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1.
Harv Rev Psychiatry ; 32(4): 140-149, 2024 07 01.
Article in English | MEDLINE | ID: mdl-38990902

ABSTRACT

ABSTRACT: Outpatient mental health care in the United States is delivered by an uncoordinated patchwork of public and private entities that struggle to effectively differentiate the care they provide. The COVID-19 pandemic catalyzed transformative changes in this space, including rapid adoption of telehealth and escalating private sector investment to provide services for individuals wishing to obtain care through insurance. In this article, we briefly review the current landscape of ambulatory mental health care. Utilizing Kissick's Iron Triangle model of health care delivery, we compare the relative strengths and weaknesses of academic medical centers and the growing private sector, entities potentially positioned to synergistically foster a mental health ecosystem with improved quality, access, and cost-effectiveness. A roadmap for strategic integration is presented for how academic centers-institutions frequently overwhelmed by patient volume-might leverage partnerships with a private sector eager to utilize novel technology to improve access, demonstrate data-driven outcomes, and advocate for improved reimbursement from payers. We also assess the potential risks and pitfalls of such collaboration. In return, academic institutions can refocus on their strengths, including research, systems knowledge, quality-improvement initiatives, education and training, and specialty clinical care.


Subject(s)
Academic Medical Centers , COVID-19 , Telemedicine , Humans , Telemedicine/organization & administration , Academic Medical Centers/organization & administration , United States , Mental Health Services/organization & administration , Private Sector/organization & administration , SARS-CoV-2
2.
Gen Hosp Psychiatry ; 85: 120-125, 2023.
Article in English | MEDLINE | ID: mdl-37864866

ABSTRACT

OBJECTIVE: A novel team-based service was developed at the beginning of the pandemic in which sixty liaisons were assigned to provide proactive, tailored psychological support for healthcare workers (HCWs) across three of NewYork-Presbyterian's Weill Cornell affiliated hospitals. METHOD: The program took the proactive approach of bringing mental health awareness to every department and major division that interfaced with COVID-19 patients. Virtual and in-person team-based "town hall" meetings were offered to provide psychoeducation, facilitate discussion, foster adaptive coping and social cohesion, and identify employees who would benefit from further individualized support. RESULTS: The program's success was reflected in the number of town halls (1000+) and attendees (6000+) and in qualitative feedback from departments who requested ongoing services. CONCLUSIONS: This article presents the development, implementation, challenges, and opportunities in designing a team-based support model for HCWs. This model may be useful for organizations that seek to develop similar programs.


Subject(s)
COVID-19 , Humans , Mental Health , Pandemics , Health Personnel/psychology , Psychosocial Support Systems
3.
Psychiatry Res ; 316: 114746, 2022 10.
Article in English | MEDLINE | ID: mdl-35917649

ABSTRACT

The increased transmissibility of the omicron variant of the SARS-CoV-2 virus resulted in a rapid increase in infection among many psychiatric inpatients in our hospital between December 2021 and February 2022. This required our institution to close affected units to new admissions. In response, we implemented a model utilizing universal SARS-CoV-2 polymerase chain reaction (PCR) testing at the time of admission, the development of "admitting units" where all patients were quarantined for four days followed by repeat PCR testing, and subsequent transition to COVID-19 negative and COVID-19 positive "receiving units" based on the results of the second test. No unit closures occurred following full implementation of the model.


Subject(s)
COVID-19 , Psychiatry , Humans , Inpatients , SARS-CoV-2
4.
J Psychiatr Pract ; 27(3): 172-183, 2021 05 05.
Article in English | MEDLINE | ID: mdl-33939371

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges to the provision of inpatient psychiatric care. The nature of the physical plant, programmatic constraints, and the patient population required a rapid and agile approach to problem-solving under conditions of uncertainty and stress. Flexibility in decision-making, excellent communication, an effective working relationship with infection prevention and control experts, and attention to staff morale and support were important elements of successful provision of care to our inpatients. We present our experience, lessons learned, and recommendations should a resurgence of the pandemic or a similar crisis occur.


Subject(s)
Attitude of Health Personnel , COVID-19 , Inpatients , Mental Disorders/therapy , Personnel, Hospital , Psychiatric Department, Hospital , Adult , COVID-19/prevention & control , Humans , Personnel, Hospital/psychology , Personnel, Hospital/standards , Psychiatric Department, Hospital/organization & administration , Psychiatric Department, Hospital/standards
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