Role Distinctions and Role Overlap Among Behavioral Health Providers.

Integrated behavioral health care (IBHC) models are a growing trend for health care delivery, particularly in the primary setting. Clinicians working within IBHC contexts provide a spectrum of behavioral health services, including screening, prevention and health promotion, assessment, and treatment services. Integration of behavioral health providers into primary and specialty medical settings addresses the significant need for behavioral health services, improves care quality, improves patient experience, and reduces costs of care, access issues, and delays in service provision. While benefits are clear, what type of model to implement and which behavioral health care providers to include in that model remain elusive. This is partly due to the failure of IBHC models to include all behavioral health providers in their design, a lack of clarity of the expertise of each provider, and how providers work together. IBHC models are also complicated by contextual issues such as the relative availability of each profession, population health needs in different clinic populations, and financial factors. The purpose of this manuscript is to the clarify roles and responsibilities of different behavioral health professions including similarities and differences in their training, areas of unique expertise (role distinctions), shared responsibilities (role overlap), and relative cost and availability in the United States.

Equity for and Inclusion of Non-Tenure-Track Pharmacy Faculty Within Academia.

Although there are at least twice as many non-tenure-track first-time pharmacy faculty as tenured and tenure-track first-time pharmacy faculty entering academia based on data collected from 2013 to 2019, there are ongoing equity, inclusion, and advancement issues between these categories of faculty that require consideration. Contracts with clear descriptions of responsibilities are needed along with regular evaluations and promotion opportunities based on the faculty member's performance of the assigned responsibilities, appropriate compensation including fringe benefits, inclusion in institutional voting and governance, and due process protections against abrupt termination. Further, universities and schools and colleges of pharmacy should foster a culture that values all faculty regardless of rank or position. The purpose of this commentary is to describe ongoing efforts and lessons learned by one public university with a college of pharmacy that has non-tenure-track and tenure-track faculty. Our hope is to provide insight into how these experiences could be used as a basis to inform changes in policy by other universities with a school or college of pharmacy, as well as to inform possible changes to the Academy's policies.

An exploratory study: the use of paroxetine for methamphetamine craving.

Methamphetamine abuse and dependence are growing problems nationally and worldwide. There are currently no effective pharmocologic treatments. Animal studies with SSRI's suggest that serotonergic modulation alters methamphetamine's behavioral effects. This exploratory study is a trial of the effects of the SSRI paroxetine versus placebo (in a double blind design) on craving and use in a population of methamphetamine users. Many subjects dropped out of the study, but those in active treatment who completed the eight week trial had a decrease in methamphetamine craving compared to the placebo treatment as measured by the OCDS modified for use in this population. Statistical analyses were not performed due to the low number of subjects. The preliminary data suggest that serotonergic agents may play a role in the effective treatment of methamphetamine abuse and dependence within the context of other effective behavioral interventions.