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Radical Collaboration: Breaking Down Barriers, Driving Towards Equity

July 28, 2022

On Wednesday, July 20, NRI’s Senior Director of Consulting and Research, Jennifer Bronson, Ph.D. spoke at the Alliance for Health Policy’s 2022 Summit on Mental Health in America. She was a part of a panel on Radical Collaboration: Breaking Down Barriers, Driving Towards Equity that covered innovative ways in which stakeholders across multiple sectors are partnering to coordinate and integrate mental health and substance use disorder care. Dr. Bronson discussed the CCBHC model and how it can improve health equity and whole-person mental health care.

New Report By NRI Highlights Knowledge Gaps in Advanced Aging in Correctional Health

July 14, 2022

Current and projected shortages in healthcare staff impact the ability to hire psychological and neuropsychological professionals best suited to administer and interpret the findings of cognitive screeners within correctional health settings. NRI Research Associate, Lance Washington, recently published the journal article "Dementia and the Aging Population: Cognitive Screening Within Correctional Health" in the International Journal of Prisoner Health to highlight the knowledge gaps surrounding advanced aging in correctional health, cognitive screening, and the risk factors associated with dementia among older adults in jails and prisons across the world.

Some of the findings include 1) identifying correctional officers as useful candidates for additional health training on the use of cognitive screeners, 2) classifying adults with an age of 55 or older as older persons due to advanced aging stemming from correctional interpersonal and environmental stressors, and 3) promoting the use of the Montreal Cognitive Assessment (MoCA) as a cognitive screener due to the assessment’s sensitivity to detecting acute pathological differences between dementias (i.e., Alzheimer’s disease, frontotemporal dementia, etc.). Read the report.

Provision and Funding of Evidence-Based Services

June 30, 2022

One of the 15 new State Mental Health Profiles reports released by NRI focuses on the provision and funding of evidence-based services (EBPs). For decades State Mental Health Agencies (SMHAs) have worked towards incorporating EBPs—services that have been demonstrated to provide positive results—into their community-based mental health services. EBPs are designed for adults with serious mental illnesses (SMI) and children/adolescents with serious emotional disturbances (SED). SMHAs have implemented or are planning to implement a variety of EBPs for adults with SMI and children/adolescents with SED.

Among EBPs designed for adults with SMI, the most frequently implemented EBPs are assertive community treatment, supported employment, and supported housing. Among EBPs designed for children/adolescents, the most frequently implemented EBPs are trauma-focused cognitive behavior therapy, parent-child interaction therapy, and therapeutic foster care. SMHAs most commonly use state general funds, Medicaid, and the SAMHSA Mental Health Block Grant to pay for these EBPs. Local and other funds are used to a lesser extent to pay for EBPs. The greatest barriers to implementing EBPs are shortage of appropriately trained workforce, provider readiness, financing issues paying for EBPs, and attaining fidelity.

The new NRI state Profiles “Provision and Funding of Evidence-Based Services” report is available at This report is one of 15 new Profiles reports available to the public. SMHA staff have exclusive access to additional state-by-state information that are summarized in the public reports. For more information about the State Profiles System, please e-mail [email protected].

Early Interventions for Psychosis: First Episodes and High-Risk Populations

Individuals with first-episode psychosis who participated in a comprehensive, team-based treatment program experienced fewer symptoms, better quality of life, and fewer inpatient hospital days over five years than those who received usual care in the community, according to a report in Schizophrenia Bulletin.

On July 11, Ted Lutterman Senior Director of Government and Commercial Research at NRI will participate in the National Academy of Sciences, Engineering, and Medicine (NASEM)’s workshop on Early Interventions for Psychosis. This free public workshop that will examine the data on the epidemiology and outcomes for people at high risk for psychosis, for those who have experienced the first episode of psychosis, and will consider ways to improve the care for these individuals. The workshop will be accessible to the public via live webcast, as well as in-person. Learn more.

New Report Release, “Persons Living with Dementia and the Criminal Legal System”

June 16, 2022

Together with the American Bar Association and UVA, NRI’s Criminal Justice & Mental Health Research Center recently completed a year-long research study on people with dementia in the criminal legal system. NRI consultant, Dr. Debra A. Pinals, clinical Professor of Psychiatry and director of the Program in Psychiatry, Law, and Ethics at the University of Michigan was also a central figure on the research team. This mixed methods research included data analysis, law case review, and interviews with people who work in law enforcement, correctional facilities, the court system, and geriatric health in order to develop policy recommendations that will improve the experiences of people living with dementia in the criminal legal system.

Recommendations include developing civic pathways for diversion; evaluating and amending laws and policies that prohibit placement in otherwise appropriate care settings; institute screening for dementia for people over age 50 who are arrested and/or in correctional facilities; develop trainings for criminal legal actors to identify the signs of dementia; and develop and fund community-based placements that can facilitate the decarceration of this population. The full report “Persons Living with Dementia and the Criminal Legal System” is available at The research was funded by the RRF Foundation.

State Mental Health Agency Use of Medicaid to Provide Mental Health Services

June 2, 2022

One of the 15 new State Mental Health Profiles report released by NRI focuses on State Mental Health Agencies (SMHAs) use of Medicaid to provide mental health services. In Fiscal year 2020, Medicaid represented over 50% of the $45.9 billion dollars SMHAs expended to provide mental health services to over eight million clients. How SMHAs use Medicaid to pay for mental health services varies from state to state, with states using different combinations of Medicaid options, waivers, managed care, and fee-for-service approaches. In 35 states, the SMHA uses a combination of fee-for-service and managed care approaches to pay for mental health services.

Funding Approaches for Medicaid-Funded Mental Health Services

The new NRI state Profiles “State Mental Health Agency Use of Medicaid to Provide Mental Health Services” report is available at This report is one of 15 new Profiles reports available to the public. SMHA staff have exclusive access to additional state-by-state information that are summarized in the public reports. For more information about the State Profiles System, please e-mail [email protected].

GRAND Model Reduced Inpatient Hospitalizations Among GLMHC Adult Clients at Wagoner Hospital by 100 Percent

May 19, 2022

This report presents the findings of an independent evaluation of Grand Lake Mental Health Center’s (GLMHC) Grand Response Access Network on Demand Model (GRAND Model) for behavioral health care, conducted by NRI Senior Director of Consulting and Research, Jennifer Bronson, Ph.D and Research Associate, Lance Washington, MA. 

Number of GLMHC Adult Clients Who Went Inpatient to Wagoner Hospital

The GRAND Model consists of 1) Urgent Recovery Centers (URC) that provide 24/7 crisis stabilization services; 2) iPads with the GRAND Model integrated support access app that are distributed to GLMHC patients, first responders, hospitals, and other community partners in order to provide instant access to a GLMHC therapist anytime, anywhere; and 3) all iPad and crisis calls are answered by fully trained, engaged, and awake clinicians who are on-site at a URC. Findings showed that, since its implementation in 2016, the GRAND Model had reduced inpatient hospitalizations among GLMHC adult client at Wagoner Hospital from 841 (2015) to 0 (2021), a reduction of 100% (Figure 1). This and other findings are also available in a summary brief of the evaluation.

Assessing Violence Risk Using Standardized Measures and Their Application to Legal “Dangerousness”

May 5, 2022

One of the 15 new State Mental Health Profiles reports released by NRI focuses on standardized measures State Mental Health Agencies (SMHAs) use to assess risk of violence. SMHAs must often assess an individual’s risk of violence, whether in managing inpatient units, planning for patients who are transitioning to less restrictive service settings, or advising courts about a patient’s committability/eligibility for release. Eight percent of SMHA use a standardized instruments to assess risk of violence (dangerousness) of individuals sent to the state for treatment. SMHAs use standardized risk assessment tools to aid in determining clinical treatments, in determining services or conditions for patients under consideration for conditional release, in determining placement or security level of patients, as well as other uses such as providing diagnoses and treatment recommendations. The most frequently used standardized measure is Historical Clinical and Risk Management (HCR) 20 (used by 23 SMHAs).

Use of HCR or Other Standardized Dangerousness Instrument by States

This new NRI state Profiles “Assessing Violence Risk Using Standardized Measures and Their Application to Legal “Dangerousness” report is available at This report is one of 15 new Profiles reports available for the public. SMHA staff have exclusive access to additional information that are summarized in the public reports. For more information about the State Profiles System, please e-mail [email protected].

A SAMHSA-Sponsored Webinar: Telling the Story – Data, Dashboards, and the Mental Health Crisis Continuum

On Monday, May 9 from 12:00 to 1:00 pm ET, NRI and NASMHPD will kick-off a two-part, SAMHSA-sponsored webinar to discuss the critical data points state behavioral health authorities (SBHAs) use to understand the quality and effectiveness of their crisis systems. The webinar will feature presenters from SBHAs in Utah, Georgia, and Tennessee who will share how they use data and visualizations to tell the story of their crisis systems. The second part of the webinar, to be held on May 27 at 1:00 pm ET, will allow for intimate dialogue between presenters and only those participants from the first webinar. Register today!
On Thursday, May 12 from 3:00 to 4:00 pm ET SMI Adviser and NRI will present a webinar on Recognizing and Supporting the Value and Careers of Peer Support Specialists. This webinar brings together peers, providers, and state behavioral health authorities from Texas, Oregon, and Arizona to discuss their experiences and strategies in developing more sustainable wages and career opportunities for peers. Register here.


Use of Mobile Apps & Technology to Promote Behavioral Health and Wellness

April 21, 2022

Now more than ever, people turn to the internet and phone apps to understand and manage health issues, including behavioral health challenges. NRI and Michigan Health Endowment Fund presented a webinar on April 5, 2022 that identified popular apps designed to improve behavioral health and wellness symptoms; reviewed key considerations including efficacy, affordability, and privacy; and highlighted the use of apps by Michigan Health Endowment Fund grant partners. 

The webinar was lead by NRI Senior Project Associate, Kristin Neylon and features presentations by NRI Research Associate, Lance Washington; Garth Falkins, Care Resources PACE; and includes a presentation by John Torous, M.D., M.B.I., the Director of the Digital Psychiatry Division in the Department of Psychiatry at Beth Israel Deaconess Medical Center. 

Criminal Justice Diversion Programs for Justice-Involved Adults with Mental Illnesses

One of the 15 new State Mental Health Profiles reports released by NRI focuses on criminal justice diversion programs for justice-involved adults with mental illnesses. Diversion programs are generally designed to keep or divert people with mental illnesses out of the criminal justice system and link them to appropriate mental health and/or substance use services. Forty states have crisis response services such as mobile crisis and crisis respite within community mental health systems that are designed to redirect justice-involved adults with mental illnesses into treatment during a crisis and avoid arrests. Thirty-seven states have crisis response services such as crisis intervention teams and embedded co-responders within local law enforcement agencies.

Crisis response Services within Community Mental Health Systems

This new NRI state Profiles “Criminal Justice Diversion Program for Justice-Involved Adults with Mental Illnesses” report is available at This report is one of 15 new Profiles reports available to the public. SMHA staff have exclusive access to additional state-by-state information that are summarized in the public report. For more information about the State Profiles System, please e-mail [email protected]

Save the Dates: NRI Webinars Planned

On Thursday, May 12 from 3:00 to 4:00 OM Eastern SMI Adviser and NRI will present a webinar on Recognizing and Supporting the Value and Careers of Peer Support Specialists. 

Also in May, NRI, in partnership with NASMHPD, will facilitate a two-part webinar series,Telling the Story: Data, Dashboards, and the Mental Health Crisis ContinuumDetails are being finalized for this two-part webinar series.

If you are interested in learning more about these webinars, please contact Kristin Neylon at [email protected]

State Mental Health Agency Crisis Services

April 7, 2022

One of the 15 new State Mental Health Profiles reports released by NRI focuses on State Mental Health Agency (SMHA) crisis services. Behavioral health crises impact millions of individuals and families every year and developing a comprehensive evidence-based systems to help individuals experiencing a crisis is a top priority of local, state, and federal governments. Well organized and functioning comprehensive crisis systems can reduce suicide attempts, reduce injuries to persons in crisis and others they are interacting with, reduce criminal justice involvement, and assure timely initiation of appropriate behavioral health services. Crisis also serve a major role in increasing equity in access to behavioral health care. SMHAs are working to assure a continuum of crisis services are available to assist individuals experiencing behavioral health crisis. In 2020, 96% of SMHA funded 24-hour call centers/hotlines with 21 states reporting 1,380,691 individuals called their hotlines, an average of 65,747 calls per state; 94% of SMHAs funded mobile crisis services with 25 states reporting mobile crisis teams responded to over 374,916 individuals in crisis. SMHAs expended more than $1.8 billion supporting their behavioral health crisis service continuum.

State Support for Core Crisis Services

The new NRI State Profiles “State Mental Health Agency Crisis Services” report is available at This report is one of 15 new Profiles reports available to the public. SMHA staff have exclusive access to additional state-by-state information that are summarized in the public reports. For more information about the State Profiles system, please e-mail [email protected].

State Mental Health Agencies Control the Expenditures of Over $47.9 Billion to Provide Mental Health Services to More than 8.1 Million Individuals Each Year

March 24, 2022

One of the 15 new State Mental Health Profiles reports released by NRI focuses on FY 2019 expenditures and funding sources from every state, as well as trends in state expenditures for mental health. Over the past 20 years Medicaid has become the largest single funding source of SMHA funds at $20 billion, followed by state general and special revenues of $18.1 billion annually. Since FY 2001, Medicaid as a funding source of SMHAs has grown by an average of 4.8% per year, while state general and special funds have increased an average of 2.3% per year. In FY 2019, states expended $145 per resident, with a range from less than $74 per resident to a high of $463 per resident. Seventy-four percent of SMHA funds supported community mental health services, 24% of SMHA funds supported inpatient care in state psychiatric hospitals, and 2% of SMHA funds supported SMHA central and regional offices.

The new NRI State Profiles “FY 2019 State Mental Health Agency Revenues and Expenditures” report is available at This report is available to the public. SMHA staff have exclusive access to additional state-by-state information on total mental health expenditures, as well as details for state psychiatric hospitals, community mental health, as well as major funding sources.. For more information about the State Profiles System, please e-mail [email protected].

Organization and Funding of Community Mental Health Services

March 10, 2022

One of the 15 new State Mental Health Profiles reports released by NRI focuses on how State Mental Health Authorities (SMHAs) organize and fund community mental health services. SMHAs offer a variety of community-based mental health services including but not limited to mobile crisis, extensive/intensive outpatient treatment, outpatient testing and treatment, case management, and assertive community treatment. SMHAs utilize a variety of funding sources, including State General Funds, Medicaid, Medicare, Mental Health Block Grant, among other, to finance community-based mental health services. In FY 2020, SMHAs expended $32 billion on community-based mental health services and supports to over 7.8 million clients. SMHAs use a combination of mechanisms to administer and fund community-based mental health services, with the majority directly funding but not operating local community-based agencies.

Organization and Funding of Community Mental Health Services

The new NRI State Profiles “Organization and Funding of Community Mental Health Services” report is available at This report is one of 15 new Profiles reports available to the public. SMHA staff have exclusive access to additional state-by-state information on the number of clients served by SMHAs as well as SMHA initiatives to restructure the delivery of community mental health services. For more information about the State Profiles System, please e-mail [email protected].

Use of State Psychiatric Hospitals Across the United States

February 24, 2022

One of 15 new public State Mental Health Profiles reports released by NRI focuses on the different ways states organize, fund, and use their state psychiatric hospitals. While every state operates psychiatric inpatient beds, how these beds are used varies widely from state to state. In FY 2020 states expended over $12 billion providing psychiatric inpatient services to nearly 125,000 individuals throughout the year. At the start of the state fiscal year (July 1 in most states) there were nearly 40,000 patients receiving services in 177 state psychiatric hospitals.  

The majority (56 percent) of individuals receiving services in state psychiatric hospitals had a forensic (criminal justice or sex offender) legal status, and only 5% of residents in state psychiatric hospitals were in the hospital voluntarily. The majority of states (34 States) reported experiencing a shortage of psychiatric inpatient capacity, with shortages of forensic beds (27 states) and acute psychiatric inpatient beds (20 states) the most frequent types of beds in short supply. However, while a few states are expanding inpatient capacity, many states are addressing bed shortages by opening crisis stabilization units, using mobile crisis response teams, and funding increased community mental health services to reduce the need for acute psychiatric inpatient services. 

Resident Patients in State Psychiatric Hospitals per 100,000 State Populations

The new NRI State Profiles “Use of State Psychiatric Hospitals” report is available at The report is one of 15 new Profiles reports available to the public. SMHA staff have exclusive access to additional detailed state-by-state about the number of patients served and use of the state hospitals that is summarized in the public reports. For more information about the State Profiles system, please e-mail [email protected]

Recognizing and Overcoming Barriers for Peer Support Specialists with a History of Criminal Justice Involvement 

Join us Monday, March 21st from 12:00 to 1:00 Eastern for an SMI Adviser/NRI webinar on Recognizing and Overcoming Barriers for Peer Support Specialists with a History of Criminal Justice Involvement. Register here:

Peer support specialists are critical to the behavioral health workforce and have significant positive impacts on recovery.  However, many individuals with lived experience are excluded from the behavioral health workforce due to having prior arrests or criminal justice involvement.  This webinar brings together individuals with lived experience of criminal justice system involvement and state leaders who have hired these individuals to discuss the significant positive impact these peers can have on recovery, the value they bring to the behavioral health workforce, and how they work to affect change in their states to increase acceptance.

Participants will learn about the special skills that peers with prior arrests bring to the recovery process, and how their experience in the criminal justice system allows them to be more relatable to others seeking help who are themselves engaged with the criminal justice system and dealing with the fallout of an arrest.  Strategies to overcome stigma and policy challenges will be discussed, with real-world examples from Colorado, Georgia, Massachusetts, and other states provided.

Presenting on the webinar are:

  • Amy Brinkley, CRS/CHW, CAPRCII: Recovery Support Systems Coordinator, NASMHPD
  • Tony Sanchez: Faces and Voices of Recovery
  • Justin Volpe: Peer Support Specialist, NASMHPD
  • Debra Pinals, MD: Director of Behavioral Health and Forensic Programs, Michigan Department of Health and Human Services

Register here:


Please also Save the Date for Thursday, May 12th for the SMI Adviser/NRI webinar on Enhancing Financing for Peer Support Specialists!

State Mental Health Agency (SMHA) Organization And Structure In State Government

February 10, 2022

Did you know that 42 states combine responsibilities for the provision of mental health and substance use services into a single state agency? Or that 13 states combine responsibilities for the provision of intellectual/developmental disability and mental health services into a single state agency (and 12 states combine all three disability services into a single state agency)? In 15 states, the State Mental Health Agency (SMHA) is organized as an independent state agency, however, in most states, the SMHA is located within a State Department of Human Services. Six states have the SMHA organizationally located within the State Medicaid agency.

Number of State Mental Health and Substance Use Authorities Combined into One Agency, 1970-2020

This information and more about the organization, structure, and responsibilities of state mental health authorities are detailed in a new NRI State Profiles report available at The report is one of 15 new Profiles reports available to the public. SMHA staff have exclusive access to additional detailed state-by-state information that is summarized in the public reports. For more information about the State Profiles system, please e-mail [email protected].

NRI Welcomes New Board Member

The NRI Board of Directors welcomes Dr. Ken Rogers as a board member. Dr. Rogers currently serves as the state director for the South Carolina Department of Mental Health (SCDMH). He is Board certified in both General Psychiatry and Child Psychiatry. He is also Chief of Psychiatry at Parkland Health and Hospital System and Professor of Psychiatry at the University of Texas Southwestern Medical Center in Dallas, TX. In his current position, Dr. Rogers has worked to expand mental health services to underserved populations by partnering with both traditional and non-traditional locations of services, including faith based communities, schools, and correctional facilities.

NRI Demonstrates New State Mental Health Agency (SMHA) Profiles Website with Information about the Organization, Policies, Services, and Financing of the Nation’s Public Mental Health System

January 27, 2022

During the January 20th NASMHPD State Mental Health Commissioners’ Meet-me-call NRI demonstrated its new State Mental Health Agency (SMHA) Profiles website with information about the organizations, policies, services, clients, and funding of state mental health systems. This new website includes a series of short topical public reports detailing high priority issues being addressed by SMHAs and a restricted access page designed for SMHA staff to access detailed state-level information. The state-restricted access site includes spreadsheets and a new, evolving Tableau data visualization that lets SMHA staff interact with their state’s information and other state data.

The 2021 SMHA Profiles project is entirely funded by SMHAs and is led by a State Steering Committee--co-chaired by Dena Stoner (Texas) and Wendy Morris (Kentucky) and with representatives from 20 states. The Steering Committee identified high-priority topics related to services, policies, and funding for collecting comparative information from the states.

Public Reports available on the new website include:

  1. State Mental Health Agency Organization/Structure in State Government
  2. Use of State Psychiatric Hospitals 
  3. Organization and Funding of Community Mental Health Services
  4. State Mental Health Crisis Service Systems
  5. Forensic Responsibilities of SMHAs and Forensic Services in State Hospitals
  6. Evaluation of Competency to Stand Trial: Use of State Hospitals, Community-based, and Jail-based Approaches
  7. Competency Restoration: Use of State Hospitals, Community-based, and Jail-based Approaches 
  8. Criminal Justice Diversion Programs
  9. Assessing Violent Risk Using Standardized Measures and their Application to Legal “Dangerousness”
  10. Use of Medicaid to Fund Mental Health Services 
  11. Provision and Funding of Evidence-Based Practices
  12. Housing Initiatives to Support Clients in the Community
  13. FY2019 State Mental Health Agency Expenditures, Funding Sources, and Trends in Expenditures Over the Past 10 Years
  14. Behavioral Health Call Centers, 988, and 911
  15. Impact of COVID On State Mental Health Services, 2020

There is a section of the website the access to which is restricted to five State staff designated by the State’s Mental Health Commissioner/Director. On the restricted site, States will be able to see:

  1. Information from their peers in other states about the topics addressed in the Highlight Reports
  2. Tableau Data Visualization of State Mental Health Agency Expenditures.  State Users can view their state’s expenditures over time and select other states or national averages for comparison. Additional Data Visualizations will be added through the year. 

Thanks to each of the SMHAs for their tremendous assistance in providing information for these reports, reviewing drafts, and supporting this innovative new effort.  We continue to update the information on the restricted site and are excited that the Steering Committee is already leading plans for the 2022 cycle of State Profiles.  An initial set of priority topics identified by Steering Committee members for focus during the 2022 Profiles include:

  • Behavioral Health Workforce issues and state approaches to address shortages
  • Crisis system implementation and financing
  • Bed needs and use of hospitals
  • Child/adolescent systems and gaps
  • Financing Mental Health Services

For more information about the NRI’s State Profiles initiative, please email [email protected] 


HHS Announces Critical Investments to Implement Upcoming 988 Dialing Code for National Suicide Prevention Lifeline

January 13, 2022

The Department of Health and Human Services, through its Substance Abuse and Mental Health Services Administration (SAMHSA), will make critical investments in suicide prevention and crisis care services, thanks to a $282 million investment to help transition the National Suicide Prevention Lifeline exit disclaimer icon from its current 10-digit number to a three-digit dialing code – 988.

NRI’s Ted Lutterman, Sr. Director of Government Research and Tim Knettler, Executive Director/CEO actively participates in Mental Health and Substance Use Disorder Providers working group as part of the 988 convening planning.

Record Provisional National and State Drug Overdose Data

December 2, 2021

Drug overdoses killed more than 100,000 people in the United States during the one-year period ending in April 2021, according to provisional data issued by the Centers for Disease Control and Prevention (CDC). This marks the first time that drug overdose deaths reached six figures in one year and represents a 29% increase in overdose deaths from the prior year.See link below for access to state data.

The report offers a visualization that presents the reported and predicted provisional counts of deaths due to drug overdose occurring nationally and in each jurisdiction

Behavioral Health Workforce is a National Crisis: Immediate Policy Actions for States

December 2, 2021

In a series of three issue briefs,Health Management Associates (HMA) and the National Council for Mental Wellbeing offers short-term policy levers to quickly impact workforce availability and retention. The issue of workforce availability was also the topic of a recent article in The Atlantic, that examined Why Healthcare Workers are Quitting in Droves.

Behavioral Health Call Centers and 988 Implementation

November 18, 2021

A new NRI report highlights the experiences of 43 State Mental Health Agencies (SMHAs) in working with state-funded Behavioral Health Crisis Call Centers as they prepare for the implementation of 988—the three-digit-number for the National Suicide Prevention Lifeline that must be live by July 16, 2022.

The report found that in most states, the SMHA is the lead agency responsible for crisis call centers, and that there are more than twice as many behavioral health crisis call centers than Lifeline call centers. Additionally, the report identifies efforts of states to work with 911 call centers to identify and refer behavioral health crisis calls to Lifeline and other behavioral health call centers.

We hope this report will help inform the field of state experiences working towards the exciting new launch of 988 and the implementation of a robust crisis services continuum to better help all individuals experiencing a behavioral health crisis. Read the full report

NRI Staff Present at NASMHPD's Annual Meeting 

October 28, 2021

At NASMHPD’s Annual 2021 Commissioners Meeting, several NRI staff members presented on topics associated with the meeting’s theme, Beyond Beds: Before, During, and After COVID-19. We invite you to watch their presentations: 

Phony Diagnoses Hide High Rates of Drugging at Nursing Homes

October 14, 2021

A recent New York Times investigation found, that least 21 percent of nursing home residents are on antipsychotic drugs. NRI Board Member, Dena Stoner spoke about the article and its findings:

“The recent NYT article on misuse of antipsychotics in nursing facilities further highlights trends that NRI documented in a sentinel 2017 research paper. Working with researchers from Brown University, NRI was able to access and analyze a national data set on nursing facility resident care. The resulting work documented trends in diagnosis of schizophrenia among nursing facility residents and the potential association with antipsychotic use. It also highlighted state efforts to decease inappropriate use of antipsychotics.  The research validated issues which states have observed and supports continuing efforts by states to decrease inappropriate use of antipsychotics. This example illustrates the value of NRI as a source of timely research focused on mental health topics of greatest interest to state policy makers. These include not only state mental health authorities, but state aging and disability authorities and state Medicaid agencies.”   

New AAMC Report: Complexities of Physician Supply and Demand: Projections From 2019 to 2033

September 30, 2021

Findings from a recent American Association of Medical Colleges report, The Complexities of Physician Supply and Demand: Projections From 2019 to 2034, indicate that physician demand will grow faster than supply, leading to a projected shortage across the non-primary care specialties of between 21,000 and 77,100 physicians; and between 10,300 and 35,600 for the "Other Specialties category” of which psychiatrists are included. 

According to the report, "the demand projections reflect changing demographics as the population grows and ages, the rapidly growing supply of advanced practice registered nurses (APRNs)" (of which psychiatric nurse practitioners are included) "and physician assistants (PAs), and other important trends in health care such as a growing emphasis on achieving population health goals.”  Read the full report

Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program

September 16, 2021

Each year the Centers for Medicare and Medicaid Services (CMS) organize a stakeholders meeting to discuss business items related to the Inpatient Psychiatric Facility Quality Reporting (IPFQR) program. This year, Glorimar Ortiz, PhD, MS, the new Senior Director of the Performance and Quality Improvement Division/BHPMS at NRI, will be participating in the meeting on September 29. Dr. Ortiz will be briefed on updates about recent changes to the IPFQR program, and will report back to 150+ facilities, public and private, that currently participate in the Behavioral Healthcare Performance Measurement System (BHPMS) founded by NASMHPD.

Learn more about NRI’s Behavioral Healthcare Performance Measurement System (BHPMS)

988 Will Benefit From Tech Innovations Jump Started by Pandemic

September 2, 2021

The Covid pandemic has sparked and expanded the use of innovative health technologies in behavioral healthcare that states can incorporate and maximize as they build out their crisis systems in anticipation of 988—the three-digit number for mental health, substance use, and suicidal crises that must be live by July 16, 2022. Kristin Neylon, M.A., senior project associate at NRI shares the latest in behavioral health tech in this article from Crisis Talk

Welcome Dr. Glorimar Ortiz as NRI's New Director of Performance & Quality Improvement

August 19, 2021

NRI congratulates Glorimar Ortiz, PhD on her promotion to the Senior Director position. She succeeds Dr. Lucille Schacht who, after 22 years, retired earlier this month. 

With a background in Public Health, specifically on research and evaluation of health service systems with an emphasis in biostatistics, Dr. Ortiz has contributed to decreasing the gap in behavioral/mental health research. At NRI, she has lead the research agenda for the BHPMS, has applied advanced analytics, and has disseminated scientific information, with an emphasis on quality improvement. Her research focuses on the mortality risk, the use of antipsychotic medications, co-occurrence of mental health and substance use disorders, readmission rates, use of seclusion and restraint measures, satisfaction with inpatient care, and smoking status among people with severe mental illness served in state psychiatric hospitals. She has also provided statistical support to the NRI’s Federal and Consulting divisions. Previous to that, she performed research with vulnerable population groups such as persons living in marginalized communities, youth with mental illness in juvenile institutions, and Latina pregnant women at risk of depression.

Please join us in welcoming her to this new role. 

Dr. Lucille Schacht Retires After Nearly 22 Years With NRI

August 5, 2021

Lucille Schacht, PhD, CPHQ has announced her retirement. Her last day with NRI will be August 13. As the Senior Director Performance and Quality Improvement and the director of the Behavioral Healthcare Performance Measurement System (BHPMS), Dr. Schacht brought more than 20 years experience working with complex data systems, applying advanced analyses, and creating technical reports and presentations. Her leadership and collaboration will be greatly missed, and we are grateful for the significant contributions she has made. We wish her the best in retirement. 

Glorimar Ortiz, PhD, MS, will succeed Dr. Schacht as Senior Director of Performance & Quality Improvement.

SAMHSA Releases New Behavioral Health Guide for National Minority Mental Health Awareness Month

Released this July in observance of National Minority Mental Health Awareness Month, this Behavioral Health Guide underscores the ways in which the National CLAS Standards can improve access to behavioral health care, promote quality behavioral health programs and practice, and ultimately reduce persistent disparities in mental health and substance use treatment for underserved minority communities. Read more.  

Oregon Legislature Passes Many New Investments in Behavioral Health

July 22, 2021

Oregon state legislators made systemic changes to health care this session, including a $474 million for the state’s behavioral health system. Of that, $130 million will boost housing and residential treatment for people with behavioral health needs. As well, $80 million will be made available for incentives to increase Oregon’s behavioral health care workforce. This includes programs such as scholarships and grants for providers to offer supervised clinical experience so professionals in training can qualify for licenses to practice psychology, marriage and family therapy, professional counseling and clinical social work. Learn more.

NAMD Executive Director and NRI Board Member Discusses Medicaid's Critical Role During Pandemic on C-SPAN

Matt Salo, National Association of Medicaid Directors (NAMD)'s executive director and NRI Board Member, recently appeared on C-SPAN’s live television broadcast of Washington Journal. During the segment, Matt discussed the critical role Medicaid has played – and continues to play – in providing access to health care during the pandemic. The segment can be viewed here

NRI Board Member Dr. Miriam Delphin-Rittmon Confirmed as Assistant Secretary for Mental Health and Substance Use, Department of Health and Human Services

July 8, 2021

Connecticut Department of Mental Health and Addiction Services Commissioner and NRI Board Member, Dr. Miriam Delphin-Rittmon was confirmed as the Assistant Secretary for Mental Health and Substance Use, Department of Health and Human Services (SAMHSA). Read more.  

NRI Board Member, Dr. Ron Manderscheid Retires from NACBHDD

Dr. Ron Manderscheid, NRI Board Member, has retired from his position as President and CEO at National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD). Recently, he reflected on NACBHDD’s progress and evolutionsince he took the reins in December 2009. 

Health Disparities Among Criminal Justice-involved Older Adults: Current Research and Future Directions

Dr. Jennifer Bronson, NRI Senior Director of Consulting and Research, is a guest editor of a special issue of the International Journal of Prisoner Health. They are accepting paper submissions on Health Disparities Among Criminal Justice-involved Older Adults until August 1. Full submission details are available

Youth Mental Wellness

A PBS episode of Healthy Minds with Dr. Jeffrey Borenstein from 2019 that features Dr. Ann M. Sullivan, commissioner of the New York State Office of Mental Health and NRI Board Member, who discusses mandated state education programs and new tools including a crisis text line. Watch now!  

Indicators of Mental Health Problems Reported by Prisoners

June 10, 2021

NRI Senior Director Jennifer Bronson, Ph.D was a co-author on a recently released statistical report on mental illness among adults in prison. Data showed that 43% of state prisoners had a history of a mental illness and 14% reported past 30-day serious psychological distress. Read the full report

Suicide and Serious Mental Illness

People who live with serious mental illness (SMI)—such as major depression, bipolar disorder, and schizophrenia—are at increased risk of suicide. It is critical to understand the problem of suicide for those who have SMI. That is the only way to create a comprehensive, effective suicide prevention plan.

SMI Adviser and the Suicide Prevention Resource Center (SPRC) present a new guide on Suicide and Serious Mental Illness. It is an ideal resource for both suicide prevention coordinators and mental health clinicians. The guide provides an overview of considerations and suicide prevention measures at the intersection of suicide and SMI. NRI has been working with SMI Adviser since its inception to identify educational needs and develop materials to fill knowledge gaps.

NRI Welcomes New Board Members

May 27, 2021

The NRI Board of Directors is excited to announce the addition of the following two new board members. Their expertise and insights in behavioral health will be greatly valued.

  • Wendy Morris, MSN, Commissioner at Kentucky Department for Behavioral Health Developmental and Intellectual Disabilities.
  • Stephanie Woodard, Psy.D., Nevada State Mental Health Authority and the Single State Authority for Substance Abuse

The Board also wishes to give a big thank you to outgoing board members, NRI Past President, Dr. Lorrie Rickman Jones, and Member-at-Large, Joyce Allen, MSW for their tremendous service. See all NRI Board of Directors.

New Network Collects Real-Time Data To Improve Treatment of Early Psychosis

The National Institute of Mental Health’s Early Psychosis Intervention Network (EPINET) aims to be a “learning health care network” continuously improving the care of patients with first episode psychosis (FEP).

NRI is working with NASMHPD and Westat to support the NIMH-funded Early Psychosis Intervention Network (EPINET). On June 2, NRI will host a webinar to provide more information for state agencies about EPINET and the Core Assessment Battery (CAB), and how your state's Coordinated Specialty Care programs can join EPINET to streamline your outcome monitoring and align with national efforts. Mihran Kazandjian of NRI will discuss updating a national Snapshot of existing CSC programs, and David Shern, PhD, past president and current member-at-large of NRI's Board of Directors and Senior Public Health Advisor at NASMHPD, will chair the webinar and facilitate a question and answer session. Register now.

Improving Tobacco Cessation with Adult Inpatient Psychiatric Clients

May 13, 2021

On Wednesdy, May 19, NRI's Lucille Schacht, PhD, CPHQ, Glorimar Ortiz, PhD, and Missy Rand, LPC, CSAC will present at a Smoking Cessation Leadership Center's webinar Improving Tobacco Cessation with Adult Inpatient Psychiatric Clients. The webinar aims to examine the basic framework of the tobacco use and treatment measures developed by The Joint Commission and used by CMS. Register now.

NRI Board Member, Miriam Delphin-Rittmon, Nominee for Assistant Secretary for Mental Health and Substance Use, Department of Health and Human Services

April 29, 2021

NRI Board Member, Dr. Miriam E. Delphin-Rittmon has been nominated by President Biden for Assistant Secretary for Mental Health and Substance Use, Department of Health and Human Services.

Dr. Miriam E. Delphin-Rittmon is currently the Commissioner of the Connecticut State Department of Mental Health and Addiction Services. She was appointed in March 2015 and previously held the positions of Deputy Commissioner, Senior Policy Advisor, and Director of the department’s Office of Multicultural Health Equity. In her role as Commissioner, Dr. Delphin-Rittmon has been committed to promoting recovery-oriented, integrated, and culturally responsive services and systems that foster dignity, respect, and meaningful community inclusion. In addition, through her 20-year career in the behavioral health field. Dr. Delphin-Rittmon has extensive experience in the design, evaluation, and administration of mental health, substance use, and prevention services and programs has received several awards for advancing policy in these areas. Most recently, she received the 2019 State Service Award from the National Association of State Drug and Alcohol Directors and the 2016 Mental Health Award for Excellence from the United Nations Committee on Mental Health. 

Bureau of Justice Statistics Publishes Three Briefs About Prison Inmates Co-Authored by NRI Researcher

April 15, 2021

Jennifer Bronson, NRI Sr. Director of Consulting and Research, is a co-author of three newly released Bureau of Justice Statistics (BJS) statistical briefs. The topics include disabilities among adults in prison, veterans in prison, and children of incarcerated parents. Findings from the disability report that showed that a cognitive disability was the most frequently reported disability (23%) among people in prison. An estimated 25% of state prisoners reported having ever attended special education classes and 26% reported that they had an attention deficit disorder. Dr. Bronson brings her extensive knowledge of correctional research and data into her role as Director of NRI’s Criminal Justice/Mental Health Research Center.

NRI’s Report on the Experiences of States Implementing Crisis Bed Registries to be the Focus of a Two-Part Webinar Series 

April 1, 2021

The SAMHSA-sponsored, two-part webinar “Improving Access to Behavioral Health Crisis Services with Electronic Bed Registries” will be held on Tuesday, April 13 from 2:00 to 3:30 p.m. (ET), with a 60-minute follow-up discussion scheduled for Friday, April 16th at 2:00 p.m. (ET). Dr. David Morrissette, NRI Consultant, and Ted Lutterman, NRI’s Senior Director of Government and Commercial Research are the featured speakers. Register now

NRI and NASMHPD Develop Needs Assessments on Technical Assistance and Education

SMI Adviser released three survey summarieson state-level needs around technical assistance and education. The surveys were fielded in 2019 by the National Association of State Mental Health Program Directors Research Institute (NRI), in partnership with NASMHPD. The audience included State Mental Health Authority (SMHA) Medical Directors, State Psychiatric Hospital Directors, and First-Episode Psychosis (FEP) Programs. Survey questions addressed topics such as the use of clinical practice guidelines, evidence-based practices, training needs, and more.

Medicaid Forward: Behavioral Health Framework

March 18, 2021

This framework, crafted by an Executive Working Group of Medicaid leaders and national behavioral health experts convened by the National Association of Medicaid Directors (executive director, Matt Salo, is on the NRI Board of Directors), offers states options to consider to promote the health and wellbeing of members and expand access to behavioral health services. Learn more

Save Lives by Prioritizing Individuals with Schizophrenia for COVID-19 Outreach and Education

The University of Michigan completed research highlighting a startling statistic about individuals with Schizophrenia and their odds of dying from COVID being right behind age. In a cohort of people with COVID-19, a Schizophrenia-spectrum diagnosis was associated with more than double the odds of dying, according to new research published in the Journal of the American Medical Association. The fact sheet highlights  the importance of including individuals with Schizophrenia in high priority groups for receiving COVID vaccinations and  discusses barriers and potential solutions in Michigan.

History of Mental Illness Associated With Earlier Signs of Aging

March 4, 2021

Individuals with a history mental illness are more likely to show signs of aging by age 45—including cognitive decline and loss of motor coordination—than are people without such a history, according to a report published in JAMA Psychiatry.

The study may provide insights to the elevated mortality risk experience by individuals with mental illness. It presents a new perspective on early aging among individuals with mental disorders by looking at biological factors and cognitive functioning. It is already known that persons with mental illness die earlier than persons in the general population and that they die mainly due to suicide, however chronic diseases have also been found to be the underlying causes of death.

NRI recently investigated the mortality status of the persons served by the Michigan Department of Health and Human Services (MDHHS) from SFY 2008 thru SFY 2013 and the findings confirmed the excess mortality among the served population. Individuals served by the MDHHS had significantly lower age at death (59 years) than individuals in the Michigan general population (76 years). The casual relationship between mental disorders and the biological aspect of aging may be one possible link for the prevention of premature mortality among this population group. Learn more.

Smoking and Risk of Negative Outcomes Among COVID-19 Patients: A Systematic Review and Meta-Analysis

February 18, 2021

This study notes the increased risk for Serious Mental Illness (SMI) populations who disproportionally have histories of current and former use of tobacco for Covid severity and mortality from it. Read the study.

NRI partnered with the Smoking Cessation Leadership Center (UCSF) to provide training and resources for psychiatric in-patient facilities to improve tobacco cessation treatment through the point of discharge planning.  These free products focus on clinical interventions and system changes that may improve the quality of care for patients.

NRI Board Presiden Named By Michigan Supreme Court to ‘Justice for All’ Commission

February 4, 2021

NRI Board President and Michigan Health Endowment Fund Senior Fellow & Program Officer Lynda Zeller has been appointed by order of the Michigan Supreme Court to the newly-created Justice for All (JFA) Commission that will work toward the goal of 100 percent access to our civil justice system. The Commission will lead the implementation of the JFA Strategic Plan aimed at helping more Michiganians solve civil legal problems such as landlord-tenant issues, family law disputes such as parenting time or custody, and access to benefits. Learn more.

NRI's Ted‌ ‌Lutterman‌ ‌on‌ ‌How‌ ‌Comprehensive‌ ‌Crisis‌ ‌Services‌ ‌Registries‌ ‌Are‌ ‌a ‌Vital‌ ‌Part‌ ‌of‌ ‌the‌ ‌Crisis‌ ‌Continuum‌

January 21, 2021

People in psychiatric crisis are often stuck in emergency rooms for hours or days waiting for placement, says Ted Lutterman, senior director of government and commercial research at  NRI. In other cases, there’s nowhere for them to go. Or worse, there are openings but no systemized way to find out where. The answer, says Lutterman, is a robust crisis continuum and a real-time comprehensive crisis services registry that helps match people to the appropriate level of services they need when they need them. Read more.

NRI and NAMHPD Work with National Data Coordinating Center for the Launch of Early Psychosis Intervention Network (EPINET)

By: David L. Shern, Ph.D. NASMHPD Senior Public Health Advisor; and Steven Adelsheim, MD, DFAACAP, DFAPA, Director, Stanford Center for Youth Mental Health and Wellbeing. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine

The National Institute of Mental Health (NIMH) launched the Early Psychosis Intervention Network (EPINET), a national learning health care system that links early psychosis clinics through standard clinical measures, uniform data collection methods, data sharing agreements, and integration of client-level data across service users and clinics. The EPINET initiative includes 8 Regional Hubs, 101 early psychosis clinics across 16 states, and the EPINET National Data Coordinating Center (ENDCC). The ENDCC is operated by Westat, and serves as the primary coordinator for EPINET activities across the Regional Hubs and early psychosis clinics. Read the full announcement.

For more information, including a list of all participating hubs and clinics, visit the ENDCC website at

CDC Reports Highest Number Of Drug Overdose Deaths Ever In A Year

January 7, 2021

The Centers for Disease Control and Prevention is reporting the highest number of overdose deaths ever in a 12-month period. Read more.

SAMHSA’s Behavioral Health Workforce Report

According to the 2019 National Survey on Drug Use and Health (NSDUH), 80% of individuals with a substance use disorder (SUD) do not get needed care; 57% of those with mental illness also do not get needed care and fully one-third of those living with serious mental illness do not get the care they need. Read more.

Tobacco Cessation: Strategies for Improvement

November 5, 2020

The use of tobacco continues to be a major public health issue as it remains the principal cause of preventable illness and death. In 2017, 47% of clients treated at psychiatric facilities screened positive for tobacco use, demonstrating an even denser population impact for this behavioral health group. NRI surveys of tobacco policies and CMS client tobacco measures have continued to reveal positive impacts since 2006 with increasing numbers of tobacco-free grounds, staff training, and progress in tobacco cessation treatment and medication offerings to hospitalized psychiatric patients.

However, only 38% of tobacco users were referred for ongoing targeted services during discharge planning in 2018 with 6% accepting those recommendations at state psychiatric facilities reporting to CMS. Building upon the recommended clinical practices to improve engagement and uptake of tobacco treatment presented in the September webinar, NRI will present a companion webinar on November 18 distilling a recent survey of facility needs and barriers to tobacco cessation services with success stories from systems who have demonstrated improvements with the proportion of clients accepting continued treatment after discharge. Register here for this free event. Contact hours available.

This presentation is made possible, in part, by funding from the Smoking Cessation Leadership Center.

Impact of COVID-19 on State Mental Health Agencies Services

October 22, 2020

To understand and assess the magnitude of the impact of the COVID-19 pandemic has had on state mental health agencies services, and how these services have adapted to challenges presented by COVID-19, NRI, in collaboration with the National Association of State Mental Health Program Directors (NASMHPD), surveyed the SMHAs during the summer of 2020. This report represents the results of this survey.

This is the first of a series of 2020 State Profiles reports on the organization, services, and financing of SMHAs that NRI will be releasing over the next few months.

The Intersection of the Opioid Crisis and Rise in Polysubstance Use

The Pew Charitable Trusts recently released a new fact sheet that addresses the opioid crisis and emerging trends in polysubstance use. The fact sheet provides data on two classes of drugs that are frequently co-used with opioids: depressants and stimulants, and notes that this has contributed to the rising number of opioid overdose deaths.

Comorbid polysubstance use and mental illnesses are common in psychiatric settings and concerning. In 2016, NRI published an article in the Journal of Psychiatric Practice, in which results indicated that the prevalence of antipsychotic polypharmacy in a sample of 86,034 discharges for adult patients that received services in state psychiatric hospitals was 12%. Antipsychotic polypharmacy continues at a high rate (23%) to affect nearly 10,000 patients with schizophrenia each year in state psychiatric hospitals. Although the research from NRI focused on antipsychotic polypharmacy to treat mental illness, substance abuse, and deaths due to accidents mainly drug overdose have been identified for individuals treated in state psychiatric hospitals. The strategies from The Pew Charitable Trusts may be modified to accommodate the needs of the people served in state psychiatric hospitals, and to reduce the mortality burden in this particular population group.

Advancing Reforms to Competence to Stand Trial and Competence Restoration: Key Learnings from Two States

October 1, 2020

The August 2020 SAMHSA GAINS Center brief highlighted some of the learnings from Oregon and Nebraska, two states that took part in Center's Learning Collaborative in 2018–2019 and a Community of Practice in 2019–2020 on competence to stand trial (CST) and competence restoration (CR). The brief mentions NRI Board Member, Sheri Dawson, who is the Director of the Division of Behavioral Health in the Nebraska Department of Health and Human Services (DHHS) and the state's effort to pass a bill that requires Nebraska to develop and implement an outpatient community restoration process by July 1, 2021. Read more.

National Dialogues on Behavioral Health 2020

September 17, 2020

The focus of the National Dialogues on Behavioral Health 2020 is focused on the new realities of the Covid-19 Pandemic. Starting today, the virtual conference will convene over six consecutive weeks to address the emerging issues and innovations related to the behavioral health crisis response in this new environment.

  • For Session 1 scheduled for Thursday, September 17 at 2:00 pm ET, NRI Board Member and Commissioner, Georgia Department of Behavioral Health, Judy Fitzgerald will present Behavioral Health Crisis Response and COVID-19: National, State, and Local Responses
  • For Session 5 scheduled for Thursday, October 15, NRI’s Senior Project Associate Kristin Neylon will present Technology, Behavioral Health Apps and Telehealth Platforms: Best Practices in Technology and Behavioral Health
  • For Session 6 scheduled for Thursday, October 22, Dr. Debra Pinals, Medical Director of Behavioral Health and Forensic Programs for the Michigan Department of Health and Human Services and a member of NRI's Mental Health/Criminal Justice Board Committee will present Behavioral Health Crisis Response for Persons with Special Needs (Intellectual Disabilities, Deaf/Hard of Hearing, Children, and Adolescents)
  • Dr. Mary Smith, NRI Senior Consultant, Former Associate Director of Decision Support, Evaluation and Services, DMH, IL serves on the conference’s Executive Committee. The full conference agenda is available online.

Where Are the Psychiatric Beds in a Community?

September 3, 2020

In this week’s issue of Psychiatric News, the newsletter of the American Psychiatric Association, an article discusses how a subgroup of the APA Presidential Task Force on Assessment of Psychiatric Bed Needs in the United States is working on defining the various kinds of psychiatric beds in a community. The article is based on interviews with NRI's Senior Director of Government & Commercial Research, Ted Lutterman and Medical Director of Behavioral Health and Forensic Programs for the Michigan Department of Health and Human Services and a member of NRI's Mental Health/Criminal Justice Board Committee, Dr. Debra Pinals. Read more.

NASMHPD Leadership Reflects on Impact of COVID-19 on Behavioral Health

August 20, 2020

In a published Open Forum article currently posted on-line in Psychiatric Services, current and former members of NASMHPD’s leadership reflect on the impact of the ongoing COVID-19 pandemic on the state of behavioral health in the U.S. Read more.

Taking Stock of COVID-Fueled Trends That Are Shaping Behavioral Healthcare

August 6, 2020

Ron Manderscheid, Executive Director, NACBHDD and NARMH and NRI Board Member writes about where behavioral healthcare currently stands on our COVID-19 response, as well as how the field is likely to change during the next several months. Read more.

NRI Presents at NASMHPD Annual 2020 Commissioners Meeting

August 6, 2020

At the end of July, NRI staff presented at this year's NASMHPD Annual Meeting.

Kristin Neylon, Senior Project Associate presented with NRI Board Member, Dr. Ron Mandersheid about the delivery of crisis services in rural and frontier areas of the U.S. She also presented the opportunities afforded by technology in facilitating the delivery of these services.

Robert Shaw, Senior Project Associate presented about how the funding of mental health crisis services has relied on state general funds and Medicaid despite the passage of two parity acts. States have organized the provision of crisis services differently, including how services are funded but all states have it within their power to bill private insurance for crisis service. Doing so will take the cooperating and hard work and possibly the reorganization of their crisis service system.

NRI Surveys State Mental Health Directors on Impact of the COVID-19 Pandemic on Operations of Public Mental Health Systems

July 9, 2020

NRI and NASMHPD have been working with an Advisory Group of State Mental Health Agency leaders to develop a short survey of State Mental Health Directors to help us and states understand what the impacts of Covid-19 have been on public mental health systems.

The survey was developed with guidance from volunteers from a number of states, NRI, and NASMHPD staff and addresses the impact of Covid-19 on:

  • state psychiatric hospitals
  • SMHA-funded or -operated community mental health providers
  • state mental health crisis systems, and
  • the use of telehealth, what of the modified rules regarding telehealth have been most useful, and what states would recommend be retained after the public health emergency has ended.

If you are a State Mental Health Director, you should have received the survey by email from NASMHPD or NRI last week. Please check your email to make sure you have not overlooked it. You may also access the survey online here. NRI will be sharing the results of this survey with NASMHPD and all states as soon as we have responses from most states. Please send the completed survey to NRI’s Ted Lutterman at [email protected] by July 10 and please feel free to contact Ted at 703-738-8164 with any questions. A summary of survey results will be provided in an upcoming spotlight.

Early Serious Mental Illness Treatment Locator

June 25, 2020

SAMHSA’s Early Serious Mental Illness Treatment Locator is a confidential and anonymous source of information for persons and their family members who are seeking treatment facilities in the United States or U.S. Territories for a recent onset of serious mental illnesses such as psychosis, schizophrenia, bipolar disorder, or other conditions. These evidence-based programs provide medication therapy, family and peer support, assistance with education and employment, and other services.

SAMHSA has integrated data on first-episode psychosis programs that was provided by NASMHPD and the NASMHPD Research Institute (NRI) into its existing treatment locator. Users receive information on Coordinated Specialty Care and other first episode psychosis programs operating in their state. This tool is designed to help quickly connect individuals with effective care in order to reduce the risk of disability. Access the SMI Treatment Locator

Creating Quality, May 2020, Devoted to Sharing the Quality Improvement Initiatives at Several Psychiatric Facilities

June 11, 2020

The journal highlights the experiences of three facilities that had taken significant steps to improve care, the underlying documentation which is the evidence of that care, and the development of clinically useful tools to assist the clinical staff with staying on-track with best practices. NRI staff authored two articles on how to spread the word and one article on how to actively engage clinical staff in quality improvement. The journal concludes with a Call to Action to share the vital learning that comes from local quality initiatives that could benefit the wider psychiatric community in promoting the best practices for both patient care and improved outcomes. Read the latest issue.

HRSA Awards Additional Funding to Support Telehealth During COVID-19

May 28, 2020

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), recently awarded $15 million to 159 organizations to increase telehealth capabilities in response to the COVID-19 pandemic. Read more.

Permanent Supportive Housing Associated with Long-Term Medicaid Savings

May 14, 2020

A University of Pittsburgh Medicaid Research Center study showed that in Pennsylvania, Permanent Supportive Housing (PSH) total Medicaid spending decreased by 13% by the third year after PSH entry. The largest relative declines were for non-behavioral health inpatient care and residential behavioral health care spending. Learn more.

Telehealth Surges: Effectiveness, Barriers & Will It Last? Comments from Dr. Joe Parks

April 30, 2020

New guidance from the federal government helped clear the way for Telehealth, which had been restricted to rural areas, and was made available to patients across the U.S. during the COVID-19 pandemic. Recently, Dr. Joe Parks, a member of NRI's Board of Directors, discussed the future of telehealth and barriers to telemedicine with WFYI for NPR radio. Read or listen to the full story.

May is Mental Health Awareness Month

Nearly 450 million people worldwide are currently living with a mental illness, yet nearly two-thirds of people with a known mental illness never seek treatment. In 2020, the theme is Tools 2 Thrive and aims to provide practical tools that everyone can use to improve their mental health and increase resiliency regardless of the situations they are dealing with.

May is also Borderline Personality Disorder Awareness Month. BPD has historically been viewed as difficult to treat. But, with newer, evidence-based treatment, many people with the disorder experience fewer or less severe symptoms and improved quality of life. Learn more by downloading or ordering free copies of National Institute of Mental Health's BPD brochure.

Additionally, there are weeks in May dedicated to specific areas of mental health:

Resources for Mental Health Awareness Month are available. Additional COVID-19 resources are also available.

APA and NASMHPD Resources for Caregivers of Seniors and SMI Patients

April 16, 2020

Two recent articles highlight advice and guidance from psychiatrists and mental health professionals about treating those with serious mental illness (SMI) during the COVID-19 Pandemic.

The American Psychiatric Association's SMI Adviser Website has a wealth of resources available for clinicians about COVID-19 and Serious Mental Illness. Resources include: educational activities, telepsychiatry, FAQs, mental health effects of COVID-19, and evidence-based practices to ensure continuity of care. NRI and NASMHPD serve in an advisory role for SMI Adviser, and work to identify evidence-based resources for inclusion in SMI Adviser's Knowledge Base. NASMHPD has provided resources that can be found here.

More States Granted Medicaid 1135 Waivers

April 2, 2020

In keeping with its commitment to ensure states have the necessary tools to respond to the 2019 Novel Coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) have granted the 1135 waiver to 41 states as of Wednesday, April 1. All Section 1135 approval letters are available via the Medicaid website and are added as they are issued.

New Federal Coronavirus Bill Waives Medicare Telehealth Restrictions

March 19, 2020

Medicare patients seeking certain medical services—including mental health services—can now be seen using live videoconferencing in their homes. They do not need to travel to a qualifying “originating site” for Medicare telehealth encounters, regardless of geographic location, according to a guidance issued this week by the Centers for Medicare and Medicaid Services (CMS). Read more.

A 2019 Multiple-Paper Follow-up to the Beyond Beds Series Now Available

March 5, 2020

Debra A. Pinals, MD, Medical Director of Behavioral Health and Forensic Programs for the Michigan Department of Health and Human Services and a member of NRI's Mental Health/Criminal Justice Board Committee authored Lessons from the International Community to Improve Mental Health Outcomes, which pivots from NASMHPD’s previous work in its Beyond Beds series to look beyond the borders of the United States to other countries for examples of successful and promising strategies across nine areas of focus. Learn more

NRI Board Member Highlights Mental Health Resources in New Public Health Course

February 20, 2020

Ron Manderscheid, NRI board member and the Executive Director of the National Association of County Behavioral Health & Developmental Disability Directors (NACBHDD) will be teaching the course Knowledge for Managing County and Local Mental Health, Substance Use, and Developmental Disability Authorities as a part of the Johns Hopkins Bloomberg School of Public Health, starting this spring. Learn more.



NRI is Creating a 2020 State Mental Health Profile System – SMHA Information Sought

February 6, 2020

The NRI Board of Directors, primarily comprised of State Mental Health Agency (SMHA) Commissioners and their senior staff, has initiated a new State Profiles System (SPS) to provide SMHAs with up-to-date information about the financing and organization of state mental health systems. For over 20 years, NRI has been providing SMHAs information about the organization, funding, operation, services, policies, statutes, staffing, and clients of all SMHAs across the U.S. States, NASMHPD, and advocates use this information in budgeting, planning, and evaluating state mental health systems and in responding to requests from Governor’s, Legislators, media, and advocates.

The 2020 SPS Components were sent to all SMHAs on January 14, 2020 and responses are due from states by March 20, 2020. NRI will begin producing topical reports utilizing the Profiles data soon after state responses are finalized.

The SPS components for 2020 were developed with guidance from an advisory group comprised of SMHA Commissioners, Planners, and program staff, as well as staff from NASMHPD and NRI. The 2020 SPS components build on prior years’ components, but have been tailored to address new issues facing the states, and edited to ensure that only relevant information is included. Based on major policy topics raised by SMHA Commissioners and their senior staff, the 2020 SPS includes expanded components addressing Forensic Mental Health Services (including a focus on competency assessment and restoration activities in hospital and community settings), and a new Residential Continuum of Care component addressing housing options and supports provided by the SMHA for individuals with mental illness.

The updated 2020 SPS is a self-funded effort by the SMHAs that recognize the value in having access to an up-to-date, comprehensive database of comparable information about all SMHAs that states can use for budgeting, planning, and policymaking at the local, state, and national levels. Having access to this information will provide critical information to SMHA leadership and will reduce the burden on SMHAs of compiling information for decision-makers, planners, researchers, and others through the availability of a centralized, standard compilation of information about the financing of SMHAs. To date, over half of the states have committed to helping fund this initiative.

Every state that completes the 2020 SPS Components will receive general reports showing state and national trends. However, states that financially support this initiative will also receive more expansive, customized state reports with additional details and trends. For more information about supporting this important initiative, please contact NRI’s Executive Director/CEO, Tim Knettler at [email protected] or 703-738-8160.

State Residential Treatment for Behavioral Health Conditions: Regulation and Policy Environmental Scan

January 23, 2020

A new report by the Assistant Secretary for Planning and Evaluation (ASPE) on state regulation of Residential Treatment programs was prepared for ASPE by Truven/IBM. NRI and NASADAD also worked to identify state regulations and facilitated state review and verification of the information summarized for the ASPE report.

The objective of this environmental scan is to summarize the peer-reviewed and grey literature on oversight of residential care for mental health and substance use care in the United States, excluding inpatient hospital care. Read the new Environmental Scan

NRI’s Resources Instrumental in Supporting Coordinated Specialty Care Programs for First Episode Psychosis

January 9, 2020

A recent article about Washington State's Early Psychosis Program highlights services received through a coordinated specialty care (CSC) program called New Journeys. NRI has produced numerous resources designed to help states implement and fund coordinated specialty care programs. Additionally, these resources help CSC programs adhere to best practices and to be culturally competent serving a diverse client base. You can access these resources on our website

NRI/SMI Adviser Survey on Technical Assistance Needed by State Mental Health Agency Medical Directors, State Psychiatric Hospitals, and and Coordinated Specialty Care Providers

December 19, 2019

NRI and NASMHPD are again working with the American Psychiatric Association’s SMI Adviser, also referred to as the Clinical Support System for Serious Mental Illness (CSS-SMI). This SAMHSA-funded center supports mental health providers to promote person-centered treatment and recovery supports to individuals with SMI. A major task that we are working on with the APA to support this endeavor is an assessment of state mental health systems and their providers to understand their needs regarding how to improve clinical services for individuals with SMI.

To help us determine what types of assistance are most needed in the implementation of Evidence-Based Practices and Clinical Practice Guidelines, NRI is distributing a survey to State Medical Directors, State Hospital Administrators, and CSC Program Leads in each of the states. This 10-to-15-minute survey will help the APA and SAMHSA better understand what types of clinical consultations, training, and other TA would be especially helpful to these audiences. Information from these surveys will be used to help inform the TA activities provided under the CSS-SMI initiative to better meet the needs of behavioral health providers and clinicians. NRI is requesting that these surveys be completed by Friday, December 20th. If you feel you should have received an invitation to participate in this survey but did not, or if you have any questions related to this initiative, please contact Kristin Neylon.

Research Report Finds Widening Disparities in Network Use and Provider Reimbursement for Individuals with Mental Health and SUD

December 5, 2019

A recent report titled, “Addiction and mental health vs. physical health: Widening disparities in network use and provider reimbursement” showed that there are increasing disparities in out-of-network utilization rates for addiction and mental healthcare services compared to medical and surgical services for inpatient, outpatient, and professional office-based settings.

In this article by Kaiser Health News, Dr. Henry Harbin, an adviser to the Bowman Family Foundation, which commissioned the report comments on the reports’ findings. Dr. Harbin was the former CEO of Magellan Health, a managed behavioral health care company. Read the report.

NRI Welcomes New Senior Director of Consulting and Research

November 21, 2019

NRI welcomes Dr. Jennifer Bronson as our new Senior Director of Consulting and Research. Dr. Bronson has 15 years of experience in health research and evaluation, with a primary focus on behavioral health, disabilities, HIV/AIDS, maternal health and children’s exposure to violence/trauma. Her criminal justice knowledge comes from experience working in a reentry services center and at the Department of Justice as a correctional health statistician. She has a PhD in Medical Sociology from Howard University. Please join us in welcoming her.

SAMHSA Releases Publication on First-Episode Psychosis and Co-Occurring Substance Use Disorders

November 7, 2019

NRI's Board President Dr. David Shern and Senior Director, Ted Lutterman served as members of the expert panel.

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced the release of a new publication titled, “First-Episode Psychosis and Co-Occurring Substance Use Disorders.” The evidence-based resource notes that young adults who experience a first-episode psychosis along with a substance use disorder (SUD) are at high risk for recurring episodes of psychosis, later physical health problems, and have a greater likelihood of future disability. Read more.