Introduction Suicide is the 10th leading cause of death in the United States (US) and the prevalence continues to increase. It is estimated that there is an average of 25 attempted suicides for every suicide death in the US, and the economic burden of suicide and attempted suicide is high. Identification of those at risk for suicide and attempted suicide can help with early and prompt intervention. Studies in Europe and Asia have shown that there is a relationship between seasonal patterns and suicidal risk. However, little is known about seasonal patterns of suicidal attempts in the US. Therefore, our study aimed to assess seasonal patterns by days of the week and months of the year in the US. Methods Hospitalized adult patients with suicide attempts and self-inflicted injury were identified using the discharge data from the National Inpatient Sample (NIS) from January 1, 2010 to December 31, 2014. We looked at the seasonal trends of patients with attempted suicide and self-inflicted injury by weekday vs weekend and month of the year over the five-year study period. We also assessed two groups, male and female with attempted suicide and compared trends and contributing risk factors over the study period using Student’s t-test and chi-square test. Results A total of 249,845 patients with attempted suicide and self-inflicted injury were reported during the study period with a prevalence rate increase of 15%, among which 70% were males, 65.5% white and 38.8% were age 40-64 years. An overall prevalence rate of about 168-200 per 100,000 hospitalizations was reported. There was a higher admission rate on weekends as compared to weekdays (190-300 vs 150-178 per 100,000 hospitalizations). Attempted suicide and self-inflicted injury admissions peaked during the months of July and August with a peak period range of 200-230 per 100,000 hospitalizations in a year. Conclusion The prevalence of attempted suicide is steadily rising. Awareness of the seasonal and epidemiological trends of attempted suicide and self-inflicted injury is a very important step towards developing effective strategies to prevent suicide and attempted suicide.
Purpose The purpose of this paper is to comprehensively identify and synthesize the mental health care provided through diverse community schools implemented in the USA. Design/methodology/approach Using PubMed, community school model websites and Google Search, we identified 21 community school models that publicly reported outcomes and conducted full review of these models. The authors also conducted e-mail and telephone communication with ten program directors and evaluators to gain insights into successes and lessons learned through implementing community school models based on community partnership. Findings Provision of mental health care though community schools leads to reducing school suspensions, disciplinary referrals, problem presentation, and risk behaviors, and improving school grades, personal responsibility, future aspiration, and family engagement. Research limitations/implications Developing standardized outcome measure for the evaluation of mental health care provided through community school models is important to establish evidence that leads policymakers and practitioners into action. Information toolbox to guide mental health administrators and practitioners about future funding and partnership mechanisms for successful implementation and sustained mental health care through community school models can be useful. Originality/value This systematic literature review provides insights into the current practice and future direction in the provision and evaluation of mental health care through community school models and addresses concrete research and practical implications to guide mental health professionals.
Introduction Opioid overdose is increasingly becoming common and so is the need for invasive mechanical ventilation (IMV) for opioid overdose admissions in hospitalized patients. Respiratory failure requiring invasive mechanical ventilation is the most common reason for the admission of opioid-associated overdose patients. The aim of our study was to assess the demographic and clinical characteristics associated with the increased need for IMV in hospitalized opioid overdose patients. Methods We analyzed all adult admissions (18 years and above) using the National Inpatient Sample (NIS) database for five years from January 1, 2010-December 31, 2014 to identify opioid overdose patients requiring invasive mechanical ventilation. We compared the demographic and clinical characteristics of opioid overdose patients requiring and not requiring mechanical ventilator support and performed univariate and multivariate analyses to determine the odds ratio (OR) of association. Results A total of 2,528,751 opioid overdose patients were identified among which 6.4% required IMV during hospitalization. The prevalence of opioid overdose and the need for IMV increased by 31% and 38%, respectively, over the study period. Multivariate logistic regression (OR (95% CI), p<0.001) determined the following to be associated with increased odds of mechanical ventilator use: (OR 1.12 (1.06-1.19)) among patients aged 25-39 years vs (1.36 (1.28-1.44)) for the age group 40-64 years when compared to 18-24 years; hospital locations in the south US region (OR 1.62 (1.49-1.75)) when compared to the northeast US region; the presence of aspiration pneumonia (OR 14.30 (13.63-15.0)), rhabdomyolysis (3.22 (3.04-3.42)), septic shock (9.15 (8.41-9.97)), and anoxic brain injury (15.5 (13.70-17.50)). Other factors associated with decreased odds of IMV include hepatitis C virus infection (OR 0.75 (0.72-0.79)) and black race (OR 0.68 (0.63-0.74)]. Opioid overdose patients requiring IMV had a higher length of stay by 8.
This study examined whether behavioral health service use post-jail release was associated with reduced risk of jail reincarceration. The study sample included 20,615 individuals who had behavioral health diagnoses and were released from the Philadelphia County jail. Using administrative records of the county jail and state-, county-, and Medicaid-funded behavioral health service use from 2010 to 2018, we conducted Cox proportional hazard analyses to estimate the association between behavioral health service use post-jail release and the risk of return to jail within 3 years. Nearly 50% of the sample returned to jail within 3 years. Individuals who used behavioral health services were 26%-38% less likely to return to jail within 3 years than were individuals who did not. The study results suggest that connecting individuals with behavioral health services upon release from jail can reduce the risk of repeated jail incarceration.
Background: Although public-academic partnerships (PAPs) to improve the health and well-being of vulnerable populations have proliferated in public care for youth, existing literature lacks information about whether PAPs lead to public care agency leaders’ use of research evidence and promote youth mental health and well-being.Aims and objectives: The document analysis was conducted to understand PAP contexts and mechanisms leading to public care agency leaders’ use of research evidence. This paper introduces US public mental health and child welfare systems, shares strategies of identifying PAPs, obtaining and conducting systematic document review of PAPs, and documents analysis findings.Methods: This project conducted document analysis of US PAPs aiming to improve mental health and promote well-being of youth aged 12–25 years.Findings: The 23 PAPs analysed had diverse partnership goals including implementation and dissemination of research/evaluation evidence, information sharing, and prioritising and streamlining research priorities. PAPs sustained longer than 10 years had more focused goals of programme and policy evaluations and professional training, while PAPs 10 years or newer were engaged in more diverse goals. The majority of PAPs used journal articles, presentations, and multimedia as dissemination strategies of findings. Fewer than half of the PAPs reported on use of PAP-generated evidence in subsequent decision making by public care agency leaders.Discussion and conclusions: Further research should examine which mechanisms link partnership contexts, PAP leaders’ research evidence use, and youth outcomes improvement. Future research should also examine PAPs by detailed stages of development and ask PAP leaders directly about their evidence use.<br />Key messages<br /><ul><li>This project conducted document analysis of PAPs focused on mental health and well-being of youth;</li><br /><li>The project aimed to reveal contexts and mechanisms that are present when PAP leaders use evidence;</li><br /><li>This paper shares strategies used and findings from conducting systematic document analysis.</li></ul>
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