Behavioral Health Bulletin

Issue 13, December 2022

On behalf of everyone at MSHP, we are wishing you and your loved ones happy and healthy holidays! We are grateful for your support and participation in our behavioral health care initiatives this year, and looking forward to continued partnership in 2023.


This month we continue our focus on substance use with some tips from our last Mind Matters ECHO meeting and a recent study addressing the utility and validity of the neurobiological approach to understanding addiction. We also share tips for staying well during the holiday season, as well as updates from the Health System on racial disparities in diagnosis and treatment of depression.

Behavioral Health Events

Some events are CME-accredited; please refer to the individual event landing pages for details


December 19, 2022

Confronting Addiction Health Inequity and Stigma


January 11, 2023

Effective Treatments for Substance Use

Join us for the next Mind Matters ECHO: January 11th


Dr. Prameet Singh, Vice President of Behavioral Health at the Mount Sinai Health System, will give a didactic presentation on effective treatments for substance use. This talk will be a continuation of his last lecture in which he offered judgment-free strategies to engage patients in conversation around substance use.


Register


Registration for the February and onwards 2023 sessions will be open soon. Keep an eye on your inbox in the upcoming weeks for registration details.

Mind Matters ECHO

About Mind Matters


Submit a case

What's new?


A new study in JAMA Health Forum investigated the relationship between ECHO attendance and prescribing buprenorphine, an evidence-based opioid use disorder (OUD) treatment. This study’s results showed a clear dose-response association with increasing attendance; those who attended at least 6 sessions had substantial increases in all outcomes.


View the recording of the last meeting


November 9, 2022

Mind Matters ECHO: Engaging Patients and Families in Destigmatized Substance Use Care

New Anxiety Screening Recommendation

USPSTF now recommends screening adults under 65 for anxiety


In a new recommendation, the US Preventive Services Task Force (USPSTF) now urges providers to screen for anxiety all adults and children aged 8-64, including pregnant and postpartum persons, who do not have a diagnosed mental health disorder or are not showing recognized signs or symptoms of anxiety.


Visit our Behavioral Health Resources page for anxiety screening tools for children and adults and watch the recording of our January 2022 Mind Matters ECHO meeting in which Dr. Vanessa Litoff gave a didactic presentation on screening for anxiety.

Mental Health and Wellbeing during the Holidays

Coping with stress and mental illness during the holiday season


In 2014, the National Alliance on Mental Illness (NAMI) found that 64% of people with mental illness say the holidays make their conditions worse. A 2021 survey showed that 3 in 5 Americans feel their mental health is negatively impacted by the holidays.


Share these tips from NAMI with your patients to help them cope during this season.

Behavioral Health Tip of the Month

Speaking with patients about substance use


There are a number of barriers to treating substance use disorder, on both the patient side (lack of acknowledgement and reporting, presenting to ED in a medical-surgical crisis as opposed to a behavioral health clinic), as well as the provider side (lack of time and treatment options, patient denial and refusal of treatment).


In his November Mind Matters talk, Dr. Prameet Singh shared some tips for inquiring about substance use with patients.


Goals of the inquiry

  • Assess presence of substance use disorder
  • Assess stage of change
  • Strengthen alliance between patient and provider
  • Look for a collaborator in patient and family
  • Provide options
  • Leave the door open


During the inquiry

  • Start off with the right expectations
  • Set a non-judgmental tone
  • Reinforce confidentiality
  • Reduce shame and guilt in your responses
  • Make gentle assumptions
  • Provide a range of expectations
  • Ask specific questions
  • Make the inquiry conversational

New on the Behavioral Health Blog

Enhancing the primary care toolbox for evaluating and responding to suicidal ideation 

 

Recent studies show that increasingly more adults in the United States struggle with depression and suicidal ideation. Before the pandemic, over half of all adults with mental health conditions received treatment within primary care, in place of seeing a therapist or mental health-specialized prescriber. The COVID-19 era has further exacerbated the problem of under addressed behavioral health needs. Suicidal thinking and suicidal behaviors, which range in severity, most often occur in the context of a psychiatric diagnosis.   

 

In this brief blog post, we will highlight resources available to primary care providers as they provide care to patients with suicidal thoughts or behaviors. We will focus on the Columbia Suicide Severity Rating Scale (C-SSRS), which is a “gold standard” measure of suicide severity that is often used in primary care settings. 

Behavioral Health in the Literature

Is addiction a brain disease?


The view that substance addiction is a brain disease, although widely accepted in the neuroscience community, has become subject to acerbic criticism in recent years. These criticisms state that the brain disease view is deterministic, fails to account for heterogeneity in remission and recovery, places too much emphasis on a compulsive dimension of addiction, and that a specific neural signature of addiction has not been identified.


The authors of this study acknowledge that some of these criticisms have merit, but assert that the foundational premise that addiction has a neurobiological basis is fundamentally sound. They also emphasize that denying that addiction is a brain disease is a harmful standpoint since it contributes to reducing access to healthcare and treatment, the consequences of which are catastrophic.


Read more

Mount Sinai's Road Map to Address Racism

Uncovering the disparities in diagnosis and treatment of depression


According to a May 2022 report, marginalized racial and ethnic communities — including Black and Hispanic Americans—are both more likely to experience severe and debilitating symptoms of depression and are less likely to receive treatment.

 

This disparity is likely caused by a combination of factors—and that means we need a holistic approach to solving it.

 

Patients of color may choose not to pursue treatment due to a mistrust of health systems based on uneven care provided to marginalized communities both historically and more recently. Studies have also shown that patients report better experiences when they share the same racial or ethnic background as their clinician—however, there is a shortage of mental health providers of color, which may lead some patients to not seek treatment. Finally, a patient’s ability to pay and lower rates of insurance coverage in communities of color, may impact their decision to not pursue care.

 

While we know it’s a long journey ahead, here at Mount Sinai, our Road Map strategies are working to address these root causes—from integrating and unifying practices regardless of patients’ insurance status, to enhancing community partnerships to build trust, to increasing recruitment, hiring, and retention of staff members from under-represented minority groups.

Mount Sinai Health Library

Information to share with your patients: first aid for drug overdose



Peruse the Mount Sinai Health Library for information to share with your patients. With over 100 psychiatry topics presented in patient-friendly language, the Health Library can be a valuable source for your patients to help understand their diagnoses.


This month, read patient- and family-friendly tips for providing first aid in case of a drug overdose

Contact Us

P: 877-234-6667

F: 646-537-1481

E: MSHP@mountsinai.org

Provider Engagement Team