Mental Health Parity and Addiction Equity Act and the Use of Outpatient Behavioral Health Services in the United States, 2005-2016.

Objectives. To assess the impact of the 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) on mental and substance use disorder services in the private, large group employer-sponsored insurance market in the United States. Methods. We analyzed data from the IBM MarketScan Commercial Database from January 2005 through September 2015 by using population-level interrupted time series regressions to determine whether parity implementation was associated with utilization and spending outcomes. Results. MHPAEA had significant positive associations with utilization of mental and substance use disorder outpatient services. A spending decomposition analysis indicated that increases in utilization were the primary drivers of increases in spending associated with MHPAEA. Analyses of opioid use disorder and nonopioid substance use disorder services found that associations with utilization and spending were not attributable only to increases in treatment of opioid use disorder. Conclusions. MHPAEA is positively associated with utilization of outpatient mental and substance use disorder services for Americans covered by large group employer-sponsored insurance. Public Health Implications. These trends continued over the 5-year post-MHPAEA period, underscoring the long-term relationship between this policy change and utilization of behavioral health services.

Correction to: Strategies to Support the Education Goals of Youth and Young Adults with Serious Mental Health Conditions: A Case Study.

The original version of this article unfortunately contained a mistake. The spelling of the fifth author's name was incorrectly published as Masha Ellison.

Strategies to Support the Education Goals of Youth and Young Adults with Serious Mental Health Conditions: A Case Study.

This manuscript describes efforts to support youth and young adults living with serious mental health conditions (SMHC) as they pursue their education goals. Case studies were conducted with three supported education initiatives across the US. Data were collected through individual interviews and focus groups. Key ingredients exist across various settings (e.g., mental health, post-secondary education) to support the pursuit of education goals for students living with SMHC, while individual settings have unique circumstances to address. Findings can inform stakeholders of relevant core components and implementation strategies across settings that support education goals for students with SMHCs.

Supported education for individuals with psychiatric disabilities: State of the practice and policy implications.

OBJECTIVE: Supported education (SEd) is a promising practice that supports and encourages educational goals and attainment among individuals with psychiatric disabilities. This paper provides insights into how SEd objectives are pursued in different settings, assesses the evidence base, and discusses policy implications. METHOD: Insights from 3 data sources were synthesized: published literature, an environmental scan, and 3 site visits to programs that support the education goals of individuals with psychiatric disabilities. RESULTS: While setting, target populations, level of coordination with supported employment, and financing strategies varied, common SEd components emerged: specialized and dedicated staffing, one-on-one and group skill-building activities, assistance with navigating the academic setting and coordinating different services, and linkages with mental health counseling. The evidence base is growing; however, many published studies to date do not employ rigorous methodology. Conclusions and Implications for Policy and Practice: Continued specification, operationalization, and testing of SEd core components are needed. The components of the evolving SEd model would benefit from rigorous testing to evaluate impact on degree completion and other key impacts such as employment; health, mental health, or recovery; and community participation. In addition to funding streams from special education and Medicaid, new opportunities for increasing the availability of SEd include the Workforce Innovation and Opportunities Act (WIOA) reauthorization, which requires state vocational rehabilitation agencies to fund preemployment services for transition-age individuals. New "set-aside" requirements for the Mental Health Services Block Grant will increase funding for early intervention services for individuals with serious mental illness, potentially including SEd. (PsycINFO Database Record

The interaction between eukaryotic initiation factor 1A and eIF5 retains eIF1 within scanning preinitiation complexes.

Scanning of the mRNA transcript by the preinitiation complex (PIC) requires a panel of eukaryotic initiation factors, which includes eIF1 and eIF1A, the main transducers of stringent AUG selection. eIF1A plays an important role in start codon recognition; however, its molecular contacts with eIF5 are unknown. Using nuclear magnetic resonance, we unveil eIF1A's binding surface on the carboxyl-terminal domain of eIF5 (eIF5-CTD). We validated this interaction by observing that eIF1A does not bind to an eIF5-CTD mutant, altering the revealed eIF1A interaction site. We also found that the interaction between eIF1A and eIF5-CTD is conserved between humans and yeast. Using glutathione S-transferase pull-down assays of purified proteins, we showed that the N-terminal tail (NTT) of eIF1A mediates the interaction with eIF5-CTD and eIF1. Genetic evidence indicates that overexpressing eIF1 or eIF5 suppresses the slow growth phenotype of eIF1A-NTT mutants. These results suggest that the eIF1A-eIF5-CTD interaction during scanning PICs contributes to the maintenance of eIF1 within the open PIC.