A structured interview survey of directors of a large national sample (n = 200) of mental health service organizations treating children examined the governance, financing, staffing, services, and implementation practices of these organizations; and, director ratings of factors important to implementation of new treatments and services. Descriptive analyses showed private organizations financing services with public (particularly Medicaid) funds are prevalent and that employment of professional staff, clinical supervision and training, productivity requirements, and outcomes monitoring are common. Results of random effects regression models (RRMs) evaluating associations between governance, financing, and organizational characteristics and the use of new treatments and services showed for-profit organizations more likely to implement such treatments, and organizations with more licensed clinical staff and weekly clinical supervision in place less likely to do so. Results of RRMs evaluating relations between director ratings of the importance to new treatment and service implementation of three factors-fit with existing implementation practices, infrastructure support, and organizational mission and support-suggest greater importance to public than private organizations of these factors. Implications for EST implementation and future research are described.

Despite negative outcomes for depressed mothers and their children, no treatment specifically designed to address maternal depression in the context of home visitation has emerged. In-Home Cognitive Behavioral Therapy (IH-CBT) is an adapted treatment that is delivered in the home, focuses on the needs of new mothers, and leverages ongoing home visiting to optimize engagement and outcomes. This study examined the efficacy of IH-CBT using a randomized clinical trial. Subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3 months postpartum were randomized into IH-CBT and ongoing home visitation (n=47) or standard home visitation (SHV; n=46) in which they received home visitation alone and could obtain treatment in the community. Depression was measured at pre- and posttreatment, and 3-month follow-up using interviews, clinician ratings, and self-report. Mothers receiving IH-CBT showed improvements in all indicators of depression relative to the SHV condition and these gains were maintained at follow-up. For example, 70.7% of mothers receiving IH-CBT were no longer depressed at posttreatment in terms of meeting criteria for major depressive disorder compared to 30.2% in the SHV group. These findings suggest that IH-CBT is an efficacious treatment for depressed mothers in home visitation programs.

Objective: To estimate the association between the release of the Netflix series 13 Reasons Why and suicide rates in the United States.Method: Using segmented quasi-Poisson regression and Holt-Winters forecasting models, we assessed monthly rates of suicide among individuals aged 10 to 64 years grouped into 3 age categories (

Using data from the 1997-2000 Medical Expenditure Panel Survey (MEPS), disparities in different stages of attention-deficit/hyperactivity disorder (ADHD) health care were investigated, from initial detection to follow-up physician visits and psychotherapy appointments. Differences in ADHD diagnoses, stimulant usage, and health-care visits were examined by age, race/ethnicity, region, and type of insurance. Major significant findings were: (1) children without insurance had lower levels of care in all stages relative to children with insurance, (2) Hispanic-American and African-American children were less likely to be diagnosed with ADHD by parent report than were white American children, and (3) African-American youths with ADHD were less likely to initiate stimulant medication relative to white American children. Implications for expanding childhood health insurance coverage, and for future work on minority mental health care in regard to ADHD, are discussed.