What is Mind Matters ECHO?

Mind Matters ECHO is a monthly meeting for healthcare providers to discuss a peer-presented case followed by a didactic presentation from a health system expert.

Mind Matters ECHO is appropriate for any clinician who encounters behavioral health needs or challenges in their practice.

Register for the next meeting

October 12, 2022

Strategies for Behavioral Health Integration — Example from the University of Virginia Health System

View the recording of the last meeting

September 14, 2022

Mind Matters ECHO: Managing Suicidal Patients in Primary Care

Submit a patient case for our upcoming Mind Matters sessions

Do you have a case to present? We're seeking cases related to any behavioral health diagnoses, suspected or confirmed. Presenters have reported they find sharing their cases and the feedback they receive to be a valuable tool in their practice.

How it Works

Email Anitha Iyer, PhD and Course Director to discuss your potential case. If selected, you'll complete our online case submission form and our team will use that information to create slides for your presentation. We'll also schedule a 30 minute run through with you ahead of your presentation to ensure everything goes smoothly.

The PHQ-9, C-SSRS, and their limitations

If you’re familiar with the PHQ-9 you know that the final question asks: “In the past 2 weeks, how much have you been bothered by thoughts that you would be better off dead, or thoughts of hurting yourself in some way?”

While this question can provide some insight into the suicidal ideation of your patient, it has its limitations:

• The question is vague, and lumps together two questions (thoughts of being better off dead and hurting yourself)
• “Bothered” is a key term: patients may not be bothered by their suicidality at all, and, in fact, it may be something they are quite comfortable and familiar with
• While it may be tempting to interpret a score of 1 (“several days”) as passive ideation, that is not necessarily the case; this question is a measure of frequency, not severity

For these reasons, the PHQ-9 item 9 is not a gold standard assessment of suicidal ideation or severity, but the Columbia-Suicide Severity Rating Scale (C-SSRS) is.

However, it is important to note that accurately predicting attempted or completed suicides is extremely difficult, as Amy Bennett-Staub, RN discusses in her blog post. About half of all patients who die by suicide denied any suicidal ideation or behaviors at their last visit, and about half of all completed suicides are by patients identified as “low risk.”

Source: Jonathan DePierro, PhD

Characterizing the phenomenology of passive suicidal ideation

Compared to active ideation, passive ideation remains relatively understudied and its clinical importance poorly defined. In a systematic review and meta-analysis, the authors found that passive ideation is a prevalent clinical phenomenon, and that notable similarities exist between passive and active ideation in terms of psychiatric comorbidity and psychological and other characteristics traditionally associated with risk.

Read more

Mental health outcomes in marginalized communities

Just like with physical health, people of color and other marginalized communities face worse mental health outcomes due to a myriad of factors, from lack of access to high-quality or culturally-competent care, to cultural stigma around mental health care, to racism and discrimination. 

Sidney Hankerson, MD, MBA, Vice Chair for Community Engagement for the Department of Psychiatry, and Director of Mental Health Equity Research for the Institute for Health Equity Research (IHER) is at the forefront of Mount Sinai’s efforts to address these mental health care disparities. 

“Oftentimes, mental health education and care isn’t always framed in a way that’s culturally accessible to communities of color,” says Dr. Hankerson. “People might be able to find comfort during times of depression in their communities, but they’re not always able to open up to a trained mental health professional. That’s why it’s crucial to engage the community in this work, and to understand how we can best offer a helping hand.” 

Learn more about Dr. Hankerson's work

Information to share with your patients: stress and health

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, try searching for the impact of stress on health.