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Psychiatric Services

Psychiatric Services
A Journal of the American Psychiatric Association

Edited by Howard H. Goldman, M.D., Ph.D.
ISSN 1075-2730
Item #PSY

Psychiatric Services focuses on the delivery of behavioral health services in organized systems, such as public mental health systems, correctional systems, and health maintenance organizations. Under health care reform, systems of care are changing to maximize quality and accessibility and lower costs. Clinicians and administrators look to Psychiatric Services for research on how to deliver evidence-based treatments, to take an integrated “whole-health” approach to care, and to better engage their patients—especially those with severe and persistent mental illnesses, who are often served by multiple systems.

Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The journal focuses on issues related to the delivery of mental health services, especially for people with severe mental illness in community-based treatment programs. Each month, Psychiatric Services features 15 research reports with results that have practical applications in the diverse settings where today's practitioners work. The journal has long recognized that providing high-quality care involves collaboration among a variety of professionals. Authors of research reports include psychiatrists, psychologists, pharmacists, drug and alcohol treatment counselors, social workers, nurses, economists, and professionals in related systems such as welfare and criminal justice systems. Monthly columns keep readers up to date on important developments in areas such as law and psychiatry and state mental health policy. Issues feature book reviews, news, and letters to the editor. Every member of the treatment team will find Psychiatric Services a valuable source of information.

To visit Psychiatric Services online, please go to

Below are some highlights from the October 2014 issue.

A Maine Community Mobilizes to Prevent Psychosis Onset
The lead article reports on a communitywide program in Portland, Maine, to prevent schizophrenia. Since 2001, the Portland Identification and Early Referral (PIER) program has trained more than 7,200 physicians, school personnel, and others to recognize youths at high risk of psychosis and refer them to family-aided treatment. First hospital admissions for psychosis have dropped by one-third among young Portland residents. The research team is currently testing the same system in six other cities.

In Welcome Shift, Supreme Court Justices Defer to Mental Health Expertise
When the Supreme Court held in 2002 that persons with intellectual disability could not be sentenced to death, it left the question of how to define the condition to the states. Some states set a hard cutoff for IQ score, but a Florida case challenged this “bright-line rule.” In a recent decision welcomed by psychiatrists, the justices sided with APA and other professional groups, ruling that a more flexible approach is needed.

Phone Call Helps Veterans Explore Treatment Avoidance
Worried about stigma, returning service members who screen positive for PTSD may avoid seeking treatment. In this randomized trial, veterans received a brief cognitive-behavioral intervention by telephone in which they were invited to explore their reasons for avoiding treatment. These veterans entered treatment sooner and experienced more immediate reductions in PTSD symptoms than veterans who received usual care.

Italy’s Spiking Antidepressant Use: A Matter of Public Health?
Like the rest of the world, Italy has experienced a surge in use of antidepressants. As this study documents, use of antidepressants in Italy increased fourfold between 2001 and 2011. Despite some positive aspects of this trend, the authors note, public health authorities should examine whether they are doing all they can to reduce depression, especially during a period of economic upheaval.

“Diagnostic Relabeling” Won’t Erase Stigma
Some have argued that giving schizophrenia another name—such “youth onset conative, cognitive, and reality distortion”—will erase stigma. But the war on stigma must be fought on several fronts, notes the author of this essay. In fact, he argues, diagnostic relabeling places the responsibility for stigma change with mental health professionals rather than where it belongs, squarely in the control of people with lived experience.

Howard H. Goldman, M.D., Ph.D., is Professor of Psychiatry, University of Maryland School of Medicine, Baltimore, where he is the Director of the Mental Health Systems Improvement Collaborative.

Howard H. Goldman, M.D., Ph.D.

Editorial Board
David A. Adler, M.D.
Benjamin G. Druss, M.D., M.P.H.
Javier I. Escobar, M.D.
Stephen M. Goldfinger, M.D.
Richard K. Harding, M.D.
Grayson S. Norquist, M.D., M.S.P.H.
Martha Sajatovic, M.D.
Bradley D. Stein, M.D., Ph.D.
Marvin S. Swartz, M.D.
Marcia Valenstein, M.D.
Roy C. Wilson, M.D.
Bonnie T. Zima, M.D., M.P.H.

Editor Emeritus
John A. Talbott, M.D.

Book Review Editor
Jeffrey L. Geller, M.D., M.P.H.

Contributing Editors
Law & Psychiatry: Paul S. Appelbaum, M.D.
Frontline Reports: Francine Cournos, M.D., and Stephen M. Goldfinger, M.D.
Public-Academic Partnerships: Lisa B. Dixon, M.D., M.P.H., and Brian Hepburn, M.D.
Personal Accounts: Jeffrey L. Geller, M.D., M.P.H.
Best Practices: William M. Glazer, M.D.
Datapoints: Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D.
Mental Health Care Reforms in Europe: Matt Muijen, M.D.
Mental Health Care Reforms in Latin America: Jos� Miguel Caldas de Almeida, M.D., and Marcela Horvitz-Lennon, M.D., M.P.H.
State Mental Health Policy: Fred C. Osher, M.D.
Case Studies in Public-Sector Leadership: Jules M. Ranz, M.D. and Susan M. Deakins, M.D.
Economic Grand Rounds: Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D.

Editorial Consultants
Norman Clemens, M.D.
Julie M. Donohue, Ph.D.
Robert E. Drake, M.D., Ph.D.
Marcia Kraft Goin, M.D., Ph.D.
Shelly F. Greenfield, M.D., M.P.H.
M. Susan Ridgely, J.D.
Laura Van Tosh

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