Psychiatric services : a journal of the American Psychiatric Association
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Comparative Study
Disengagement from care: perspectives of individuals with serious mental illness and of service providers.
This study sought to describe reasons for disengagement from services and practical guidelines to enhance engagement among individuals with serious mental illness and high need for treatment. ⋯ Individuals with serious mental illness and providers often do not agree on reasons for seeking care. The framework of acceptable, accessible, and available services identifies opportunities for providers to adjust practices and maximize engagement in services among individuals with serious mental illness who are in high need of treatment.
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The purpose of this study was to investigate the prevalence and predictors of service utilization for mental health problems of the first-generation migrant population in Shenzhen, China, a city that attracts millions of unskilled rural laborers each year. ⋯ In Shenzhen, few migrants used mental health services and most used complementary and alternative medicine services. Future studies of service utilization patterns in migrant populations should give special attention to personal characteristics, such as family support.
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Suicide risk after discharge from psychiatric inpatient care is high, particularly in the first few weeks. The aim of the study was to identify risk factors and protective factors (that is, factors associated with a reduced risk of suicide), including variation in health care received, for suicide among patients in the two-week postdischarge period. ⋯ Discharged patients viewed as being at high risk of suicide require immediate community follow-up. Mental health services should be mindful of discharging patients after a short admission. The potential role of detrimental life experiences indicates that mental health clinicians need to be aware of the circumstances into which patients are being discharged. Use of enhanced levels of care, such as that offered by the Care Programme Approach, may play a strong role in preventing suicide within two weeks of discharge.
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Provisions in the Affordable Care Act (ACA) are likely to expand access to substance use disorder treatment for low-income individuals. The aim of the study was to provide information on the need for substance use disorder treatment among individuals who may be eligible for Medicaid under the ACA. ⋯ Findings suggest that Medicaid insurance expansions under the ACA will reduce unmet need for substance use disorder treatment.