Three Rs for Psychiatric Services: An Update

After the processing of nearly 3,000 submissions, I began my fourth year of editing Psychiatric Services this past January. Yikes! How did this time go so quickly? While I have written many tweets, I have not written a follow-up to my initial essay to the readership (1). It is time for an update.

My initial vision was to maintain rigor and enhance relevance. To these I would now add a third R, increase range. I will focus on each in turn.

Scientific rigor remains a foundation of Psychiatric Services. In order to promote rigor, we have reached out to investigators and to clinical and health services researchers to seek high-quality submissions. Outstanding review is a core element of rigor. To keep our reviewer database current, the publisher partners with Publons, a service to locate potential peer reviewers for manuscripts submitted by authors who have recently published in the same or a similar area to better target those qualified to comment.

Rigor considers both internal and external validity. For a journal devoted to the delivery of services, external validity (or “generalizability”) assumes a high priority. Further, evaluation of rigor in the context of implementation science can require different yardsticks than those used to assess rigor for studies that are focused on the efficacy and effectiveness of services. Implementation science aims to increase generalizable knowledge regarding how to scale evidence-based practices. For example, rigor can be a function of the appropriate use of qualitative and mixed methods; the inclusion of a range of stakeholders; consideration of community, organizational, provider, and patient levels; and attention to specific approaches to training and dissemination. A narrow conceptualization of rigor does not fit with our journal.

Relevance means important to the matter at hand. Relevant articles and essays have implications for today’s services. And I confess that after spending much of my career chasing the rigor of R01s, I am delighting in the clutter of pursuing relevance. Our strategy for expanding relevance has been multielement. Our columns tell timely stories that offer important current lessons. We have created two new columns, one that focuses on technology in mental health and the other on social determinants of mental health. The former Best Practices column has been renamed Promoting High-Value Mental Health Care in order to reflect the shift of focus in general service delivery. Efforts to expand relevance also extend across borders; we have solicited and received an increasing number of international submissions.

Columns are one of the many types of articles Psychiatric Services publishes. In order to promote relevance, we also created Viewpoints and have frequently invited commentaries that provide perspective on a controversial or challenging issue in service delivery. Special articles and more flexible structures for review articles allowed us to partner with the National Association of State Mental Health Program Directors and foundations such as Scattergood to publish articles based on policy essays written by thought leaders and commissioned by these partners.

Relevance demands a significant digital presence. We now have an increasing digital signature on Twitter and an emerging presence on other social media sites. In addition, we have created a podcast, From Pages to Practice, that has a growing listenership and that now has over 30 episodes. An additional resource that readers can access is the Editor’s Choice collections of articles. Here, early-career psychiatrists who are members of a newly created Early-Career Psychiatrist Advisory Group have worked with me to curate sets of articles published in Psychiatric Services on specific topics. These collections are intended to provide quick and convenient curricula on popular topics and can be thought of as electronic special issues. We expect that the participation of early-career psychiatrists enhances the relevance of the collections to current practice.

The third R I have added to my goals as editor is to expand the journal’s range. Traditionally, Psychiatric Services and its predecessor, Hospital and Community Psychiatry, has focused primarily on services for individuals experiencing so-called serious mental illness. I remain committed to that population and expect to continue that focus. At the same time, I have expanded our attention to other populations. Articles have appeared that focus on services for children, on adults with disorders of childhood, on substance use, and even on eating disorders. I expect to continue to welcome this expanded focus of illnesses while maintaining a focus on service delivery. To ensure continued receipt of submissions that increase the journal’s range, we have partnered with TrendMD, an article recommendation service that promotes our articles as recommended further reading on other online platforms that host closely related content. The recommendations are displayed alongside related articles across thousands of the world’s leading journals so that scholars can find our work and see we are publishing in their area of interest. I consider all psychiatric services, both in the private and public sectors, to be in scope for the journal. Expanding our range also includes welcoming submissions from across the globe. A global perspective demands that we all think together about common lessons to be derived from studies within different service delivery systems and cultures.

Sticking with the R theme, let’s move to ratings. How is Psychiatric Services performing? What metrics do we follow? Impact factor, of course. This metric, which measures citations within a time period, is the one with which academicians, scholars, and publishers are highly familiar, so we would ignore it at our peril. The eigenfactor measures citations within a period and weights citations in higher-impact journals more heavily. On this metric, we’re proud that Psychiatric Services ranks as the highest mental health journal—and seventh highest overall—of the more than 80 journals indexed in the Health Policy and Services category. Similarly, our performance on numbers of citations is off the charts. Psychiatric Services had 10,947 total citations by the universe of journals tracked in the 2018 Journal Citation Reports database. This is a strong showing, ranking the journal fourth for total citations in the Health Policy and Services category. In the spirit of relevance, we also monitor Altmetric scores closely. Such scores provide timely information about the penetration of our articles in social media and the news.

What are we planning moving forward? We have just created a multidisciplinary Psychiatric Services Policy Advisory Group, which aims to use several strategies to maximize our impact on mental health policy. We recognize that policy makers increasingly rely on evidence-based solutions to improve health services for people with mental and substance use disorders. The journal plays a crucial role in peer reviewing and publishing high-quality research and pieces from thought leaders that help advance evidence-based policymaking. We also plan to work with the American Psychiatric Association’s new Task Force on Interprofessional Collaboration in order to strengthen our multidisciplinary base. Psychiatric Services serves the field—not only psychiatrists. In that spirit, we look forward to welcoming two new accomplished members of our Editorial Board who are not psychiatrists. Leadership at APA Publishing has been hugely supportive in developing and growing the journal. I want to say a huge thank you to the committed staff at APA Publishing. I look forward to continued innovation and impatience with the status quo and our limitations. Please feel free to e-mail your ideas and comments!