Palliative care patients' attitudes and openness towards psilocybin-assisted psychotherapy for existential distress.

Introduction: Patients with incurable illnesses often experience existential distress, profoundly impacting their well-being. Current medical approaches have limitations in addressing these burdens. Psilocybin, a promising psychedelic compound, may offer therapeutic benefits. This pilot survey study aimed to investigate the attitudes and openness toward psilocybin-assisted psychotherapy (PAT) among patients with incurable illnesses. The objective is to assess patients' attitudes toward PAT and identify potential barriers and concerns, including exploring the association between beliefs in psilocybin's therapeutic benefits and interest in receiving this treatment. Methods: The survey study was conducted at the Tampa General Hospital Palliative Care Outpatient office in the United States. Participants were 32 English-fluent patients, aged 18 or older, with incurable illnesses. The survey included demographic questions, a validated tool to measure existential distress, and questions about knowledge and concerns regarding psilocybin. Attitudes toward PAT and interest in its future use were assessed using Likert scale responses. Results: Among the 31 analyzed participants, 51.6% expressed interest in future psilocybin treatment, while 32.3% did not indicate interest. Belief in the psilocybin's therapeutic benefits for stress and anxiety significantly correlated with interest in use. Concerns included risk of psychosis, lack of trained providers, and potential for exploitation. No demographic factors were associated with interest or levels of distress. Conclusions: This pilot study provides insights into the attitudes and concerns toward PAT among patients with incurable illnesses. Over half of participants expressed interest. However, concerns regarding its use were identified, with patients' concern for the risk of exploitation associated with PAT as an especially novel concern documented in this patient population. This highlighted the need for further education of risks and benefits or PAT by trained clinicians and rigorous training of clinicians with the establishment of safeguards against exploitation. Further research is necessary to explore the potential benefits of PAT and related non-psilocybin psychedelic compounds in addressing existential distress among patients with incurable illnesses.

Prescribing Psychotropic Medications for Justice-Involved Juveniles.

Psychiatric disorders are exceedingly common in justice-involved youth. Relevant justice systems are varied, evolving, complex, and underserved. The intent of this article is to highlight the research and best practices related to managing the psychiatric disorders of justice-involved youths with a particular focus on pharmacotherapy. We review relevant features of the justice system and related case law, how prescribing for these individuals varies from both community settings and for incarcerated adults, effective assessment and medication selection, informed consent, management of nonadherence and medication diversion, and applied evidence for specific psychiatric problems common in these patients. Psychiatrists caring for justice-involved youth will benefit from tools, like this article, for training and orientation to provide timely and effective treatment services and consultation in these settings.

The Interplay Between Digital Media Use and Development.

Today's youth develop immersed in a digital media world and the effects are specific to their developmental stage. Clinicians and caretakers should be mindful regarding digital media use patterns; however, this complex and reciprocal relationship defies simple linear descriptions. The impacts of digital media can be powerful. It is important to be cautious but not over-pathologize media use because digital media enables social connections, allows self-soothing in some children, and fills needs for stimulation and self-expression. Young children or those with psychiatric disorders or developmental delays should be considered vulnerable to harmful effects of media content and overuse.

Collaborative Health Care and Emerging Trends in a Community-Based Psychiatry Residency Model.

OBJECTIVE: This paper provides a report of an academic department of psychiatry's journey into the change process associated with addressing the new requirements in health-care delivery, the emphasis on person-centered treatment models, and the implications for residency training programs. Louisiana State University Health Sciences Center Department of Psychiatry's experience is based on responding to real-world shifts in which academic departments can play a leadership role. METHODS: Importantly, methods are based on person-centered collaboration being central to a successful change process and include a description of the training, with data supporting implementation of the model. RESULTS: The model demonstrates increased access to care and improved behavioral health symptoms. It indicates that with proper training and supervision, psychiatry residents can be an agent of change. CONCLUSION: This brief review of our experience offers to other departments of psychiatry examples of collaborative strategies substantially informed by the needs and preferences of both persons accessing services and local communities.

The Future of Psychiatric Collaboration in Federally Qualified Health Centers.

Federally qualified health centers (FQHCs) provide comprehensive care to underserved and disadvantaged populations. FQHCs now comprise the largest primary care network in the United States. Currently, many FQHCs provide limited access to psychiatric services; and when such services are available, most use traditional on-site psychiatric clinics. The author reviews the rationale for increasing access to behavioral health care in FQHCs by adopting collaborative models of care, describes challenges to adopting these models in FQHCs, and discusses ways to increase the primary care team's ability to support patient self-care and family functioning.

Telepsychiatry in juvenile justice settings.

Telepsychiatry is emerging as a valuable means of providing mental health care in juvenile justice settings. Youth in the juvenile justice system have high levels of psychiatric morbidity. State and local juvenile justice systems frequently struggle to provide specialized psychiatric care, as these systems have limited resources and often operate in remote locations. Case studies in the use of telepsychiatry to provide improved care in juvenile corrections in 4 states are described, along with a review of advantages and disadvantages of telepsychiatry in these settings.

The media: relationships to psychiatry and children: a seminar.

Media technologies and content exert powerful effects on individuals and society. The authors describe a multilecture seminar, intended for general and child and adolescent psychiatry residents, that focuses on media impacts on society. The presentations are intended to prompt critical thinking regarding the opportunities and risks that media forms and content present for children and adolescents. The potential uses of media in psychiatric education and clinical work are discussed in this context.