Administration and Policy in Mental Health and Mental Health Services Research最新文献

{"title":"Comparing Suicide Rates Across Subpopulations of Veterans Receiving Veterans Health Administration Care, 2017–2021: The Suicide Risk Encyclopedia","authors":"Kevin G. Saulnier,&nbsp;Stuart Brabbs,&nbsp;Kallisse R. Dent,&nbsp;John F. McCarthy","doi":"10.1007/s10488-026-01510-0","DOIUrl":"10.1007/s10488-026-01510-0","url":null,"abstract":"<div><p>This study presents suicide surveillance findings from the Veterans Health Administration (VHA) Suicide Risk Encyclopedia, a novel population-based suicide rate comparison tool, demonstrating which Veteran VHA patient subpopulations experience the most elevated suicide rates. For cohorts of Veteran VHA patients alive as of the last day of 2016, 2017, 2018, 2019, and 2020 and with VHA encounters in the prior 2 years, we assessed subpopulation size, number of suicide deaths in the subsequent calendar year, and the suicide rate for 482 measures of Veteran characteristics, diagnoses, and services utilization. We compared suicide rates across measures and years and rank-ordered subgroups by suicide rates. For subgroups with at least 20 suicides from 2017 to 2021, the measures with the highest suicide rates were: prior-year suicide attempts (suicide rate: 380.9/100,000 person-years), high-risk Veterans Crisis Line (VCL) calls (i.e., calls rated as high risk by the VCL responder; 354.1/100,000 person-years), moderate-to-high-risk VCL calls (276.6/100,000 person-years), VHA suicide high risk flag receipt (263.8/100,000 person-years), and suicidal ideation diagnostic codes (257.5/100,000 person-years). For measures with a prevalence of at least 10%, the measures with the top suicide rates were alcohol use disorder diagnoses (99.8/100,000 person-years), anxiolytic prescriptions (87.9/100,000 person-years), non-psychotherapy and medication management mental health outpatient encounters (e.g., 82.7/100,000 person-years), unspecified anxiety disorder diagnoses (75.0/100,000 person-years), and other-specified depression diagnoses (73.5/100,000 person-years). Findings identify high risk VHA patient subpopulations, provide information on trends, and include data regarding subpopulation sizes. These findings highlight the potential value of health systems developing population-based risk comparison tools.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 5","pages":"495 - 505"},"PeriodicalIF":2.6,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148012623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Issues of Culture in Peer Work – A Qualitative Study","authors":"Niharika Hiremath,&nbsp;Louise Byrne,&nbsp;Helena Roennfeldt,&nbsp;Jonathan P. Edwards,&nbsp;Claudia McKenley,&nbsp;Anton Isaacs,&nbsp;Chyrell D. Bellamy","doi":"10.1007/s10488-026-01509-7","DOIUrl":"10.1007/s10488-026-01509-7","url":null,"abstract":"<div><p>Peer work and Lived Expertise are vital for shaping individual and collective understandings of mental health, addiction, and behavioral health service systems. Culturally and Racially Marginalized [CARM] people are underrepresented in peer support work but also encounter multiple challenges as they navigate often traditional service settings. There is an urgent need for more diverse voices within these spaces, especially those of CARM communities. This research aims to contribute to a deeper understanding of the complexities surrounding experiences of equity, diversity, inclusion, and belonging by peer workers employed in traditional behavioral health settings. Employing grounded theory methods to guide data collection and analysis, it examined qualitative data derived from a larger study of peer workers from five multidisciplinary organizations in the United States. The analysis identified key themes and challenges encountered by diverse CARM peer workers within behavioral health systems. The themes include: Potential enablers for CARM individuals in peer work contexts; Mental health and AOD systems dominated by white cultural perspectives; CARM people not having a voice in the peer movement; and Challenges faced by CARM people within peer work contexts and when taking on peer work roles. Each domain was divided into subthemes that either support or hinder the promotion of cultural responsiveness in settings that center lived experience and Lived Expertise. The findings of this study have significant implications for practice, underscoring the need for systemic and structural changes to ensure peer work environments are inclusive, equitable, and reflective of the diverse, intersectional communities they serve.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 5","pages":"481 - 494"},"PeriodicalIF":2.6,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-026-01509-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Real-World Implementation of Measurement-Based Care and its Influence on Emergency Department Visit Risk Among Outpatients With Mood and Anxiety Disorders","authors":"Mason T. Breitzig,&nbsp;Gavin N. Rackoff,&nbsp;Tyson S. Barrett,&nbsp;Amber Shergill,&nbsp;Lan Kong,&nbsp;Michelle G. Newman,&nbsp;Erika F. H. Saunders,&nbsp;Guodong Liu","doi":"10.1007/s10488-026-01508-8","DOIUrl":"10.1007/s10488-026-01508-8","url":null,"abstract":"<div><p>The practice of using validated rating scales to guide treatment—measurement-based care (MBC) remains underutilized in behavioral health. This study examined the association between real-world MBC implementation, ascertained by measure completion, and emergency department (ED) visits. A retrospective cohort design made use of medical insurance claims data (2015–2023) to examine adult psychiatric outpatients exposed to real-world MBC (“MBC” sample; <i>n</i> = 524); 482 were propensity score-matched to patients who received care as usual (“CAU” sample; <i>n</i> = 964). The index visit was the date of registry enrollment for the MBC sample and the first psychiatric encounter while enrolled for the CAU sample. Time-to-event and negative binomial models were used to estimate hazard ratios (HRs) and incidence rate ratios (IRRs) for ED visits. The overall sample included 1,488 patients (63% female and 44 years old, on average). Among the MBC sample, 171 (33%) experienced at least 1 ED visit in one year of follow-up versus 299 (31%) in the CAU sample. There was no significant group difference in time to the first ED visit. However, the MBC sample had a 34% lower ED visit rate (IRR = 0.66; 95% CI: [0.54, 0.80]). Compared to patients who received MBC at less than 6% of their visits, those who received MBC at 15% or more had lower ED visit risk (HR = 0.61 [0.40, 0.94]; median time to ED visit 123 days vs. 101, among those who visited). Completion of measures at as little as 15% of behavioral healthcare visits was associated with significantly fewer ED visits in a dose-dependent manner.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"462 - 474"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Demand Analysis to Examine Private Practice Mental Health Providers’ Decision to Accept Health Insurance","authors":"Kyler R. Lehrbach,&nbsp;Briana S. Last,&nbsp;Elizabeth Rawa,&nbsp;Daniel Zweben,&nbsp;Danielle R. Adams,&nbsp;Donald A. Hantula,&nbsp;Aden Littlewood,&nbsp;Philip C. Kendall,&nbsp;Margaret E. Crane","doi":"10.1007/s10488-026-01507-9","DOIUrl":"10.1007/s10488-026-01507-9","url":null,"abstract":"<div>\u0000 \u0000 <p>Less than half of insured Americans can access mental health care due to a variety of barriers, including low provider participation in insurance networks. Providers report insufficient reimbursement rates and administrative burdens as reasons they do not accept insurance. We examined the importance of these barriers and the extent to which reimbursement rates would need to increase for private practice providers to accept insurance. Private practice mental health providers (i.e., psychologists, marriage and family therapists, mental health counselors, and social workers) completed an online survey containing two behavioral economic tasks. In the <i>Criteria Ranking Task</i>, providers (<i>n</i> = 326) ranked barriers that most deterred them from accepting insurance, reporting insufficient reimbursement rates as the most important, followed by administrative burdens. In the <i>Hypothetical Demand Task</i>, providers indicated the likelihood of accepting Medicare at various reimbursement rate increases with and without hypothetical administrative assistance. Participants indicated they would accept insurance following 83% rate increases (P_max = $188.97) for doctoral providers (<i>n</i> = 188) and 118% rate increases (P_max = $168.51) for master’s-level providers (<i>n</i> = 112). If provided administrative assistance, participants indicated they would accept insurance following 100% rate increases (P_max = $206.28) for doctoral providers and 169% rate increases (P_max = $207.90) for master’s-level providers. Results support existing research findings that insufficient reimbursement rates and administrative burdens are the primary barriers to mental health providers accepting insurance. Policy efforts to increase access to mental healthcare must consider the incentives and burdens that impact providers and their decision to accept insurance.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"451 - 461"},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-026-01507-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Stigma within Social Networks for Individuals with Serious Mental Illnesses: An Inductive Model","authors":"Kristen Gurdak,&nbsp;Rohini Pahwa,&nbsp;John Brekke,&nbsp;Erin Kelly","doi":"10.1007/s10488-026-01505-x","DOIUrl":"10.1007/s10488-026-01505-x","url":null,"abstract":"<div>\u0000 \u0000 <p>Stigma remains a critical social determinant of health for individuals with serious mental illnesses (SMIs), influencing access to resources, social inclusion, and overall well-being. This study uses a multi-method approach to examine how individual and interpersonal stigma operate within social networks, shaping experiences of exclusion, disclosure, safety, and community participation. Using semi-structured qualitative interviews and egocentric social network interviews, we employed case study and thematic analysis to examine sources and types of stigma among 30 participants with SMIs receiving community-based services in a large Western U.S. city. Findings highlight three primary stigma types—anticipated, experienced, and internalized—emerging within social networks, with family members, friends, service providers, and acquaintances identified as sources of stigma. The interplay between stigma types within social networks contributed to downstream psychological and behavioral consequences, including self-imposed isolation, disclosure dilemmas, and heightened safety concerns. These findings underscore the need for multi-level interventions that address stigma at both the individual and interpersonal levels, including challenging negative self-perceptions, strengthening social support networks, and fostering inclusive environments. By examining stigma in social networks, this study contributes to a growing body of qualitative research on stigma, mental health, and community participation, offering critical insights for policy, practice, and future research.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"420 - 434"},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimbursement Potential of Collaborative Care Model (CoCM) Billing Codes for Opioid Use Disorder Co-Occurring with Mental Disorders: Descriptive Estimates from a Pragmatic Trial","authors":"Alex R. Dopp,&nbsp;Rebecca L. Weir,&nbsp;Grace M. Hindmarch,&nbsp;Lia Pak,&nbsp;Sapna Mendon-Plasek,&nbsp;Michael Schoenbaum,&nbsp;Jasen Christensen,&nbsp;Valerie Carrejo,&nbsp;Caroline Bonham,&nbsp;Miriam Komaromy,&nbsp;Katherine E. Watkins","doi":"10.1007/s10488-026-01503-z","DOIUrl":"10.1007/s10488-026-01503-z","url":null,"abstract":"<div>\u0000 \u0000 <p>In 2017, the U.S. Centers for Medicare and Medicaid Services approved reimbursement for billing codes specific to the Collaborative Care Model (CoCM), an evidence-based practice for improving access and quality of behavioral health services in primary care. However, it remains unclear how reimbursement through these billing codes aligns with applications of CoCM for complex patient populations, such as those with co-occurring mental and substance use disorders. We examined the reimbursement potential of CoCM intervention activities documented during a pragmatic clinical trial of CoCM for patients with opioid use disorder co-occurring with depression and/or post-traumatic stress disorder. We defined reimbursement potential based on federal (i.e., Medicare) CoCM billing code rules and reimbursement rates, as of 2024. Across 381 patients and 10 care managers (i.e., the CoCM interventionists), we documented 90,996 total intervention activity minutes in the project’s care management registry. Under ideal conditions where all CoCM billing codes can be and are used, a maximum of 56% of minutes would be billable, generating $91.61 reimbursement per hour of care management. Reimbursement potential was lower under restrictive billing conditions and settings, resulting in $79.32 per hour. Most commonly, minutes were unbillable due to not meeting CoCM service requirements or exceeding maximum billable time for a month. Sensitivity analyses showed that reimbursement potential could be notably lower in alternative scenarios (e.g., $39.63–$43.04 per hour with minimum plausible Medicaid billing rates). Continued attention is needed to align CoCM reimbursement potential with clinical needs to ensure feasibility and sustainability with complex patient populations.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"388 - 401"},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapist Delivery of Evidence Based Practice (EBP) Strategies in a System-Driven Implementation of Multiple EBPs for Children","authors":"Teresa Lind,&nbsp;Anna Lau,&nbsp;Julia Cox,&nbsp;Colby Chlebowski,&nbsp;Joyce Lui,&nbsp;Y. Vivian Byeon,&nbsp;Lauren Brookman-Frazee","doi":"10.1007/s10488-026-01501-1","DOIUrl":"10.1007/s10488-026-01501-1","url":null,"abstract":"<div>\u0000 \u0000 <p>Examples of system-driven implementation of multiple evidence-based practices (EBPs) are becoming more frequent in efforts to improve community mental health care, but there is limited understanding of how these efforts change community therapist practice. Within one such implementation effort in the Los Angeles County Department of Mental Health, this observational study sought to: (1) examine observer ratings of therapist delivery of EBP strategies in sessions where therapists claimed reimbursement to one of six youth mental health EBPs; and (2) explore factors associated with extensiveness of EBP strategy delivery. Data were drawn from 680 sessions with 273 youth delivered by 103 therapists in 14 agencies. Sessions were audio recorded and rated by trained observers for extensiveness of therapist delivery of EBP technique and content strategies. Therapists were observed to use EBP techniques (Structuring Treatment Techniques and Skill Building Techniques) in the majority of sessions. Consistent with expectations, use of specific EBP content strategies were more targeted and less commonly observed at every session. Finally, the following factors were associated with higher observed EBP strategy extensiveness: sessions completed in a non-English language (compared with sessions completed in English), sessions using an EBP with a prescribed session content/order (compared with sessions using an EBP without a prescribed session content/order), higher levels of therapist reported self-efficacy with the EBP being delivered, older client age, and therapists with a cognitive behavioral theoretical orientation (compared with therapists with an orientation other than cognitive behavioral). Patterns of therapist EBP strategy delivery followed expected patterns, with techniques strategies used in the majority of sessions and specific content strategies used in a more targeted fashion. Given the dearth of observational measurement of EBP implementation-as-usual, these findings contribute to our understanding of key outcomes of scale-up efforts. Predictors of EBP strategy use have implications for targeting efforts to promote sustainment, such as improving provider EBP self-efficacy.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"353 - 369"},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-026-01501-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It Doesn’t Look Like Work, but it Works: A Qualitative Study of Staff Experiences with a Self-Harm Strategy in Danish Inpatient Mental Health Services","authors":"Kristine Høst Poulsen,&nbsp;Lisbeth Hybholt,&nbsp;Carsten Hjorthøj,&nbsp;Erik Simonsen,&nbsp;Bo Bach,&nbsp;Philip Tønder Hartvig,&nbsp;Mickey Toftkjær Kongerslev","doi":"10.1007/s10488-026-01506-w","DOIUrl":"10.1007/s10488-026-01506-w","url":null,"abstract":"<div>\u0000 \u0000 <p>Non-suicidal self-injury (NSSI) is common in inpatient mental health care and poses challenges for staff, patients, and organizations. While training programs can improve knowledge and attitudes, less is known about how staff collectively experience implementing new strategies for managing self-harm and how such strategies influence ward culture and professional practice. This qualitative study was part of a broader evaluation of implementing a regional self-harm strategy in a Danish inpatient mental health service. The strategy included staff training, clinical tools, and supervision. Four focus group interviews with 25 staff members from five inpatient units were conducted in 2024. Data were analyzed using reflexive thematic analysis. The analysis generated four interrelated themes: (1) <i>Relational work as invisible yet essential</i>: Staff valued listening and dialogue as crucial for preventing escalation but described these practices as undervalued and the first to be dropped under pressure. (2) <i>Diagnostic hierarchies: psychosis as the legitimate inpatient diagnosis</i>,<i> self-harm as responsibility</i>: Psychotic patients were viewed as genuinely ill and beyond control, while patients who self-harm were often framed as responsible, sustaining moralized hierarchies of care. (3) <i>Cultural change – from control to dialogue</i>: The strategy disrupted routines of restraint in relation to self-harm. Initially perceived as “doing nothing,” the new strategy was increasingly legitimized as staff witnessed calmer units, reduced coercion, and clearer professional roles grounded in relational practice. (4) <i>Responsibility</i>,<i> guilt</i>,<i> and emotional distance</i> — Staff struggled with the emotional and moral burden of refraining from coercion, negotiating professional boundaries, and managing feelings of guilt and emotional withdrawal. Implementing a self-harm strategy requires more than new clinical tools. It depends on staff integrating the approach into everyday practice, supported by structural and cultural change. Sustainable implementation relies on legitimizing relational care as skilled clinical work, creating space for reflection, and addressing the emotional demands placed on staff. The findings also show that diagnostic hierarchies continue to shape how legitimacy and responsibility are distributed within psychiatric care.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"435 - 450"},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-026-01506-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Risk Factors, and Treatments for Suicidality in People Living with Premenstrual Dysphoric Disorder (PMDD): A Systematic Review","authors":"Eliza Zhitnik,&nbsp;Tesia Britt,&nbsp;Elizabeth Bertone-Johnson,&nbsp;Thomas I. Mackie,&nbsp;Jamie Hartmann-Boyce","doi":"10.1007/s10488-026-01504-y","DOIUrl":"10.1007/s10488-026-01504-y","url":null,"abstract":"<div><p>In 2013, premenstrual dysphoric disorder (PMDD) was officially recognized as a psychiatric diagnosis. It is estimated to affect 1.3% to 5.8% of people who menstruate. Previous evidence has suggested an association between PMDD and suicidality. We set out to systematically review the most up-to-date evidence on prevalence, risk factors, and treatments for suicidality in people living with PMDD. We searched PubMed and PsycInfo (07/2024) and CENTRAL (08/2024) for primary empirical studies available in English published from 2013 onwards; concepts included: people who menstruate; discussion of PMDD; and suicidality-related data (outcomes, prevalence, risk-factors). Evidence was narratively synthesized and grouped by outcome and then within-outcome by population. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal. Eighteen studies were included (n = approximately 2,600,000). MMAT assessments flagged issues with 70% of studies. Across studies reviewed, eight suicidality-related indicators/outcomes were significantly associated with PMDD and/or PMDs. Prevalences ranged across indicators: 16%-30.47% for ‘suicidality’; 26%-86% for suicidal ideation; 11.5%-41.5% for suicide planning; and 7.1%-60.7% for suicide attempts. Common suicidality-related risk factors included: other psychiatric comorbidities; scoring highly on personality tests measuring impulsivity, aggression, and feelings of hopelessness; and hormonal factors. No identified studies evaluated treatments for suicidality in people with PMDD. The field of PMDD research requires consistent definition of PMDD and suicidality-related indicators/outcomes to facilitate research, diagnosis and treatment. Despite clinical and methodological heterogeneity, evidence is clear that people with PMDD are at increased risk of suicidality, signaling a need for research on interventions in this population.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"402 - 419"},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Built Environment Interventions to Improve Patient and Staff Outcomes in Emergency Department Mental and Behavioral Healthcare","authors":"Monica Gripko,&nbsp;Sara Kennedy,&nbsp;Anjali Joseph,&nbsp;RIPCHD.PED Study Group","doi":"10.1007/s10488-026-01502-0","DOIUrl":"10.1007/s10488-026-01502-0","url":null,"abstract":"<div><p>The built environment of Emergency Departments (EDs) provides the context and setting for care delivery, influences workflows, and shapes user interactions, but its noisy, sterile, stimulating nature can be counter-therapeutic to patients in psychiatric crises. As ED Mental and Behavioral Health (MBH) presentation rates rise, healthcare organizations and designers must develop strategies to address challenges and improve care. This systematic review analyzes emergency department-based built environment interventions implemented to improve the safety and experiences of patients seeking emergency MBH care and ED staff involved in their care. Our team searched six databases in March 2023 using PRISMA methods and the SEIPS 3.0 framework to identify and analyze nineteen studies of ED-based built environment interventions for MBH care. Interventions occurred at three scales – unit, room, and element – and impacted patient and staff outcomes. For example, MBH units located outside of the main ED contributed to decreases in length of stay, boarding, and inpatient psychiatric admissions. Room and element-scale interventions helped improve patient experiences and increase safety. This review summarizes existing knowledge surrounding built environment interventions for emergency MBH care and identifies opportunities for design and clinical practice applications. Future research is necessary to capture patient and staff voices, examine various types of EDs, and compare interventions across hospitals. This review shows how physical interventions in the built environment of EDs – from individual elements to entire units – can improve processes, safety, and experiences for MBH patients and staff, especially when incorporated into broader, systems-based changes.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"370 - 387"},"PeriodicalIF":2.6,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147626966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}