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

{"title":"Scaling Early Parenting Interventions: A Qualitative Investigation of Factors that Enable Successful Scaling of Early Parenting Interventions for Sustainable Implementation and Impact","authors":"Jane Kohlhoff,&nbsp;Martina Donkers,&nbsp;Sara Cibralic","doi":"10.1007/s10488-026-01500-2","DOIUrl":"10.1007/s10488-026-01500-2","url":null,"abstract":"<div><p>Recent decades have seen emergence of numerous evidence-based early parenting interventions. To make an impact at a population level, they need to be delivered at scale. This study aimed to identify factors that enable successful scaling of early parenting interventions for sustainable implementation and impact. Participants were 22 individuals from the United States of America, Australia, Korea and the Netherlands, all who had experience in the development, implementation dissemination and/or scaling of early parenting interventions. Participants completed in-depth interviews about their experiences or observations of scaling early parenting intervention, and enablers and barriers to successful scaling. Transcripts were analysed using thematic analysis. Results revealed <b>s</b>ix key themes: (1) adopting a business mindset, including sustainable funding and governance models; (2) securing multi-level stakeholder buy-in, from clinicians to policymakers; (3) implementing flexible, context-sensitive models that support fidelity and adaptation; (4) ensuring intervention quality, including evidence-based design and cultural relevance; (5) assembling multidisciplinary teams with the necessary expertise and leadership; and (6) time and planning. Results suggest that scaling early parenting interventions is a dynamic, non-linear process that can take considerable time and planning. Scaled interventions need to be evidence-based and culturally relevant, but there also needs be a sound business model, widespread stakeholder involvement, and strong leadership. Sensitivity and flexibility to meet the needs of local contexts are also vital. Taken together, this study offers actionable insights for policymakers, funders, and practitioners seeking to expand the reach and impact of early parenting interventions within diverse service systems.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"338 - 352"},"PeriodicalIF":2.6,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-026-01500-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621488","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":"Enhancing Clinical Depression Treatment Outcomes: A Comprehensive Approach Using Measurement-Based Care, Research Benchmarks, and Systematic Quality Improvements","authors":"Fabian Lenhard,&nbsp;Lisa Wahlström Amnéus,&nbsp;Ida Viklund,&nbsp;Erik Andersson,&nbsp;Lars-Göran Öst","doi":"10.1007/s10488-026-01499-6","DOIUrl":"10.1007/s10488-026-01499-6","url":null,"abstract":"<div>\u0000 \u0000 <p>Depression is a leading cause of global disease burden. Although psychotherapy and pharmacotherapy effectively reduce depressive symptoms, access to high-quality care remains limited. This study examined whether a Continuous Quality Improvement (CQI) process incorporating measurement-based care and benchmarking could enhance depression treatment outcomes in specialized mental healthcare. Data were drawn from two outpatient mental health clinics in Stockholm, Sweden. First, patient-reported outcome measures (PROMs) were used to compare local clinical results with a meta-analytic benchmark. Next, a CQI framework was implemented to improve outcomes. The sample included 415 patients receiving treatment for depression. Compared to the benchmark, the clinical sample had higher pre-treatment depression severity, attended more appointments, and had lower data attrition. Initial year-to-year analyses showed that treatment effects were significantly lower than the benchmark (Hedge’s g = 0.87–1.01 vs. g = 1.51). After implementing the CQI process, treatment effects improved (g = 1.25–1.27) and were no longer inferior to the benchmark. These findings suggest that integrating measurement-based care, benchmarking, and CQI can improve depression treatment outcomes in specialized settings and may help close the gap between real-world care and evidence-based standards.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 4","pages":"329 - 337"},"PeriodicalIF":2.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-026-01499-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580298","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":"Latent Profile Analysis of Distinct Patterns of Treatment and Assessment Practices among Youth Mental Health Providers","authors":"Evelyn Cho,&nbsp;Kristin M. Hawley","doi":"10.1007/s10488-026-01498-7","DOIUrl":"10.1007/s10488-026-01498-7","url":null,"abstract":"<div>\u0000 \u0000 <p>Evaluations of youth mental health providers’ treatment and assessment practices have largely examined trends in evidence-based treatment (EBT) and standardized measures use separately. Evidence-based practice (EBP) integrates EBTs with accurate, valid assessment. Thus, there is a need to understand how individual providers integrate treatment and assessment practices in routine care. To address this gap, the current study used latent profile analysis to derive distinct profiles of assessment and treatment practices, identified provider and practice settings characteristics that predict profiles, and compared provider-reported top influences on their current practices between profiles. In a multidisciplinary national survey, 1,092 youth mental health providers self-reported their assessment (i.e., use of standardized, unstandardized assessment measures) and treatment (i.e., strategies common across EBTs for multiple problem areas, strategic specific to EBTs for a single problem area, and strategies not included in EBTs for any of the problem areas) practices. Four distinct profiles were identified. The largest profile, “EBT Eclectics” (73%), reported a mix of common and specific EBT and other treatment strategies and unstandardized measures, but minimal standardized measures use. The profile that most closely resembled EBP, “EBP Integrationists” (17%), reported frequent use of common and specific EBT strategies alongside some standardized measures use. The two smaller profiles were differentiated by their relative use of specific EBT (“Key Ingredients Specialists”, 6%) and other treatment strategies (“Generalists”, 5%). Profiles were differentiated by provider and practice characteristics, and provider-reported top influences. Findings highlight future directions to enhance EBP in routine care settings.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"304 - 321"},"PeriodicalIF":2.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-026-01498-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519694","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 Impact of Incentives and Programmatic Changes on the Uptake of Evidence-Based Training for Public Sector Youth-Serving Mental Health Providers","authors":"Robert William Garvey,&nbsp;Kimberly Eaton Hoagwood,&nbsp;Elena Conte,&nbsp;Andrew Cleek,&nbsp;Meaghan Baier,&nbsp;Nicole Wang,&nbsp;Aleta Angelosante,&nbsp;Sarah McCue Horwitz","doi":"10.1007/s10488-026-01497-8","DOIUrl":"10.1007/s10488-026-01497-8","url":null,"abstract":"<div>\u0000 \u0000 <p>Despite recent increases in youth mental health challenges, the lack of training in evidence-based treatments (EBTs) has led to alarmingly low rates of their use in public systems. Several states have responded with significant investments in EBT training or technical assistance, but fewer than one-quarter have established incentives to encourage attendance. This study examined the impact of incentives and programmatic changes on participation in a state-wide training initiative for clinicians serving children and youth. Data were drawn from a large cohort of clinicians employed at large Mid-Atlantic state funded youth-serving agencies (<i>N</i> = 3,897) who participated in trainings between 2014 and 2024. The study analyzed the effects of financial incentives, free CEUs, and programmatic changes, including virtual delivery and a briefer training option, on provider engagement, return attendance, dropout rates, and geographical diversity. Varied training options appealed to trainees of different ages and experience levels. Participants in the full MAP training tended to be younger (M = 37.24 ± 11.06) and earlier in their careers (17.44% with &lt; 1 year of experience) compared to participants in the briefer trainings. CEUs were associated with lower dropout rates in the full training (<i>p</i> &lt; .001) but had no impact on briefer trainings. CEUs also attracted younger (33.49 ± 9.65), less experienced trainees (3.88 ± 4.09). Financial incentives to agencies reduced dropout rates (18.90% vs. 51.30%; <i>p</i> &lt; .001) and expanded geographical diversity, attracting more participants from regions outside of the Metropolitan Region (<i>p</i> = .01). Incentives and programmatic modifications can affect participation rates of experienced vs. less experienced clinicians, encourage repeat attendance, reduce dropout rates, and broaden geographical reach. These strategies can inform future training initiatives designed to overcome systemic barriers to EBT adoption in public mental health systems.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"293 - 303"},"PeriodicalIF":2.7,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508569","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":"Mental Health-Related Disabilities, Healthcare Utilization, and Access in Young Adults with Anxiety and Depression: A Scoping Review","authors":"Sandy Rao,&nbsp;Gina Dimitropoulos,&nbsp;Katrina Milaney,&nbsp;Dean T. Eurich,&nbsp;Scott B. Patten,&nbsp;The HEARTS Study Coresearchers","doi":"10.1007/s10488-026-01494-x","DOIUrl":"10.1007/s10488-026-01494-x","url":null,"abstract":"&lt;div&gt;&lt;p&gt;Young adults with anxiety and depression often experience mental health-related disabilities (MHRD) that impair social, academic, occupational and daily functioning. These impairments, while significant, are frequently invisible, episodic, or lacking formal recognition; factors that limit their acknowledgment within healthcare systems designed to respond to more visible or diagnostically stable conditions. As MHRD rates among young adults rise there remains limited evidence on how functional impairments shape access to care. This scoping review examines peer-reviewed research on healthcare access and utilization for young adults aged 18 to 30 with anxiety and/or depression, with particular attention to how disability and functional impairment are defined, measured, and operationalized. The review was guided by the JBI (formerly Joanna Briggs Institute) methodology for scoping reviews and reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The finalized search strategy was applied across four major databases: MEDLINE, CINAHL, PsycINFO, and Embase, covering all available years from 2013 to February 27, 2025. Studies were eligible if they examined access or utilization of healthcare services for young adults with anxiety and/or depression and addressed disability or functional impairment either directly or through related constructs. Only peer-reviewed articles published in English were included. A total of 20 studies met the inclusion criteria and were analyzed using descriptive and pre-defined classifications. Findings reveal that while access barriers are consistently reported, disability and functional impairment are rarely examined through frameworks that center disability as a primary analytic focus. Instead of drawing on established tools or models designed to assess impairment and functioning, many studies relied on diagnostic categories or symptom scales as indirect proxies. This limited the conceptual clarity and comparability of findings across studies. The invisibility of MHRD was rarely named, but evident in how inconsistently impairments were defined, measured, or accommodated. Across studies, impairments were most commonly reported in relation to interpersonal functioning, learning, cognition, and emotional regulation. Despite the diversity of health system contexts represented, including universal and insurance-based models, access inequities persisted across settings. Notably, few studies engaged youth or young adults with lived experience in the research process, and very few applied social theories or disability frameworks to guide their analysis.This review highlights a disconnect between how MHRD is experienced and how it is represented in the research evidence. While there is growing awareness of these limitations, few studies have moved beyond identification of gaps. Advancing access for this population will require greater theoreti","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"262 - 280"},"PeriodicalIF":2.7,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479520","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":"Analysis of real-world scale-up processes for school-based mental health interventions","authors":"Kristel Jenniskens,&nbsp;Sanne Rasing,&nbsp;Daan Creemers,&nbsp;Arne Popma,&nbsp;Rixt Smit,&nbsp;Dominique van Pelt,&nbsp;Leonie van Vuuren,&nbsp;Saskia Mérelle,&nbsp;Jan Spijker,&nbsp;Femke van Nassau","doi":"10.1007/s10488-026-01491-0","DOIUrl":"10.1007/s10488-026-01491-0","url":null,"abstract":"<div>\u0000 \u0000 <p>The global rise in adolescent anxiety, depression, and suicidality has intensified calls for large-scale implementation of effective school-based interventions. This study examined determinants and strategies for scaling up school-based interventions targeting these mental health concerns. A mixed-methods approach was used, involving authors of published school-based mental health intervention trials. Of these, 45 authors completed a survey on scale-up decisions, intentions, and strategies. Determinants and strategies were further explored through 12 in-depth interviews. In our analysis of survey data, we identified interventions that were implemented on a small- or large-scale. In our analysis of interview data, we identified discontinued-, in the process of being scaled-up-, and scaled-up interventions. Half of the interventions surveyed reported intentions to scale up. Determinants for scale-up according to participants fell into three themes: (1) intervention characteristics (e.g., evidence base), (2) resources and support (e.g., availability of financial resources), and (3) school context (e.g., alignment with school curricula). The most relevant strategies for scaling up the included interventions were intervention registries for dissemination, adapting interventions to new settings, establishing organizational structures, and assessing/reducing costs. Our findings highlight strategies that potentially contribute to successfully scale-up of school-based mental health interventions. To enhance impact, we recommend applying such strategies – such as leveraging intervention registries and creating organizational support.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"224 - 239"},"PeriodicalIF":2.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-026-01491-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388951","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":"Integrating Primary Care and Mental-Health Care: A Commentary on the Collaborative Care Model and the Psychiatry Consultation Clinic Model","authors":"Robert E. Drake,&nbsp;Jill I. Blumberg","doi":"10.1007/s10488-026-01496-9","DOIUrl":"10.1007/s10488-026-01496-9","url":null,"abstract":"<div>\u0000 \u0000 <p>Many patients with mental health conditions receive treatments in primary care settings rather than in specialty mental health settings. Although the Collaborative Care Model offers an evidence-based approach to integrating mental health care within primary care, it has implementation problems, and other models, such as the Psychiatric Consultation Model, have emerged as alternatives needing further research. We used a Google search and our own experiences to review Collaborative Care and alternative approaches, highlighting barriers to integrating mental and physical health care in the U.S. and recommending evidence-based approaches to developing models such as the Psychiatric Consultation Model. Integration of mental and physical health care in the U.S. requires addressing three fundamental concerns: weaknesses of the biomedical model, lack of rigorous research (for approaches other than Collaborative Care), and system implementation issues. To create effective integration of mental and physical health care in the U.S., the field needs further development of alternatives to Collaborative Care, rigorous research, and fundamental changes in the U.S. health-care system. </p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"322 - 327"},"PeriodicalIF":2.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388954","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":"Evaluating Evidence-Based Psychotherapy Utilization Patterns Among Suicide-Risk-Stratified Veterans Diagnosed with Major Depressive Disorder","authors":"Maxwell Levis,&nbsp;Monica Dimambro,&nbsp;Joshua Levy,&nbsp;Brian Shiner","doi":"10.1007/s10488-026-01495-w","DOIUrl":"10.1007/s10488-026-01495-w","url":null,"abstract":"<div>\u0000 \u0000 <p>Major depressive disorder (MDD) is a leading risk factor for death by suicide. To better treat MDD, and reduce suicide risk, the US Department of Veterans Affairs, prioritizes a range of psychotherapeutic treatments, including MDD specific evidence-based psychotherapies (EBPs). To better understand the utilization of these interventions, and these interventions’ roles in suicide prevention, this study investigates a national sample of MDD-diagnosed VA patients who died and did not die by suicide in 2017 and 2018. The study used a dataset of VA patients diagnosed with MDD who died by suicide and received psychotherapy in the year before death (cases) and patients who had comparable diagnoses, demographics, and received psychotherapy during the same interval and remained alive (controls). Each case was matched with 10 controls who shared the same VA’s suicide risk algorithm risk score. The study tracked non-differentiated psychotherapy and MDD EBP, analyzed cases and controls’ utilization rates across risk-tiers (high, moderate, low), and conceptualized eight sessions as the minimum adequate treatment. Our final sample included high-risk (cases = 257; controls = 2570), moderate-risk (cases = 428 cases; controls = 4280), and low-risk (cases = 53; controls = 529) patients. No groups received adequate session count. MDD EBP utilization was markedly low, especially among cases, with &lt; 1% of the high-risk sample receiving adequate sessions. Higher proportions of moderate- and low-risk controls received MDD EBP and received more sessions than matched cases. Even with VA efforts to promote EBPs, within our sample, MDD EBP usage was limited, particularly among patients who died by suicide. Further research is needed to understand utilization barriers and improve MDD EBP delivery to better support suicide prevention.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"281 - 292"},"PeriodicalIF":2.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353494","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":"Sustainment of Four Evidence-Based Treatments for Patients with Psychosis: A Prospective Cohort Study in Norway","authors":"Torleif Ruud,&nbsp;Robert E. Drake,&nbsp;Maria Lie Selle,&nbsp;Miriam Hartveit,&nbsp;Karin Drivenes,&nbsp;Kristin Heiervang,&nbsp;Tordis S. Høifødt,&nbsp;Vegard Ø. Haaland,&nbsp;Inge Joa,&nbsp;Jan Olav Johannessen,&nbsp;Karl Johan Johansen,&nbsp;Bjørn Stensrud,&nbsp;Espen Woldsengen Haugom,&nbsp;Hanne Clausen,&nbsp;Eva Biringer,&nbsp;Gary R. Bond","doi":"10.1007/s10488-026-01493-y","DOIUrl":"10.1007/s10488-026-01493-y","url":null,"abstract":"<div><p>Research on sustainment of implemented evidence-based practices (EBPs) for people with psychosis has been limited in mental health services. This prospective cohort study extended a cluster-randomized trial (trial registration number NCT03271242) of implementation of four EBPs in Norwegian mental health services. In the trial 39 clinical units were randomized to receive implementation support for one of two chosen EBPs. This study aimed to measure sustainment for two biological EBPs (physical health care, antipsychotic medication management) and two psychosocial EBPs (family psychoeducation, illness management and recovery), and to explore factors influencing sustainment. Fidelity to the EBP with implementation support was measured after 18 months of implementation support and at 36 months (18 months post-implementation), additionally key informants reported factors influencing sustainment. Among 27 sites with high or moderate fidelity at 18 months, 20 (74%) sustained the practice at the same or higher level at 36 months; 10 of 13 sites, most with psychosocial EBPs, sustained high fidelity, and 10 of 14 sites, most with biological EBPs, sustained moderate fidelity. Sustaining sites demonstrated significantly greater efforts to continue the EBP, while non-sustaining sites encountered greater barriers including leadership change or key clinician turnover. With efforts to continue the EBP, most sites sustained the practice with high fidelity for psychosocial EBPs and moderate fidelity for biological practices. A clinical director or champion determined to continue the practice together with a trained clinical staff were the two main ingredients for sustainment.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"251 - 261"},"PeriodicalIF":2.7,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-026-01493-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353438","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":"Sex Difference in Risk and Protective Factors of State Psychiatric Hospital Readmissions among Non-forensic Psychiatric Patients in the United States in 2020—2023: Discrete-Time Hazard Models Applied To the National Mental Health Client-Level Data","authors":"Kanako Ishida,&nbsp;Makayla Ogdahl,&nbsp;Joy Binion,&nbsp;Nathan Donnelly","doi":"10.1007/s10488-026-01492-z","DOIUrl":"10.1007/s10488-026-01492-z","url":null,"abstract":"<div>\u0000 \u0000 <p>Researchers and policymakers use hospital readmission rates as measures of health care quality and cost. This study used the Mental Health Client-Level Data (MH-CLD) to document hospital readmission rates and determinants of readmission for female and male patients discharged from state psychiatric hospitals across 36 U.S. states and Puerto Rico between 2020 and 2023. The results show that the readmission rate was significantly higher among males than among females at 30 days (7.8% vs. 7.1%) and throughout the 26-week post-discharge observation period. Based on discrete-time hazard models applied to discharge-week panel data constructed from discharge data from 110,353 unique patients, the most important common risk factors for both sexes were being Hispanic, a diagnosis of schizophrenia or other psychotic disorders or bipolar disorder, co-occurring substance use problems, and having a serious mental illness (SMI). However, a diagnosis of depressive disorders increased the likelihood of re-hospitalization only among males and a diagnosis of bipolar disorder increased the likelihood of re-hospitalization more substantially for males than females. Being married was a common protective factor for both sexes, but its effect was significantly greater for males. Other significant sex differences included Black male patients having a higher likelihood of readmission than their White counterparts, but this was not observed among Black female patients. Involuntary admission had opposite effects by sex: it increased the likelihood of readmission for females but decreased it for males. Consideration of the types and length of treatment at hospitals and post-discharge care may provide insight into these sex differences.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"240 - 250"},"PeriodicalIF":2.7,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146256954","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}