Tag: Monteith

Reading of the Week: Measurement-based Care – the New Psych Services Paper; Also, Agentic AI, and Dr. Johari on Losing a Patient

From the Editor

Studies show that measurement-based care improves patient outcomes, from better functioning to fewer readmissions. Not surprisingly, expert practice guidelines, including the CANMAT clinical guidelines for depression, recommend their use. Yet – despite years of enthusiasm – most of us don’t use scales or questionnaires to monitor symptoms and outcomes.

In a new systematic literature review, Christian Burr (of the Bern University of Applied Sciences) and his co-authors try to identify effective strategies by analyzing recent studies. In their Psychiatric Services paper, they focused on 16 studies in a systematic literature review. “Effective measurement-based care implementation requires context-sensitive strategies, interprofessional collaboration, and active involvement of patients, service users, and caregivers.” We consider the paper and its implications.

In the second selection from The British Journal of Psychiatry, Dr. Scott Monteith (of Michigan State University) and his co-authors write about the evolution of artificial intelligence. They focus on agentic AI (arguably the next big thing), seeing a clear role in education, yes, and in patient care – but they also note problems. “Agentic artificial intelligence systems offer a unique approach to supporting physicians in dealing with the challenges of clinical medicine but also pose validity, privacy, malpractice and security risks.”

And in this week’s final selection, Dr. Paniz Johari, a psychiatrist who works at Northwell Health, writes personally and thoughtfully about the loss of her patient to suicide. In JAMA, she discusses her grief and rumination. “The absence of anything remarkable made it harder to understand and harder to set aside.”

DG

Continue reading

Reading of the Week: Adolescent Mental Health With Papers on School-Based Mindfulness, Firearms & Youth Suicide, and GenAI

From the Editor

The MYRIAD Trial was ambitious, involving more than 8 300 adolescents at 84 schools, with the aim of preventing depression and improving mental well-being by teaching mindfulness through a universal school program. The only catch? There was no difference in outcomes at one year.

Would it be possible to identify adolescents who would benefit from mindfulness? Christian A. Webb (of Harvard University) and his co-authors attempt to answer that question, using AI. And so, a longstanding objective, prevention, was joined with a modern method, machine learning. In the first selection, a paper from JAMA Psychiatry, the authors detail a secondary analysis using two complementary machine learning approaches and the MYRIAD Trial data. “This study found that analyses using machine learning identified a subgroup of participants with a statistically detectable but clinically trivial differential intervention response. These findings highlight the substantial challenges in achieving clinically useful personalization in universal school-based prevention programs.” We consider the paper and its implications.

In the second selection, from the Journal of the American Academy of Child & Adolescent Psychiatry, Alison Athey (of Johns Hopkins University) and her co-authors evaluate the impact of child access prevention laws on youth suicide deaths by firearms. They drew on more than 30 years of mortality data from the Centers for Disease Control and Prevention. “Laws that require families to store firearms unloaded and secured in a locking device appear to effectively prevent youth suicide deaths and firearm-related youth deaths by accident and homicide.”

And in this week’s third selection, Dr. Scott Monteith (of Michigan State University) and his co-authors write about generative AI and adolescents for The British Journal of Psychiatry. They note a surge in use – some 80% of British teens use generative AI – and consider problems, from cyberbullying to mental healthcare. “There is a need to increase awareness of how GenAI may have a negative impact on the mental health of teenagers.”

DG

Continue reading

Reading of the Week: MAiD, Suicide & the Patient-Family Perspective – the new CJP Paper; Also, AI & Misinformation, and Palus on Mental Health Merch 

From the Editor

In March, medical assistance in dying will be expanded in Canada to include those with mental illness. Not surprisingly, many people feel strongly about it, with some seeing the change as a natural extension of basic rights and others arguing that it will be a profound mistake. 

What do patients and family members think? How does it relate to their views of suicide in general? Lisa Hawke (of the University of Toronto) and her co-authors attempt to answer these questions in a new Canadian Journal of Psychiatry paper. They do a qualitative analysis, interviewing 30 people with mental illness and 25 family members on medical assistance in dying when the sole underlying medical condition is mental illness (or MAiD MI-SUMC). “Participants acknowledge the intersections between MAiD MI-SUMC and suicidality and the benefits of MAiD MI-SUMC as a more dignified way of ending suffering, but also the inherent complexity of considering [such] requests in the context of suicidality.” We consider the paper and its implications.

In the second selection, Dr. Scott Monteith (of Michigan State University) and his co-authors write about artificial intelligence and misinformation in a new British Journal of Psychiatry paper. They note the shift in AI – from predictive models to generative AI – and its implications for patients. “Misinformation created by generative AI about mental illness may include factual errors, nonsense, fabricated sources and dangerous advice.”

And in the third selection, writer Shannon Palus discusses the rise of “mental health merch” – clothing items and other merchandise that tout mental health problems, including a pricey sweatshirt with “Lexapro” written on the front (the US brand name for escitalopram). In Slate, Palus discusses her coolness to such things. “As a person who struggles with her own mental health, as a Lexapro taker – well, I hate this trend, honestly! I find it cloying and infantilizing.”

Note that there will be no Reading next week.

DG

Continue reading