Reimbursement for a Broader Array of Services in Coordinated Specialty Care for Early Psychosis.

Despite the growing evidence supporting the benefits of coordinated specialty care (CSC) for early psychosis, access to this multimodal, evidence-based program in the United States has been hindered by a lack of funding for core CSC services and activities. The recent approval of team-based reimbursement codes by the Centers for Medicare and Medicaid Services has the potential to fund substantially more CSC services for clients with insurance coverage that accepts the new team-based billing codes. This streamlined and more inclusive billing strategy may reduce administrative burden and support the financial viability of CSC programs.

Mental Health Community and Health System Issues in COVID-19: Lessons from Academic, Community, Provider and Policy Stakeholders.

The coronavirus pandemic of 2019 (COVID-19) has created unprecedented changes to everyday life for millions of Americans due to job loss, school closures, stay-at-home orders and health and mortality consequences. In turn, physicians, academics, and policymakers have turned their attention to the public mental health toll of COVID-19. This commentary reporting from the field integrates perceptions of academic, community, health system, and policy leaders from state, county, and local levels in commenting on community mental health needs in the COVID-19 pandemic. Stakeholders noted the broad public health scope of mental health challenges while expressing concern about exacerbation of existing disparities in access and adverse social determinants, including for communities with high COVID-19 infection rates, such as African Americans and Latinos. They noted rapid changes toward telehealth and remote care, and the importance of understanding impacts of changes, including who may benefit or have limited access, with implications for future services delivery. Needs for expanded workforce and training in mental health were noted, as well as potential public health value of expanding digital resources tailored to local populations for enhancing resilience to stressors. The COVID-19 pandemic has led to changes in delivery of health care services across populations and systems. Concerns over the mental health impact of COVID-19 has enhanced interest in remote mental care delivery and preventive services, while being mindful of potential for enhanced disparities and needs to address social determinants of health. Ongoing quality improvement across systems can integrate lessons learned to enhance a public mental well-being.

Criminal records of persons served in the public mental health system.

OBJECTIVE: The authors examined the frequency and severity of arrests of persons served by Medicaid as well as public mental health treatment patterns before and after arrest. METHODS: A random sample of 6,624 persons was drawn from claims of the public mental health system in Los Angeles County between July 1993 and June 2001. Clients' claims were matched to criminal justice records from 1991 to 2001. Cross-tabulations and logistic regression analyses were used to examine the likelihood and seriousness of criminal involvement, as well as clients' involvement in mental health treatment around the time of the arrest. RESULTS: Twenty-four percent of the sample had at least one arrest over the ten-year period. Sixty-two percent of arrested individuals had as their most serious offense a nonviolent crime. Half of all observed arrests did not lead to conviction. There was no statistical difference in the total treatment services received between arrested and not-arrested individuals. Among those arrested, there was only a small difference in the likelihood of receiving treatment services before and after arrest. CONCLUSIONS: Almost a quarter of persons with serious mental illness were arrested at least once over ten years. More than one-third of these individuals were arrested for violent crimes, with drug crimes the second most common category. The seriousness of the offense varied with diagnosis. Arrest was not associated with meaningful increases in service use, pointing to potential missed opportunities for treatment.