Reports & Publications

Reports Listed by Year

 

Please note that this is not a complete listing of all our reports and publications, please contact us if you cannot find what you are looking for.

2016

New  State Behavioral Health Authorities' Use of Performance Measurement Systems

Kristin Neylon, Robert Shaw, Ted Lutterman, NRI, NASMHPD

This report provides information about the evolution of performance measurement in state behavioral health agencies (SBHA); a national overview of SBHAs’ uses of performance measurement systems, and includes lessons learned from six states that have implemented performance measurement systems, while addressing the potential benefits and challenges of implementing such a system.

New   Colorado Behavioral Health Funding Study

NRI, WICHE, Milliman

This study examines funding for public behavioral health services in Colorado in the context of the impacts of Medicaid expansion and the Affordable Care Act.  A key focus of the study is funding provided by the Colorado Office of Behavioral Health for indigent (non-Medicaid) individuals.  An in-depth examination of the clinical characteristics of the OBH indigent populations is provided in an attempt to identify any unique or distinct needs of the indigent population in an effort to inform the allocation of state funds for this population. 

Antipsychotic Medication Prescribing Practices Among Adult Patients Discharged From State Psychiatric Inpatient Hospitals

Glorimar Ortiz, Vera Hollen, Lucille Schacht, NRI

The cross-sectional study looked at all discharges for adult patients from state psychiatric inpatient hospitals in 2011. Data for  86,034 patients from age 18 through 64 were analyzed. The study found the prevalence of antipsychotic polypharmacy to be 12 percent. Further, of discharged patients prescribed at least one antipsychotic medication, 18 percent were on antipsychotic polypharmacy.  The study concludes that clinicians continue to prescribe multiple antipsychotic medications for reasons other than those with empirical evidence to support the practice.  Clinicians could use this information to develop and implement quality initiatives that could help further reduce the use of antipsychotic polypharmacy.

 
2015

Smoking Ban Implementation in Psychiatric Inpatient Hospitals: Update and Opportunity for Performance Improvement

Glorimar Ortiz, Lucille Schacht, NRI

This study examines the incidence and prevalence rates of smoking bans in state psychiatric hospitals, compares the implementation practices among hospitals prohibiting and allowing smoking, and provides opportunities for performance improvement. It analyzes data collected from 165 surveys conducted by NRI in 2011.  The incidence and prevalence rates were 70% and 79%, respectively. Significant differences between hospitals prohibiting and allowing smoking were found in the identification of smoking risks during formal screenings. Hospitals prohibiting and allowing smoking included the patient’s smoking status in the continuing care plan at very similar low rates. Hospitals could maximize the reporting of the continuing care and or transition/record performance measures including patient’s smoking status at discharge and treatments into the next level of care recommendations to heighten awareness of the risks for smoking and promote continuation of tobacco cessation.

 

Behavioral Health and Criminal Justice Systems: Identifying New Opportunities for Information Exchange

Vera Hollen, Glorimar Ortiz, Lucille Schacht, NRI 

This report explores the multiple and various sources of data and information used by agencies that are engaged with justice-involved persons who have a mental illness.   Opportunities and limitations for expanded knowledge exchange among agencies are discussed and suggestions for how these data sources can be better used to address policy questions are provided.  The report was completed under contract to NASMHPD’s Technical Assistance Coalition and funded by the Center for Mental Health Services/SAMHSA.

 

Colorado Department of Human Service Behavioral Health Needs Analysis

NRI, WICHE, AHP

The Colorado Department of Human Service's Office of Behavioral Health is pleased to present the findings of a comprehensive behavioral health needs analysis. The analysis, conducted for the Department by the Western Interstate Commission for Higher Education, National Association of State Mental Health Program Directors' National Research Institute, and Advocates for Human Potential, is the result of months of study. The report assessed current resources and projected what will be needed, not just statewide but by seven regions of the state, as well.

 

Tracking the History of State Psychiatric Hospital Closures

Ted Lutterman, NRI

Since the 1950s, the number of beds in state psychiatric hospitals has declined by over 91 percent. As a result of this phenomenon, many state psychiatric hospitals that had once served thousands of patients every day are now much smaller and many states that had multiple psychiatric hospitals have consolidated their acute inpatient services by merging facilities. Since 1998, the number of individuals served on a single, given day (residents) in state psychiatric hospitals has dropped to just over 41,600, a decrease of 39 percent.  In the past 18 years, the number of state psychiatric hospitals has decreased from 254 to 195, a 24% reduction.

 

Mental Health and Substance Use Comorbidity Among Adolescents in Psychiatric Inpatient Hospitals: Prevalence and Covariates

Vera Hollen, Glorimar Ortiz

This study examines the mental health (MH) and substance use (SU) diagnoses comorbidity in inpatient adolescents and explores the relationship between demographic and environmental covariates. It analyzes 2008 data of 9,154 adolescents ages 11 to 17 in psychiatric hospitals. Twenty-five percent of adolescents had dual diagnosis. Comorbidity differences between boys and girls occurred as they grew older. Boys with conduct disorder (CD) were 1.6 times more likely than girls with the same diagnosis to use alcohol.  Hispanics with CD had 2 to 3.5 times increased risk of comorbidity.  The study yields specificity in various MH and SU subgroups vital for prevention services and program planning. 

 

An Inventory and Environmental Scan of Evidence-Based Practices for Treating Persons in Early Stages of Serious Mental Disorders

NRI and NASMHPD Staff

10-Feb-2015, this PDF report is 1019 KB

This inventory reviews a variety of programs and practices to address early stages of serious mental disorders, including schizophrenia, bipolar and affective disorders, as well as other serious mental illnesses.  A majority of research and program models, both in the United States and internationally, have focused on addressing First Episode Psychosis (FEP), with an emphasis on programs for persons with non-affective psychosis.

 

 
2014

Case Studies of Three Policy Areas and Early State Innovators: 2014 State Profiles

Theodore C. Lutterman, Azeb Berhane, Robert Shaw, Kristin Neylon

9-Sep-30, this PDF is

The report, Case Studies of Three Policy Areas and Early State Innovators: 2014 State Profiles, focuses on what some early innovator SMHAs and SSAs were doing in three areas:  Health-Behavioral Health Integration, Implementation of Evidence-based Practices, and Changing State Business Practices.

 

Examining patient’s perceptions of care to identify opportunities for quality improvement in psychiatric inpatient hospitals

Glorimar Ortiz

7-Mar-2014, the link is to the article published in “The Patient”

Our objectives were to examine patients' perceptions with psychiatric care to prioritize action for quality improvement (QI), and to explore differences in care experiences across domains of care by sample subgroups in psychiatric inpatient hospitals. Analysis of frequency, central tendency, and variation examined the distribution of 11,778 Inpatient Consumer Surveys (ICS), from 67 psychiatric inpatient hospitals, by domain of care and Likert scale.

 

 

2013

Funding and Characteristics of Single State Agencies for Substance Abuse Services and State Mental Health Agencies

Theodore C. Lutterman, Azeb Berhane, Robert Shaw, Kristin Neylon

9-Sep-2015, this PDF report is 5,335 KB

The report utilizes information reported by all states on the organization, policies, services, and financing strategies of SMHAs and SSAs in 2013. This report has information states and others can use to understand how their systems compares with other states across the nation, and allows policy makers and other stakeholders to better understand the context in which states provide behavioral health services.

 

National Public Rates, Age Stratification Report

Lucille M. Schacht, Ph. D.

11-Nov-13, this PDF report is 122 KB

Providers respect patient autonomy and thus avoid using physically restrictive methods. These methods should be minimalized and the overuse of them implies the lack of less-restrictive alternatives.

 

 

National Public Rates

Lucille M. Schacht, Ph. D.

11-Nov-13, this PDF report is 136 KB

NRI's Behavioral Healthcare Performance Measurement System (BHPMS) makes aggregate performance measure rates available using critical measures identified by state psychiatric hospitals nationwide. The Inpatient Consumer Survey (ICS) rates for 5 domains are included.

 

 

Smoking Cessation Care in State-Operated or State-Supported Psychiatric Hospitals: From Policy to Practice

Glorimar Ortiz, M.S., Lucille Schacht, Ph.D., G. Michael Lane, Jr., M.A., M.P.H.

1-Jul-13, this link is to the article published in Psychiatric Services

The aims of this study were to identify changes in smoking policies and their implementation and to determine the level of smoking cessation care provided at state-operated or state-supported psychiatric inpatient hospitals.

 

 

Characteristics of State-operated or Supported Psychiatric Hospital Inpatient Care

Vera Hollen, M.A., Glorimar Ortiz, M.S.

14-Jan-13, this PDF is an overview of the full report and is 131 KB)                

State-operated or supported psychiatric inpatient hospitals tend to serve individuals with serious mental disorders who cannot afford treatment in private psychiatric hospitals or who present a danger to themselves or others. This report provides an unprecedented complete enumeration of individuals served within the public psychiatric and forensic inpatient settings and provides a consolidated overview of state psychiatric hospitals for one year including staffing, revenues, expenditures, hospital characteristics, and characteristics of individuals served.

 

 

2012

Fiscal Year 2010 Revenues and Expenditure Study Results

Ted Lutterman

18-Dec-12, this PDF report is 731 KB

A brief report of the findings from the 2010 cycle of SMHA Revenues and Expenditures Data Collection

 

History of HBIPS

BHPMS

10-Oct-12, this PDF paper is 142 KB

The HBIPS core measure set allows for national comparisons on fundamental aspects of inpatient care. This paper describes the development, insights from testing, and potential uses of the performance measure data.

 

Psychometric Evaluation of an Inpatient Consumer Survey Measuring Satisfaction with Psychiatric Care

Glorimar Oritz, M.S., Lucille M. Schacht, Ph.D.

September 2012, this is a link to article published in “The Patient”                            

Measurement of consumers’ satisfaction in psychiatric settings is important because it has been correlated with improved clinical outcomes and administrative measures of high-quality care. These consumer satisfaction measurements are actively used as performance measures required by the accreditation process and for quality improvement activities.

 

Smoking Policy and Practices Report 2011

Lucille Schacht, Ph.D., Glorimar Ortiz, M.S., and G. Michael Lane, Jr., M.P.H.

15-Apr-12,  this PDF Report is 254 KB

The 2011 Smoking Practices and Policy project of NRI provides an update in the trend toward smoke free state psychiatric hospitals. Included in this report are details related to available treatments and continuity of care.

 

The Impact of the State Fiscal Crisis on State Mental Health Systems: Winter 2011-2012

Ted Lutterman

01-Mar-12, this PDF Report is 2.3 MB

A presentation by Ted Lutterman on the impact of the state fiscal crisis on state mental health systems.

 

2011

Fiscal Year 2009 State Mental Health Revenue and Expenditure Study Results

Ted Lutterman

12-Oct-11, the PDF is a Summary of Study Results and it is 281 KB

A brief report of the findings from the 2009 cycle of SMHA Revenues and Expenditures data collection.

 

Funding and Characteristics of SMHAs 2009

Theodore C. Lutterman, Azeb Berhane, Robert Shaw, Kristin Neylon, and Verda Rana

19-Aug-11, this is a link to report at SAMHSA’s website   

State Mental Health Agencies (SMHAs) are the state government agencies responsible for assuring the provision of mental health services to persons with mental illnesses and emotional disturbances. SMHAs annually administer nearly $30 billion to provide mental health services to over 6 million individuals. SMHAs vary widely regarding how they are organized within state government, the specific array of disability services they deliver, the way they organize and deliver mental health services, and their eligibility and funding requirements. This report provides a comprehensive review of the various ways SMHAs are organized and structured, their major policy initiatives to better meet the mental health needs of the residents of their state, the mental health services they provide or fund, and how they finance these services.

 

2010

Funding and Characteristics of SMHAs 2007

Theodore C. Lutterman, Bernadette E. Phelan, Ph.D., Azeb Berhane, Robert Shaw, and Verda Rana

19-Jan-10. the link is to the report at theSAMHSA’s website

State Mental Health Agencies (SMHAs) are the state government agencies responsible for assuring the provision of mental health services to persons with mental illnesses and emotional disturbances. SMHAs annually administer nearly $30 billion to provide mental health services to over 6 million individuals. SMHAs vary widely regarding how they are organized within state government, the specific array of disability services they deliver, the way they organize and deliver mental health services, and their eligibility and funding requirements. This report provides a comprehensive review of the various ways SMHAs are organized and structured, their major policy initiatives to better meet the mental health needs of the residents of their state, the mental health services they provide or fund, and how they finance these services.

 

 

Effects of adopting a smoke-free policy in state psychiatric hospitals

Vera Hollen, M.A., Glorimar Ortiz, M.S., Lucille Schacht, Ph.D., Maryam Mojarrad, M.P.H., G. Michael Lane Jr, M.A., M.P.H, and Joseph J. Parks, M.D.

September 2010, the link is to the article published in “Psychiatric Services”

The aim of this study was to investigate how adopting a smoke-free policy in state psychiatric hospitals affected key factors, including adverse events, smoking cessation treatment options, and specialty training for clinical staff about smoking-related issues. Hospitals were surveyed in 2006 and 2008 about their smoking policies, smoking cessation aids, milieu management, smoking cessation treatment options, and aftercare planning and referrals for smoking education.

Also available, Smoking Policy & Practices 2008, 2006, and 2005.

 

 
Visit Us

3141 Fairview Park Drive

Suite 650

Falls Church, Virginia 22042

Contact Us

Telephone: 703-738-8160

Fax: 703-738-8185

E-Mail: NRI@nri-inc.org

Follow Us
  • Wix Facebook page

© 2015 NRI, Inc.  All rights reserved.