Beacon Clinical Topic Series: Connecting Practice with the Evidence Base

As part of our commitment to clinical knowledge-sharing among our clinicians, Beacon Health Options focuses on a new clinical topic each month to provide historical background and present-day insights on common behavioral health conditions. The initiative introduces these monthly topics through webinars and topical guides that outline the latest developments and promote discussion among our clinical teams, helping bridge the gap between practice and the evidence base.

As these clinical topics are intended to be job aides to Beacon clinicians, it is important to note that the information presented here is not considered exhaustive. However, we believe that providers would benefit from these tools as well for their own internal training and education efforts.

  • Trauma-Informed Care: Trauma-informed care is an approach to care that acknowledges and responds to the prevalence of trauma in our communities and workplaces, while also addressing the impact it has on providers and members. The approach is noteworthy because its reach extends beyond just the treatment environment by addressing the way organizations interact with individuals who have histories of trauma.
  • Long-Acting Injectables: One of the biggest challenges in treating people with severe and persistent mental illness is their significant risk for hospital readmission, primarily related to non-adherence of prescribed oral medications. To address this issue, Beacon advocates for an evidence-based treatment that several studies have shown to improve recovery and community tenure: long-acting injectable antipsychotics. Specifically, Beacon strongly recommends that psychiatric prescribers use a shared decision-making process and systematically offer this evidence-based clinical approach as a first-line intervention for most individuals who require long-term antipsychotic treatment.
  • Adverse Childhood Experiences and their Outcomes: According to self-reported data from the Adverse Childhood Experiences (ACE) Study, at least one in four kids in the U.S. has experienced some type of neglect or abuse during their childhood with one in seven having experienced abuse or neglect in the last year. When we fail to address these issues, we put children further at risk for chronic health conditions and mental illness. Beacon’s October Clinical Topic discusses the connection between childhood trauma and adult functioning and well-being and focuses on three areas to address adverse childhood experiences: proactive identification, provider collaboration, and evidence-based treatment such as trauma-focused Cognitive Behavior and trauma-informed care, Dialectical Behavior Therapy, and Multisystemic Therapy.
  • Outpatient Child Psychiatry Consultation Service: The Children’s Defense Fund reports that one in ten children has a mental illness serious enough to impair their home and school functioning. Yet with a worsening shortage of child psychiatrists nationally, access to behavioral health treatment is a significant problem. September’s Clinical Topic explores the Outpatient Child Psychiatry Consultation Service. Initially launched as a pilot program by the University of Massachusetts Medical School, it later became the Massachusetts Child Psychiatry Access Project (MCPAP), a program designed and implemented by Beacon’s Massachusetts Behavioral Health Partnership. Based on the effectiveness of this psychiatric consultation model supporting primary care providers, similar programs (including our own programs in Connecticut and Colorado) have emerged in 26 states, covering more than a third of all U.S. children.
  • Traumatic Brain Injury: An estimated 1.7 million people sustain a traumatic brain injury (TBI) in the U.S. annually; approximately 20% of us has experienced a TBI during our lifetime. Beacon’s latest clinical topic on Traumatic Brain Injuries addresses the link between TBI and psychiatric illness and the challenge in assessing behavioral health symptoms post-TBI. We describe the prognosis of mild TBI versus moderate/severe brain injuries and give guidance on TBI and associated psychiatric overlapping symptoms as well as the distinction between them.
  • First Episode Psychosis: Neurologists popularized the adage “time is brain” to emphasize the urgency of stroke treatment. In psychiatry, we are also learning that “time is brain” when it comes to the treatment of psychosis, with the current push to develop interventions for early detection and treatment of First Episode Psychosis (FEP) in order to improve long-term outcomes.
  • Schizophrenia: In our topical guide on schizophrenia, we delve into a complicated diagnosable condition, including how we define, diagnose, and treat it, and eight predictors that can lead to either a good or poor prognosis.
  • Suicide and suicide prevention: Suicide and suicide prevention remains a complex and elusive topic. Indeed, since many clinicians were trained, the approach to addressing suicide has evolved. We now have an evidence base to support treating suicide as a condition in its own right, rather than focusing on treating co-occurring conditions.