Political Party and Mental Health

As political polarization increases and mental health worsens, it is becoming crucial to investigate the potential link between these. This project investigated the link between political party and mental health in the United States. Data was analyzed from previous U.S. elections, Mental Health America, and the Substance Abuse and Mental Health Services Administration to investigate the relationships in four studies. The first analyzed current associations between state mental health rankings and voting margins in the 2020 presidential election. The second analyzed this same connection but over previous years. The third compared the percentage of liberal control in the government with the percentage of American adults receiving mental health care services to uncover if the party in power had an effect on overall mental health. The fourth analyzed voting margins and state mental health rankings at the end of the term to determine if mental health was associated with being governed by the party for which the state voted. Studies 1, 2, and 4 were found to have significant relationships at a 99% confidence level. This indicates that voting liberal is associated with better mental health rankings at the state level, both currently and throughout previous elections. It also signifies that being governed by the party for which the state voted is associated with better mental health at the state level. In future studies, it may be beneficial to conduct individual assessments to determine if this relationship exists only at the state level.

Outer-context determinants in the sustainment phase of a reimbursement-driven implementation of evidence-based practices in children’s mental health services

Background Although there is increasing investment to implement evidence-based practices (EBPs) in public systems across the USA, continued or sustained use of EBPs after initial implementation remains a challenge. The low integration of EBPs in routine practice severely limits their public health impact, highlighting the need to understand factors that affect the return on costly investments in EBP implementation. This study aims to (1) characterize trajectories of EBP delivery volume through a reimbursement-driven implementation and (2) examine impacts of system-level policy regulatory activity and state-level mental health services funding on the implementation reimbursement strategy. Methods This study involved secondary data analyses. Psychotherapy administrative claims and regulatory site visit data from the Los Angeles County Department of Mental Health and California state mental health expenditures were extracted from 2010 to 2017. Multilevel regression examined EBP claims volume over time with state expenditures and regulatory compliance as predictors. Results EBP claims volume trajectories demonstrated a rapid initial increase, followed by a period of decrease, and a small increase in the final year. State mental health expenditures increased across time reflecting increased funding availability. State mental health expenditures and system regulatory compliance were inversely related to EBP claims volume. Conclusions The impact of reimbursement-driven EBP implementation strategy is sensitive to multiple outer-context determinants. At the system level, commitment to fidelity of implementation regulations resulted in reduced use of the reimbursement strategy. Alternative reimbursement streams not tied to EBPs coupled with an expanded array of reimbursable services also impacted the use of the reimbursement strategy to implement EBPs.

The Impact of the COVID-19 Pandemic and Associated Public Health Response on People with Eating Disorder Symptomatology: A National Australian Study

Background Associated with the COVID-19 pandemic is a mental health crisis. People with lived experience of eating disorders (ED) may be particularly vulnerable due to exasperating factors including social isolation, co-occurring conditions, etc. This study investigates the association of the pandemic with ED symptomatology to consider impact and identify risk factors for clinical consideration. Methods Australian participants over 16 years self-reported ED diagnosis and/or symptomatology. An online survey was conducted due to reach, cost-effectiveness, safety and suitability. Participants recorded ED status, co-occurring mental health conditions, completed validated measures of ED illness, state mental health and loneliness, and changes in ED symptoms during the pandemic. Results Of 1723 participants (mode age 24.9 years, 91.6% identifying as female, EDE Global Score x = 4.08, SD = 1.18), 88.0% reported an increase in body image concerns, 74.1% in food restriction, 66.2% binge eating and 46.8% driven exercise during the pandemic. Increased ED symptomatology was associated with poorer state mental health and loneliness across the ED symptom profile. Most participants were negatively impacted by various aspects of the public health response, more so for those with more acute illness. Conclusions With 40.5% of participants not having sought formal diagnostic assessment and less than half in treatment, this study provides evidence for the detrimental impact of the pandemic on people with a lived experience of an eating disorder, especially for those not yet supported by the health care system. This presents baseline data - investigation is ongoing to 6 month follow up to assess longer-term impact.