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

{"title":"Optimal and Minimal Doses of Acceptance and Commitment Therapy to Improve Psychological Distress: A Meta-Analysis, Meta-Regression, and Subgroup Analysis of Controlled Trials","authors":"Habibolah Khazaie,&nbsp;Azad Maroufi,&nbsp;Amirhossein Khazaie,&nbsp;Saeid Komasi,&nbsp;Mohammad Taghi Yasamy","doi":"10.1007/s10488-026-01490-1","DOIUrl":"10.1007/s10488-026-01490-1","url":null,"abstract":"<div><p>Optimal doses of psychotherapy prevent overtreatment and help mental health service managers better allocate resources and tailor treatment to fit individual needs. This meta-analysis originally aimed to evaluate the optimal and minimal doses of acceptance and commitment therapy (ACT) to improve overall psychological distress (anxiety, depression, and stress). PubMed, Scopus, and PsycNET databases were systematically searched to discover eligible studies until October 2024. More manual searches were conducted using Google Scholar. Due to heterogeneity, standard mean differences (Cohen’s <i>d</i>) were estimated using the random-effects method. Meta-regression and subgroup analyses were used to explore some potential moderators. Analysis of data from 91 studies (6,639 people) from 20 different regions showed that ACT moderately (<i>d</i> = –0.46, <i>p</i> &lt; .001) reduced psychological distress with stable improvements (<i>d</i> = –0.31, <i>p</i> &lt; .001) over time. Meta-regression analysis indicated that the pooled estimates were influenced by seven moderators, including age, gender, control type, population type, geographic region, risk of bias, and study year. Additionally, psychological distress was significantly reduced in 9 of the 17 treatment doses studied, with 8 sessions identified as optimal and 4 sessions as minimal. We conclude that the improvements in the outcome across optimal and minimal doses of ACT are remarkable and relatively stable over time. Evaluating optimal doses of ACT for other psychological outcomes will be the target of future meta-analyses.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"211 - 223"},"PeriodicalIF":2.7,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211930","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":"Partnering for Success: Provider Perspectives of an Inter-agency Initiative between Child Welfare and Mental Health Systems","authors":"Geetha Gopalan,&nbsp;Suzanne Kerns,&nbsp;Maria Jose Horen,&nbsp;Jennie Lowe","doi":"10.1007/s10488-026-01489-8","DOIUrl":"10.1007/s10488-026-01489-8","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;p&gt;The Partnering for Success (PfS) inter-agency initiative was implemented in the U.S. to ensure children involved in child welfare (CW) services received effective mental health (MH) treatments. CW strategies included use of standardized MH screening assessments, facilitating referrals to MH treatment, and tracking MH treatment progress. MH providers were trained in Cognitive Behavioral Therapy – Plus Trauma-Focused CBT (CBT +), which targets common child MH disorders (i.e., anxiety, behavioral difficulties, depression, traumatic stress). A web-based monitoring system, ongoing consultation, joint training, inter-agency team meetings, and post-training transfer activities further supported implementation. This study presents the perspectives of CW and MH frontline, supervisory, and administrative staff regarding the perceived benefits and challenges of implementing PfS. CW (n = 15) and MH (n = 14) staff from the first three PfS implementation cohorts (2014–2017) participated in n = 6 focus groups and n = 10 individual interviews (60–90 min long) conducted via audio-recorded web-based conference calls. Throughout the analysis process, authors used Consensual Qualitative Research strategies. The current study focused on questions related to providers’ perceived benefits and challenges when using PfS (i.e., What are the benefits of using the PfS model in your practice? What are the challenges?). Providers perceived benefits and challenges along five core ideas: practice change, workload burden, referrals, client engagement, and provider engagement. Providers reported improved frontline, supervisory, and interprofessional practice which enhanced client care and symptom reduction. However, limited training opportunities and individual provider characteristics limited agency-wide practice change. CW and MH staff reported mixed reactions regarding the influence of PfS on workload burden: while some tasks became easier, PfS also generated additional work. Workload burden also increased due misalignment with MH billing structures, provider characteristics, turnover, and client crises. Providers reported an enhanced and expedited referral process as more MH therapists were trained. However, limited training, high turnover, provider and client characteristics hampered processes. PfS resources and tools, and the time-limited nature of CBT + , engaged clients, while families struggling with child behavioral problems were hardest to engage. Provider engagement grew as more providers became trained, observed PfS benefits, and shared experiences. However, more experienced providers expressed greater difficulties engaging in PfS and altering practice, compared to less experienced providers. Findings are situated within the Practical, Robust, Implementation, and Sustainability Model (PRISM) framework to support broader applicability, alignment with prior research, and further refinement of the PRISM conceptual model. The combina","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 3","pages":"189 - 210"},"PeriodicalIF":2.7,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211911","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":"Correction to: The Potential Role of Peer Support Workers in General Practice: Perspectives of Consumers, Carers, Peer Support Workers and General Practice Staff","authors":"Sharon Lawn,&nbsp;Megan Rattray,&nbsp;Belinda Fuss,&nbsp;Tania Shelby-James,&nbsp;Louise Byrne,&nbsp;Paul Worley,&nbsp;Sam Manger,&nbsp;Geoff Harris,&nbsp;Bill Gye,&nbsp;Amaya Alvarez,&nbsp;Daya Henkel,&nbsp;Paul Creedon,&nbsp;Tony Stevenson,&nbsp;Vivian Isaac,&nbsp;Billy Kaambwa,&nbsp;Shahid Ullah,&nbsp;Caroline Phegan","doi":"10.1007/s10488-026-01488-9","DOIUrl":"10.1007/s10488-026-01488-9","url":null,"abstract":"","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 2","pages":"142 - 143"},"PeriodicalIF":2.7,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091669","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 Structural Functional and Experiential Model of Defining Community: Transferability To Suburban Adults with Serious Mental Illnesses","authors":"Melissa E. Smith,&nbsp;Rohini Pahwa","doi":"10.1007/s10488-026-01487-w","DOIUrl":"10.1007/s10488-026-01487-w","url":null,"abstract":"<div>\u0000 \u0000 <p>Adults with serious mental illnesses (SMIs) in the United States are increasingly residing in non-urban settings such as suburban and rural communities. A variety of positive and negative factors of non-urban settings (e.g., access to nature; lack of overcrowding; a culture of social support and cohesion; stigma fueled by decreased opportunities for informal interactions with individuals with SMIs) suggests that non-urban residents with SMIs may have a qualitatively different understanding of community than their urban counterparts. Using principles of Constructivist Grounded Theory and Framework Analysis, the aim of the current study was to explore how suburban residents with SMIs define their communities and to enhance the transferability of a Structural-Functional-Experiential (SFE) model of defining community by incorporating their experiences into the urban-based model. Fifteen racially/ethnically diverse adults with SMIs receiving Assertive Community Treatment in Montgomery County, MD were interviewed between January and July 2019. Semi-structured interviews were audio-recorded, transcribed, and analyzed using ResearchTalk’s “Sort and Sift, Think and Shift” methodology. Participants’ definitions of community aligned with the majority of their urban counterparts’ definitions including structural communities defined as people and places, functional communities that enhanced support, help and socialization; and experiential communities that included shared experiences and the importance of feeling safe. Within the SFE model, participants shared some notable differences in their definitions of community including virtual spaces (structural); reciprocal help (functional); and fostering positive feelings and shared interests (experiential). Implications for community-based practice with suburban residents with SMIs and transferability of the SFE model in non-urban settings is discussed.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 2","pages":"173 - 187"},"PeriodicalIF":2.7,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091718","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":"Transforming Mental Health Service Delivery in Schools: Recommendations for Implementation of a Cross-System Collaborative Approach","authors":"Tali Raviv,&nbsp;Mira Snider,&nbsp;Saadia Elahi,&nbsp;Mashana Smith,&nbsp;Rimma Ilyumzhinova,&nbsp;Katherine Calderon,&nbsp;Tarrah DeClemente,&nbsp;Kathryn Ramirez-Mercado,&nbsp;Alexandra Sontag,&nbsp;Colleen Cicchetti","doi":"10.1007/s10488-025-01486-3","DOIUrl":"10.1007/s10488-025-01486-3","url":null,"abstract":"<div><p>Amid the alarming prevalence of youth mental health concerns and limited capacities of communities to provide adequate mental health services, there is an urgent need for increased collaboration between education and health sectors to effectively address the mental health needs of students in the U.S. This paper describes a cross-sector approach to integrating individually operating behavioral health service delivery systems across public health, education, and community mental health partners in Chicago, Illinois to establish a coordinated city-wide school mental health service system. A primary component of this work was a comprehensive landscape analysis comprised of literature reviews, service agreement reviews, survey data, structured interviews and listening sessions with strategically selected individuals from key departments and agencies across the city. Findings from the landscape analysis identified gaps and opportunities for increased efficiency between sectors. The foundation for a collaborative working relationship was also laid between the city school district and the department of public health to facilitate a pilot of implementation plans that emerged from the landscape analysis. In addition to elucidating our learnings from the landscape analysis procedures and findings, this paper summarizes generalizable recommendations to inform leaders in health and education who are committed to promoting integrated behavioral health service delivery systems in their own communities.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 2","pages":"156 - 172"},"PeriodicalIF":2.7,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028174","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 Qualitative Study Exploring the Lived Experience of Caregivers’ Attending Child and Adolescent Mental Health Services (CAMHS)","authors":"Laura Bond,&nbsp;Aoife Gordon,&nbsp;Rebecca Parkin,&nbsp;John Hayden,&nbsp;Suzanne Guerin,&nbsp;Fiona McNicholas","doi":"10.1007/s10488-025-01485-4","DOIUrl":"10.1007/s10488-025-01485-4","url":null,"abstract":"<div><p>Child and Adolescent Mental Health Services (CAMHS) are specialist, publicly funded services that play a vital role in supporting young people with moderate to severe mental health needs. In Ireland, and internationally, CAMHS face enduring systemic pressures, including underinvestment, workforce shortages, and long waits for assessment and intervention. Caregivers are central to service engagement, acting as advocates and coordinators of care, yet their perspectives remain underrepresented in the literature. Understanding caregiver experiences is essential to improving quality, strengthening therapeutic relationships, and shaping meaningful reform. To explore the lived experiences of caregivers engaging with CAMHS in Ireland and to examine the relational, systemic, and structural factors shaping these experiences. Reflexive thematic analysis (RTA) was used to analyse semi-structured interviews and focus groups. A qualitative study design was employed, with participants purposively sampled following a national caregiver survey. Data collection and analysis were iterative and reflexive across all stages. Twenty-two caregivers participated, generating six interrelated themes: (1) When CAMHS Works: Feeling Seen, Heard, and Supported, (2) Barriers to Communication and Trust: Caregiver–Clinician Disconnects, (3) Fragmented and Standardised Care: Impacts on Continuity and Engagement, (4) Limited Access and Inadequate Crisis Response, (5) Workforce and Infrastructure Deficits, and (6) Neuroinclusion Gaps: Barriers for Autistic and Neurodivergent Young People. These findings illustrate how structural and relational challenges shape caregiver experiences and inform priorities for CAMHS reform. Caregivers described fragmented care, poor communication, and limited neuroinclusion, exacerbated by staff shortages, service fragmentation, and inconsistent support. Positive examples were rare but highlighted the value of relational, family-centred practice. The findings underscore the need for structural reform alongside a cultural shift toward more inclusive, family-centred and neurodiversity-informed CAMHS, in line with international calls for accessible, high-quality youth mental health services.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 2","pages":"144 - 155"},"PeriodicalIF":2.7,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809218","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":"Validation of the Implementation Climate Scale (ICS) in a Community-Based Learning Collaborative","authors":"Elizabeth Lane,&nbsp;Grace Woodard,&nbsp;Amanda Jensen-Doss,&nbsp;Adriana Novello","doi":"10.1007/s10488-025-01483-6","DOIUrl":"10.1007/s10488-025-01483-6","url":null,"abstract":"<div>\u0000 \u0000 <p>Implementation climate is a key determinant of successful adoption (Ehrhart et al. in Evid Based Nurs 18(2):85–92, https://doi.org/10.1111/wvn.12500, 2014). Previous studies examined the Implementation Climate Scale (ICS) across diverse contexts, with mixed findings on its factor structure, particularly concerning the Rewards for EBP subscale (Ehrhart et al. in Child Abuse Neglect 53:17–26, https://doi.org/10.1016/j.chiabu.2015.10.017, 2016, Subst Abuse Treat Prev Policy 14(1):35, https://doi.org/10.1186/s13011-019-0222-52019, 2019, Peters et al. in BMC Health Serv 22(1):1–11, https://doi.org/10.1186/s12913-021-07441-w, 2022, Lyon et al.in Implement Sci 13:1–14, https://doi.org/10.1186/s13012-017-0705-6, 2018; Engell et al. in Child Youth Serv Rev 119:105509, https://doi.org/10.1016/j.childyouth.2020.105509, 2020). This study replicated and extended prior research by evaluating the psychometric properties of the ICS in a sample of 255 participants in a community-based learning collaborative that trained providers in Trauma-Focused Cognitive Behavioral Therapy and Trauma-Focused Case Management. Confirmatory factor analyses assessed the original six-factor structure, a five-factor model omitting the Rewards for EBPs subscale, and second-order latent factor models. Both six- and five-factor models demonstrated acceptable fit; however, the five-factor model was selected due to the Rewards subscale’s poor endorsement, weak correlations, and limited relevance in community mental health settings. A chi-square difference test between the five-factor first- and second-order models revealed no significant difference in fit (χ²diff(5) = 11.01, <i>p</i> &gt; .05), supporting the use of the five-factor second-order structure given comparable fit and the theoretical advantage of an ICS total score. These findings validate the use of the ICS in community mental health settings across provider types and suggest that omitting the Rewards subscale may improve applicability and interpretability, particularly in resource-limited environments. Future research should further explore alternative incentive structures in resource-limited contexts and examine the impact of policy and financial incentives on the perceived relevance of the Rewards subscale.</p>\u0000 </div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 1","pages":"115 - 123"},"PeriodicalIF":2.7,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779825","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":"Methodologies Employed in Economic Evaluation of Suicide Prevention Interventions: A Scoping Review","authors":"Linda Ryen,&nbsp;Elin Vimefall","doi":"10.1007/s10488-025-01481-8","DOIUrl":"10.1007/s10488-025-01481-8","url":null,"abstract":"<div><p>Economic evaluations can be a powerful tool to assist policymakers in prioritizing interventions to reduce the number of suicides. However, the number of economic evaluations of suicide prevention is low and their quality vary. The aim of this paper is to review the literature on economic evaluations for suicide prevention, specifically focusing on the methods used to measure and value the effect of interventions. To identify articles, we searched PubMed, Web of Science and Scopus for the period from 2000 to 2023. Since the aim was to investigate how a reduction in the number of suicides is measured and valued when evaluating suicide prevention interventions, we only included studies containing effects on mortality. In total 560 unique hits were identified. Most studies were excluded after the first screening of abstracts and titles. The most common reason for exclusion was that the study did not evaluate an intervention for suicide prevention. The final analysis included 16 studies. The number of economic evaluations of suicide prevention is still low, but there is a positive trend and methodological improvements have been made. Nevertheless, several areas where more research is needed were identified, regarding both how to measure and value the effect.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 1","pages":"64 - 76"},"PeriodicalIF":2.7,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-025-01481-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145706899","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":"Mix and MATCH: The use of a Modular Approach for Youth Psychotherapy in Routine Clinical Care and Associations with Outcomes","authors":"Phyllis Lee,&nbsp;Jason M. Lang","doi":"10.1007/s10488-025-01484-5","DOIUrl":"10.1007/s10488-025-01484-5","url":null,"abstract":"<div><p>The Modular Approach to Therapy for Children (MATCH) consists of individual evidence-based components (modules) that clinicians can flexibly select to target a range of emotional and behavioral symptoms. The treatment manual includes flowcharts that outline a sequence of modules recommended for each problem area: anxiety, depression, and conduct problems. This study explored the use of modules and associations with outcomes for youths who received MATCH in routine clinical care. The sample included 964 youths ages 3–17 (51% female, 52% White, 35% Hispanic, 9% Black) with primary anxiety, depression, or conduct problems. Youths typically received modules from the MATCH flowchart for their primary problem as well as some modules from other problem areas. The use of more modules from the flowchart for the youth’s primary problem predicted greater clinician-rated improvement (Clinical Global Impressions-Improvement; CGI-I). In addition, youths with primary depression improved more when they received more modules from the anxiety flowchart and youths with primary conduct problems improved more when they received more modules from the depression flowchart, based on the CGI-I at the last timepoint. Providing more modules from the flowchart for a youth’s primary problem area predicted the severity of top problems (Top Problems Assessment; TPA) at the last timepoint for youths with primary depression (based on caregiver and youth report) and primary conduct problems (based on caregiver report). Results suggest that clinicians should generally use modules from the flowchart for the youth’s primary problem and incorporate modules from other problem areas to address additional concerns as needed.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 1","pages":"93 - 106"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653168","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 Literature Review on the Role of Paraprofessionals in Delivering Brief Psychological Interventions","authors":"Emily J. Lubin,&nbsp;Alice Xie,&nbsp;Mu-Yin Chang,&nbsp;Youngsuk Kim","doi":"10.1007/s10488-025-01482-7","DOIUrl":"10.1007/s10488-025-01482-7","url":null,"abstract":"<div><p>The global demand for mental health services exceeds available resources, particularly in low- and middle-income countries where access remains limited. Even in high-resource nations, many individuals still lack adequate care, a gap exacerbated by the COVID-19 pandemic. Brief psychological interventions (BPIs) offer a structured, short-term therapeutic approach to address this need. Typically delivered in fewer than ten sessions, BPIs incorporate evidence-based therapy components and can be administered by paraprofessionals, non-credentialed individuals trained to provide mental health support. This review synthesizes research on paraprofessionally delivered BPIs by describing study characteristics across populations, settings, and intervention modalities, characterizing the paraprofessional workforce, and summarizing reported mental health outcomes and patterns of effectiveness. A PsycINFO and PubMed search identified 47 articles, including 45 unique studies. To provide a clearer picture of effectiveness, box-score analyses were conducted on randomized controlled trials (RCTs) and pilot/feasibility RCTs. Findings indicate that paraprofessional-delivered BPIs, particularly those grounded in cognitive-behavioral therapy (CBT) and delivered remotely, are consistently effective across diverse populations and contexts. The evidence base is strongest for adult populations and posttraumatic stress disorder (PTSD) outcomes, with weaker support for adolescents and school-based programs. Paraprofessionals’ cultural and community alignment also enhanced engagement and reduced stigma-related barriers. Nonetheless, inconsistencies in training, supervision, intervention fidelity, and recruitment criteria present challenges for scalability. This review highlights the absence of a rigorously tested definition of BPIs and the lack of consensus on the term <i>paraprofessional</i>. It underscores the need for standardized training and supervision guidelines to ensure fidelity and sustainability. Further research is essential to refine best practices and optimize paraprofessionals’ integration into mental health systems, thereby improving accessibility and equity.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"53 1","pages":"77 - 92"},"PeriodicalIF":2.7,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534368","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}