Research

This month, SAMHSA released results from the 2021 National Survey on Drug Use and Health (NSDUH), an annual nationwide survey on mental health, substance use, treatment rates, and more. Approximately 1 in 5 U.S. adults (22.8%) experienced mental illness in the past year. A third of young adults ages 18-25 (33.7%) experienced mental illness in the past year – the highest rate of any age group. Although new data collection methods limit the comparability of the 2021 NSDUH data to previous years, the data show just how common experiences of mental health conditions have become, particularly among young people. To learn more, see the 2021 National Survey on Drug Use and Health.  

Much of the available information about psychosis comes from a medical perspective, which can make those experiencing psychosis feel misunderstood or invalidated by the mental health care system. Two researchers, both diagnosed with schizophrenia, began “Psychosis Outside the Box” to provide an alternative. “Psychosis Outside the Box” is an ongoing project that compiles first-person accounts of psychosis in an online repository. The researchers hope the stories can be shared with other researchers and clinicians to better identify and serve individuals experiencing psychosis, particularly during the early stages when engagement is critical. To learn more, see the article in Psychiatric Services.  

NAMI Provider is a no-cost training program designed to help mental health professionals understand the lived experience of mental illness and promote a collaborative model of care. To assess the effectiveness of different delivery methods, 325 medical students were assigned to participate in either a traditional, community-based program (Cohort 1) or an online, active learning program (Cohort 2). Both cohorts showed reduced anxiety interacting with patients with mental illness, decreased stereotyping attitudes, and improved confidence incorporating psychiatry into routine care, with stronger effects among students receiving the online format. The findings highlight the potential benefits of the NAMI Provider program, even when adapted to a virtual learning environment. To learn more, see the article in Medical Education Online.

This month, the American Psychological Association released results from its third annual COVID-19 Practitioner Impact Survey in which it surveyed nearly 63,000 active, licensed psychologists in the U.S. In 2022, 79% of psychologists reported an increase in patients with anxiety since the pandemic began, 66% in patients with depression, and 26% in patients with severe mental illness. Despite the increased need for mental health care, 60% of psychologists report having no openings for new patients.Telehealth has been critical to providing treatment as 31% of respondents report exclusively using telehealth and 58% report using a hybrid approach. To learn more, see the report from the American Psychological Association.

Social determinants of health (SDoHs) are the conditions present in a person’s life that impact health outcomes and quality of life. A recent analysis of Medicaid claims data of 245,000 youth with a psychiatric diagnosis examined the relationship between SDoHs and self-harm. Controlling for demographic characteristics and clinical diagnoses, adverse SDoHs such as abuse and neglect, child welfare placement and parent-child conflict were significantly associated with self-harm. Researchers advocate for collecting SDoH data in medical records to help identify and intervene in cases of youth at risk for self-harm and suicide. To learn more, see the article in Psychiatric Services.  

Mindfulness is a popular technique for addressing stress and anxiety. However, less is known about how it compares to first-line medication treatment for diagnosed anxiety disorders. A randomized clinical trial of 208 adults compared the effectiveness of mindfulness-based stress reduction (MBSR) to a flexible dosage of the antidepressant escitalopram in treating anxiety disorders. After an 8-week treatment period, adults in the MBSR group reported similar improvements to the escitalopram group on a severity scale of symptoms. Participants in the MBSR group were also less likely to report an adverse event and therefore less likely to drop out of the study. To learn more, see the article in JAMA Psychiatry.

Researchers from the University of California Irvine surveyed over 5,500 adults representative of the U.S. population during the spring of 2020 and later in the fall of 2020 about their experiences with mental health, COVID-19, isolation, loneliness, and distress. Researchers identified exposure to the COVID-19 virus, knowing someone who passed from COVID-19, and consuming hours of media related to COVID-19 as risk factors for experiencing psychological distress and loneliness. State-level mitigation practices, such as stay-at-home orders and public information campaigns, did not appear to affect mental health outcomes. The findings can help inform future public health responses designed to prioritize limiting loss of life, exposure to disease, and psychological distress. To learn more, see the study in Health Psychology.  

Adverse childhood experiences (ACEs) are potentially traumatic events that occur during childhood and can negatively impact mental health and well-being into adulthood. Recent data from the 2021 Adolescent Behaviors and Experiences Survey (ABES) showed that nearly three-quarters (73%) of U.S. high school students reported at least one ACE during the COVID-19 pandemic. Students with four or more ACEs were about four times more likely to have poor current mental health and 25 times more likely to have past-year suicide attempts compared to those without any ACEs. Identifying vulnerable youth early and providing them with trauma-informed care can help address the mental health needs brought on by ACEs and the COVID-19 pandemic. To learn more, see the report from the CDC.  

Despite being effective for treatment-resistant schizophrenia, clozapine is underutilized. To increase prescriptions, a clozapine community clinic with a multidisciplinary team of health practitioners was established in 2015. Providers utilized the best practice alert (BPA) to identify ideal patient candidates for clozapine treatment and since its inception, the number of patients receiving clozapine treatment increased from 57 to 124. Patients received weekly group support, education, telehealth, and access to a centralized clozapine resource toolkit. Intervention programs also evaluated existing attitudes and awareness regarding clozapine and provided education to healthcare providers. To learn more, see the article in Psychiatric Services.