Building and Landing the Plane While Flying: How New York State Addressed the Needs of People With Serious Mental Illness During the COVID-19 Pandemic.

New York State was the epicenter for COVID-19 in Spring 2020 when little was known about the pandemic. Dire circumstances necessitated New York State's (NYS) public mental health system to rapidly pivot, adapt, and innovate its policies and procedures to ensure continuous high-level care to individuals with serious mental illness (SMI), a population especially vulnerable to both the physical and psychosocial sequelae of COVID-19. NYS rapidly adopted emergency measures to support community providers, expanded the capacity of its State-Operated facilities, created policies to promote improved infection control access, collaborated to enhance the public-private continuum of service to support people with SMI, and broadened the use of new technologies to ensure continued engagement of care.

Inpatient Psychiatry During COVID-19: A Systems Perspective.

Numerous reports describe how individual hospitals responded to the COVID-19 pandemic, but few describe how these changes occurred across a large public health system of care. As the early epicenter of the pandemic, New York State's response, particularly the New York City metropolitan area, included a range of coordinated planning and regulatory efforts to preserve and create medical and intensive care unit capacity where needed; maintain access to acute psychiatric services; and redefine inpatient psychiatric care through strict infection control, easing of regulatory requirements, and use of telehealth. These strategies reflected similar efforts across the United States.

A Qualitative Investigation Into Faith and LGBTQ Identities in a Nonclinical Sample of Readers of the Dear Abby Column: The Dear Abby Project.

ABSTRACT: To better understand the relationship between faith and LGBTQ+ identity, we conducted a qualitative analysis of 86 respondents to a general question posed through the Dear Abby column. Responses were anonymized and analyzed using a grounded theory approach. Analysis revealed six themes, reflecting a diversity of lived experience from community rejection to acceptance, and self-rejection to feelings of acceptance by God. Despite frequent media portrayals of conflict between faith and LGBTQ+ identity, the reality is more complex, and faith and LGBTQ+ identity development can be complementary.

Care Considerations for LGBTQ Patients in Acute Psychiatric Settings.

Caring for any patient in psychiatric crisis in an acute care setting requires a keen understanding of risk assessment as well as creation and maintenance of a safe and therapeutic treatment environment. The long-term success of acute psychiatric care is also dependent on competent discharge planning. Yet, current psychiatric practices in acute care settings often fail to account for the unique barriers faced by lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients, starting from the moment of arrival in the emergency room and continuing through discharge from the hospital. This article highlights best practices to address the needs of LGBTQ patients in acute psychiatric settings, including inclusive and affirming communication and culturally competent history taking, risk assessment, treatment environments, and discharge considerations.

The Growing Regulation of Conversion Therapy.

Conversion therapies are any treatments, including individual talk therapy, behavioral (e.g. aversive stimuli), group therapy or milieu (e.g. "retreats or inpatient treatments" relying on all of the above methods) treatments, which attempt to change an individual's sexual orientation from homosexual to heterosexual. However these practices have been repudiated by major mental health organizations because of increasing evidence that they are ineffective and may cause harm to patients and their families who fail to change. At present, California, New Jersey, Oregon, Illinois, Washington, DC, and the Canadian Province of Ontario have passed legislation banning conversion therapy for minors and an increasing number of US States are considering similar bans. In April 2015, the Obama administration also called for a ban on conversion therapies for minors. The growing trend toward banning conversion therapies creates challenges for licensing boards and ethics committees, most of which are unfamiliar with the issues raised by complaints against conversion therapists. This paper reviews the history of conversion therapy practices as well as clinical, ethical and research issues they raise. With this information, state licensing boards, ethics committees and other regulatory bodies will be better able to adjudicate complaints from members of the public who have been exposed to conversion therapies.

Anemia e renda per capita familiar de crianças frequentadoras da creche do Centro Educacional Unificado Cidade Dutra, no Município de São Paulo / Anemia and per capita income in children enrolled in a childhood education center in São Paulo, Brazil

OBJETIVO: Avaliar a freqüência de anemia de acordo com a renda familiar per capita de crianças matriculadas no Centro de Educação Infantil (CEI) do Centro Educacional Unificado (CEU) Cidade Dutra, no Município de São Paulo, São Paulo, em 2004. MÉTODOS: Estudo transversal, com 190 crianças de 11 a 57 meses de idade distribuídas em duas faixas de renda familiar per capita (< 1 e > 1 salário mínimo). Foram consideradas anêmicas as crianças com taxa de hemoglobina <11g/dL, medida em amostra de sangue capilar digital por meio de fotômetro portátil Hemocue®. Na análise dos resultados foram empregados o teste do qui-quadrado e a análise de variância de Kruskal-Wallis. RESULTADOS: A anemia foi observada em 31,6 por cento das crianças investigadas, sendo a sua freqüência significantemente maior nas crianças de menor faixa etária. A freqüência de anemia foi de 72,7 por cento, 41,2 por cento, 19,7 por cento e 15,4 por cento, respectivamente nas crianças de 11 a 23 meses, 24 a 35 meses, 36 a 47 meses e 48 a 57 meses. Entre as crianças de famílias com renda inferior a um salário mínimo, a freqüência de anemia foi de 36,7 por cento, e naquelas com um ou mais salário mínimo, a prevalência foi 22,9 por cento. CONCLUSÕES: Na creche do CEU Cidade Dutra, a freqüência de anemia foi maior nas crianças de 11 a 23 meses e nas famílias com renda per capita inferior a um salário mínimo.

OBJECTIVE: To evaluate the frequency of anemia according to family per capita income in children enrolled in a day care center in São Paulo, Brazil, in 2004. METHODS: This cross-sectional study enrolled 190 children aged 11 to 57 months divided into two groups of per capita income (<1 or > 1 minimum wage). Hemoglobin level was evaluated in capillary blood (finger-stick test) using a Hemocue® portable photometer. Anemia was considered when hemoglobin level was below 11g/dL. The results were analyzed using chi-square and Kruskal-Wallis tests. RESULTS: Anemia was found in 31.6 percent of the investigated children, with a higher proportion in younger children. The frequency of anemia was, respectively, 72.7 percent, 41.2 percent, 19.7 percent and 15.4 percent in children aged 11-23 months age, 24-35 months, 36-47 months, and 48-57 months. Among children of families with low per capita income, the frequency of anemia was 36.7 percent. In families earning more than one minimum wage per capita per month, there were 22.9 percent of children with anemia. CONCLUSIONS: At the day care center, the frequency of anemia was higher among children aged 11-23 months, especially when the family per capita income was less than one minimum wage per month.