As of: 2026-08-11. Appends Phase 0 register (phase0-source-register.md S1–S17). New IDs continue from S18. §4–§6 append S36+; §7–§8 append S54+.
| ID | Source | Type / vintage | What it establishes | Limits |
|---|---|---|---|---|
| S18 | SAMHSA, Behavioral Health Spending and Use Accounts, 1986–2014 (SMA-16-4975 lineage) | Federal spending accounts, 2014 data | MH spend 186B * *(6.4220B; Medicaid 25% / private 28% / Medicare 15% of MH | Last full official payer split located; dated |
| S19 | Commonwealth Fund, Medicaid’s Role in Mental Health and Substance Use Care (May 2025) | Policy explainer citing IHME disease accounts + NSDUH 2023 | Medicaid MH >58B * */SUD * *17B (2019); inpatient MH+SUD half-Medicaid; Medicaid covers 26% of adults with AMI or SUD | Secondary compilation of IHME; not CMS NHEA |
| S20 | MACPAC, Spending topic page | Congressional commission fact | Medicaid ≈24% of US MH+SUD services | Standing fact; methods in underlying MACPAC work |
| S21 | CMS / Health Affairs NHEA 2023 highlights | Federal expenditure accounts | Total Medicaid $871.7B (18% of NHE 2023); no clean MH disease line located | NHEA ≠ BHSUA construct |
| S22 | BEA Health Care Satellite Account (MEPS Account) — mental illness per-capita series | Federal satellite account | Mental-illness medical services $639 per capita (2021, MEPS basis) | Per-capita; not filing-ready national MH total with payer shares |
| S23 | Brahmbhatt & Schpero, “Access to Psychiatric Appointments for Medicaid Enrollees in 4 Large US Cities” JAMA 2024 | Peer-reviewed secret shopper | 17.8% of listed Medicaid psych prescribing clinicians offered appointment; city waits 11–64 days median | 4 cities; no commercial arm; depression script |
| S24 | Zhu, Charlesworth, Polsky & McConnell, “Phantom Networks…” Health Affairs 2022 | Peer-reviewed claims vs directories | 67.4% of listed MH prescribers phantom in Oregon Medicaid 2018 | Single state |
| S25 | Ludomirsky et al., “In Medicaid Managed Care Networks…” Health Affairs 2022 | Peer-reviewed claims | Care concentrated among small share of listed physicians | Concentration ≠ acceptance rate |
| S26 | Wen, Wilk, Druss et al., Medicaid acceptance NAMCS update JAMA Psychiatry 2019 | Peer-reviewed NAMCS extension | Same instrument family as Bishop through expansion years | Not independent of Method 1 |
| S27 | HRSA, State of the Behavioral Health Workforce 2024 / 2025 brief | Federal workforce | MH HPSA population ~122M (Aug 2024) → ~137M / 40% (Dec 2025) | Designation ≠ realized access |
| S28 | HRSA, Designated HPSA Quarterly Summary (as of Jun 30, 2026) | Federal administrative | 7,109 MH HPSAs; designated pop 157.1M; 26.53% need met; 7,825 practitioners needed | Facility/pop double-count risks per footnotes |
| S29 | McBain et al., “Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011–2023” PLOS Medicine 2025 | Peer-reviewed HCRIS | Total IPBs 28.4/100k (2023); STACH 8.9, psych hospitals 19.5; stable total, composition shift; waiver states no sig. higher beds | Excludes VA/IHS/military; not payer-resolvable |
| S30 | JAMA Network Open 2025 (STACH IPU availability 2011–2023) | Peer-reviewed HCRIS | STACHs with IPU 24.9%→20.6% | Companion to S29 |
| S31 | TAC, Prevention Over Punishment (2024) | Advocacy survey 2023 | State-hospital staffed 36,150 / 10.8/100k; 52% forensic | Advocacy; Construct A only |
| S32 | NRI, Use of State Psychiatric Hospitals, 2025 | SMHA Profiles survey | 90% of responding states report bed shortage; forensic most cited | Shortage reports ≠ bed census |
| S33 | CMS, SMDL #18-011 (Nov 2018) + SMI/SED §1115 opportunity page | Agency guidance | Waiver path for short-term adult MH IMD stays | Perishable state list |
| S34 | Pearlmutter et al., “Analysis of ED Length of Stay for Mental Health Patients at Ten Massachusetts EDs” Ann Emerg Med 2017 | Peer-reviewed multi-site | Boarding drives LOS; Medicaid/uninsured longer; >2× odds ≥24h stay | One state |
| S35 | BJS, Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2011–12 | Federal inmate survey | Jail: 44% history of mental disorder; 26% SPD | Vintage; self-report ≠ SMI diagnosis; not a bed census |
Search record (workstream negatives / locks)
| Question | Result | Status |
|---|---|---|
| Current CMS NHEA MH disease-line total | Not located as clean BHSUA-comparable table | Gap — use BHSUA 2014 + secondary 2019 |
| MEPS national MH expenditure total with payer shares (recent) | Per-capita BEA/MEPS only without microdata re-tab | Gap |
| Second independent AMI survey series >1.5× vs NSDUH | NHIS lacks AMI/SMI | H1 support via within-instrument band |
| National by-payer wait series | Still absent | KC1 stands |
| Payer-resolvable national bed inventory | Not located | H3 indeterminate path disclosed; statutory path used |
| ≥2 waiver vs non-waiver bed/boarding evaluations showing capacity gain | McBain null on beds; boarding pair not located | Softens architecture claim for waivers |
§4–§6 sources (S36+)
| ID | Source | Type / vintage | What it establishes | Limits |
|---|---|---|---|---|
| S36 | GAO-26-108114, Suicide Prevention: Capacity and Federal Assessment of the 988 Lifeline | Federal audit, Jul 2022–Sep 2025 data | ~19.1M routed contacts; volume ~+90%; call answer rates improved; capacity = volume/answer/wait | Not diversion outcomes |
| S37 | KFF, 988 Two Years After Launch (Jul 2024) | Policy analysis of Lifeline metrics | May 2024 >0.5M monthly contacts; answer 70%→89%; outcome metrics missing | Secondary extract of Lifeline |
| S38 | GAO-25-107586, Behavioral Health crisis-response federal activities | Federal descriptive | SAMHSA crisis programs / evaluation status | No multi-state 988 diversion causal |
| S39 | Swanson et al. mobile-crisis arrest outcomes (Michigan; Psychiatr Res Clin Pract lineage) | Peer-reviewed IPTW | Mobile crisis ~45% lower 11-mo arrest incidence vs LE-only | Single state; not 988 |
| S40 | Kalb et al., BHCC availability & ED use (Health Serv Res / PMC11911218) | Peer-reviewed zip panel | Walk-in crisis stabilization ↔︎ lower MBD ED utilization | Facility availability ≠ 988 |
| S41 | Zhu et al., Medicaid Reimbursement For Psychiatric Services Health Affairs 2022 | Peer-reviewed fee schedules | Medicaid 81% of Medicare avg; indices uncorrelated with Medicaid psychiatrist supply | Cross-section |
| S42 | Allegheny County / MCO Medicaid rate-setting MH paper (2025) | Local quasi-experiment | Supply elasticity ≈0.16; response stronger near Medicare parity | One market |
| S43 | ASPE/Mathematica/RAND, CCBHC Implementation and Impacts | Official demo evaluation | Wait 9.0→5.4 days; clients +~9%; DID heterogeneous | Clinic-reported waits; 8-state demo |
| S44 | ASPE/Mathematica, CCBHC Report to Congress 2023 | Congressionally mandated | DY1–DY4 access stability; 94% open-access; 988 coordination | Self-report survey items |
| S45 | GAO-21-104466, CCBHC payment rates vs costs | Federal audit | Mixed state spending; CMS guidance gaps on PPS alignment | Early demo window |
| S46 | NACHC behavioral health / BHI materials (2025–26) | Association | FQHC BH expansion; same-day billing barriers; dual CHC–CCBHC count | Advocacy org |
| S47 | Decker SL, Medicaid primary-care fee bump & reported participation Health Aff 2018 | Peer-reviewed | No association fee bump ↔︎ physician-reported Medicaid participation | Primary care, not psychiatry |
| S48 | DOL/HHS/Treasury, Requirements Related to MHPAEA Final Rules (Sep 2024) + fact sheet | Final rule | Codifies NQTL analysis content; data evaluation; meaningful benefits | 2025 nonenforcement of new pieces |
| S49 | Departments, Statement regarding enforcement of 2024 MHPAEA final rule (May 2025) | Enforcement policy | Nonenforcement of new 2024 provisions pending revisit; CAA 2021 remains | Perishable |
| S50 | DOL, 2024 MHPAEA Report to Congress (+ 2022/2023 RTCs) | Statutory enforcement report | Initial comparative analyses insufficient; corrections for millions of participants; EBSA covers ~2.6M plans / ~136M lives | Investigative, not census |
| S51 | GAO-20-150; GAO-22-104597; GAO-23-105642 | Federal oversight | State exams miss self-funded ERISA; no ERISA numeric network-adequacy statute | Older GAO vintages for structure |
| S52 | DOL OIG 09-25-001-12-001 (2025), EBSA MHPAEA enforcement challenges | OIG | Investigator scarcity vs plan count; NQTL resource risk | Capacity snapshot |
| S53 | Wit v. United Behavioral Health, 9th Cir. (Jan 26 & Aug 22, 2023) | Holdings | GASC-coextensive requirement reversed; denial-of-benefits class reversed; state-mandate portion unappealed | Holdings only — no press |
Search record (§4–§6 negatives / locks)
| Question | Result | Status |
|---|---|---|
| Multi-state causal 988→ED or arrest diversion estimate | Not located | H4 Supported |
| Single official SAMHSA “2× in two years” annual multiplier | Not located; use Jan KPI or GAO growth | Anchor 7 sharpened |
| Cross-state Medicaid psych fees → participation correlation | Null (Zhu 2022) | Rates need change designs |
| 2024 MHPAEA rule currently enforced as written | New provisions under nonenforcement (May 2025) | Anchor 10 + perishable |
| State exams covering self-funded majority | No — ERISA preemption | KC3 fires |
§7–§8 sources (S54+)
| ID | Source | Type / vintage | What it establishes | Limits |
|---|---|---|---|---|
| S54 | Swartz et al., “Assessing Outcomes for Consumers in New York's Assisted Outpatient Treatment Program” Psychiatr Serv 2010 | Peer-reviewed admin + Medicaid | AOT admission OR 0.77 (initial) / 0.59 (renewal) vs pre-order | Selected eligibles; pre/post |
| S55 | NYS OMH / Duke AOT evaluation (2009 lineage) | State-sponsored evaluation | Pre/post hospitalization, homelessness, arrest drops under Kendra’s Law | Selection + service intensification |
| S56 | CA DHCS Laura’s Law / AOT legislative reports | State statutory reports | County-reported drops in homelessness/hospitalization/LE among enrollees | Opt-out geography; pre/post |
| S57 | Mass. M.G.L. c.26 §8K + CY2023 MH parity summary | Statute + DOI exam notice | Mandatory parity market-conduct exams (21 carriers in 2023 wave) | Open-exam finding limits |
| S58 | NY DFS 11 NYCRR 38 + 11 NYCRR 230.3 | State regulation | Behavioral network adequacy / wait standards; parity compliance programs | Fully insured / DFS-regulated only |
| S59 | VHA MH access standards (Uniform MH Services successors; Directive 1161 staffing) + GAO-16-24 | Federal directive + audit | Same-day/next-day screen; published wait metrics; preferred-date metric caveats | VA eligibility; not civilian Medicaid |
| S60 | OECD bed-rate dispersion via PLOS Medicine global bed commentary (2022 OECD extracts: Japan 2.58 / Italy 0.08 / US 0.35 per 1,000; median ~0.64) | International statistics | Bed ratios ≠ disease burden; community substitution explains spread | Construct differs from US Construct A/B |
| S61 | MJA / OECD Australia low-bed + high readmission comparisons | Peer clinical / OECD | Counter-steelman: low beds without offset → acute pressure | Not US Medicaid |
| S62 | Swenson & Urban, “Effects of expanding access to mental health services on SS(D)I applications and awards” Labour Econ 2023 (RDRC WI21-05) | Peer-reviewed / RDRC | +MH establishments → +SSI/SSDI apps; awards↑ in poor counties | Pathway ≠ scarcity overflow |
| S63 | SSA SSI ASR 2023 Table 37 representative payees by diagnosis | Federal statistical report | High payee shares for autism/intellectual/psychotic bands (18–64) | SSI construct ≠ DI worker stock |
| S64 | OpenSecrets LDA extracts (SAMHSA agency profile; APA bills lobbied, 2026 cycle samples) | Lobby disclosure | MH orgs lobby SAMHSA + Medicaid reimbursement bills | Not causal proof of blocked rate floors |
| S65 | SAMHSA / appropriations crosswalks — agency ~7.4BFY2026class; MHBG 1.0B | Budget docs / secondary | Discretionary MH scale ≪ Medicaid BH spend | Enacted totals perishable |
Search record (§7–§8 negatives / locks)
| Question | Result | Status |
|---|---|---|
| Fitted multi-country bed × outpatient → boarding model | Not located | H7 (a) directional |
| Multi-state causal 988 diversion (re-check) | Still absent | H4 unchanged |
| Awards plurality for mental disorders | Fails at 12.7% | H8 not supported as written |
| Scarcity → higher award rates | Opposite direction in Swenson | Overflow valve rewritten |
| DI worker stock mental share | ≈28.6% (GBMT-12) | Hand stock; no re-own |