JSA Health Telepsychiatry is pleased to announce that construction is well under way on the new Emergency Health Network Extended Observation Unit in El Paso, Texas. JSA is please to continue it's work on this unit...providing consulting and telepsychiatry services. The EOU is set to open in January 2014. Congratulations to Emergence Health Network for bringing this project to fruition - from EHN's Facebook page:
JSA Health Telepsychiatry is pleased to announce the development of a second MHEC (Mental Health Emergency Center) for Texas .. this one in Waco, Texas … for the Heart of Texas Regional MHMR Center. The MHEC model has won two prestigious awards for innovation…the American Psychiatric Association’s Gold Award for Innovation and the National Council for Behavioral Healthcare’s Impact Award for Excellence in Service Innovation.
JSA Health Telepsychiatry will once again be providing round the clock services for the Heart of Texas MHEC – called the the Crisis Treatment Center (CTC). The CTC will consist of a triage unit, a 12 bed voluntary crisis residential unit, a 4 bed extended observation unit, and an intensive outpatient program. JSA Health Telepsychiatrists will be making rounds three times a day, and doing all admissions in real time on an on-demand basis. JSA expects that the CTC will provide a significant ability to decompress the region’s emergency departments as JSA is also providing telepsychiatry services on an on-demand capacity to the 12 emergency departments surrounding Waco.
The MHEC model is thriving with additional MHEC units being planned and built for:
Community HealthCore: Three MHEC units to be built in Longview and Texarkana, Texas
Emergence Health Network: One MHEC currently under construction in El Paso, Texas
Austin Texas Regional Partnership: One MHEC unit as part of the Central Health System
JSA Health Telepsychiatry is proud to have co-developed the MHEC model the Burke Center of Lufkin, Texas. Plans for a MHEC Foundation are in the works to study the MHEC model and promulgate standards.
JSA Health Telepsychiatrist Chris Chee is an author of a new paper published this past week…here it is presented in Yale News:
Left-handed people more likely to have psychotic disorders such as schizophrenia: Yale Study
Being left-handed has been linked to many mental disorders, but Yale researcherJadon Webb and his colleagues have found that among those with mental illnesses, people with psychotic disorders like schizophrenia are much more likely to be left-handed than those with mood disorders like depression or bipolar syndrome.
The new study is published in the October-December 2013 issue of the journal SAGE Open.
About 10% of the U.S. population is left-handed. When comparing all patients with mental disorders, the research team found that 11% of those diagnosed with mood disorders such as depression and bipolar disorder are left-handed, which is similar to the rate in the general population. But according to Webb, a child and adolescent psychiatry fellow at the Yale Child Study Center with a particular interest in biomarkers of psychosis, “a striking of 40% of those with schizophrenia or schizoaffective disorder are left-handed.”
“In general, people with psychosis are those who have lost touch with reality in some way, through hallucinations, delusions, or false beliefs, and it is notable that this symptom constellation seems to correlate with being left-handed,” said Webb. “Finding biomarkers such as this can hopefully enable us to identify and differentiate mental disorders earlier, and perhaps one day tailor treatment in more effective ways.”
Webb and his colleagues studied 107 individuals from a public outpatient psychiatric clinic seeking treatment in an urban, low-income community. The research team determined the frequency of left-handedness within the group of patients identified with different types of mental disorders.
The study showed that white patients with psychotic illness were more likely to be left-handed than black patients. “Even after controlling for this, however, a large difference between psychotic and mood disorder patients remained,” said Webb.
What sets this study apart from other handedness research is the simplicity of the questionnaire and analysis, said Webb. Patients who were attending their usual check-ups at the mental health facility were simply asked “What hand do you write with?”
“This told us much of what we needed to know in a very simple, practical way,” said Webb. “Doing a simple analysis meant that there were no obstacles to participating and we had a very high participation rate of 97%. Patients dealing with serious symptoms of psychosis might have had a harder time participating in a more complicated set of questions or tests. By keeping the survey simple, we were able to get an accurate snapshot of a hard-to-study subgroup of mentally ill people — those who are often poverty-stricken with very poor family and community support.”
Other authors on the study include Mary I. Schroeder, Christopher Chee, Deanna Dial, Rebecca Hana, Hussam Jefee, Jacob Mays, and Patrick Molitor.
Citation: Sage Open vol. 3 no. 4 2158244013503166 (October-December 2013)
JSA Health Telepsychiatry is pleased to announce that North Texas State Hospital of Wichita Falls, Texas has chosen JSA, and it’s team of dedicated forensic telepsychiatrists, to staff an inpatient unit dedicated to Not Guilty By Reason of Insanity (NGRI) patients. JSA’s forensic telepsychiatrist will be running treatment teams and assisting in treatment to help restore the patient’s to competency to stand trial.
From the North Texas State Hospital Website:
The Vernon campus of North Texas State Hospital has 284 adult beds and 78 adolescent beds. It is a maximum-security facility that services both adults with criminal (forensic) issues and adolescents with dually-diagnosed substance abuse and mental health problems most of whom are there as a condition of their probation, having had significant involvement with the juvenile justice system.
The Vernon campus was mandated by the 70th Texas Legislature to provide services to six populations:
- Persons with felony charges who have been found incompetent to stand trial;
- Persons admitted for pre-trial evaluations for competency and issues of insanity;
- Persons found not guilty by reason of insanity;
- Persons from other state hospitals who have been found to be manifestly dangerous;
- Mentally disabled persons who have been found incompetent to stand trial on misdemeanor or felony charges
JSA Health Telepsychiatry is proud to have been chosen to staff the new Helen Farabee Open Access Program. This innovative program, created under the 1115 Medicaid Waiver, makes walk-in, on-demand appointments to see a psychiatrist possible using telepsychiatry. The goal is to drastically decrease the time it takes to see a psychiatrist after being intaked in the Helen Farabee system. The expected outcome during the Waiver period is to increase the number of psychiatric evaluations provided within one business day by creating an on-demand model.
From the 1115 Medicaid Project for Texas Region 10:
This project expands the hours for psychiatric evaluation by expanding our current contract for
The expanded hours will provide for open-access (on-demand) routine psychiatric evaluations for
individuals determined eligible to receive services under the Texas Recovery and Resiliency
model. The target population for this project is adults/children who meet diagnostic service
eligibility requirements per our contract with the Department of State Health Services (adults
with major depression, bipolar disorder, schizophrenia and children with a diagnosis of mental
illness who exhibit serious emotional, behavioral, or mental health disorders).The project fits
within the Project Area, since psychiatry is considered specialty care and is being expanded. The
project fits within the intervention in that the expansion of psychiatric availability improves
access to these services by eligible individuals.
Goals and Relationship to Regional Goals:
The project goals include collecting baseline data for wait times, completing and submitting a
plan for electronic referrals, training medical staff, implementing referral technology to improve
provider communications, and incrementally increasing the volume of specialty care visits via
the open-access model.
This project meets the following Regional goals:
The project is related to Regional Area of Focus One: Access to Care. The majority of Regional
survey respondents indicated access to routine specialty care was difficult. Mental/behavioral
health care services were the most difficult for low-income patients to access.
The project is related to Area of Focus Two: Care Coordination. The majority of respondents did
not believe that low-income patients could access behavioral/mental health providers.
The project is related to Area of Focus Three: Community Health. Respondents felt that
behavioral health, substance abuse and insufficient access to care were the top issues affecting
The Helen Farabee Center primarily serves low-income individuals seeking mental/behavioral
health care. The open-access model removes a major barrier to obtaining access to quick and
meaningful psychiatric evaluations and initial pharmacological treatments.
Currently the average wait time for an initial psychiatric evaluation is 10 weeks, making access
to much-needed psychiatric medical care delayed at the Helen Farabee Center. The project
addresses this barrier by creating on open-access (on-demand) model for psychiatric evaluation
via telemedicine. The team implementing this project consists of initial intake clinicians who
make the initial referrals for psychiatric evaluations, support staff who coordinate the video
session, and contracted psychiatrists and other medical support personnel who conduct the
5-Year Expected Outcome for Provider and Patients:
There is currently no mechanism for on-demand (walk-in) psychiatric evaluations for routine
outpatient behavioral health services. The expected outcome during the Waiver period is to
increase the number of psychiatric evaluations provided within one business day by creating an
on-demand model. This is designed to have the anticipated effect of improving quality of life
through removing a barrier to outpatient behavioral health services. Another expected outcome
would be at least a 5% increase in the number of unique patients accessing services.
There are currently no on-demand psychiatric evaluations for routine behavioral health services.
Expediting services can decrease symptoms and increase functioning in individuals, ensuring
timely access to initial evaluations and freeing other prescribers to provide quicker follow-up
encounters. Neufeld et al. (2012)78 used the mean time between appointments as potential
indicators for measuring quality of life. An on-demand (walk-in) model of care would expedite
services, potentially reduce psychiatric admissions,79 and potentially reduce emergency
department usage by individuals in Wise County.