Journal of Behavioral Health Services & Research最新文献

{"title":"Identifying Staff Behaviors and Client Outcomes of High-Performing Staff at a National Homeless Hotline for Veterans.","authors":"Jack Tsai, Laura Witte, Aerin DeRussy, Amanda Burden, Ann Elizabeth Montgomery","doi":"10.1007/s11414-026-09996-0","DOIUrl":"10.1007/s11414-026-09996-0","url":null,"abstract":"<p><p>Crisis call centers serve important functions for public health. With the rise of artificial intelligence (AI) and potential roles in crisis call centers, it is important to examine what human behaviors influence the effectiveness of call center outcomes. The authors studied the U.S. Department of Veterans Affairs (VA) National Call Center for Homeless Veterans (NCCHV) to (1) examine differences in staff behaviors between top and average performers and (2) evaluate client outcomes of top-performing and average-performing staff. Of 159 NCCHV staff, 10 top-performing and 10 average-performing staff were randomly selected based on their annual performance ratings from fiscal years 2020-2023. For each NCCHV staff selected, three audio-recorded calls were sampled and blindly rated by researchers on a list of nine coded behaviors (e.g., empathy, thoroughness). Healthcare outcomes of clients served by these NCCHV staff were examined through analysis of their VA medical records data. Results found that top-performing staff were significantly more likely to be rated as tactful and empathetic, thorough with information gathering, and less likely to be rated as providing inappropriate advice and being forceful/rigid with clients than average-performing staff. Clients served by top-performing NCCHV staff showed significant increases in VA healthcare use including outpatient healthcare and homeless services after calling NCCHV which were not observed in clients served by average-performing NCCHV staff. Together, these findings suggest human behaviors of homeless call center staff influence client engagement with care, emphasizing the importance of staff training and caveating any potential use of AI in these call centers.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"607-621"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of Mental Health Services among Substance Use Disorder Treatment Programs in the United States.","authors":"Jemima A Frimpong, Zeddy Kipyegon, Yinfei Kong, Suojin Wang","doi":"10.1007/s11414-026-10009-3","DOIUrl":"10.1007/s11414-026-10009-3","url":null,"abstract":"<p><p>Substance use disorders (SUDs) represent a critical public health challenge, frequently compounded by co-occurring mental health conditions. While integrated care is the evidence-based standard of care, implementation gaps persist. This study utilized data from 3764 outpatient facilities from the 2023 National Substance Use and Mental Health Services Survey to evaluate mental health service integration and identify key predictors. Despite treating highly comorbid populations, 33% of facilities offered no mental health assessments. Integration levels varied sharply by facility type; opioid treatment programs (OTPs) served more clients with co-occurring disorders and were over twice as likely to provide comprehensive integration (43%) compared to non-OTPs (20%). Generalized ordered logistic regression revealed that private non-profit and public ownership, Joint Commission (TJC) accreditation, private insurance acceptance, and a higher co-occurring client volume were strong positive predictors of integrated care in the full sample. Conversely, CARF accreditation, Medicaid acceptance, and being in the Midwest were associated with a lower likelihood of integrated care. Stratified analysis uncovered critical variations by program type. Medicaid acceptance specifically lowered odds of integration in OTP. Furthermore, CARF accreditation was a negative predictor for OTPs but a positive predictor for non-OTPs. At the state level, location in a Medicaid managed care organization state significantly reduced integration odds solely for OTPs, while an increasing proportion of adults with a drug use disorder significantly increased likelihood of integration for non-OTPs. These results underscore how organizational structures, including facility type, accreditation, and state-level funding mechanisms shape care delivery. Addressing these systemic barriers, particularly financial and regulatory, is essential to closing the implementation gap and ensuring comprehensive care.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"516-535"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How CCBHCs Are Helping Close the Gap in Substance Use Treatment with Integrated Care.","authors":"Chuck Ingoglia","doi":"10.1007/s11414-026-10019-1","DOIUrl":"10.1007/s11414-026-10019-1","url":null,"abstract":"","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"513-515"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Implementation Science Assessment of Intranasal Esketamine's Limited Integration into Mainstream Psychiatric Treatment.","authors":"Benjamin Anderson, Megan O'Grady","doi":"10.1007/s11414-025-09975-x","DOIUrl":"10.1007/s11414-025-09975-x","url":null,"abstract":"<p><p>Major Depressive Disorder is one of the most common mental illnesses worldwide, with oral antidepressant medication being the first-line psychopharmacological treatment option. The term Treatment Resistant Depression (TRD) is used to describe patients who remain symptomatic despite multiple trials of antidepressant medication. There had been limited FDA-approved treatment options for patients with TRD, but in 2019, intranasal esketamine was approved by the FDA for patients with TRD after safety and efficacy were established in the drug development clinical trial program. Since approval, multiple researchers have explored esketamine's effectiveness in real-world treatment settings. Despite established efficacy and effectiveness, most psychiatric treatment settings do not offer intranasal esketamine. This limited implementation is reviewed using the Consolidated Framework for Implementation Research (CFIR), and steps forward are proposed to improve accessibility for patients with TRD.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"677-685"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Integrated Treatment Services and Access to Detoxification and MOUD Across US Treatment Facilities.","authors":"Fares Qeadan, Falak Choudry, Rose Thornquist","doi":"10.1007/s11414-026-10003-9","DOIUrl":"10.1007/s11414-026-10003-9","url":null,"abstract":"<p><p>Integrated treatment services for co-occurring mental health and substance use disorders are recommended best practice, yet their relationship with facility-level provision of detoxification and medications for opioid use disorder (MOUDs) is not well understood. The researchers analyzed 2021-2023 National Substance Use and Mental Health Services Survey (N-SUMHSS) data from 49,623 facilities offering any substance use services. Multivariable logistic regression models examined associations between integrated services and availability of detoxification and MOUD, adjusting for facility characteristics and Chronic Care Model elements. Primary treatment focus (substance use, mental health, mixed) was evaluated as an effect modifier. Overall, 61.2% of facilities offered integrated services, 21.2% provided detoxification, and 56.0% provided MOUD. Among substance use-focused facilities, integrated services were associated with higher odds of offering detox (adjusted odds ratio [aOR] = 1.27, 95% CI 1.17-1.37) and MOUD (aOR = 1.44, 95% CI 1.34-1.56). Among mixed-focus facilities, integrated services were associated with higher odds of MOUD (aOR = 1.39, 95% CI 1.28-1.51) but not detoxification. Among mental health-focused facilities, integrated services were associated with lower odds of detoxification (aOR = 0.34, 95% CI 0.22-0.53) and did not predict MOUD availability. Facility type, ownership, and Chronic Care Model elements, including delivery system redesign, self-management support, and clinical information systems, were strong independent predictors of both outcomes. Integrated services may be associated with greater access to detoxification and MOUD in substance use-focused settings but appear insufficient within mental health-focused facilities; efforts to strengthen integrated care should account for facility focus and infrastructure capacity.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":"574-589"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Graduate Programs Develop and Sustain Practicum Sites for Behavioral Health Trainees: A Mixed Methods Study.","authors":"Lisa de Saxe Zerden, Danya K Krueger, Maria G Gaiser, Hanna L Erhardt, Brianna M Lombardi","doi":"10.1007/s11414-026-10023-5","DOIUrl":"https://doi.org/10.1007/s11414-026-10023-5","url":null,"abstract":"<p><p>Practicum education is a foundational component of master's-level training across social work, counseling, and marriage and family therapy programs. However, expanding and sustaining practicum placements with community partners remains difficult due to rising service demands, high caseloads, and systemic workforce challenges. This explanatory sequential mixed methods study examined practicum site development and supervision supports among a cross-disciplinary sample of accredited U.S. master's-level behavioral health training programs. A cross-sectional survey collected data from 68 practicum education leaders across 31 states and Puerto Rico to describe recruitment strategies and their perceived effectiveness, material incentives, and structural barriers. Semi-structured interviews with 24 practicum education leaders contextualized the quantitative findings and explored the dynamics of academic-community partnerships. The results indicated that programs expand placement capacity primarily through informal, relational strategies, such as alumni outreach, student-initiated proposals, and extending existing partnerships, rather than formalized recruitment infrastructure. Quantitatively, 72% of participating programs reported providing no direct financial or material incentives to either host sites or site supervisors. Qualitative themes showed that placement capacity is fundamentally relational and relies heavily on uncompensated, time-intensive labor from both academic staff and community partners. The most salient barriers to expanding capacity included a lack of available agency-based supervisors, supervisor time constraints, and bureaucratic hurdles such as legal and insurance compliance. This study suggests that continued reliance on professional goodwill and uncompensated supervisory labor may be difficult to sustain, underscoring the need for greater structural investment in practicum infrastructure.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Experience Versus Professional Expertise: Preferences for Features of Informal and Formal Mental Health Support Among College Students.","authors":"Samuel T Murphy, Victoria A Brown, Elizabeth A Emanuel, Ingrid E O'Brien","doi":"10.1007/s11414-026-10022-6","DOIUrl":"https://doi.org/10.1007/s11414-026-10022-6","url":null,"abstract":"<p><p>Informal caregiving serves vital functions in the USA, filling important gaps in formal care systems. However, informal caregiving for psychological disorders has received relatively limited research attention. In this study, we evaluated perspectives towards informal and formal caregiving in a sample of 554 college students attending a large public university in the Deep South and contrasted the relative importance of care elements in the context of informal and formal care. Results from evaluation of preferred elements of care between informal care and formal care were consistent with personal experience and professional expertise having differential importance to informal and formal care. The largest difference in relative importance identified was for psychological expertise, which was found to be more important to formal than informal care (d = 0.70). The care provider having experience working with individuals facing challenges related to living in rural areas was also seen as more desirable in the context of formal care, though the size of this effect was much smaller (d = 0.16). Three elements of care were preferred in the context of informal care, including the care provider having struggled with the same mental health concerns as oneself (d = 0.17), a shared background with the care provider (d = 0.19), and the care provider being knowledgeable about diversity and discrimination (d = 0.14). We also evaluated how rural residence status influenced the importance of experience working with clients from a rural background, finding that participants who self-reported currently residing in a rural area viewed a rural background on the part of the provider as more desirable than non-rural participants, both in the context of informal (d = 0.37) and formal care (d = 0.49). Participants were also asked to indicate whom they would look to consult prior to seeking formal psychological treatment and overwhelmingly preferred to consult family (65.5%) and friends (57.2%) over mental health professionals (28.2%), highlighting the role of informal care networks in accessing formal treatment. Findings provide insight into important attributes of informal and formal care and may inform efforts to increase treatment uptake and suggest that behavioral health clinics serving rural communities should prioritize rural cultural competence.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician-Level Variation in MAUD Prescribing: The Role of Behavioral Health Experience.","authors":"Sarah A Friedman, Ying Guo, Lex Owen, Lung-Chang Chien, Stephanie Woodard, Michelle S Keller","doi":"10.1007/s11414-026-09998-y","DOIUrl":"https://doi.org/10.1007/s11414-026-09998-y","url":null,"abstract":"<p><p>Less than 10% of Medicaid patients diagnosed with AUD in the USA received medication treatment for AUD (MAUD), despite its proven clinical effectiveness. Documenting clinician MAUD prescribing patterns can suggest solutions. Do clinicians with behavioral health (BH) experience have higher rates of MAUD prescribing in a Medicaid program in a state with a low supply of clinicians? This cross-sectional study used Nevada Medicaid professional and pharmacy claims data (2016-2019) to identify 7003 clinicians who prescribed to patients with alcohol use disorder (AUD). BH experience (exposure) was determined by (1) BH specialty from taxonomy, (2) BH patient volume above the median number of BH patients (n = 15), and (3) buprenorphine prescribing during the study period. Logistic regressions estimated adjusted odds ratios (aORs) for any prescribing, controlling for clinician characteristics. Zero-inflated negative binomial regressions estimated incidence rate ratios for the number of MAUD-prescribed patients and MAUD prescriptions. Only 8% (n = 541) of the study cohort prescribed MAUD. Clinicians with BH experience had higher odds of prescribing MAUD: those with BH specialty versus primary care (aOR 7.6, 95% CI 5.8-9.9), those who prescribed buprenorphine versus those who did not (aOR 3.9, 95% CI 2.9-5.3), and those with high versus low BH patient volume (aOR 6.1, 95% CI 4.4-8.4). Clinicians with BH experience had significantly higher counts of MAUD-prescribed patients and MAUD prescriptions than other clinicians. Amid MAUD underuse, clinicians with BH experience were instrumental MAUD prescribers for Nevada's Medicaid population. Expanding BH and primary care integration/colocation, increasing the BH workforce, and providing additional BH training in primary care could improve MAUD access.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appreciation to Reviewers.","authors":"","doi":"10.1007/s11414-026-10020-8","DOIUrl":"https://doi.org/10.1007/s11414-026-10020-8","url":null,"abstract":"","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric Advance Directives: Closing the Gap Between Evidence and Crisis Care Practice.","authors":"Daniel Holguin, Allea Frazier, Stephanie A Rolin","doi":"10.1007/s11414-026-10018-2","DOIUrl":"https://doi.org/10.1007/s11414-026-10018-2","url":null,"abstract":"<p><p>Psychiatric advance directives (PADs) are designed to preserve patient preferences during psychiatric crises and reduce reliance on coercive interventions. Although PADs are supported by randomized and observational evidence, they remain infrequently used in US behavioral health systems. This Policy Perspective argues that PAD underuse reflects failures in system design rather than lack of effectiveness or patient interest. We describe the magnitude and consequences of PAD under-implementation, including its implications for crisis-based care, racial and ethnic inequities, and system inefficiency. We then examine how existing policies and health system structures limit PAD accessibility and use during psychiatric emergencies, despite evidence that facilitated PADs can improve outcomes. Finally, we outline policy and system-level reforms to support PAD implementation, including investment in infrastructure, reimbursement for facilitation, integration into crisis response workflows, and equity-focused community partnerships. Advancing PAD implementation represents a practical opportunity to reduce coercive crisis responses and strengthen equity in behavioral health care.</p>","PeriodicalId":49040,"journal":{"name":"Journal of Behavioral Health Services & Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}