The United States is in the midst of an evolving overdose crisis, driven by the proliferation of potent synthetic opioids (e.g., illicitly made fentanyl), the resurgence of stimulants (e.g., methamphetamine), and the introduction of adulterants (e.g., xylazine) into the illicit drug supply. These substance use challenges are happening against the backdrop of rising mental health challenges that are closely linked to substance use and overdose. As overdose deaths have increased, the demographic profile of those dying has shifted and now disproportionately affects certain racial and ethnic minority populations. Social determinants of health (SDOH) are an underexplored component of the prevention response but are particularly salient in addressing substance use and overdose. Many SDOH have been linked to an increased risk for substance use and overdose, either directly or indirectly. The author examines the connection between SDOH and substance use and overdose, with a particular focus on

Objective: Midbrain dopamine function plays a key role in translational models of substance use disorders. Whether midbrain dopamine function is associated with substance use frequency and severity or reward function in 20–24 year-olds remains a critical gap in knowledge. The authors collected neuromelanin-sensitive magnetic resonance imaging (NM-MRI), a validated index of lifetime dopamine function in the substantia nigra/ventral tegmentum area (SN-VTA) complex, to characterize altered dopamine function. Method: Midbrain NM-MRI contrast-to-noise ratio (CNR) was acquired in 135 20–24 year-olds (105 women and 30 men). A composite measure of cumulative substance use was derived from factor analysis of lifetime alcohol intoxications, lifetime cannabis use, use of nicotine in heaviest month, number of classes of drugs used, and ever meeting DSM-5 criteria for a SUD. Trait reward function was assessed by self-report. Results: Cumulative substance use was significantly positively associated

Objective: The present study examined whether clients enrolled in coordinated specialty care (CSC) programs for first-episode psychosis (FEP) across 22 states and territories showed improved clinical and functional outcomes and assessed whether program- or client-level predictors were associated with client outcomes. The study included CSC programs that subscribe to a variety of models, including Early Assessment and Support Alliance, OnTrack, and NAVIGATE. Methods: Deidentified demographic and outcome data were collected from clients (N=770) receiving CSC services in 36 programs at the time of program entry and every 6 months for up to 18 months. Programs participated in fidelity assessment by using the First-Episode Psychosis Services Fidelity Scale, version 1.0, developed for the study and based on the components of the CSC model defined by NIMH. Additional program-level variables assessed during the study included staff turnover rate and time spent on CSC services. Results: Across

Objective: Expanded funding to support care across the crisis continuum is intended to improve behavioral health outcomes. A greater understanding of how to effectively implement and integrate local crisis care systems has been identified as a research and policy priority. The aim of this study was to explore provider perceptions of the barriers and facilitators associated with implementing effective behavioral health crisis services. Methods: The authors conducted semistructured qualitative interviews with personnel from 15 behavioral health crisis care programs across California. Purposive sampling was used to ensure adequate representation of peer specialists, clinicians, mental health workers, and program leaders. Interview transcripts were analyzed via an inductive approach to thematic analysis. On the basis of patterns identified in the data, initial codes were developed, reviewed, and combined into overarching preliminary themes and subthemes. Results: Twenty-nine crisis care pe

Objective: Many people receiving services for psychiatric disorders live on low incomes, navigate complex financial situations, and have limited economic security. The authors sought to determine whether a financial wellness intervention delivered virtually by peers would increase financial literacy, reduce economic strain, and improve financial competency. Methods: One hundred participants receiving services for psychiatric disorders were recruited from community programs and via social media and were randomly assigned (1:1) to receive either an intervention called Building Financial Wellness (N=51) or services as usual (N=49). The intervention involved six virtual 1.5-hour group sessions, followed by three virtual one-on-one booster sessions. Outcomes were assessed with the Consumer Financial Protection Bureau’s Financial Well-Being Scale (primary), Financial Strain Questionnaire, Financial Capability Scale, and Financial Self-Sufficiency Scale. Knowledge regarding money management w