Implementing a college mental health program - an overview of the first twelve months.

OBJECTIVE: To evaluate the demographics and clinical utilization patterns among college students during the initial 12 months of a novel, multi-disciplinary, collaborative, college mental health program (CMHP). PARTICIPANTS: Undergraduate and graduate students receiving treatment at the CMHP from Jan-Dec 2015. METHODS: De-identified data was obtained via electronic health records for all students receiving care through the CMHP. RESULTS: 1.2 FTE clinical providers treated 278 undergraduate and graduate students during the year (65.1% < age 26, 53.6% female, 49.6% caucasian). There were 1822 CMHP outpatient visits, 318 other medical visits and 103 total emergency room (ER)/inpatient visits. Ten students were identified as high utilizers of ER/inpatient services, while charges to the CMHP totaled $470,157 and total charges to the Health System were $2,378,315. CONCLUSIONS: Students with complex psychiatric/medical co-morbidities received cost effective, convenient and integrative treatment. Over time, we hope to intervene earlier and decrease ER/inpatient visits.

Treat and Teach Our Students Well: College Mental Health and Collaborative Campus Communities.

This article presents a selective review of best practices for the psychiatric care of college student populations. It describes psychiatric advances in evidence-based practice for college students and offers a brief compendium for college health practitioners. College mental health services are delivered in a specialized milieu, designed to address many of the unique needs of college students and to support their successful scholastic advancement and graduation. Practical steps for implementing these best practices within the college community setting are identified, with a focus on the initial student evaluation, risk assessment, treatment planning and goal setting, and steps to optimize academic functioning during psychopharmacologic and nonpharmacologic treatment. At the center of these practices is the use of a collaborative team and psychoeducation that engages students to actively learn about their mental health. By applying common sense and evidence-based practices within interdisciplinary and student-centered services, college communities can effectively meet the mental health needs of their students and empower them to reach their educational goals.

Negative symptoms and impaired social functioning predict later psychosis in Latino youth at clinical high risk in the North American prodromal longitudinal studies consortium.

AIM: Examining ethnically related variables in evaluating those at risk for psychosis is critical. This study investigated sociodemographic and clinical characteristics of Latino versus non-Latino clinical high-risk (CHR) subjects and healthy control (HC) subjects in the first North American Prodrome Longitudinal Study. METHODS: Fifty-six Latino CHR subjects were compared to 25 Latino HC and 423 non-Latino CHR subjects across clinical and demographic variables. Thirty-nine of the 56 CHR subjects completed at least one subsequent clinical evaluation over the 2.5-year period with 39% developing a psychotic illness. Characteristics of Latino CHR subjects who later converted to psychosis ('converters') were compared to those who did not ('non-converters'). RESULTS: Latino CHR subjects were younger than non-Latino CHR subjects and had less education than Latino HC subjects and non-Latino CHR counterparts. Latino CHR converters had higher scores than Latino non-converters on the Structured Interview for Prodromal Syndromes total negative symptoms that were accounted for by decreased expression of emotion and personal hygiene/social attentiveness subsections. Latino CHR converters scored lower on the global functioning:social scale, indicating worse social functioning than Latino non-converters. CONCLUSION: Based on this sample, Latino CHR subjects may seek treatment earlier and have less education than non-Latino CHR subjects. Deficits in social functioning and impaired personal hygiene/social attentiveness among Latino CHR subjects predicted later psychosis and may represent important areas for future study. Larger sample sizes are needed to more thoroughly investigate the observed ethnic differences and risk factors for psychosis in Latino youth.

Strategies for effective recruitment of individuals at risk for developing psychosis.

AIM: Early identification of individuals in the prodrome and first episode of psychosis can lead to pre-emptive intervention and perhaps prevention of the significant functional decline that often accompanies a first psychotic episode. The development of an extensive community outreach and education campaign is essential for programmes that aim to identify and treat individuals in the early stages of psychotic illness. METHODS: Over the last decade, the Cognitive Assessment and Risk Evaluation (CARE) programme at the University of California San Diego has implemented a recruitment strategy to increase public awareness about early psychosis and establish community collaboration in San Diego county. Educational materials were distributed to community partners, local media and via the Internet. The number and pattern of referrals were then analysed to inform ongoing recruitment efforts. RESULTS: Overall, 799 referrals were telephone screened. Of the 313 who completed diagnostic interviews, 223 were enrolled including 122 in an 'At Risk' state and 101 in an early psychotic episode. The majority who met inclusion criteria were referred by outpatient mental health practitioners (46.6%), whereas 16.1% came from inpatient facilities and 16.1% were from Internet sites. Other important referral sources were the public schools, community colleges and the National Alliance on Mental Illness. CONCLUSIONS: The successful recruitment efforts of the CARE programme reflect not only the extensive educational outreach but also the emphasis on enhancing professional relationships with community partners. The Internet became an important source of information and referrals and will likely be an essential component of any public education campaign.