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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.  

Ketamine has been found to be highly effective for treatment-resistant depression, but its fast-acting effects typically do not last more than one to two weeks. A randomized clinical trial of 154 adults with moderate to severe depression measured how a behavioral therapy known as “active automated self-association training” (ASAT) influenced the antidepressant effects of intravenous ketamine infusion. After 30 days, adults who received a ketamine infusion with ASAT reported the lowest depression scores compared to either adults who received ketamine with placebo ASAT or sham ketamine with ASAT. The findings suggest that the antidepressant effects of ketamine may be strengthened and lengthened in combination with behavioral therapy. To learn more, see the study in the American Journal of Psychiatry.  

To understand how environmental disasters impact mental health outcomes, researchers surveyed nearly 2,000 residents from Flint, Michigan five years after the onset of the water crisis. Approximately one quarter of respondents met diagnostic criteria for depression (22%) and posttraumatic stress disorder (24%) within the past year. Despite the community’s growing need for psychological care, just over one third of Flint residents (35%) were offered mental health services. Individuals with prior exposure to traumatic events were also more likely to report higher rates indicating the cumulative effects of trauma. The findings emphasize the need to advocate for psychiatric support for victims of environmental disasters. To learn more, see the study in JAMA Network Open.