Exploring Antidepressant Adherence at a Student-Run Free Mental Health Clinic

Mann, Claire L.; Rifkin, Robert; Nabel, Elisa M.; Thomas, David C.; Meah, Yasmin; Katz, Craig L.

doi:10.1007/s10597-018-0301-5

Cited by 8 publications

(14 citation statements)

References 18 publications

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“… 51 By contrast, the more recent measured antidepressant medication adherence rates and found generally lower rates than in these comparison groups. 52 Another study, of a program attempting depression screening of all patients presenting to a SRC, diagnosed 19 previously undiagnosed cases of depression amongst 206 patients screened. Of patients with depression cared for in this clinic with two or more PHQ-9 tests at least four weeks apart, 57.1% saw clinically significant improvement.…”

Section: Resultsmentioning

confidence: 99%

Patient Outcomes from Student-Run Health Services: An Integrative Review

Broman¹,

Tokolahi²,

Wilson³

et al. 2022

JMDH

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Background Student-run clinics (SRCs) offer an innovative approach to expand healthcare access and equity and increase clinical placement opportunities for students. However, research on the health benefits and/or outcomes of such clinics is currently fragmented. Methods An integrative review was conducted to capture and synthesize findings across a range of study types involving varied student disciplines, student delivered intervention types, and health conditions addressed or care areas of focus. Only published and peer reviewed studies were included. Studies needed to report outcomes in a defined study group measured over time, or report SRC data with explicit comparisons to non-SRC settings. Data were analyzed using inductive content analysis to identify major themes and natural clustering of health outcomes measured. Results Fifty-one articles were selected for review based on the eligibility criteria. Studies were predominantly from the United States, and most (n = 34, 67%) adopted a case review methodology for measuring outcomes. Health outcomes were evaluated in relation to a range of health conditions that, for the purposes of this review, were considered to naturally cluster into eight categories: diabetes, hypertension, functional health/quality of life, depression, hospital utilization, substance use, weight, health screening/vaccinations, and others. Conclusion This integrative review sought to evaluate the health outcomes accrued by patients in student-run health clinics. Taken as a whole, the literature suggests positive health outcomes resulting from student-run clinics across a range of health conditions. Greater confidence in care-related findings would be achieved from future research utilizing more robust and prospective study designs.

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Section: Resultsmentioning

confidence: 99%

Patient Outcomes from Student-Run Health Services: An Integrative Review

Broman¹,

Tokolahi²,

Wilson³

et al. 2022

JMDH

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show abstract

“…To conduct hypothesis-testing, we first retrieved data collected and published by the NYS DOH [ 23 – 25 ]. For the effective antidepressant medication management acute- and continuation-phase metrics, we also included our previously published data [ 15 ] in the comparisons to determine if the E-MHC’s performance improved over time. Due to the small sample size in our study and the unbalanced group sizes, Fisher exact tests were used to quantify the likelihood of patients having met the specific metric criteria between the E-MHC in 2019 and those from each of the comparator groups.…”

Section: Methodsmentioning

confidence: 99%

“…A study from the Yale-affiliated HAVEN clinic found that students could be trained to provide psychoeducation and lay counseling to depressed patients that led to symptom improvement [ 13 ]. Our clinic has reported preliminary evidence that an SRFC could provide clinical services for depressed patients that were as good as or superior to those rendered to patients enrolled in public health insurance programs [ 14 ]; however, a later report [ 15 ] documented lower rates of effective acute- and continuation-phase antidepressant treatment. While a follow-up study [ 16 ] indicated that on-site antidepressant dispensing may improve adherence rates, it is not known if this led to overall improvements in the number of patients meeting criteria for effective acute- and continuation-phase treatment long-term.…”

Section: Introductionmentioning

confidence: 99%

Design of and outcomes in a student-run free mental health clinic serving the uninsured in East Harlem

et al. 2022

Self Cite

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Background Safety-net clinics are an important source of low-cost or free mental healthcare to those with limited financial resources. Such clinics are often staffed by trainees in early stages of their career. Only limited data exist on best practices in treatment-implementation and on clinical outcomes attained in such clinics. The primary purpose of this article is to describe the design of an outpatient psychiatry student-run free clinic (SRFC) serving uninsured individuals in New York City’s East Harlem neighborhood and to analyze the quality of services provided and the clinical outcomes attained. Methods The authors conducted a retrospective chart review of n = 69 patients treated in the EHHOP Mental Health Clinic (E-MHC) to describe the demographic and clinical characteristics of the study population. Utilizing Health Effectiveness Data and Information Set metrics, they estimated the likelihoods of patients meeting metric quality criteria compared to those in other New York State (NYS) insurance groups. The authors derived linear mixed effect and logistic regression models to ascertain factors associated with clinical outcomes. Finally, the authors collected patient feedback on the clinical services received using a customized survey. Results Almost all patients were of Hispanic ethnicity, and about half of patients had more than one psychiatric disorder. The clinical service performance of the E-MHC was non-inferior on most measures examined. Factors associated with symptom improvement were the number of treatment sessions and certain demographic and clinical variables. Patients provided highly positive feedback on the mental healthcare services they received. Conclusions SRFCs can provide quality care to vulnerable patients that leads to clinically meaningful reductions in psychiatric symptoms and is well-received by patients.

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“…SRCs predominantly target the primary care needs of uninsured patients, with an emphasis on health care maintenance and chronic disease management (Smith et al, 2014 ). Several SRCs have offered mental health screening and care as increasing needs for these services are recognized (Batra et al, 2009 ; Doyle et al, 2012 ; Fischbein et al, 2020 ; Khonsari et al, 2019 ; Knoll et al, 2021 ; Liberman et al, 2011 ; Mann et al, 2019 ; Mishan & Dragatsi, 2017 ; Schweitzer & Rice, 2012 ; Soltani et al, 2015 ; Stuard et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…To expand psychiatric services in primary care settings, some clinics have developed a model in which medication management occurs under the direct guidance of a consulting psychiatrist (Batra et al, 2009 ; Mishan & Dragatsi, 2017 ). SRCs have also begun to incorporate dedicated mental health treatment teams, allowing psychiatrists to work directly with medical students to provide medication management services with supportive interventions (Doyle et al, 2012 ; Khonsari et al, 2019 ; Knoll et al, 2021 ; Mann et al, 2019 ; Schweitzer & Rice, 2012 ; Soltani et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Weill Cornell Medicine Wellness Qlinic: Adapting the Student-Run Clinic Model to Expand Mental Health Services and Medical Education

Zhou

Fruitman

Szwed

et al. 2022

Community Ment Health J

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The Weill Cornell Medicine Wellness Qlinic (Wellness Qlinic) is a student-run mental health clinic serving the lesbian, gay, bisexual, transgender, and queer (LGBTQ +) community in New York City. Student-run clinics have successfully provided primary care to underserved communities experiencing barriers to accessing health care. Psychiatric evaluation and medication management have also been implemented in several student-run clinics, but providing sustainable psychotherapy services has been a challenge. In this paper, we present a student-run mental health program incorporating interdisciplinary trainees to provide robust short-term psychiatric treatment, including individual psychotherapy, medication management, and group therapy. Results of a chart-review study to evaluate patient engagement and treatment outcomes are presented. The Wellness Qlinic’s treatment model resulted in 90% patient retention and positive clinical outcomes for patients while addressing an education and training gap in LGBTQ + mental health for multidisciplinary mental health care providers.

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Exploring Antidepressant Adherence at a Student-Run Free Mental Health Clinic

Cited by 8 publications

References 18 publications

Patient Outcomes from Student-Run Health Services: An Integrative Review

Patient Outcomes from Student-Run Health Services: An Integrative Review

Design of and outcomes in a student-run free mental health clinic serving the uninsured in East Harlem

Weill Cornell Medicine Wellness Qlinic: Adapting the Student-Run Clinic Model to Expand Mental Health Services and Medical Education

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