The Health Resources and Services Administration has identified 5,833 Mental Health Professional Shortage Areas (MHPSAs), many of which are rural, and could be served by Certified Peer Specialists (CPSs). This paper examines the relationship between CPS employment and MHPSA residency. Data are from a 2020 survey of 572 CPS certified in one of four states. A higher proportion of those living in MHPSAs were employed in peer support jobs (rather than other job types or unemployed) compared to those living in non-MHPSAs. MHPSA residential status was not a significant predictor of employment status but was significantly associated with greater likelihood of employment in peer support compared to other jobs, both for the entire sample, and among those currently employed. The greater likelihood of working in peer support among those residing in MHPSAs suggests that CPSs may leverage their credential to address shortages. As a result, peer support may become a more necessary part of the traditional service array. Policies that enable CPS to practice in MHPSAs should be encouraged.
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Recent changes in legislation regarding mental health parity in Medicare will revolutionize payment for mental health care and delivery systems. This commentary discusses why this policy change was essential to promote adequate care for populations served by Medicare and to address expected changes in beneficiary, provider, and plan behavior as more equitable payments by Medicare are implemented.
Read MoreThis chapter provides an overview of what can be done in the future to address the prevention and control of mental and behavioral disorders. It begins with a description of what has come before, examining progress and pitfalls. This is followed by a discussion of the evolution needed to bring about Winslow's vision of mental health care as an integral part of the public health. It examines the growing role of such factors as the social determinants of health; attention to the full spectrum of mental health and illness from prevention through recovery across the life span; the importance of resilience in preventing behavioral problems; the still evolving key role of consumers in treatment and recovery; and the policy changes needed to embrace mental health as an intrinsic part of the public health.
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This pre-post study examined mental health service utilization and cost before and after participating in self-direction. Findings from this modest pre-post examination of self-direction suggest that mental health self-direction can result in more person-driven, individualized services without increasing costs.
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Lack of comprehensive medical care coverage and mental health symptoms were associated with increased odds of perceived difficulties in accessing medical care; personal empowerment was negatively associated with perceived difficulties attributed to stigma; education was positively associated. The findings highlight unmet need for medical care in this population and the need to recognize stigma as a barrier medical care. Interventions to empower patients and educate medical providers about wellness for people with serious mental illness could help to reduce barriers.
Read MoreThis study examined the relationship between the culturally determined beliefs and expectations of four ERD groups (African Americans, Latinos, Portuguese-speakers, and Haitians, total N = 160) and the technical quality of treatment for depression provided in four “culturally-specific” primary care clinics. Using data from the Experiences of Care and Health Outcomes survey, chart reviews and focus groups, the study addressed a set of questions related to the psychometric properties of perceived care measures and the technical quality of care. The groups differed in preferred cultural elements except all preferred inclusion of religion. They did not differ in overall perceived quality.
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This study examined peer-run organizations’ attitudes towards collaborating in health homes. Data were drawn from the 2012 National Survey of Peer-Run Organizations. Multinomial logistic regression modeled the association between organizational willingness to participate in a health home and salient factors. Current efforts, planned efforts to encourage physical healthcare, and staff size were associated with willingness to collaborate in health homes. Some organizations were concerned about power dynamics with potential medical collaborators. Relationships with medical providers, staffing capacity, and concerns about coercion should be considered when integrating peer-run organizations and health homes.
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