Affiliation(s)
- Oluwatoyin Ashekun
- Ms. Ashekun and Ms. Langlois are Research Assistants at DeKalb Community Service Board, Decatur, GA. Ms. Zern is Research Project Manager in the Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY. Dr. Compton is a Professor of Psychiatry in the Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY and Research Psychiatrist, New York State Psychiatric Institute, New York, NY
| | - Adria Zern
- Ms. Ashekun and Ms. Langlois are Research Assistants at DeKalb Community Service Board, Decatur, GA. Ms. Zern is Research Project Manager in the Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY. Dr. Compton is a Professor of Psychiatry in the Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY and Research Psychiatrist, New York State Psychiatric Institute, New York, NY
| | - Stephanie Langlois
- Ms. Ashekun and Ms. Langlois are Research Assistants at DeKalb Community Service Board, Decatur, GA. Ms. Zern is Research Project Manager in the Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY. Dr. Compton is a Professor of Psychiatry in the Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY and Research Psychiatrist, New York State Psychiatric Institute, New York, NY
| | - Michael T Compton
- Ms. Ashekun and Ms. Langlois are Research Assistants at DeKalb Community Service Board, Decatur, GA. Ms. Zern is Research Project Manager in the Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY. Dr. Compton is a Professor of Psychiatry in the Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY and Research Psychiatrist, New York State Psychiatric Institute, New York, NY.
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Samaranayake DP, Feeney SB, Baker T, Hans JJ, Jacobs D, Compton MT. Overrepresentation of In-Home, Natural Deaths Among Individuals Treated for Mental Illnesses in New York State. Psychiatr Serv 2023; 74:885-888. [PMID: 36820522 DOI: 10.1176/appi.ps.202100732] [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] [Indexed: 02/24/2023]
Abstract
OBJECTIVE The authors compared rates of in-home, natural death among individuals receiving treatment for mental illnesses with those in the general population. METHODS Two data sets were used to determine the prevalence of in-home, natural deaths in the general population and among those receiving treatment for mental illnesses in New York State, outside New York City, for the period 2016-2018. RESULTS Overall, 37% of natural deaths among individuals receiving mental health treatment occurred in the home, compared with 26% in the general population. Earlier death was also apparent; for example, 26.4% of in-home deaths among those receiving mental health treatment were among those ages 45-54 years, compared with 5.5% in the general population. In-home, natural deaths were also higher among non-Hispanic Black and Hispanic subpopulations. CONCLUSIONS These findings suggest a need for programmatic and policy advances to reduce disparities in general health care for those living with mental illnesses. Additional analyses are warranted.
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Affiliation(s)
- Dhanushki P Samaranayake
- New York State Office of Mental Health, Albany, New York (Samaranayake, Feeney, Baker, Hans, Jacobs); New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton)
| | - Suzanne B Feeney
- New York State Office of Mental Health, Albany, New York (Samaranayake, Feeney, Baker, Hans, Jacobs); New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton)
| | - Tami Baker
- New York State Office of Mental Health, Albany, New York (Samaranayake, Feeney, Baker, Hans, Jacobs); New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton)
| | - John J Hans
- New York State Office of Mental Health, Albany, New York (Samaranayake, Feeney, Baker, Hans, Jacobs); New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton)
| | - Deanna Jacobs
- New York State Office of Mental Health, Albany, New York (Samaranayake, Feeney, Baker, Hans, Jacobs); New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton)
| | - Michael T Compton
- New York State Office of Mental Health, Albany, New York (Samaranayake, Feeney, Baker, Hans, Jacobs); New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton)
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Compton MT, Pope LG, de Bibiana JT, Boswell T, Fu E, Zern A, Bello I, Broussard B, Ford E, Jones N, Monahan Pollard J, Watson AC, Dixon L. Changes in knowledge, behavioural expectations, self-efficacy, and stigma after an educational campaign about early psychosis for jail correction officers. Early Interv Psychiatry 2023; 17:798-806. [PMID: 36641811 DOI: 10.1111/eip.13370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 05/26/2022] [Revised: 08/29/2022] [Accepted: 01/02/2023] [Indexed: 01/16/2023]
Abstract
AIM Given a lack of interventions to identify and engage individuals with early psychosis in jail and connect them to specialty care in the community upon release, we designed a Targeted Educational Campaign (TEC) for correction officers working in jails. We report on impacts of the TEC on officers' cognitive and attitudinal outcomes. METHODS Three different cohorts of officers-totaling n = 451-took part in a survey: 200 at baseline before the TEC began, 123 at 6-months into the TEC, and 128 at 12-months into the TEC. Among each cohort of officers, four constructs were measured: (1) knowledge about early psychosis; (2) self-efficacy around detecting early psychosis and referring to mental health services within the jail; (3) expectations about the benefits of detection and referral to specialty care; and (4) social distance stigma toward detainees with early psychosis. RESULTS While exposure to TEC elements was as-planned in the first 6-months, exposure diminished substantially at 12-months, coinciding with increasing fatigue among correction officers due to the COVID-19 pandemic as well as serious staffing shortages. Knowledge, behavioural expectations, and self-efficacy scores improved from baseline to 6-months, with greater exposure to roll-call messages driving scores. Knowledge and behavioural expectations at 12-months were associated with having received an information post card. Social distance stigma worsened across timepoints. CONCLUSIONS An educational campaign for jail staff can enhance knowledge, self-efficacy, and behavioural expectations regarding early psychosis, though only while the campaign elements are active. Further research should investigate whether or not social distance stigma or other types of stigma increase alongside improvements.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | | | - Tehya Boswell
- Columbia University Mailman School of Public Health, New York, New York, USA
| | - En Fu
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Iruma Bello
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Beth Broussard
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Elizabeth Ford
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Nev Jones
- University of Pittsburgh School of Social Work, Pittsburgh, Pennsylvania, USA
| | - Jessica Monahan Pollard
- State of Maine Department of Health and Human Services, Office of Behavioral Health, Augusta, Maine, USA
| | - Amy C Watson
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Lisa Dixon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
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Compton MT, Ku BS, Covington MA, Metzger C, Hogoboom A. Lexical Diversity and Other Linguistic Measures in Schizophrenia: Associations With Negative Symptoms and Neurocognitive Performance. J Nerv Ment Dis 2023; 211:613-620. [PMID: 37256631 DOI: 10.1097/nmd.0000000000001672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
ABSTRACT Straightforward linguistic measures may be indicators of reduced language production and lexical diversity among individuals with schizophrenia with negative symptoms and neurocognitive impairments. We compared 98 patients with schizophrenia to 101 unaffected controls on six language variables ( e.g. , number of relationships between objects, use of complex transitions in the narrative structure), number of words produced, and lexical diversity computed as the moving average type-token ratio from both speaking and writing tasks. Patients differed from controls on nearly all of the linguistic measures; number of words produced had the strongest effect, with an average Cohen's d of 0.68; values pertaining to lexical diversity were 0.50 and 0.32, respectively, for the speaking tasks and the writing tasks. Most measures were correlated with alogia and other domains of negative symptoms (including avolition-apathy and anhedonia-asociality), as well as with diverse neurocognitive domains, especially those pertaining to working memory, verbal learning, and verbal category fluency. Further work is needed to understand longitudinal changes in these linguistic variables, as well as their utility as measures of alogia.
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Affiliation(s)
| | - Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta
| | - Michael A Covington
- Institute for Artificial Intelligence, The University of Georgia, Athens, Georgia
| | - Celia Metzger
- Department of English, Linguistics Program, William & Mary, Williamsburg, Virginia
| | - Anya Hogoboom
- Department of English, Linguistics Program, William & Mary, Williamsburg, Virginia
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Sturm ET, Thomas ML, Sares AG, Dave S, Baron D, Compton MT, Palmer BW, Jester DJ, Jeste DV. Review of Major Social Determinants of Health in Schizophrenia-Spectrum Disorders: II. Assessments. Schizophr Bull 2023; 49:851-866. [PMID: 37022911 PMCID: PMC10318889 DOI: 10.1093/schbul/sbad024] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
BACKGROUND AND AIMS Social determinants of health (SDoHs) impact the development and course of schizophrenia-spectrum psychotic disorders (SSPDs). Yet, we found no published scholarly reviews of psychometric properties and pragmatic utility of SDoH assessments among people with SSPDs. We aim to review those aspects of SDoH assessments. STUDY DESIGN PsychInfo, PubMed, and Google Scholar databases were examined to obtain data on reliability, validity, administration process, strengths, and limitations of the measures for SDoHs identified in a paired scoping review. STUDY RESULTS SDoHs were assessed using different approaches including self-reports, interviews, rating scales, and review of public databases. Of the major SDoHs, early-life adversities, social disconnection, racism, social fragmentation, and food insecurity had measures with satisfactory psychometric properties. Internal consistency reliabilities-evaluated in the general population for 13 measures of early-life adversities, social disconnection, racism, social fragmentation, and food insecurity-ranged from poor to excellent (0.68-0.96). The number of items varied from 1 to more than 100 and administration time ranged from less than 5 minutes to over an hour. Measures of urbanicity, low socioeconomic status, immigration status, homelessness/housing instability, and incarceration were based on public records or targeted sampling. CONCLUSIONS Although the reported assessments of SDoHs show promise, there is a need to develop and test brief but validated screening measures suitable for clinical application. Novel assessment tools, including objective assessments at individual and community levels utilizing new technology, and sophisticated psychometric evaluations for reliability, validity, and sensitivity to change with effective interventions are recommended, and suggestions for training curricula are offered.
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Affiliation(s)
- Emily T Sturm
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Anastasia G Sares
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | | | - David Baron
- Western University of Health Sciences, CA, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, and New York State Psychiatric Institute, New York, NY, USA
| | - Barton W Palmer
- Department of Psychiatry, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Mental Illness Research, Education, and Clinical Center, San Diego, CA, USA
| | - Dylan J Jester
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, CA, USA (Retired)
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Jester DJ, Thomas ML, Sturm ET, Harvey PD, Keshavan M, Davis BJ, Saxena S, Tampi R, Leutwyler H, Compton MT, Palmer BW, Jeste DV. Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: I. Clinical Outcomes. Schizophr Bull 2023; 49:837-850. [PMID: 37022779 PMCID: PMC10318890 DOI: 10.1093/schbul/sbad023] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
BACKGROUND Social determinants of health (SDoHs) are receiving growing attention and are particularly relevant to persons with schizophrenia-spectrum psychotic disorders (SSPDs), considering their heightened risk of comorbidities, cognitive and functional decline, and early mortality. Yet, we did not find any comprehensive review of multiple SDoHs in SSPD. STUDY DESIGN We conducted a scoping review of meta-analyses and systematic reviews of nine major SDoHs in SSPD. STUDY RESULTS Childhood abuse, parental psychopathology, parental communication problems, bullying, and urban settings with lower socioeconomic status were major risk factors for the greater incidence of SSPD and/or worse health. Social network size was inversely associated with overall psychopathology and negative symptoms. Experiences of racial/ethnic discrimination correlated with the prevalence of psychotic symptoms and experiences. Compared to native populations, the risk of psychosis was higher in immigrants, refugees, and asylees. Social fragmentation was associated with an increased prevalence of schizophrenia. Homeless populations had a 30-fold higher prevalence of schizophrenia than the general population. Seriously mentally ill people were 2.7 times more likely to report food insecurity than controls. The prevalence of non-affective psychosis in prisoners was 2.0%-6.5%, compared to 0.3% in the general population. Certain potentially positive factors like family and community resilience remain poorly studied. CONCLUSIONS SDoHs are associated with higher rates of and worse outcomes in SSPD. Well-designed longitudinal studies are needed to understand SDoHs' contribution to health in persons with SSPD, to develop interventions, and to implement changes in clinical care and public health policies that would reduce adverse health impacts of SDoHs. Positive SDoHs deserve greater attention.
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Affiliation(s)
- Dylan J Jester
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Emily T Sturm
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Philip D Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, and Research Service, Bruce W. Carter Miami VA Medical Center, Miami, FL, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess medical Center and Harvard Medical School, Boston, MA, USA
| | - Beshaun J Davis
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shekhar Saxena
- Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Rajesh Tampi
- Department of Psychiatry, Creighton University School of Medicine, Omaha, NE, USA
| | - Heather Leutwyler
- Department of Physiological Nursing, University of California, San Francisco, CA, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Barton W Palmer
- Department of Psychiatry, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Mental Illness Research, Education, and Clinical Center, San Diego, CA, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, CA, USA
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Compton MT. Improving the well-being of older adults requires programs that enhance resilience as well as policies, across sectors, that promote health. Int Psychogeriatr 2023; 35:215-217. [PMID: 37078193 DOI: 10.1017/s1041610223000303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Affiliation(s)
- Michael T Compton
- Columbia University Vagelos College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, NY, USA
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20
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Ku BS, Walker EF, Druss BG, Murray CR, Compton MT. Residential instability during adolescence predicts earlier age at onset of psychosis: The moderating role of extraversion. Early Interv Psychiatry 2023; 17:527-531. [PMID: 36650675 PMCID: PMC10175105 DOI: 10.1111/eip.13375] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 09/20/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Residential instability (RI) during adolescence is associated with poor health outcomes. Also, extraversion has been shown to be a moderator of these associations. However, the associations between RI, extraversion, and age at onset of psychosis (AOP) remain unknown. METHODS Data were collected from patients with first-episode psychosis (FEP). Linear regression models assessed the association between RI during adolescence and AOP. Extraversion was tested as a moderator using the interaction term RI-by-extraversion. RESULTS Among 89 participants with FEP, both RI (adjusted β = -.278, p = .006) and the interaction term RI-by-extraversion (adjusted β = .290, p < .001) were associated with earlier AOP. Stratified analyses showed that RI was only significantly associated with earlier AOP among those with low extraversion (adjusted β = -.598, p < .001). CONCLUSIONS RI predicted earlier AOP and this association was moderated by extraversion. These findings suggest that extraversion may buffer the negative relationship between RI and AOP. Future research should replicate these findings.
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Affiliation(s)
- Benson S. Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Elaine F. Walker
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Benjamin G. Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Camille R. Murray
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Michael T. Compton
- New York State Psychiatric Institute, New York, NY, United States
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
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21
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Pope LG, Stagoff-Belfort A, Warnock A, de Bibiana JT, Watson AC, Wood J, Compton MT. Competing Concerns in Efforts to Reduce Criminal Legal Contact Among People with Serious Mental Illnesses: Findings from a Multi-City Study on Misdemeanor Arrests. Adm Policy Ment Health 2023; 50:476-487. [PMID: 36717527 PMCID: PMC9886548 DOI: 10.1007/s10488-023-01252-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/15/2023] [Indexed: 02/01/2023]
Abstract
People with serious mental illnesses are disproportionately involved in the criminal legal system, often for low-level, non-violent misdemeanors. This paper examines how decision-makers at different stages of the criminal legal system articulate unique visions of the "best approach" for addressing this problem of over-representation. Focus groups and in-depth interviews were conducted with 94 stakeholders from Atlanta, Chicago, New York City, and Philadelphia to understand how decision-makers from different agencies use and process specific misdemeanor charges in relation to people with serious mental illnesses. Data were analyzed using a thematic approach. The data reveal a series of tensions regarding how criminal legal system stakeholders process people with serious mental illnesses through the misdemeanor system. Three key themes emerged from analysis. The first characterizes the shared commitment across agencies to reducing system contact among people with mental illnesses. The second explores how agencies differ on how to make good on that commitment because of the distinct values and goals they bring to the table. The final theme explores the limits of current approaches to reducing system contact for people with mental illnesses. Findings are discussed in the context of literature on "loose coupling" and the focal concerns framework and demonstrate that decisions about how and when to intervene with people with mental illnesses in the criminal legal system are influenced by the varying orientations, goals, and values of stakeholder agencies. Understanding these core differences is a critical step toward value alignment in strategies to reduce system involvement among people with mental illnesses.
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Affiliation(s)
- Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | | | - Amanda Warnock
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Amy C Watson
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jennifer Wood
- Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia, PA, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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22
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Wood JD, Watson AC, Pope L, Warnock A, Nelson V, Gesser N, Zern A, Stagoff-Belfort A, de Bibiana JT, Compton MT. Contexts shaping misdemeanor system interventions among people with mental illnesses: qualitative findings from a multi-site system mapping exercise. Health Justice 2023; 11:20. [PMID: 37014478 PMCID: PMC10071260 DOI: 10.1186/s40352-023-00219-8] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND People with mental illnesses are disproportionately entangled in the criminal legal system. Historically, this involvement has resulted from minor offending, often accompanied by misdemeanor charges. In recent years, policymakers have worked to reduce the footprint of the criminal legal system. This paper seeks to better understand how misdemeanor systems intervene in the lives of people with mental illnesses. METHODS System mapping exercises were conducted with misdemeanor system stakeholders from the jurisdictions of Atlanta, Chicago, Manhattan, and Philadelphia. Narrative detail on decision-making and case processing, both generally and in relation to specific types of behavior, including trespassing, retail theft/shoplifting, and simple assault, were coded and analyzed for thematic patterns. Based on the qualitative analysis, this paper offers a conceptual diagram of contexts shaping misdemeanor system interventions among people with mental illnesses. RESULTS All four sites have been engaged in efforts to reduce the use of misdemeanor charges both generally and in relation to people with mental illnesses. Decision-makers across all sites experience contexts that shape how, when, and where they intervene, which are: (1) law and policy environments; (2) location of the behavior; (3) expectations of stakeholders; (4) knowledge of mental illnesses; and (5) access to community resources. Law and policy environments expand or constrain opportunities for diversion. The location of offending is relevant to who has a stake in the behavior, and what demands they have. Clinical, experiential, and system-level knowledge of mental illnesses inform a chain of decisions about what to do. The capacity to address mental health needs is contingent on access to social services, including housing. CONCLUSION People making decisions along the criminal legal continuum are critical to illuminating the dynamic, inter-related contexts that facilitate and frustrate attempts to address defendants' mental health needs while balancing considerations of public safety. Multi-sector, scenario-based or case study exercises could help identify concrete ways of improving each of the contexts that surround whole-of-system decisions.
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Affiliation(s)
- Jennifer D. Wood
- Department of Criminal Justice, Temple University, Philadelphia, PA USA
| | - Amy C. Watson
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI USA
| | - Leah Pope
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Amanda Warnock
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Veronica Nelson
- Department of Criminal Justice, Temple University, Philadelphia, PA USA
| | - Nili Gesser
- Department of Psychology, University of North Dakota, Grand Forks, ND USA
| | - Adria Zern
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | | | | | - Michael T. Compton
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
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23
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Frimpong EY, Ferdousi W, Rowan GA, Chaudhry S, Swetnam H, Compton MT, Smith TE, Radigan M. Racial and Ethnic Disparities in Health Care Access and Utilization among Medicaid Managed Care Beneficiaries. J Behav Health Serv Res 2023; 50:194-213. [PMID: 35945481 DOI: 10.1007/s11414-022-09811-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/27/2022]
Abstract
This quasi-experimental study examined the impact of a statewide integrated special needs program Health and Recovery Plan (HARP) for individuals with serious mental illness and identified racial and ethnic disparities in access to Medicaid services. Generalized estimating equation negative binomial models were used to estimate changes in service use, difference-in-differences, and difference-in-difference-in-differences in the pre- to post-HARP periods. Implementation of the special needs plan contributed to reductions in racial/ethnic disparities in access and utilization. Notable among those enrolled in the special needs plan was the declining Black-White disparities in emergency room (ER) visits and inpatient stays, but the disparity in non-behavioral health clinic visits remains. Also, the decline of Hispanic-White disparities in ER, inpatient, and clinic use was more evident for HARP-enrolled patients. Health equity policies are needed in the delivery of care to linguistically and culturally disadvantaged Medicaid beneficiaries.
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Affiliation(s)
| | | | - Grace A Rowan
- New York State Office of Mental Health, New York, NY, USA
| | - Sahil Chaudhry
- New York State Office of Mental Health, New York, NY, USA
| | - Hannah Swetnam
- New York State Office of Mental Health, New York, NY, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA.,New York State Psychiatric Institute, New York, NY, USA
| | - Thomas E Smith
- New York State Office of Mental Health, New York, NY, USA.,Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
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24
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Hogoboom A, Rouch M, Lauerman D, Pauselli L, Compton MT. Initial evidence of vowel space reduction in a subset of individuals with schizophrenia. Schizophr Res 2023; 255:158-164. [PMID: 36989674 DOI: 10.1016/j.schres.2023.03.026] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/06/2023] [Accepted: 03/12/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE Acoustic phonetic measures have been found to correlate with negative symptoms of schizophrenia, thus offering a path toward quantitative measurement of such symptoms. These acoustic properties include F1 and F2 measurements (affected by tongue height and tongue forward/back position, respectively), which determine a general "vowel space." Among patients and controls, we consider two phonetic measures of vowel space: average Euclidean distance from a participant's mean F1 and mean F2, and density of vowels around one standard deviation of mean F1 and of F2. METHODS Structured and spontaneous speech of 148 participants (70 patients and 78 controls) was recorded and measured acoustically. We examined correlations between the phonetic measures of vowel space and ratings of aprosody obtained using two clinical research measures, the Scale for the Assessment of Negative Symptoms (SANS) and the Clinical Assessment Interview for Negative Symptoms (CAINS). RESULTS Vowel space measurements were significantly associated with patient/control status, attributed to a cluster of 13 patients whose phonetic values correspond to reduced vowel space as assessed by both phoenetic measures. No correlation was found between phonetic measures and relevant items and averages of ratings on the SANS and CAINS. Reduced vowel space appears to affect only a subset of patients with schizophrenia, potentially those on higher antipsychotic dosages. CONCLUSIONS Acoustic phonetic measures may be more sensitive measures of constricted vowel space than clinical research rating scales of aprosody or monotone speech. Replications are needed before further interpretation of this novel finding, including potential medication effects.
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Affiliation(s)
- Anya Hogoboom
- William & Mary, Department of English, Linguistics Program, Williamsburg, VA, USA
| | - Megan Rouch
- William & Mary, Department of English, Linguistics Program, Williamsburg, VA, USA
| | - Diana Lauerman
- William & Mary, Department of English, Linguistics Program, Williamsburg, VA, USA
| | - Luca Pauselli
- Icahn School of Medicine at Mount Sinai, Morningside/West Hospitals, Department of Psychiatry, New York, NY, USA
| | - Michael T Compton
- Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
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25
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Compton MT, Ku BS. Prevalence of Food Insecurity and Living in a Food Desert among Individuals with Serious Mental Illnesses in Public Mental Health Clinics. Community Ment Health J 2023; 59:357-362. [PMID: 35963919 PMCID: PMC10209833 DOI: 10.1007/s10597-022-01013-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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] [Received: 12/05/2021] [Accepted: 07/26/2022] [Indexed: 01/25/2023]
Abstract
Very little is known about the prevalence of food insecurity-and living in a food desert-among persons with serious mental illnesses, such as schizophrenia and major mood disorders. This study evaluated those prevalences and assessed for associations with six other variables. Surveys were conducted with 300 patients with a psychotic or mood disorder receiving outpatient services at five community mental health agencies in Washington, D.C. The prevalences of low food security and very low food security were 68.9% and 46.8%, compared to national rates of 13.7% (13.2% in Washington, D.C.) and 5.4% (4.8% in Washington, D.C.). 50.0% of participants lived in food desert census tracts, which was associated with both severe and morbid obesity (p = .02 and p = .03, respectively). Additional research, evaluation of clinical implications, and potential policy approaches to these concerning social determinants of physical and mental health, in an already vulnerable patient population, are warranted.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 722 W. 168, Street, Room R249, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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26
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Compton MT, Zern A, Langlois S, Ashekun O. Associations Between Adverse Childhood Experiences and Tobacco, Alcohol, and Drug Use Among Individuals with Serious Mental Illnesses in Public-Sector Treatment Settings. Community Ment Health J 2023; 59:363-369. [PMID: 35976478 DOI: 10.1007/s10597-022-01014-9] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023]
Abstract
Adverse childhood experiences (ACEs) increase risk of substance use disorders (SUDs). Little research has focused on individuals with serious mental illnesses (SMI), despite their high prevalence of both ACEs and SUDs. We combined two datasets from prior studies (n = 299 and n = 240, total n = 539) that measured ACEs and made research diagnoses for SUDs. When controlling for other variables-age, gender, race, diagnostic category (psychotic disorder versus mood disorder), and study site (Washington, DC-area versus southeast Georgia)- in logistic regression models, ACE score was associated with tobacco use, presence of any SUD, alcohol use disorder, cannabis use disorder, and cocaine use disorder. Each one-unit increase in the ACE score increased the odds of SUD-related outcomes by 9-18%. Clinicians, program planners, and researchers should be aware of the powerful and long-lasting impact of ACEs, and the need for thorough screening and assessment of both SUDs and ACEs among patients with SMI.
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Affiliation(s)
- Michael T Compton
- New York State Psychiatric Institute, 722 W. 168th Street, Room R249, 10032, New York, NY, USA. .,Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
| | - Adria Zern
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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27
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Compton MT, Kelley ME, Anderson S, Ellis S, Graves J, Broussard B, Pauselli L, Zern A, Pope LG, Johnson M, Haynes NL. Opening Doors to Recovery: A Randomized Controlled Trial of a Recovery-Oriented Community Navigation Service for Individuals With Serious Mental Illnesses and Repeated Hospitalizations. J Clin Psychiatry 2023; 84. [PMID: 36652687 DOI: 10.4088/jcp.22m14498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective: Opening Doors to Recovery (ODR) is a community navigation and recovery support model created in southeast Georgia by diverse, collaborative stakeholders. Following promising results from a quasi-experimental study, this randomized controlled trial hypothesized that, among patients with serious mental illnesses being discharged from inpatient psychiatric settings, compared to those randomized to traditional case management (CM) services, those randomized to ODR would have (1) lower likelihood of hospitalization, fewer hospitalizations, and fewer inpatient days; (2) lower likelihood of arrest, fewer arrests, and longer time to arrest; and, secondarily, (3) greater housing satisfaction and housing stability; and (4) higher scores on several scales measuring recovery-related constructs. Methods: 240 individuals with Structured Clinical Interview for DSM-5 Disorders-based psychotic or mood disorders, functional impairment, and repeated hospitalizations were randomized (December 2014 to June 2018) to ODR or CM. Hospitalization and arrest data were collected from State agencies after 12 months, and housing- and recovery-related measures were collected in person, longitudinally at 4, 8, and 12 months. Intention-to-treat analyses were conducted. Effects of dropout were accounted for, and sensitivity analyses were run. Results: ODR was associated with fewer days hospitalized (RR = 0.86, P = .001), a lower incidence of arrests (OR = 0.35, P < .0005), and longer time to arrest (HR = 0.42, P = .001). In addition, measures of housing satisfaction (Cohen d = 0.45) and recovery (Cohen d = 0.33) were significantly more improved in ODR patients compared to CM patients. Conclusions: The ODR model appears to have advantages over more traditional CM services and could fill a gap in the service array. Studying the mediators of success, cost benefit, dissemination, fidelity, and financing of the model is warranted. Trial Registration: ClinicalTrials.gov identifier: NCT04612777.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.,New York State Psychiatric Institute, New York, New York.,Corresponding author: Michael T. Compton, MD, MPH, Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, 722 W. 168th St, Room R249, New York, NY 10032
| | - Mary E Kelley
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health at Emory University, Atlanta, Georgia
| | | | | | | | - Beth Broussard
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Luca Pauselli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Morningside/West Hospitals, New York, New York
| | - Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.,New York State Psychiatric Institute, New York, New York
| | - Mark Johnson
- Gateway Behavioral Health Services, Savannah, Georgia
| | - Nora Lott Haynes
- National Alliance on Mental Illness (NAMI) Georgia, Atlanta, Georgia
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28
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Compton MT, Zern A, Pope LG, Gesser N, Stagoff-Belfort A, Tan de Bibiana J, Watson AC, Wood J, Smith TE. Misdemeanor Charges Among Individuals With Serious Mental Illnesses: A Statewide Analysis of More Than Two Million Arrests. Psychiatr Serv 2023; 74:31-37. [PMID: 35795979 DOI: 10.1176/appi.ps.202000936] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Reducing the overrepresentation of individuals with serious mental illnesses in the criminal legal system requires a better understanding of the charges for which they are most commonly arrested. This study aimed to compare violent offenses, penal code classifications, Uniform Crime Reporting (UCR) codes, and specific charges in arrests among individuals with and individuals without serious mental illnesses. METHODS The authors analyzed all arrests (N=2,224,847) in New York State during 2010-2013. Medicaid data and the state mental health authority's records were used to create an indicator of serious mental illness for each arrest. RESULTS Among arrests involving individuals with the serious mental illness indicator (N=91,363), 7.3% were for violent offenses, compared with 7.6% of arrests involving individuals without the indicator. Among 10 penal code classifications, class B felonies and class A misdemeanors were more likely in arrests among those with the indicator than among those without it. Of the 14 UCR codes examined, seven were more common in arrests with the serious mental illness indicator. Criminal trespass was among the most common charges in arrests involving individuals with the indicator. CONCLUSIONS Most arrests involving people with serious mental illnesses were for misdemeanors, specifically class A misdemeanors, and this class comprised a larger proportion of arrests for those with the indicator than of arrests for those without it. New approaches are needed to address the situations-usually related to socioeconomic disadvantage-that result in individuals with mental illnesses receiving misdemeanor charges and cycling through the criminal legal system.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Nili Gesser
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Aaron Stagoff-Belfort
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Jason Tan de Bibiana
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Amy C Watson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Jennifer Wood
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Thomas E Smith
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
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29
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Boswell T, Zern A, Anderson S, Ellis S, Graves J, Broussard B, Compton MT. A Community Navigation Scale for Persons With Serious Mental Illnesses. Psychiatr Serv 2022; 73:1367-1372. [PMID: 35611514 DOI: 10.1176/appi.ps.202000545] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The recovery paradigm in the context of serious mental illnesses pertains to several characteristics of community functioning, adjustment, and integration, among other constructs. Additional rating scales would be beneficial for measuring various facets of community functioning for research that is recovery oriented as opposed to symptom focused. The Community Navigation Scale was developed as part of the Opening Doors to Recovery project to address several aspects of navigating community resources. METHODS After item development, the 21-item Community Navigation Scale was used across two studies with 340 participants who had serious mental illnesses. Factor analysis revealed three potential factors, and subscales were computed. RESULTS The social and physical well-being subscale (seven items, Cronbach's α=0.82) addressed community involvement, volunteering, finding enjoyable activities, and engaging in positive health behaviors. The accessing external resources subscale (nine items, Cronbach's α=0.80) tapped one's ability to obtain needed resources, ranging from medications to housing and from small appliances to classes in the community. The home and self-maintenance subscale (five items, Cronbach's α=0.73) measured abilities around shopping, cooking, cell phone use, house cleaning, and personal grooming and hygiene. Initial validity of the subscales was suggested through correlations with the Multnomah Community Ability Scale (r=0.65, 0.55, and 0.41 for social and physical well-being, accessing external resources, and home and self-maintenance, respectively). CONCLUSIONS The Community Navigation Scale assesses dimensions of community functioning among persons with serious mental illnesses and may add to the array of research and clinical measures pertinent to recovery outcomes. Additional research on its psychometric properties is warranted.
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Affiliation(s)
- Tehya Boswell
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Boswell, Zern, Compton); Gateway Behavioral Health Services, Savannah, Georgia (Anderson, Ellis, Graves); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Broussard); New York State Psychiatric Institute, New York City (Compton)
| | - Adria Zern
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Boswell, Zern, Compton); Gateway Behavioral Health Services, Savannah, Georgia (Anderson, Ellis, Graves); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Broussard); New York State Psychiatric Institute, New York City (Compton)
| | - Simone Anderson
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Boswell, Zern, Compton); Gateway Behavioral Health Services, Savannah, Georgia (Anderson, Ellis, Graves); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Broussard); New York State Psychiatric Institute, New York City (Compton)
| | - Samantha Ellis
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Boswell, Zern, Compton); Gateway Behavioral Health Services, Savannah, Georgia (Anderson, Ellis, Graves); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Broussard); New York State Psychiatric Institute, New York City (Compton)
| | - JaShala Graves
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Boswell, Zern, Compton); Gateway Behavioral Health Services, Savannah, Georgia (Anderson, Ellis, Graves); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Broussard); New York State Psychiatric Institute, New York City (Compton)
| | - Beth Broussard
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Boswell, Zern, Compton); Gateway Behavioral Health Services, Savannah, Georgia (Anderson, Ellis, Graves); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Broussard); New York State Psychiatric Institute, New York City (Compton)
| | - Michael T Compton
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Boswell, Zern, Compton); Gateway Behavioral Health Services, Savannah, Georgia (Anderson, Ellis, Graves); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Broussard); New York State Psychiatric Institute, New York City (Compton)
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Ehntholt A, Frimpong EY, Compton MT, Rowan GA, Ferdousi W, Swetnam H, Chaudhry S, Radigan M, Smith TE, Rotter M. Prevalence and Correlates of Four Social Determinants in a Statewide Survey of Licensed Mental Health Services. Psychiatr Serv 2022; 73:1282-1285. [PMID: 35538747 DOI: 10.1176/appi.ps.202100380] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This analysis examined the distribution of four social determinants of health among recipients of state-licensed mental health services and analyzed relationships between determinants and individuals' clinical and demographic characteristics. METHODS With data from the New York State Office of Mental Health 2017 Patient Characteristics Survey (N=103,416), prevalences of four social determinants (education, employment, housing, and criminal legal involvement) among mental health service recipients were described. Results were stratified to explore differences by diagnosis, gender, race and ethnicity, and region of residence. RESULTS High proportions had low education (20.9%), unemployment (79.1%), homelessness (8.2%), and criminal legal involvement (12.2%), surpassing statistics for the general state population. Prevalences of alcohol-related, drug-related, and psychotic disorders were higher among these groups than were prevalences of other diagnoses. People of color and male recipients were overrepresented among those with adverse social determinants. CONCLUSIONS Results highlight the magnitude of social adversity among those receiving mental health services, as well as potential inequities.
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Affiliation(s)
- Amy Ehntholt
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Eric Y Frimpong
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Michael T Compton
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Grace A Rowan
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Wahida Ferdousi
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Hannah Swetnam
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Sahil Chaudhry
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Marleen Radigan
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Thomas E Smith
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Merrill Rotter
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
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Compton MT, Graves J, Zern A, Pauselli L, Anderson S, Ashekun O, Ellis S, Langlois S, Pope L, Watson AC, Wood J. Characterizing Arrests and Charges Among Individuals With Serious Mental Illnesses in Public-Sector Treatment Settings. Psychiatr Serv 2022; 73:1102-1108. [PMID: 35378991 DOI: 10.1176/appi.ps.202000581] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Individuals with serious mental illnesses are overrepresented in all facets of the legal system. State-level criminal histories of patients with serious mental illnesses were analyzed to determine the proportion who had been arrested and number of lifetime arrests and charges, associations of six variables with number of arrests, and the most common charges from individuals’ first two arrests and most recent two arrests. METHODS A total of 240 patients were recruited at three inpatient psychiatric facilities and gave consent to access their criminal history. Information was extracted from Record of Arrest and Prosecution (RAP) sheets for lifetime arrests in Georgia. RESULTS A total of 171 (71%) had been arrested. Their mean±SD lifetime arrests were 8.6±10.1, and mean lifetime charges were 12.6±14.6. In a Poisson regression, number of arrests was associated with lower educational attainment, Black or African American race, the presence of a substance use disorder, the presence of a mood disorder, and female sex. Common early charges included marijuana possession, driving under the influence of alcohol, and burglary and shoplifting. Common recent charges included probation violations, failure to appear in court, officer obstruction–related charges, and disorderly conduct. CONCLUSIONS Findings point to a need for policy and program development in the legal system (e.g., pertaining to charges such as willful obstruction of an officer), the mental health community (e.g., to ensure that professionals know about clients’ legal involvement and can partner in strategies to reduce arrests), and social services sectors (to address charges, such as shoplifting, often related to material disadvantage).
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - JaShala Graves
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Luca Pauselli
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Simone Anderson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Oluwatoyin Ashekun
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Samantha Ellis
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Stephanie Langlois
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Leah Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Amy C Watson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Jennifer Wood
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
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Pope LG, Compton MT. "If This Is an Emergency, Hang up and Dial 911" in the Era of 988. Psychiatr Serv 2022; 73:1179-1181. [PMID: 35895843 DOI: 10.1176/appi.ps.20220261] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The recent implementation of 988 as a behavioral crisis hotline is a critical opportunity for improving crisis care across the United States. The bold vision for 988 is to offer individuals experiencing a mental health crisis a rapid entry into a coordinated crisis system and reduce reliance on 911 (and prevent a police response when it is not warranted). In this Open Forum, the authors suggest that mental health professionals have a role to play in educating their clients about when to use 988. Promoting 988 will also depend on answering key questions about what constitutes a crisis and how 988 is being implemented at a local level.
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Affiliation(s)
- Leah G Pope
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City
| | - Michael T Compton
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City
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Ku BS, Aberizk K, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Carrión RE, Compton MT, Cornblatt BA, Druss BG, Mathalon DH, Perkins DO, Tsuang MT, Woods SW, Walker EF. The Association Between Neighborhood Poverty and Hippocampal Volume Among Individuals at Clinical High-Risk for Psychosis: The Moderating Role of Social Engagement. Schizophr Bull 2022; 48:1032-1042. [PMID: 35689540 PMCID: PMC9434451 DOI: 10.1093/schbul/sbac055] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Reductions in hippocampal volume (HV) have been associated with both prolonged exposure to stress and psychotic illness. This study sought to determine whether higher levels of neighborhood poverty would be associated with reduced HV among individuals at clinical high-risk for psychosis (CHR-P), and whether social engagement would moderate this association. This cross-sectional study included a sample of participants (N = 174, age-range = 12-33 years, 35.1% female) recruited for the second phase of the North American Prodrome Longitudinal Study. Generalized linear mixed models tested the association between neighborhood poverty and bilateral HV, as well as the moderating role of social engagement on this association. Higher levels of neighborhood poverty were associated with reduced left (β = -0.180, P = .016) and right HV (β = -0.185, P = .016). Social engagement significantly moderated the relation between neighborhood poverty and bilateral HV. In participants with lower levels of social engagement (n = 77), neighborhood poverty was associated with reduced left (β = -0.266, P = .006) and right HV (β = -0.316, P = .002). Among participants with higher levels of social engagement (n = 97), neighborhood poverty was not significantly associated with left (β = -0.010, P = .932) or right HV (β = 0.087, P = .473). In this study, social engagement moderated the inverse relation between neighborhood poverty and HV. These findings demonstrate the importance of including broader environmental influences and indices of social engagement when conceptualizing adversity and potential interventions for individuals at CHR-P.
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Affiliation(s)
- Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GAUSA
| | | | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, USA
| | | | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CTUSA
- Department of Psychology, Yale University, New Haven, CTUSA
| | - Ricardo E Carrión
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York, NY, USA
| | - Barbara A Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GAUSA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, and San Francisco Veterans Affairs Medical Center, San Francisco, CAUSA
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Ming T Tsuang
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CTUSA
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Compton MT, Krishan S, Broussard B, Bakeman R, Fleischmann MH, Hankerson-Dyson D, Husbands L, Stewart T, D'Orio B, Del Pozo B, Watson AC. Using the Theory of Planned Behavior to Understand How Crisis Intervention Team (CIT) Training Facilitates Police Officers' Mental Health Referrals. Community Ment Health J 2022; 58:1112-1120. [PMID: 34812962 PMCID: PMC9197601 DOI: 10.1007/s10597-021-00920-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/25/2020] [Accepted: 11/12/2021] [Indexed: 11/27/2022]
Abstract
The Theory of Planned Behavior posits that behaviors are predicted by one's intention to perform them; intention is driven by attitude toward the behavior, subjective norm, and perceived behavioral control. We used this theory to predict Crisis Intervention Team (CIT)-trained and non-CIT officers' intention to facilitate referral of persons with suspected mental illnesses to mental health services. CIT-trained (n = 251) and non-CIT (n = 335) officers from six law enforcement agencies participated. CIT-trained officers had significantly greater scores on all constructs. Theory constructs fit the data well, and fit did not differ meaningfully between the two groups. Direct and indirect predictors together accounted for 28% and 21%, respectively, of variance in behavioral intention. Attitude was the strongest predictor. Intentions to facilitate mental health referrals may be driven by the same factors among CIT-trained and non-CIT officers, but CIT officers, even at a median of 22 months after training, have significantly higher scores on those factors.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 722 W. 168th Street, Room R249, New York, NY, 10032, USA. .,New York State Psychiatric Institute, New York, NY, USA.
| | - Shaily Krishan
- Council of State and Territorial Epidemiologists, Atlanta, GA, USA
| | - Beth Broussard
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Roger Bakeman
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Matthew H Fleischmann
- Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Dana Hankerson-Dyson
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Letheshia Husbands
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Barbara D'Orio
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Brandon Del Pozo
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Amy C Watson
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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van der Ven E, Jones N, Bareis N, Scodes JM, Dambreville R, Ngo H, Mathai CM, Bello I, Martínez-Alés G, Mascayano F, Lee RJ, Veling W, Anglin DM, Lewis-Fernandez R, Susser ES, Compton MT, Dixon LB, Wall MM. An Intersectional Approach to Ethnoracial Disparities in Pathways to Care Among Individuals With Psychosis in Coordinated Specialty Care. JAMA Psychiatry 2022; 79:790-798. [PMID: 35767311 PMCID: PMC9244772 DOI: 10.1001/jamapsychiatry.2022.1640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/30/2022] [Indexed: 01/12/2023]
Abstract
Importance Intersecting factors of social position including ethnoracial background may provide meaningful ways to understand disparities in pathways to care for people with a first episode of psychosis. Objective To examine differences in pathways to care by ethnoracial groups and by empirically derived clusters combining multiple factors of social and clinical context in an ethnoracially diverse multisite early-intervention service program for first-episode psychosis. Design, Setting, and Participants This cohort study used data collected on individuals with recent-onset psychosis (<2 years) by clinicians with standardized forms from October 2013 to January 2020 from a network of 21 coordinated specialty care (CSC) programs in New York State providing recovery-oriented, evidence-based psychosocial interventions and medications to young people experiencing early psychosis. Exposures Ethnoracial group and other factors of social position (eg, insurance status, living situation, English fluency, geographic region) intersecting with first-contact experiences (ie, type of first service, referral source, and symptoms at referral). Main Outcomes and Measures Outcome measures were time from onset to first contact, first contact to CSC, and onset to CSC. Results The total study sample consists of 1726 individuals aged 16 to 30 years and included 452 women (26%), 1263 men (73%), and 11 (<1%) with another gender enrolled in the network of CSC programs. The total sample consisted of 153 Asian (9%), 599 Black (35%), 454 Latinx (26%), and 417 White individuals (24%). White individuals had a significantly shorter time from onset to first contact (median [IQR], 17 [0-80] days) than Asian (median [IQR], 34 [7-94] days) and Black (median [IQR], 30 [1-108] days) individuals but had the longest period from first contact to CSC (median [IQR], 102.5 [45-258] days). Five distinct clusters of individuals emerged that cut across ethnoracial groups. The more disadvantaged clusters in terms of both social position and first-contact experiences had the longest time from onset to first contact, which were longer than for any single ethnoracial group. Conclusions and Relevance In this cohort study of individuals with recent-onset psychosis, time-to-treatment outcomes differed by ethnoracial group and by empirically derived clusters combining multiple factors of social and clinical context. The examination of disparities in durations to treatment through an intersectional, ethnoracial lens may improve understanding of the inequities resulting from the various intersecting factors that may compound delays in treatment initiation.
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Affiliation(s)
- Els van der Ven
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Nev Jones
- School of Social Work, University of Pittsburgh, Pennsylvania
| | - Natalie Bareis
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York
| | - Jennifer M. Scodes
- Area Mental Health Data Science, New York State Psychiatric Institute, New York
| | - Renald Dambreville
- Area Mental Health Data Science, New York State Psychiatric Institute, New York
| | - Hong Ngo
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York
- Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York
| | - Chackupurackal M. Mathai
- Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York
| | - Iruma Bello
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York
- Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Instituto de Investigación Hospital Universitario La Paz (IdiPaz), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Franco Mascayano
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Rufina J. Lee
- Silberman School of Social Work, Hunter College, City University of New York, New York
- Department of Psychology, The City College of New York, City University of New York, New York
| | - Wim Veling
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Deidre M. Anglin
- Department of Psychology, The City College of New York, City University of New York, New York
- The Graduate Center, City University of New York, New York
| | - Roberto Lewis-Fernandez
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York
| | - Ezra S. Susser
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Michael T. Compton
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York
- Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York
| | - Lisa B. Dixon
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York
- Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York
| | - Melanie M. Wall
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York
- Area Mental Health Data Science, New York State Psychiatric Institute, New York
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
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Compton MT, Krishan S, Broussard B, Bakeman R, Fleischmann MH, Hankerson-Dyson D, Husbands L, Stewart T, D'Orio B, Watson AC. Modeling the effects of Crisis Intervention Team (CIT) training for police officers: How knowledge, attitudes, and self-efficacy drive de-escalation skills and referral decisions. Int J Law Psychiatry 2022; 83:101814. [PMID: 35759936 DOI: 10.1016/j.ijlp.2022.101814] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 11/29/2021] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Prior research on Crisis Intervention Team (CIT) training for police officers has demonstrated improvements in knowledge, attitudes, self-efficacy, and stigma, but how these factors work together to influence behavioral outcomes like de-escalation skills and referral decisions remains unstudied. METHOD 251 CIT-trained and 335 non-CIT officers completed in-depth surveys measuring these six constructs. We used structural equation modeling to test fit of the data to our hypothesized model and made indicated changes to improve fit. RESULTS An alternate 8-path model (with three paths originally hypothesized being removed) fit reasonably well, and allowing path coefficients to differ for CIT and non-CIT groups resulted in models with similar fit statistics. CONCLUSION CIT training enhances knowledge and attitudes, both of which have beneficial effects on stigma. Though an important outcome itself, lower stigma does not have an effect on de-escalation skills and referral decisions, though self-efficacy clearly does.
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Affiliation(s)
- Michael T Compton
- Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
| | - Shaily Krishan
- Council of State and Territorial Epidemiologists, Atlanta, GA, USA
| | | | - Roger Bakeman
- Georgia State University, Department of Psychology, Atlanta, GA, USA
| | - Matthew H Fleischmann
- McGill University, Department of Educational & Counselling Psychology, Montreal, Quebec, Canada
| | | | | | | | | | - Amy C Watson
- University of Wisconsin-Milwaukee, Helen Bader School of Social Welfare, Milwaukee, WI, USA
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Abstract
Pretrial detention reform is keeping people who have been arrested on low-level charges out of jail while they await trial. This reform has implications for people with serious mental illnesses who are overrepresented in the criminal legal system and who can now stay connected to families, employment, community supports, and treatment providers while their cases are processed. However, such reforms may have uniquely negative consequences for those with serious mental illnesses. In this Open Forum, the authors argue that it is critical for mental health professionals to understand what pretrial reform entails and to incorporate planning around clients' criminal legal system involvement into their routine clinical work.
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Affiliation(s)
- Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (all authors); Research Foundation for Mental Hygiene, Inc., New York City (Pope, Erickson); New York State Psychiatric Institute, New York City (Compton)
| | - Tehya Boswell
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (all authors); Research Foundation for Mental Hygiene, Inc., New York City (Pope, Erickson); New York State Psychiatric Institute, New York City (Compton)
| | - Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (all authors); Research Foundation for Mental Hygiene, Inc., New York City (Pope, Erickson); New York State Psychiatric Institute, New York City (Compton)
| | - Blake Erickson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (all authors); Research Foundation for Mental Hygiene, Inc., New York City (Pope, Erickson); New York State Psychiatric Institute, New York City (Compton)
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (all authors); Research Foundation for Mental Hygiene, Inc., New York City (Pope, Erickson); New York State Psychiatric Institute, New York City (Compton)
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Ku BS, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Compton MT, Cornblatt BA, Druss BG, Keshavan M, Mathalon DH, Perkins DO, Stone WS, Tsuang MT, Woods SW, Walker EF. The associations between area-level residential instability and gray matter volumes from the North American Prodrome Longitudinal Study (NAPLS) consortium. Schizophr Res 2022; 241:1-9. [PMID: 35066429 PMCID: PMC8960350 DOI: 10.1016/j.schres.2021.12.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 04/13/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Area-level residential instability (ARI), an index of social fragmentation, has been shown to explain the association between urbanicity and psychosis. Urban upbringing has been shown to be associated with reduced gray matter volumes (GMV)s of brain regions corresponding to the right caudal middle frontal gyrus (CMFG) and rostral anterior cingulate cortex (rACC). We hypothesize that greater ARI will be associated with reduced right CMFG and rACC GMVs. METHODS Data were collected at baseline as part of the North American Prodrome Longitudinal Study Phase 2. Counties where participants resided during childhood were geographically coded using the US Census to area-level factors. ARI was defined as the percentage of residents living in a different house 5 years ago. Generalized linear mixed models tested associations between ARI and GMVs. RESULTS This study included 29 healthy controls (HC)s and 64 clinical high risk for psychosis (CHR-P) individuals who were aged 12 to 24 years, had remained in their baseline residential area, and had magnetic resonance imaging scans. ARI was associated with reduced right CMFG (adjusted β = -0.258; 95% CI = -0.502 to -0.015) and right rACC volumes (adjusted β = -0.318; 95% CI = -0.612 to -0.023). The interaction term (ARI-by-diagnostic group) in the prediction of both brain regions was not significant, indicating that the relationships between ARI and regional brain volumes held for both CHR-P and HCs. CONCLUSIONS ARI may adversely impact similar brain regions as urban upbringing. Further investigation into the potential mechanisms of the relationship between ARI and neurobiology, including social stress, is needed.
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Affiliation(s)
- Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, United States
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, CA, United States
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States
| | - Barbara A Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, CA, United States; San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Ming T Tsuang
- Department of Psychiatry, University of California, San Diego, CA, United States
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, United States
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Del Pozo B, Compton MT. Voluntary Registries: Filling the Critical Information Gap in First Response to Mental Health Crises. J Law Med Ethics 2022; 50:364-367. [PMID: 35894566 PMCID: PMC10782591 DOI: 10.1017/jme.2022.63] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We argue that voluntary mental health registries integrated into the 9-1-1 system, where patients and caregivers can establish a repository of this information, will help fill this information gap by enabling first responders to quickly understand the context of a call for service with a mental health component, and to make better informed decisions. Despite valid concerns about privacy, stigma, and the potential misuse of protected health information, such registries, if carefully designed and administered, can improve the health outcomes of 9-1-1 calls for service involving mental health-related crises.
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Affiliation(s)
| | - Michael T Compton
- NEW YORK STATE PSYCHIATRIC INSTITUTE AND COLUMBIA UNIVERSITY, NEW YORK, NY, USA
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Abstract
Objective: Accumulating evidence implicates social context in the etiology of psychosis. One important line of epidemiologic research pointing to a potentially causal role of social context pertains to what is termed social fragmentation. The authors conducted a systematic review of the relationship between area-level social fragmentation and psychosis. Data Sources: Three databases (MEDLINE, PsycINFO, and Web of Science) were searched from inception to May 2, 2021. There were no language restrictions. Search terms were those that identify the area-level orientation, social fragmentation, sample, and outcome. Study Selection: Inclusion criteria were the following: (1) social environment measured at the area level with (2) psychosis outcomes (incidence rates, prevalence of psychosis or schizophrenia, age at onset of psychosis, psychotic symptom severity, and duration of untreated psychosis). In total, 579 research articles were identified, and 19 were eligible to be included in this systematic review. Data Extraction: Two reviewers independently screened, extracted data from, and coded all articles. Results: Evidence from 14 of 19 articles indicates that area-level characteristics reflecting social fragmentation are associated with higher psychosis rates and other outcomes of psychosis even after controlling for other area-level characteristics including deprivation, social capital, race/ethnicity, and urbanicity and individual-level characteristics including age, sex, migrant status, and socioeconomic status. Conclusions: In conclusion, this review finds evidence that measures of area-level social fragmentation are associated with higher psychosis rates. Further research into mechanisms is needed to better characterize this association.
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Affiliation(s)
- Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.,Corresponding author: Benson S. Ku, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr NE #300, Atlanta, GA 30329
| | - Michael T Compton
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, Georgia
| | - Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Ku BS, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Compton MT, Cornblatt BA, Keshavan M, Mathalon DH, Perkins DO, Stone WS, Tsuang MT, Walker EF, Woods SW, Druss BG. Association between residential instability at individual and area levels and future psychosis in adolescents at clinical high risk from the North American Prodrome Longitudinal Study (NAPLS) consortium. Schizophr Res 2021; 238:137-144. [PMID: 34673386 PMCID: PMC10800030 DOI: 10.1016/j.schres.2021.09.025] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/09/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Accumulating evidence supports an association between residential instability and increased risk for psychosis, but the association between residential instability and conversion to psychosis among adolescents at clinical high risk (CHR) is unclear. In this study, we determined whether individual-level and area-level residential instability and their interaction are associated with conversion to psychosis within two years. METHODS Data were collected as part of the North American Prodrome Longitudinal Study Phase 2. Individual-level residential instability, defined as having ever moved during lifetime, was derived from the Life Events Scale. Area-level residential instability, defined as the percentage of people who were not living in the same house five years ago, was derived from the U.S. Decennial Censuses. RESULTS This study included 285 adolescents at CHR (including 36 subjects who later converted to full psychosis). We found that individual-level residential instability was associated with conversion (adjusted OR = 2.769; 95% CI = 1.037-7.393). The interaction between individual-level and area-level residential instability was significant (p = 0.030). In a subgroup of CHR participants who have never moved (n = 91), area-level residential instability during childhood was associated with conversion (adjusted OR = 1.231; 95% CI = 1.029-1.473). Conversely, in a subgroup of CHR participants who resided in residentially stable areas during childhood (n = 142), the association between individual-level residential instability and conversion remained significant (adjusted OR = 15.171; 95% CI = 1.753-131.305). CONCLUSIONS These findings suggest that individual-level and area-level residential instability may be associated with conversion to psychosis.
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Affiliation(s)
- Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, United States
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, CA, United States
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, United States
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States
| | - Matcheri Keshavan
- Harvard Medical School, Departments of Psychiatry at Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, Boston, MA, United States
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - William S Stone
- Harvard Medical School, Departments of Psychiatry at Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, Boston, MA, United States
| | - Ming T Tsuang
- Department of Psychiatry, University of California, San Diego, CA, United States
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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Ku BS, Pauselli L, Covington MA, Compton MT. Computational linguistic analysis applied to a semantic fluency task: A replication among first-episode psychosis patients with and without derailment and tangentiality. Psychiatry Res 2021; 304:114105. [PMID: 34298424 PMCID: PMC8719331 DOI: 10.1016/j.psychres.2021.114105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/06/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 12/01/2022]
Abstract
Automated tools do not yet exist to measure formal thought disorder, including derailment and tangentiality, both of which can be subjectively rated using the Scale for the Assessment of Positive Symptoms after a clinical research interview. CoVec, a new automated tool, measures the semantic similarity among words averaged in a five- and ten-word window (Coherence-5 and Coherence-10, respectively). One prior report demonstrated that this tool was able to differentiate between patients with those types of thought disorder and patients without them (and controls). Here, we attempted a replication of the initial findings using data from a different sample of patients hospitalized for initial evaluation of first-episode psychosis. Participants were administered a semantic fluency task and the animal lists were analyzed with CoVec. In this study, we partially replicated the prior findings, showing that first-episode patients with derailment had significantly lower Coherence-5 and Coherence-10 compared with patients without derailment. Further research is warranted on this and other highly reliable and objective methods of detecting formal thought disorder through simple assessments such as semantic fluency tasks.
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Affiliation(s)
- Benson S. Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Luca Pauselli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Morningside/West Hospital Center, New York, NY, USA
| | | | - Michael T. Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA,Corresponding author: Michael T. Compton, M.D., M.P.H., New York State Psychiatric Institute, 722 W. 168 Street, Room R249, New York, NY 10032. Tel: 646-774-8476.
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Langlois S, Zern A, Kelley ME, Compton MT. Adversity in childhood/adolescence and premorbid tobacco, alcohol, and cannabis use among first-episode psychosis patients. Early Interv Psychiatry 2021; 15:1335-1342. [PMID: 33289325 DOI: 10.1111/eip.13086] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/14/2020] [Accepted: 11/14/2020] [Indexed: 11/29/2022]
Abstract
AIM Premorbid substance use is widely recognized as a crucial factor in early psychosis. We explored the effects of childhood/adolescent adversity on premorbid tobacco, alcohol, and cannabis use. We hypothesized that adversity in childhood would be associated with an increased likelihood of use, and amount of intake, of tobacco, alcohol, and cannabis. We analysed which domains of adversity have the greatest impact. METHODS First-episode psychosis patients were enrolled from six inpatient psychiatric units in Atlanta, Georgia and Washington, D.C. Premorbid substance use was thoroughly measured, and childhood/adolescent adversity was rated using 14 scales/subscales. Factor analysis was used to reduce these scales/subscales to the three domains of adversity (termed Violence and Environmental Adversity, Interpersonal Abuse, and Neglect and Lack of Connectedness). Regression analyses determined associations between adversity domains and premorbid substance use. RESULTS Our sample (n = 247) primarily consisted of African Americans (86.2%) and males (74.5%). Violence and Environmental Adversity was significantly associated with five of six substance use variables and marginally associated with the sixth. Interpersonal Abuse was unassociated with substance use, and Neglect and Lack of Connectedness was associated only with a lower likelihood cannabis use. When Violence and Environmental Adversity results were stratified by gender, effects on tobacco use and amount of tobacco use were stronger among females. CONCLUSIONS Childhood/adolescent trauma and adversity have meaningful associations with premorbid substance use in first-episode psychosis patients. First-episode psychosis and clinical high-risk treatment settings may benefit from expanding the assessment of childhood/adolescent adversity to include factors pertaining to violence exposure and adversities beyond abuse and neglect.
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Affiliation(s)
| | - Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Mary E Kelley
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health of Emory University, Atlanta, Georgia, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
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Abstract
Calls to defund and reform police agencies have been emphasized in recent public discourse. Demands range from shuttering police agencies to shifting resources and responsibility for responding to noncriminal social and behavioral health vulnerabilities to the health and social services sector. This Open Forum discusses how police officers became primary responders to behavioral health concerns, how this arrangement disproportionately and negatively affects communities of color, and several solutions to these circumstances. The mental health field must advocate for the policies and resources needed to address urgent mental health needs and crisis response. Several conditions for successful outcomes that do not further compound racial inequities are discussed.
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Affiliation(s)
- Amy C Watson
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Research Foundation for Mental Hygiene (Pope), New York State Psychiatric Institute (Compton), and Columbia University Vagelos College of Physicians and Surgeons (Pope, Compton), New York City
| | - Leah G Pope
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Research Foundation for Mental Hygiene (Pope), New York State Psychiatric Institute (Compton), and Columbia University Vagelos College of Physicians and Surgeons (Pope, Compton), New York City
| | - Michael T Compton
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Research Foundation for Mental Hygiene (Pope), New York State Psychiatric Institute (Compton), and Columbia University Vagelos College of Physicians and Surgeons (Pope, Compton), New York City
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Watson AC, Owens LK, Wood J, Compton MT. The Impact of Crisis Intervention Team Response, Dispatch Coding, and Location on the Outcomes of Police Encounters with Individuals with Mental Illnesses in Chicago. Policing (Oxf) 2021; 15:1948-1962. [PMID: 34659453 PMCID: PMC8507917 DOI: 10.1093/police/paab010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Crisis Intervention Team (CIT) model has been implemented in over 3,000 communities across the USA. Research to date has shown beneficial results in terms of officers' knowledge, attitudes, self-efficacy, stigma, and force preferences. This study aimed to broaden the lens on the implementation context of CIT to examine whether factors in the environment and response process affect how calls are resolved. This study focused on several factors-CIT response, call location, and upstream decisions to pre-identify calls as mental health-related-that may impact call outcomes. Our findings suggest that CIT response, dispatch coding, and the places where calls originate play a role in shaping outcomes. More research is needed to unpack the effects of this wider CIT implementation environment.
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Affiliation(s)
- Amy C Watson
- Amy C. Watson, Helen Bader School of Social Welfare, University of Wisconsin–Milwaukee, Milwaukee, WI, USA
| | - Linda K Owens
- Linda K. Owens, Carle Foundation Hospital, Champaign, IL, USA
| | - Jennifer Wood
- Jennifer Wood, Department of Criminal Justice, Temple University, Philadelphia, PA, USA
| | - Michael T Compton
- Michael T. Compton, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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Zern A, Seserman M, Dacus H, Wallace B, Friedlander S, Manseau MW, Smalling MM, Smith TE, Williams JM, Compton MT. Screening and Treatment of Tobacco Use Disorder in Mental Health Clinics in New York State: Current Status and Potential Next Steps. Community Ment Health J 2021; 57:1023-1031. [PMID: 33083939 DOI: 10.1007/s10597-020-00726-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/07/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022]
Abstract
The prevalence of smoking is higher among individuals with serious mental illnesses than the general population. Evidence-based practices exist for tobacco cessation, but little is known about mental health clinics' tobacco cessation treatment practices/protocols. Mental health clinics in New York State were surveyed about their tobacco use treatment protocols and outdoor-smoking policies. One-third of clinics were not providing individual counseling for tobacco use disorder, 39% were not prescribing nicotine replacement therapy, and nearly half reported not prescribing bupropion or varenicline. Even smaller proportions reported implementing other clinical practice guidelines, with only 25.2% providing staff training and 20.3% having a dedicated staff member for coordinating tobacco use disorder treatment. Regarding outdoor smoke-free policies, 38% of clinics reported not allowing any tobacco use anywhere on grounds. Despite some successes, many clinics do not provide evidence-based tobacco use treatments, meaning important opportunities exist for mental health clinics and oversight agencies to standardize practices.
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Affiliation(s)
- Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Heather Dacus
- New York State Department of Health, Albany, NY, USA
| | | | | | | | | | - Thomas E Smith
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,New York State Office of Mental Health, Albany, NY, USA.,New York State Psychiatric Institute, New York, NY, USA
| | - Jill M Williams
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. .,New York State Psychiatric Institute, New York, NY, USA.
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Pope LG, Ashekun O, Zern A, Kelley ME, Compton MT. Associations Between Childhood and Adolescence Adversity and Risk for Arrest Among Patients With First-Episode Psychosis. Psychiatr Serv 2021; 72:826-829. [PMID: 33820443 DOI: 10.1176/appi.ps.202000238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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 The authors assessed associations between childhood and adolescent adversity and arrest among individuals with first-episode psychosis (FEP). The authors also sought to determine which domains of adversity had the greatest impact and whether associations varied by gender. METHODS Data were analyzed from 247 patients with FEP admitted to inpatient psychiatric units between August 2008 and June 2013. Analyses focused on self-reported history of arrest and seven scales of past adversity, with 14 subscales reduced to three factors. Binary logistic regression and negative binomial regression determined associations between the three childhood adversity factors and having ever been arrested and number of arrests, respectively. RESULTS Past experience of violence and environmental adversity was significantly (p<0.001) associated with both history of arrest (odds ratio=2.29) and number of arrests (β=0.60), and this association was stronger for female patients than for male patients. CONCLUSIONS Findings suggest a need to address both past adversity and criminal justice system involvement in the context of early psychosis specialty care.
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Affiliation(s)
- Leah G Pope
- Research Foundation for Mental Hygiene, Inc., New York City (Pope); DeKalb Community Service Board, Decatur, Georgia (Ashekun); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Pope, Zern, Compton); Department of Biostatistics and Bioinformatics, Rollins School of Public Health of Emory University, Atlanta (Kelley); New York State Psychiatric Institute, New York City (Compton)
| | - Oluwatoyin Ashekun
- Research Foundation for Mental Hygiene, Inc., New York City (Pope); DeKalb Community Service Board, Decatur, Georgia (Ashekun); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Pope, Zern, Compton); Department of Biostatistics and Bioinformatics, Rollins School of Public Health of Emory University, Atlanta (Kelley); New York State Psychiatric Institute, New York City (Compton)
| | - Adria Zern
- Research Foundation for Mental Hygiene, Inc., New York City (Pope); DeKalb Community Service Board, Decatur, Georgia (Ashekun); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Pope, Zern, Compton); Department of Biostatistics and Bioinformatics, Rollins School of Public Health of Emory University, Atlanta (Kelley); New York State Psychiatric Institute, New York City (Compton)
| | - Mary E Kelley
- Research Foundation for Mental Hygiene, Inc., New York City (Pope); DeKalb Community Service Board, Decatur, Georgia (Ashekun); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Pope, Zern, Compton); Department of Biostatistics and Bioinformatics, Rollins School of Public Health of Emory University, Atlanta (Kelley); New York State Psychiatric Institute, New York City (Compton)
| | - Michael T Compton
- Research Foundation for Mental Hygiene, Inc., New York City (Pope); DeKalb Community Service Board, Decatur, Georgia (Ashekun); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Pope, Zern, Compton); Department of Biostatistics and Bioinformatics, Rollins School of Public Health of Emory University, Atlanta (Kelley); New York State Psychiatric Institute, New York City (Compton)
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48
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Rabin LA, Miles RT, Kamata A, Krishnan A, Elbulok-Charcape M, Stewart G, Compton MT. Development, item analysis, and initial reliability and validity of three forms of a multiple-choice mental health literacy assessment for college students (MHLA-c). Psychiatry Res 2021; 300:113897. [PMID: 33887516 DOI: 10.1016/j.psychres.2021.113897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/06/2020] [Accepted: 03/20/2021] [Indexed: 11/25/2022]
Abstract
Despite increasing rates of mental health disorders among college students, there are a limited number of validated mental health literacy measures that can be quickly administered and scored in this population. We developed a 54-item multiple-choice measure, consisting of three forms with 18 items on each form. Our items focus on knowledge of more than 20 mental health disorders including their etiology, risk factors, diagnoses, symptoms, treatment, course, and outcome, as well as the application of this knowledge to real world situations. Data were collected on three independent samples of undergraduate students enrolled at an urban public university system in the northeast United States: pilot (n=292), test refinement (n=1,272), and validation (n=683). Basic demographics for the combined test refinement and validation samples were: age=22 ± 4.9 years; 62.2% female; 71.7% non-White. We report on the development of the Mental Health Literacy Assessment-college (MHLA-c) and provide support for its reliability and validity. We also provide descriptive statistics, stratified by gender, college major, and personal experience with a mental health issue to enable its use in diverse settings. The MHLA-c may be useful in measuring knowledge of mental health disorders and related topics among college students. Moreover, the availability of parallel forms will facilitate its use within educational or interventional studies that employ pre-post testing designs.
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Affiliation(s)
- Laura A Rabin
- Brooklyn College of The City University of New York, Department of Psychology, Brooklyn, NY, USA.
| | - Rona T Miles
- Brooklyn College of The City University of New York, Department of Psychology, Brooklyn, NY, USA
| | - Akihito Kamata
- Southern Methodist University, Simmons School of Education and Human Development, Dallas, TX, USA
| | - Anjali Krishnan
- Brooklyn College of The City University of New York, Department of Psychology, Brooklyn, NY, USA
| | | | - Genéa Stewart
- University of North Texas, Department of Educational Psychology, Denton, TX, USA
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Bernardini F, Attademo L, Rotter M, Compton MT. Social Determinants of Mental Health As Mediators and Moderators of the Mental Health Impacts of the COVID-19 Pandemic. Psychiatr Serv 2021; 72:598-601. [PMID: 33593101 DOI: 10.1176/appi.ps.202000393] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 12/01/2022]
Abstract
Contracting COVID-19, being exposed to it, or being affected by societal containment measures can have consequences that are themselves social determinants of health. Preexisting social determinants of health also drive the disproportionately high prevalence of COVID-19 infection and deaths among minority, marginalized, and other vulnerable populations. Thus, the social determinants of mental health act as both mediators and moderators of the pandemic's impacts, and like all social determinants, the effects of the pandemic are underpinned by public policies and social norms. The major economic impacts of containment measures have had cascading effects that will affect mental health for years to come.
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Affiliation(s)
- Francesco Bernardini
- Department of Mental Health, Psychiatric Diagnosis and Care Service (SPDC) Pordenone, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy (Bernardini); Planetary Health Lab, University of Edinburgh, Edinburgh (Bernardini, Attademo); Department of Mental Health, SPDC Potenza, ASP Basilicata, Potenza, Italy (Attademo); Albert Einstein College of Medicine, New York City (Rotter); New York State Psychiatric Institute, New York City (Compton). Ruth S. Shim, M.D., M.P.H., and Michael T. Compton, M.D., M.P.H., are editors of this column
| | - Luigi Attademo
- Department of Mental Health, Psychiatric Diagnosis and Care Service (SPDC) Pordenone, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy (Bernardini); Planetary Health Lab, University of Edinburgh, Edinburgh (Bernardini, Attademo); Department of Mental Health, SPDC Potenza, ASP Basilicata, Potenza, Italy (Attademo); Albert Einstein College of Medicine, New York City (Rotter); New York State Psychiatric Institute, New York City (Compton). Ruth S. Shim, M.D., M.P.H., and Michael T. Compton, M.D., M.P.H., are editors of this column
| | - Merrill Rotter
- Department of Mental Health, Psychiatric Diagnosis and Care Service (SPDC) Pordenone, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy (Bernardini); Planetary Health Lab, University of Edinburgh, Edinburgh (Bernardini, Attademo); Department of Mental Health, SPDC Potenza, ASP Basilicata, Potenza, Italy (Attademo); Albert Einstein College of Medicine, New York City (Rotter); New York State Psychiatric Institute, New York City (Compton). Ruth S. Shim, M.D., M.P.H., and Michael T. Compton, M.D., M.P.H., are editors of this column
| | - Michael T Compton
- Department of Mental Health, Psychiatric Diagnosis and Care Service (SPDC) Pordenone, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy (Bernardini); Planetary Health Lab, University of Edinburgh, Edinburgh (Bernardini, Attademo); Department of Mental Health, SPDC Potenza, ASP Basilicata, Potenza, Italy (Attademo); Albert Einstein College of Medicine, New York City (Rotter); New York State Psychiatric Institute, New York City (Compton). Ruth S. Shim, M.D., M.P.H., and Michael T. Compton, M.D., M.P.H., are editors of this column
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50
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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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