Exploring Disparities in Behavioral Health Service Use in the Early Stages of the COVID-19 Pandemic.

BACKGROUND: Previous studies examined the impact of the COVID-19 pandemic on mental health, but few studies looked at associations between the pandemic and state-funded behavioral health service utilization. We aimed to examine behavioral health service utilization during the early phase of COVID-19 among individuals with psychiatric disorders (PD), substance use disorders (SUD), and co-occurring disorders (COD). METHODS: Using the last Adult Needs and Strengths Assessment (ANSA) completed in 2019 and 2020 in a Midwestern state, a column proportion test and Poisson regression model examined the associations of the pandemic year, age, gender, race/ethnicity, diagnostic type, and behavioral health needs. RESULTS: Between 2019 and 2020, the number of adults newly involved in behavioral health services increased from 11,882 to 17,385. The number of total actionable items (TAI) differed by gender and age group. Adults who were Black or American Indian were more likely to have a significantly higher number of needs that interfered with functioning (ß = 0.08; CI [0.06, 0.09]), (ß = 0.16; CI [0.08, 0.23]), respectively, than White peers. Individuals with COD showed the highest number of needs (ß = 0.27; CI [0.26, 0.28]) when compared to the needs of individuals with psychiatric disorders, after controlling for year, age, gender, and race/ethnicity. CONCLUSIONS: Additional research is needed to better understand the intersections of age, gender identity, race/ethnicity, the complexity of needs, and useful strengths. The involvement of practitioners, service organizations, researchers, and policymakers will be required to provide accessible, effective behavioral health services with cultural and developmental adaptations to support recovery.

Chloe for COVID-19: Evolution of an Intelligent Conversational Agent to Address Infodemic Management Needs During the COVID-19 Pandemic.

There is an unprecedented demand for infodemic management due to rapidly evolving information about the novel COVID-19 pandemic. This viewpoint paper details the evolution of a Canadian digital information tool, Chloe for COVID-19, based on incremental leveraging of artificial intelligence techniques. By providing an accessible summary of Chloe's development, we show how proactive cooperation between health, technology, and corporate sectors can lead to a rapidly scalable, safe, and secure virtual chatbot to assist public health efforts in keeping Canadians informed. We then highlight Chloe's strengths, the challenges we faced during the development process, and future directions for the role of chatbots in infodemic management. The information presented here may guide future collaborative efforts in health technology in order to enhance access to accurate and timely health information to the public.

State-Community System of Care Development: an Exploratory Longitudinal Review.

The system of care (SOC) philosophy evolved into a framework to support access to effective behavioral health services for children. This study explored the use of the System of Care Implementation Survey (SOCIS) to monitor SOC development during one Midwestern state's federal planning and expansion grants. Utilizing a translational framework, results showed that despite fluctuations in SOC factor implementation over time, state and local SOCs had mid-level development. Further, inferential analysis of select factors indicated that outreach and access to services and the skilled provider network were significantly worse over time. Significant improvement in the treatment quality was documented but not sustained. Changes for Family Choice and Voice and Collaboration were not statistically significant. Variability in survey participation limited the evaluation. Refinement of evaluation methods is needed to monitor progress and to manage SOC development.