@bradleydstein
Child psychiatrist/ health services/policy researcher at RAND, studying improving access, treatment, and outcomes for individuals with mental health and substance use disorders. Often found at youth soccer games and finding recipes to try in my smoker
Want to know more? Find details and recommendations from our NIMH supported research with colleagues from
@rand.org @harvardmed.bsky.social @deptpopmed.bsky.social @bostonchildrens.bsky.social @brownpublichealth.bsky.social here: jamanetwork.com/journals/jam...
Our research spotlights both promise and pitfalls. Parents, clinicians, and tech companies must work together to ensure AI support is trustworthy, safe, and effective
But there are risks: Without oversight, chatbots may give advice that isn’t always safe, accurate, or appropriate—especially for those with serious needs
The upside? AI tools are accessible and may help fill support gaps when traditional mental health care isn’t available
Most who turn to AI for help do so regularly- monthly or more. For millions of young people, chatbots are now likely part of coping and support routines
The vast majority of users find this advice useful. But this varies by groups. Black respondents reported benefits less often than their White peers
13.1%—about 1 in 8—of US youths have asked an AI chatbot for advice during tough times. Among 18–21-year-olds, this rises to more than 1 in 5.
New research alert: How are teens and young adults really using AI? Our national survey led by Ryan McBain in @jamanetworkopen.com helps offer a clear, data-driven answer.
Really important research about a school mental health intervention. Studies without significant findings often have a hard time getting published, but its just as important to know what interventions don't seem to have a significant benefit as knowing what interventions do.
Read the full NIMH supported study with my @rand.org colleagues Amy Mahler and Rosanna Smart here: www.jaacap.org/article/S089...
Pediatricians, child psychiatrists and educators need to work together to help families find solutions—like pharmacy navigation and behavioral supports—so kids don’t fall behind during medication shortages
These differences mean the shortage could deepen existing gaps in academic achievement and behavioral health for children already facing challenges and barriers to care
Teachers in these schools were significantly more likely to report students having to stop their medication—over 77% in majority-minority schools and 76% in schools with mostly low-income students.
New research alert: The nationwide stimulant shortage didn’t affect all schools equally. Our new national study in JAACAP found much higher rates of ADHD medication interruption in schools where most students are from racial/ethnic minorities or low-income backgrounds.
The number of people initiating and continuing medication treatment for opioid use disorder declined in the six months after Medicaid unwinding began.
New study: https://bit.ly/42vlomV
Read the full NIMH supported study here with co-authors Skyler Hulser and Brendan Saloner from @brownpublichealth.bsky.social : www.healthaffairs.org/doi/full/10....
These treatment settings all matter for recovery, meaning broader Medicaid access offered more pathways for people with SUD to get help when needed most, critical when the overdose crisis was intensifying
Even 6+ years later, treatment rates remained higher than pre-expansion, showing sustained improvements—not just a one-time bump.
Treatment episodes for SUD surged across the board in the first 2-3 years after expansion: overall rates up 39–40% after 2–5 years, with strong gains across the board, in residential, intensive outpatient, and non-intensive outpatient care.
New research led by @jcmecon.bsky.social of @georgemasonu.bsky.social in @healthaffairs.bsky.social finds Medicaid expansion has yielded lasting gains in access to specialty substance use disorder (SUD) treatment—benefiting thousands experiencing drug or alcohol problems.
See the full paper with co-authors Jon Cantor, Ryan McBain, Aaron Kofner, Fang Zhang, Alyssa Burnett, Josh Breslau. Melissa Kilberti, Ateev Mehrota from @brownpublichealth.bsky.social and Hao Yu from @deptpopmed.bsky.social here: jamanetwork.com/journals/jam...
Thanks to the NIMH for funding this work and shout-out to all the school leaders who responded to the @rand.org American School Leader Panel!
Policymakers and school boards: are you considering neighborhood context when crafting phone policies? Open dialogue with parents, teachers, and students is key to making effective rules
These differences raise important questions on equity and the impacts for different student populations— teens using phones more freely at school could see impacts on learning and mental health. Middle and high school principals face tough choices balancing safety, independence, and distractions.
And most elementary schools stick to strict bans: over 81% only allow phones on campus if students keep them put away all day. By high school, policies get much looser—many let students use phones outside class or at teacher discretion.
Our national analysis found schools in higher-income communities are more likely to allow phones than those in high-poverty neighborhoods.
New Research Alert: Did you know nearly all U.S. public schools restrict student cell phone use—but the types of bans are very different depending on the school? Our recent paper, led by led by my @rand.org colleague Jon Cantor, just published in @jamahealthforum.com examines this issue
Such an important topic. Great to see @parcka.bsky.social diving into this with my @rand.org colleague Liz!
Want all the numbers? Check out the NIDA and Foundation for Opioid Response Efforts supported study here:
journals.lww.com/journaladdic...
Bottom line: Medicaid unwinding wasn’t just a paperwork issue- it disrupted effective treatment of opioid use disorder for thousands. Policymakers must find ways to protect coverage and care continuity as insurance rules evolve.