Incorporating Digital Interventions into Mental Health Clinical Practice: a Pilot Survey of How Use Patterns, Barriers, and Opportunities Shifted for Clinicians in the COVID-19 Pandemic.

Although many digital mental health interventions are available, clinicians do not routinely use them in clinical practice. In this pilot survey, we review the factors that supported the rapid transition to televisits during the COVID-19 pandemic, and we explore the barriers that continue to prevent clinicians from using other digital mental health interventions, such as mindfulness applications, mood trackers, and digital therapy programs. We conducted a pilot survey of mental health clinicians in different practice environments in the USA. Survey respondents (n = 51) were primarily psychiatrists working in academic medical centers. Results indicated that systemic factors, including workplace facilitation and insurance reimbursement, were primary reasons motivating clinicians to use televisits to provide remote patient care. The shift to televisits during the pandemic was not accompanied by increased use of other digital mental health interventions in patient care. Nine clinicians reported that they have never used digital interventions with patients. Among the 42 clinicians who did report some experience using digital interventions, the majority reported no change in the use of digital applications since transitioning to televisits. Our preliminary findings lend insight into the perspective of mental health clinicians regarding the factors that supported their transition to televisits, including institutional support and insurance reimbursement, and indicate that this shift to virtual patient care has not been accompanied by increased use of other digital mental health interventions. We contend that the same systemic factors that supported the shift toward virtual visits in the COVID-19 pandemic may be applied to support the incorporation of other digital interventions in mental healthcare. Supplementary Information: The online version contains supplementary material available at 10.1007/s41347-022-00260-8.

Building brain capital.

Brains are indispensable drivers of human progress. Why not invest more heavily in them? We seek to place Brain Capital at the center of a new narrative to fuel economic and societal recovery and resilience.

A 1-Hour Session to Refresh Motivational Interviewing Skills for Internal Medicine Residents Using Peer Interviews.

Introduction: Motivational interviewing (MI) is an interviewing style with extensive evidence to support its use in clinical encounters. Physicians and other health professionals require dedicated education to learn MI techniques. Methods: We developed a replicable, 1-hour session to refresh MI skills for internal medicine residents. The session focused on utilizing MI to address health behavior change during ambulatory visits. Using mixed presentation methods, the session offered a review of the conceptual background of MI followed by the introduction of a brief interview structure adapted from the SBIRT (Screening, Brief Intervention, and Referral to Treatment) technique. Learners then conducted peer interviews to discuss a health-promoting behavior and were observed by a peer and the instructor. Methods: Based on immediate pre- and postfeedback, resident learners expressed enjoyment of the sessions and reported a perception of improved skills and confidence in MI, suggesting the session met its objectives. The session was refined over 2 years to fit standard 1-hour learning sessions in an internal medicine residency curriculum. Though the adaptations are not presented here, the slides and supporting materials were used in multiple settings with other levels and disciplines of learners. Discussion: We offered a 1-hour session to refresh skills in MI. The session accommodated the learning needs of resident physicians working in primary care but could be adapted to other groups of learners. This refresher session is not intended for nor likely to be successful with learners who have not had prior training in MI.

An exploratory study examining lipid-lowering medications in reducing fasting serum lipids in schizophrenia patients treated with atypical antipsychotics.

BACKGROUND: We present a retrospective study examining response to treatment with fibrates or statins in schizophrenia patients. METHODS: We identified the patient population using the Research Patient Data Registry. Demographic data, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and non-HDL cholesterol (non-HDL-C) levels were obtained before initiation of treatment with lipid-lowering medication (LLM) and after LLM treatment was initiated (N = 183). RESULTS: Treatment with LLMs resulted in a statistically significant decrease in total cholesterol, triglycerides, LDL-C, and non-HDL-C. An independent-samples t test comparing the statin treatment-alone group with the fibrate treatment-alone group showed a significant reduction in triglyceride levels from baseline to 1-year follow-up in the fibrate treatment-alone group. CONCLUSIONS: The results of this study indicate that schizophrenia patients respond to LLMs in a manner consistent with the general population. Future studies would benefit from a larger sample, as well as comparisons between more specific treatment groups, such as those defined by type of statin or fibrate, to observe differential effects on specific markers of dyslipidemia in this population.