Change in Benzodiazepine Prescribing Practices of Mental Health Providers After Implementation of an Agency-Specific Protocol

Purpose: As a class of drugs, benzodiazepines are highly effective in treating anxiety disorders. However, the use of benzodiazepines carries a risk for dependence with an increased incidence in individuals with cooccurring disorders. The project evaluated the impact of a benzodiazepine prescribing protocol on mental health providers’ prescribing practices. Methods: A retrospective chart review (N = 237) was conducted to assess changes in benzodiazepine prescribing patterns prior to and following the implementation of an agency-specific protocol. A convenience sample of 15 providers included nurse practitioners and psychiatrists from a regional mental health center in East Tennessee. For the diagnoses of anxiety disorders, the number of benzodiazepine prescriptions written, dose reduced or discontinued was determined along with concordance to current recommendations for benzodiazepine use. Results: No statistically significant differences were found in scores between study periods, even though there was a decrease in the number of prescriptions written between the pre- (n = 81) and postmeasures (n = 34). Conclusion: The implementation of a benzodiazepine protocol does not necessarily bring about significant changes in providers’ prescribing practices. Audit and feedback are an essential part of the intervention strategy and are often required to change performance-related outcomes.

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Assessing the Impact of COVID-19 on Mental Health Providers in the Southeastern United States

Psychiatry Research ◽

10.1016/j.psychres.2021.114055 ◽

2021 ◽

pp. 114055

Author(s):

Henry Slone ◽

Arianna Gutierrez ◽

Caroline Lutzky ◽

Demi Zhu ◽

Hannah Hedriana ◽

...

Keyword(s):

Mental Health ◽

United States ◽

Southeastern United States ◽

Mental Health Providers ◽

Health Providers ◽

The Impact

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Embedding interagency working between schools and mental health specialists: A service evaluation of theMental Health Services and Schools and Colleges Link Programmeworkshops

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104519849640 ◽

2019 ◽

Vol 24 (4) ◽

pp. 906-920 ◽

Cited By ~ 2

Author(s):

Melissa A. Cortina ◽

Judith Shipman ◽

Felicity Saunders ◽

Laurie Day ◽

Rachel Blades ◽

...

Keyword(s):

Mental Health ◽

Health Services ◽

Mental Health Professionals ◽

Good Practice ◽

Service Evaluation ◽

Mental Health Providers ◽

Health Providers ◽

Building Relationships ◽

Continuous Contact ◽

The Impact

There is increasing focus on the need for schools to work more effectively with specialist mental health providers, but there have been historic challenges in embedding closer interagency working. This article reports the results of a service evaluation of a 2-day workshop designed to facilitate improved working between schools and children and young people’s mental health services (CYPMHS). Mental health leads from 255 schools, mental health professionals and other key stakeholders all took part in one of 26 two-day workshops across the United Kingdom. The impact on interagency working was examined using changes in pre- and post-survey results, changes in self-reported aspects of interagency working and 10 local reviews of practice. The pre–post questionnaires showed improvements in interagency working (e.g. 55% of school leads reported being in ‘monthly’ or ‘continuous’ contact with the National Health Service (NHS) CYPMHS1at follow-up, compared with 24% at baseline). The group-completed CASCADE framework showed an overall increase in collaborative working, although some areas continued to report significant challenges such as in relation to common outcome measures. The local reviews found positive changes in interagency working, in terms of building relationships, improved communication and sharing good practice. This service evaluation of the workshops found some evidence of improved interagency working between schools and CYPMHS, but more controlled research is needed to consider generalisability and scalability.

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Adolescence

10.1093/med/9780190610999.003.0010 ◽

2017 ◽

Author(s):

Rachel Mandel ◽

Ruth Gerson

Keyword(s):

Mental Health ◽

Systems Of Care ◽

Age Group ◽

Mental Health Providers ◽

Health Providers ◽

Health Issues ◽

Remarkable Change ◽

Family Trauma ◽

The Impact ◽

Universal Stage

Adolescence is a time of remarkable change—a time of physical and emotional growth with many potential problems. It is a turbulent yet universal stage of life, and mental health providers can be flummoxed in approaching, diagnosing, and treating adolescents, with the ongoing question of “What is normal adolescent behavior?” Providers sometimes lose sight of central issues in adolescent life, such as school, family, trauma, foster care, and burgeoning responsibilities. This chapter provides a case example of a typical teen presentation in the emergency department and uses it to illustrate the complexity of adolescent mental health issues. Favorable outcomes are possible when clinicians are mindful of the special needs of this age group, including risky behavior, the impact of bullying, and academic stress, and when clinicians can navigate the corresponding systems of care.

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An observational study of the impact of COVID-19 and the rapid implementation of telehealth on community mental health center providers

Implementation Science Communications ◽

10.1186/s43058-021-00123-y ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Marisa Sklar ◽

Kendal Reeder ◽

Kristine Carandang ◽

Mark G. Ehrhart ◽

Gregory A. Aarons

Keyword(s):

Mental Health ◽

Community Mental Health ◽

Mental Health Center ◽

Health Service Delivery ◽

Community Mental Health Service ◽

Mental Health Providers ◽

Health Providers ◽

Mental Health Service Delivery ◽

Provider Perspectives ◽

The Impact

Abstract Background The COVID-19 pandemic has remarkably altered community mental health service delivery through the rapid implementation of telehealth. This study reports provider perspectives on the impact that COVID-19 and the transition to telehealth had on their work and their ability to deliver evidence-based practices (EBPs). Methods Providers (n = 93) completed online surveys with quantitative measures and open-ended items exploring their reactions to COVID-19 and to the transition to providing services via telehealth. Results Perceptions of personal risk and rumination around COVID-19 were low, while telehealth was viewed positively by providers. Three major themes emerged regarding the major impacts of COVID-19 on work: (1) the altered nature of interactions between patient/client and provider due to telehealth implementation, (2) changes in provider expectations regarding productivity, and (3) challenges maintaining work-life balance. In regard to the major impacts of COVID-19 on EBP delivery, three themes emerged: (1) increased difficulty delivering certain therapies via telehealth, (2) potential limitations to session confidentiality, and (3) challenge of engaging children in telehealth. Conclusions In the context of the COVID-19 pandemic, community mental health providers continued to engage with clients and deliver EBPs while navigating a number of changes related to the rapid transition to and implementation of telehealth. This study highlights the need for further work on what supports providers need to effectively engage with clients and deliver EBPs via telehealth, and has implications for how telehealth is sustained or de-implemented post-COVID-19.

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Online CBT training for mental health providers in primary care

The Journal of Mental Health Training Education and Practice ◽

10.1108/jmhtep-08-2017-0049 ◽

2018 ◽

Vol 13 (4) ◽

pp. 228-237

Author(s):

Kristen Sorocco ◽

Joseph Mignogna ◽

Michael R. Kauth ◽

Natalie Hundt ◽

Melinda A. Stanley ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Online Training ◽

Small Sample ◽

Self Report ◽

Mental Health Providers ◽

Health Providers ◽

Health Administration ◽

Content Type ◽

The Impact

Purpose The purpose of study was to assess the impact of an online training program for a brief cognitive-behavioral therapy (CBT) that integrated physical health management designed for use by mental health providers in the primary care setting. Design/methodology/approach In total, 19 providers from two Veterans Health Administration (VHA) medical centers completed online training as part of a larger trial. Statistical analyses compared provider self-reported CBT knowledge and abilities at pretraining, posttraining, and long-term follow-up. Additionally, data were collected on providers’ experiences of the training. Findings Providers’ baseline to post-training scores improved on general CBT knowledge and ability, as well as across 11 CBT principles and techniques. Post-training scores were maintained over time. Research limitations/implications A small sample size, sole focus on VHA data, and reliance on self-report measures are limitations of the study. Practical implications Qualitative data suggested training was feasible, acceptable, and potentially scalable; however, a one-size-fits-all approach may not be ideal. Originality/value Online training has potential for providing wider access to providers with limited access to traditional face-to-face training.

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