From the Pages of Psychiatric Times: July 2022

The experts weighed in on a wide variety of psychiatric issues for the July 2022 issue of Psychiatric Times.

In the July issue of Psychiatric TimesTM, we worked with experts from multiple psychiatric areas to bring you thoughtful articles about a wide variety of psychiatric issues, from the new 988 suicide hotline to the role of antipsychotic selection in reducing nonadherence in schizophrenia. Here are some highlights from the issue.

New 988 Suicide Hotline: Hope or Hype?

The National Suicide Prevention Lifeline is getting an upgrade. On July 16, 2022, the Lifeline will change from its previous number (800-273-8255) to just 3 digits: 988. Although the old number will remain available for calls, individuals may call, text, or chat 988, where they will be connected with trained counselors.

Additionally, if functioning as intended, operators will be able to counsel callers 24 hours a day and dispatch specially trained responders, hopefully reducing armed law enforcement interventions and emergency department (ED) visits. Continue Reading

It's Time to Think of Women: Mental Health Services for First-Episode Psychosis

As the World Health Organization reminds us, gender is a critical determinant of health, including mental health. Psychosis affects 3 in 100 individuals worldwide and typically develops around age 21 years. It includes diagnoses such as those of the schizophrenia spectrum and affective disorders. Early intervention services hold the promise of changing the trajectory of psychosis by providing specialized, coordinated care to individuals experiencing their first episode of psychosis (FEP). Evidence shows that FEP services can improve short-term and long-term outcomes for the individual (eg, employment) and for their community (eg, reduced disruptive public behavior, legal charges). What remains unknown, and maybe overlooked, is that women experiencing FEP might encounter gender-based disparities in accessing and receiving specialized care. Continue Reading

Antipsychotic Selection is Important for Reduced Nonadherence in Schizophrenia

“Mr Spear” is a white man, age 43 years, with a 20-year history of schizophrenia who presents for an initial outpatient appointment with a primary complaint of insomnia. Upon further questioning, he explains that he is afraid to sleep due to paranoia because there are individuals outside his home at night who want to kill him. He will not take any medication that makes him drowsy. His mental status is otherwise unremarkable. He denies any suicidal or homicidal ideations and does not appear to attend to internal stimuli. He reports several previous psychiatric hospitalizations, but none in the past 3 years. He works full-time in construction and denies any work-related problems. After a discussion of risks and benefits, he agrees to a trial of daily low-dose aripiprazole (morning) and to return to the clinic in 4 weeks. However, Mr Spear does not show up for his follow-up appointment, he does not return a phone call to reschedule, and he never returns to the clinic. Continue Reading

Caregiving: Walking the Personal and Professional Tightrope

August 16, 2019, in New Haven, Connecticut, was a beautiful summer evening. A delicious dinner at the Study at Yale hotel, where we were staying for the night, wrapped up a packed day of activities. These included a presentation and conversations about evidence-based addictions treatment modalities. The day could not have been better. I remember thinking that this was addiction treatment done right. A colleague invited a group of us to walk over to the Arethusa Farm Dairy store for their famous “designer” ice cream. I asked for a minute to go to my room and slip on some comfortable shoes for the 5-minute walk. I never returned. Instead, I called my colleague to tell him and everyone else to go ahead—I had to handle an urgent matter. I had at least 10 missed calls and several text messages from 2 neighbors. Continue Reading

See the full July issue of Psychiatric TimesTM here. And be sure to stay up-to-date by subscribing to the Psychiatric TimesTM E-newsletter.

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