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Mental Health

Programs and Tools to Improve the Quality of
Mental Health Services

Topics:

Aging / Children / Depression / HIV/AIDS / Men's/Women's Health /
Schizophrenia / Services Research / Stress / Substance Abuse/Addiction

Aging

U.S. Preventive Services Task Force Recommendations:
Screening for Dementia

Agency Press Releases
6/3/03 Task Force Says More Research Is Needed To Determine Usefulness of Routine Screening for Dementia

Research Findings

Research Activities, March 2004:
Depression is common among people who are primary caregivers for patients with dementia

Research Activities, January 2004:
Researchers examine factors affecting diagnosis of acute illness and mental health conditions among nursing home residents

Research Activities, November 2003:
Use of antidepressants for elderly primary care patients has increased markedly

Research Activities, September 2003:
Depression and anxiety affect a substantial number of elderly people living in the community

Research Activities, September 2000:
Studies suggest better ways to manage elderly hip fracture patients with delirium and end-stage dementia

Research Activities, July 2000:
Urinary incontinence is associated with the risk of depression among the elderly

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Children

Research Findings

Research Activities, May 2004:
National survey reveals how primary care doctors identify and manage young children with developmental delays

Research Activities, December 2003:
Researchers examine the effects of family and community violence and risky behaviors on children and adolescents

Research Activities, November 2003:
Functional limitations and family stressors worsen psychosocial adjustment among disabled school-aged children

Research Activities, July 2003:
One-third of adult survivors of childhood cancer suffer from psychological problems

Research Activities, January 2003:
Study demonstrates a powerful association between decreasing social class and poor health and behavior problems in children

Research Activities, June 2002:
Primary care doctors suspect that one in five childhood injuries they see is due to physical abuse
Primary care physicians often prescribe psychotropic drugs to treat hyperactivity and depression in children

Research Activities, May 2002:
Adolescents who were born prematurely at a very low birthweight have self-esteem similar to other adolescents

Research Activities, February 2002:
Specialized training helps ER nurses better manage children at risk for suicide

Research Activities, October 2001:
Young people with coexisting substance abuse and emotional problems need specialized residential treatment

Research Activities, August 2001:
ER staff can use a brief questionnaire to identify children and adolescents who are suicidal

Research Activities, July 2001:
Newborns weighing 2.2 pounds or less have long-term behavior problems related mostly to social and attention deficits

Research Activities, August 2000:
Monograph and summary focusing on children's mental health issues now available from AHRQ

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Depression

Evidence Report/Technology Assessment: Number 7
Treatment of Depression—Newer Pharmacotherapies (Clinical Focus)

Evidence Report/Technology Assessment: Number 64
S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease (Clinical Focus)

Fact Sheet, January 2000:
Improving Quality of Care for People With Depression

U.S. Preventive Services Task Force Recommendations:
Screening for Depression

Agency Press Releases
4/5/04 Improving Depression Care has Long-lasting Benefits for African Americans and Hispanics

Research Findings

Research Activities, April 2004:
Improving depression care has long-lasting benefits for blacks and Hispanics
Diagnosis and treatment of depression in the elderly increased in the 1990s, but racial and other disparities persist

Research Activities, March 2004:
Depression is common among people who are primary caregivers for patients with dementia

Research Activities, December 2003:
Studies focus on diagnosis and treatment of low back pain, as well as related pain and disability
Researchers focus on diabetes care
Researchers examine the effects of family and community violence and risky behaviors on children and adolescents

Research Activities, November 2003:
Use of antidepressants for elderly primary care patients has increased markedly
Functional limitations and family stressors worsen psychosocial adjustment among disabled school-aged children

Research Activities, October 2003:
Despite improvements in access to medications and psychotherapy, many depressed primary care patients are not treated
Patients with depressed mood and persistent anxiety use more medical care and have higher costs than other patients

Research Activities, September 2003:
Depression and anxiety affect a substantial number of elderly people living in the community

Research Activities, August 2003:
Researchers examine medication effectiveness and depression among cardiac patients

Research Activities, April 2003:
Studies focus on depression, disease self-management, and vaccination status among people with diabetes

Research Activities, March 2003:
Researchers examine efforts to improve primary care for depression

Research Activities, February 2003:
Almost one-third of depressed primary care patients reported either hazardous drinking, use of illicit drugs, or misuse of prescription drugs

Research Activities, December 2002:
Patient satisfaction seems to lead to higher quality of care for depression

Research Activities, October 2002:
Using an electronic medical record for diagnostic and treatment feedback does not lead to better primary care for depression
Cognitive impairment and depression are associated with functional decline in elderly people

Research Activities, August 2002:
Newer antidepressant drugs are prescribed more often than other medications for patients hospitalized for depression

Research Activities, July 2002:
Patients suffering from depression often overestimate their insurance coverage for mental health services

Research Activities, June 2002:
Depression in people with diabetes is associated with increased health care use and higher expenditures
Primary care physicians often prescribe psychotropic drugs to treat hyperactivity and depression in children
Although a sense of control at work and home affects people's risk for depression and anxiety, social class also counts

Research Activities, January 2002:
Few patients being treated for depression in primary care are counseled about substance abuse problems
QI programs that foster collaboration between mental health specialists and primary care doctors enhance depression care

Research Activities, December 2001:
Women are far more likely than men to have their depression diagnosed by their primary care doctors
Managed care cost-containment policies strengthen continuity of primary care for depressed patients
Researchers weigh benefits and costs of QI programs to enhance treatment of depression in primary care

Research Activities, November 2001:
Low education and income are related to poor health, chronic illness, and depression among Medicare-insured older women

Research Activities, May 2001:
Better ratings of the patient-provider relationship are associated with higher quality of care for depression

Research Activities, April 2001:
Feedback from an electronic medical record can help primary care doctors improve their initial management of depression

Research Activities, March 2001:
Quality improvement programs improve primary care clinician knowledge about depression treatment over 18 months

Research Activities, December 2000:
Most primary care patients with depression prefer counseling over medication

Research Activities, August 2000:
Materials now available for quality improvement of depression care in primary care practices

Research Activities, July 2000:
Newer and older antidepressants are equally effective for treating major depression in adults, but side effects differ
Sexual assault is a major problem for homeless women, which often correlates with physical and mental health problems

Research Activities, June 2000:
Recognizing and treating depression in primary care can prevent unnecessary hospitalizations and save money

Research Activities, April 2000:
Researchers assess programs to improve the quality of primary care for depression in managed care
Newer antidepressants are as effective as older tricyclic agents in primary care patients

Research Activities, January 2000:
Helping patients recover from depression should be a high priority in primary care practices

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HIV/AIDS

Research Findings

Research Activities, January 2004:
Recent HCSUS studies focus on HIV infection in older individuals and women, use of complementary and alternative therapies, and insurance status

Research Activities, November 2003:
Researchers report recent findings from the HIV Cost and Services Utilization Study

Research Activities, July 2003:
Among people with HIV/AIDS, whites are much more likely than blacks to use medication to treat psychological problems

Research Activities, November 2001:
HCSUS studies examine mental health, drug abuse, insurance effects, and quality of life among people with HIV

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Men's/Women's Health

Research Findings

Research Activities, April 2004:
Step-by-step procedures may help health care providers treat victims of intimate partner violence

Research Activities, February 2004:
Studies demonstrate high rates of assault and unmet health care needs among homeless women

Research Activities, July 2003:
One-third of adult survivors of childhood cancer suffer from psychological problems

Research Activities, March 2003:
Women are more likely than men to experience long-term posttraumatic stress disorder after major trauma

Research Activities, April 2002:
Disparities between men and women in minor mental health problems may reflect differences in social roles

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Schizophrenia

Patterns of Usual Care for Schizophrenia

Schizophrenia PORT Treatment Recommendations

Research Findings

Research Activities, December 2001:
Missed diagnosis of mood and anxiety disorders is more likely among black than white schizophrenics

Research Activities, October 2001:
Age and race are associated with receipt of Medicare-funded outpatient care among people with schizophrenia

Research Activities, August 2000:
Satisfaction and clinical outcomes are similar for patients with schizophrenia treated in VA and non-VA facilities

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Services Research

AHRQ Focus on Research: Mental Health

Compendium of Research Related to Mental Health

Programs and Tools to Improve the Quality of Mental Health Services

Research Findings

Research Activities, December 2003:
Formularies are not likely to control costs for psychotropic drugs as well as they do for some other types of drugs

Research Activities, July 2003:
Medicaid shifts to widely used mental health carve-out programs may interrupt therapy among the most needy patients

Research Activities, May 2003:
Patient characteristics and insurance coverage affect their ratings of managed behavioral health care plans

Research Activities, January 2003:
Behavioral health care workers need increased training to meet the changing realities of today's practice

Research Activities, June 2002:
New case study indicates that mental health parity did not raise costs for a large employer who used a managed care arrangement

Research Activities, October 2001:
Increasing primary care patients' access to short-term psychotherapy leads to lasting improvement in mental health

Research Activities, July 2001:
Facility, patient, and community factors are associated with long-term care costs for people with mental retardation

Research Activities, June 2001:
Consumer input is a critical component of efforts to improve the quality of behavioral health care services

Research Activities, May 2001:
ICU patients need to feel safe, a feeling that is influenced by family, friends, ICU staff, and other factors

Research Activities, April 2001:
Equalizing coverage for mental health and physical health would substantially reduce consumers' share of mental health costs

Research Activities, February 2001:
Mental health visits are cut by one-fourth when providers are paid a fixed rate per patient

Research Activities, December 2000:
Decentralization of California's mental health system enhanced access to care for the most severely ill patients

Research Activities, January 2000:
Financial incentives may influence health care providers' mental health treatment decisions

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Stress

Research Findings

Research Activities, March 2004:
Depression is common among people who are primary caregivers for patients with dementia

Research Activities, February 2004:
Studies demonstrate high rates of assault and unmet health care needs among homeless women

Research Activities, November 2003:
Functional limitations and family stressors worsen psychosocial adjustment among disabled school-aged children

Research Activities, October 2003:
Patients with depressed mood and persistent anxiety use more medical care and have higher costs than other patients

Research Activities, September 2003:
Depression and anxiety affect a substantial number of elderly people living in the community

Research Activities, August 2003:
Ongoing distress from a traumatic event, not the trauma itself, is related to impaired functioning in patients with chronic pain

Research Activities, March 2003:
Women are more likely than men to experience long-term posttraumatic stress disorder after major trauma

Research Activities, February 2002:
Posttraumatic stress disorder affects nearly a third of trauma patients and hampers their recovery

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Substance Abuse/Addiction

Evidence Report/Technology Assessment: Number 3
Pharamacotherapy for Alcohol Dependence (Clinical Focus)

U.S. Preventive Services Task Force Recommendations:
Screening for Alcohol Misuse

Workshop Summary, July 19-21, 1999:
Integrating Mental Health and Substance Abuse Strategies: A Workshop for Denior State Officials

Research Findings

Research Activities, February 2004:
Studies demonstrate high rates of assault and unmet health care needs among homeless women

Research Activities, May 2003:
Patients with traumatic brain injury should be screened for alcohol problems that can interfere with neurologic recovery

Research Activities, February 2003:
Almost one-third of depressed primary care patients reported either hazardous drinking, use of illicit drugs, or misuse of prescription drugs

Research Activities, January 2002:
Few patients being treated for depression in primary care are counseled about substance abuse problems

Research Activities, November 2001:
HCSUS studies examine mental health, drug abuse, insurance effects, and quality of life among people with HIV

Research Activities, October 2001:
Young people with coexisting substance abuse and emotional problems need specialized residential treatment

Research Activities, March 2001:
Veterans seeking help for postraumatic stress disorder generally admit to their abuse of drugs

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