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COVID-19 in a New York City Behavioral Health Housing and Treatment System

Tse, Jeanie; Kingman, Emily; LaStella, Drew; Chow, Elisa; Pearlman, Shoshannah
OBJECTIVE:This study sought to characterize the incidence of COVID-19 illness, hospitalization, and death among congregate and noncongregate cohorts served by a New York City behavioral health agency. METHODS:From March 9 to May 3, 2020, data were collected on COVID-19 symptoms, testing, hospitalization, and mortality for 8,256 individuals living in 29 congregate programs (residences and homeless shelters) or served by 41 noncongregate programs (scattered-site housing or outpatient treatment programs). RESULTS:Of the 218 (2.6%) individuals who developed COVID-19-like illness, 84 (39%) were able to obtain testing. Of the 77 individuals who tested positive, 49 (64%) were hospitalized and 19 (25%) died. Congregate housing, age over 45, and intellectual/developmental disabilities were significantly associated with hospitalization and death. CONCLUSIONS:Further research on risk and preventive factors is needed to address the high risk for people with serious mental illnesses and intellectual/developmental disabilities during a pandemic, particularly for those living in congregate housing.
PMID: 34015948
ISSN: 1557-9700
CID: 5060822

Integrating Primary Care Into Assertive Community Treatment

Tse, Jeanie; Cheng, Jason E; Tabasky, Edward; Kingman, Emily; LaStella, Drew; Quitangon, Gertie; Woodlock, David
OBJECTIVE/UNASSIGNED:This program evaluation examined integration of primary care nurse practitioners into assertive community treatment (ACT). METHODS/UNASSIGNED:From January to June 2019, primary care nurse practitioners in a postgraduate fellowship program were assigned to five ACT teams (N=305 participants). Focus groups explored staff members' and participants' experiences. Screening rates for hemoglobin A1c and cholesterol for ACT participants were compared over time. RESULTS/UNASSIGNED:Staff and participants in ACT described improved engagement in primary care, citing benefit from colocation and consultation. Field visits were not found to be an efficient use of the primary care nurse practitioners' time to serve most ACT participants. A significant increase in screening was observed after 6 months for the ACT teams with integrated primary care. CONCLUSIONS/UNASSIGNED:An integrated primary care nurse practitioner readily available for participant engagement and consultation with the ACT team, using a cardiometabolic registry to guide care, may offer a sustainable model of integration.
PMID: 34496631
ISSN: 1557-9700
CID: 5178252

ACT for Life: Why Psychiatrists Pound the Pavement to Provide Care

Tse, Jeanie; Chablani, Raj
To better understand the experience of psychiatrists working on assertive community treatment (ACT) teams and the factors that may draw them to this work, the authors created a survey and distributed it through e-mail groups of the American Association of Community Psychiatrists, the Columbia University Public Psychiatry Fellowship Alumni, and the New York State Center for Practice Innovations ACT Institute. A second survey, with questions primarily regarding safety concerns for ACT providers, was distributed to respondents of the first survey. Responses suggested that ACT leaders should foster teamwork, fieldwork, creativity, flexibility, safety, and leadership opportunities on ACT teams if they wish to engage psychiatrists in this work.
PMID: 33957768
ISSN: 1557-9700
CID: 4874092

Telehealth Acceptability and Feasibility Among People Served in a Community Behavioral Health System During the COVID-19 Pandemic

Tse, Jeanie; LaStella, Drew; Chow, Elisa; Kingman, Emily; Pearlman, Shoshannah; Valeri, Linda; Wang, Hao; Dixon, Lisa B
OBJECTIVE/UNASSIGNED:The authors examined the acceptability and feasibility of telehealth services shortly after their rapid introduction into a community behavioral health agency as part of the response to the COVID-19 pandemic. METHODS/UNASSIGNED:Individuals receiving services during May 8-18, 2020, from behavioral health programs that had introduced telehealth in March 2020, were invited to participate in a survey regarding their perceptions of the telehealth services. Ordinal logistic regressions were used to test for differences in survey responses in three ways: between program types, between the 2020 sample and a 2018 sample, and between individuals reported by staff to be distressed or not distressed by the COVID-19 pandemic. RESULTS/UNASSIGNED:Of 1,482 survey respondents, >80% reported that their ability to connect to staff, receive support, and get an appointment was at least as great as before the pandemic. Among 80% of respondents indicating interest in continuing remote services after the pandemic ended, 83% preferred a mix of remote and face-to-face services. From February 2020 to April 2020, total service utilization remained stable for treatment, outreach, and housing programs. In addition, mental health-related hospital utilization did not increase. CONCLUSIONS/UNASSIGNED:The findings of this study suggest that telehealth, including telephone-based services, is an acceptable and even preferred service delivery mode for clients with severe mental illness. Continued investigation into the optimal dosing of face-to-face versus remote services in various settings is needed to inform service practice during and after the COVID-19 pandemic.
PMID: 33957769
ISSN: 1557-9700
CID: 4874102

Differences in Metabolic Profiles among Women of Differences Races with Diabetes in Pregnancy [Meeting Abstract]

Martingano, D; Patel, N P; Tse, J; Shah, T; Singh, S
INTRODUCTION: The purpose of the study is to evaluate the racial differences in metabolic profiles among pregnant women with gestational (GDM) and pregestational (T2DM) diabetes and its impact on management.
METHOD(S): We conducted a 3-year retrospective study on all pregnant women who were diagnosed as GDM or T2DM during the third trimester of pregnancy. Fasting C-peptide, fasting blood sugar (FBS), total cholesterol (TC), triglycerides (TG), and high density lipoprotein (HDL) were drawn prior to insulin use.
RESULT(S): This study included 200 patients, 68% GDM and 32% T2DM. Difference in fasting C-peptide values for Asian (A), Hispanic (H), African Black (AB), and Caribbean/Haitian Black (CHB) pregnant women and FBS were noted, p<0.01 and p=0.91, respectively. After adjusting for BMI respective to race, C-peptide values still differed significantly, p<0.01. Differences in insulin sensitivity by ISHOMA (C peptide) also demonstrated this effect, p<0.01. TG were higher on average for A and CHB versus H and AB p=<0.01. Differences in HDL and TC differ between race groups, p=0.05 and p=0.03, respectively. A and CHB required insulin therapy more often than H and AB, p=0.04.
CONCLUSION(S): Pregnant A and CHB women likely have beta cell defects resulting in low fasting insulin levels as measured by fasting C-peptide but higher insulin sensitivity on ISHOMA (C peptide) and higher TC, HDL, TG, whereas women of AB race appear to have metabolic profiles more similar to H women
ISSN: 1873-233x
CID: 4749422

Teaching cultural humility: Understanding others by reflecting on ourselves

Chapter by: Cabán-Alemán, Carissa; King, Jordanne; Padilla, Auralyd; Tse, Jeanie
in: Teaching Empathy in Healthcare: Building a New Core Competency by
[S.l.] : Springer International Publishing, 2019
pp. 179-191
ISBN: 9783030298753
CID: 4508702

A case-based approach to public psychiatry

Tse, Jeanie; Volpp, Serena Yuan
New York, NY, US: Oxford University Press, 2018
Extent: vii, 224 p.
ISBN: 978-0-19-061099-9
CID: 3054592

Integrated health care

Chapter by: Cheng, Jason; Tse, Jeanie
in: A case-based approach to public psychiatry by Tse, Jeanie [Ed]; Volpp, Serena Yuan [Ed]
New York, NY, US: Oxford University Press, 2018
pp. 21-28
ISBN: 978-0-19-061099-9
CID: 3054572

Motivation-Based Interventions for Obesity in Serious Mental Illness [Editorial]

Tse, Jeanie; Chow, Elisa; Sultana-Cordero, Rosemarie; Titus-Prescott, Marcia; Chiles, Ruth; Cleek, Andrew; Cleek, Elizabeth
ISSN: 0048-5713
CID: 157629