Understanding and Addressing Mental Health Disorders: a Workplace Imperative.

PURPOSE OF REVIEW: This article seeks to provide a broad overview of the workplace mental health literature, highlight practical implications of current research, and formulate key recommendations for stakeholders. Various aspects of disability related to mental health disorders, their associated financial costs, and the impact of stigma are covered. This article also discusses key strategies for assessing mental health problems among employees and reviews different types of interventions in the workplace. RECENT FINDINGS: Workplace mental health is an evolving area, particularly in the wake of the pandemic. While established national workplace mental health standards do not currently exist, mental illness continues to have a severe impact on the health of organizations, employees, and the economy. Additional research is needed to fully understand and address the diversity of mental health needs among the broad range of employees and organizations across the USA. Employers have a responsibility and an opportunity to create workplaces that support the whole person, not just the employee. While research in the area has increased in the last decade, there is still much to learn in terms of the most effective ways to support our workforce.

Going Virtual During a Pandemic: An Academic Psychiatry Department's Experience with Telepsychiatry.

Background: The novel coronavirus pandemic (COVID-19) led healthcare providers, including mental health providers, across the U.S. to swiftly shift to telemedicine. Objectives: This shift gave our Department of Psychiatry a chance to better understand key challenges and opportunities vis-à-vis virtual mental healthcare. We aimed to obtain provider feedback on the use of telepsychiatry and to learn from the provider perspective about patient experiences with video visits. This information will be used to inform the telemedicine strategy at a systems level within our psychiatry department, our academic health system, as well as the field of telemedicine as a whole. Design and Sample: A 22-item online questionnaire comprising 16 quantitative and six qualitative items was distributed to providers currently using video visits to provide care. Results: A total of 89 mental health providers completed the questionnaire. Outcomes demonstrated that while providers perceive challenges associated with virtual care (e.g., fatigue, technology-related issues, and age-related concerns), they also recognize a number of benefits to themselves and their patients (e.g., convenience and increased access). Overall, provider satisfaction, comfort, and willingness to use telepsychiatry was high. Conclusions: The vast majority of providers adapted quickly to the use of virtual platforms; many endorse advantages that suggest virtual care will continue to be a modality they provide in the future, post-COVID-19. It will be important to continue to evaluate aspects of virtual care that may limit clinical assessments and to optimize use to improve access, convenience, and cost-efficiency of mental healthcare delivery.

Improving psychiatric medication use through the Michigan e-psychopharmacology course for nurse practitioners: A pre-post/follow-up study.

PURPOSE: Increasing demands for mental health treatment represent a key opportunity for nurse practitioners (NPs) to provide more psychiatric medication treatment (psychopharmacology). Given this need, NPs could benefit from opportunities to enhance knowledge and skills in psychopharmacology. DESIGN AND METHODS: A novel videoconference course was developed and tested, with 6 weekly sessions taught by a facilitator and a speaker, evaluated by multiple outcomes. FINDINGS: Course feasibility and evidence of improved NP confidence and performance in psychopharmacology were both demonstrated. PRACTICE IMPLICATIONS: Continuing education providers should consider adopting this model for effective and accessible NP psychopharmacology education, potentially expanding NP mental healthcare delivery.

Videoconferencing Technology to Facilitate a Pilot Training Course in Advanced Psychopharmacology for Psychiatrists.

OBJECTIVE: Psychopharmacology requires practitioners to continually upgrade knowledge and skills, but attendance at live continuing medical education events presents many barriers. In addition, technology has generated new learning approaches. In response, a videoconference-based course on psychopharmacology was developed and evaluated for feasibility and acceptability. Specific goals included whether learners would engage and whether the technology would work well for both learners and instructors. Additional aims included providing guideline-concordant psychopharmacology training, enhancing patient safety, and fostering case discussion. METHODS: The course used BlueJeans® videoconferencing technology. Each of the six weekly sessions was taught by a facilitator and a speaker. Every class incorporated a 1-h interactive didactic presentation, followed by 1 h for case reviews. Topics included six major psychiatric disorders, managing key drug interactions, and pharmacogenomics. Three types of online self-report evaluations were conducted-individual session evaluation, overall evaluation, and faculty speaker evaluation. RESULTS: Nineteen participants enrolled, with 85% of respondents reporting course objectives were met as "very good" or "excellent." Moreover, 92% of respondents rated the course as "very good" or "excellent." Sixty percent of the faculty were "somewhat satisfied" and 40% were "extremely satisfied" with the videoconferencing tool. Qualitative responses from both participants and faculty were positive overall. CONCLUSIONS: This course provides preliminary evidence that an online, live longitudinal course in psychopharmacology is both acceptable and effective, both for CME learners and teachers. The authors plan to disseminate this model of CME to other institutions while extending the reach of the present course to more diverse practitioners.

The Michigan Peer-to-Peer Depression Awareness Program: School-Based Prevention to Address Depression Among Teens.

OBJECTIVE: The Peer-to-Peer Depression Awareness Program (P2P) is a school-based program that aims to decrease mental illness and promote well-being among students by empowering high school students as both learners and educators. Specific goals include improving the school climate around mental health, directing students to resources, and encouraging help-seeking behavior. METHODS: In the 2015-2016 academic year, 121 students across 10 high schools organized into teams and were trained to develop and implement peer-to-peer depression awareness campaigns. Outcomes were assessed via pre- and posttest questionnaires. RESULTS: A total of 878 students completed questionnaires. Outcomes demonstrated improved knowledge and attitudes toward depression, increased confidence in identifying and referring peers with depression, improved help-seeking intentions, and reduced stigma. CONCLUSIONS: The P2P program increased depression literacy through the use of youth-designed and youth-implemented depression awareness and outreach activities, which may ultimately result in earlier detection of depression and in fewer depression sequelae.

Drug Use Normalization: A Systematic and Critical Mixed-Methods Review.

OBJECTIVE: Drug use normalization, which is a process whereby drug use becomes less stigmatized and more accepted as normative behavior, provides a conceptual framework for understanding contemporary drug issues and changes in drug use trends. Through a mixed-methods systematic review of the normalization literature, this article seeks to (a) critically examine how the normalization framework has been applied in empirical research and (b) make recommendations for future research in this area. METHOD: Twenty quantitative, 26 qualitative, and 4 mixed-methods studies were identified through five electronic databases and reference lists of published studies. Studies were assessed for relevance, study characteristics, quality, and aspects of normalization examined. RESULTS: None of the studies applied the most rigorous research design (experiments) or examined all of the originally proposed normalization dimensions. The most commonly assessed dimension of drug use normalization was "experimentation." In addition to the original dimensions, the review identified the following new normalization dimensions in the literature: (a) breakdown of demographic boundaries and other risk factors in relation to drug use; (b) de-normalization; (c) drug use as a means to achieve normal goals; and (d) two broad forms of micro-politics associated with managing the stigma of illicit drug use: assimilative and transformational normalization. CONCLUSIONS: Further development in normalization theory and methodology promises to provide researchers with a novel framework for improving our understanding of drug use in contemporary society. Specifically, quasi-experimental designs that are currently being made feasible by swift changes in cannabis policy provide researchers with new and improved opportunities to examine normalization processes.

Providing detailed information about latent tuberculosis and compliance with the PPD test among healthcare workers in Israel: a randomized controlled study.

BACKGROUND: The compliance of screening for latent tuberculosis (TB) with the tuberculin purified protein derivative (PPD) test is very low among healthcare workers (HCWs) in Israel. METHODS: This randomized controlled study uses the Health Belief Model (HBM) as a conceptual framework to examine whether providing more information about latent TB and the PPD test increases the response rate for PPD screening among HCWs. All candidate HCWs for latent TB screening were randomly allocated to one of the following two invitations to perform the PPD test: regular letter (control group, n=97), and a letter with information about latent TB and the PPD test (intervention group, n=196). RESULTS: 293 HCWs were included (185 nurses, and 108 physicians). Overall, 36 (12.3%) HCWs were compliant with the PPD test screening. Compliance with PPD testing in the intervention group was not statistically different from the control group, RR 0.87 (95% CI, 0.46-1.65). CONCLUSIONS: Compliance for latent TB screening is low among HCWs in northeastern Israel. Providing detailed information about latent TB was not associated with increased test compliance. Understanding existing disparities in screening rates and potential barriers to latent TB screening among HCWs is important in order to move forward and successfully increase screening rates.