Ryan K. McBain

@ryankmcbain on Twitter

Policy Researcher; Professor of Policy Analysis

Washington Office

Education

Ph.D. in public health, Harvard University; M.P.H. in public health, Harvard University; B.A. in psychology, Oxford University; B.A. in psychology, Gordon College

One Page Bio

Overview

Ryan K. McBain is a policy researcher at the RAND Corporation. He focuses on the design and evaluation of health policies and programs meant to reach vulnerable populations—including those coping with mental health conditions, HIV/AIDS, homelessness, and poverty. To achieve this, McBain has utilized a wide range of methodologies, including econometric approaches for quasi-experimental analysis, cost-effectiveness analysis, and decision analytic models, as well as key informant interviews and focus group discussions. Internationally, McBain has worked with the World Bank, World Health Organization, Harvard University and Partners In Health, primarily in sub-Saharan Africa and Haiti. McBain holds a Ph.D. and M.P.H. in public health with concentrations in health economics and policy analysis from Harvard University, as well as a B.A. in psychology from Gordon College and Oxford University in the United Kingdom.

Research Focus

Recent Projects

Assessing the Transition to Telehealth for Mental Health Care in the Wake of COVID-19
Adult Psychiatric Bed Capacity, Needs and Shortage Estimates in California
Integrating a Stepped Care Model of Screening and Treatment for Depression into Malawi's National HIV Care Delivery Platform
Evaluating Safety and Quality of Pain Care and Opioid Use in the Military Health System
The Mental Health Landscape in America

Selected Publications

McBain R, Eberhart N, Breslau J, Frank L, Burnam A, Kareddy V, Simmons M. , How to transform the U.S. mental health system: 15 evidence-based recommendations, , 2021

McBain R, Rose AJ, LaRochelle MR, "The U.S. opioid crisis: one disease, diverging tales," Preventive Medicine, 112, 2018

McBain R, Ashwood JS, Eberhart N, Montemayor C, Azhar GS., Evaluating cost savings associated with Los Angeles County's mental health full service partnerships, RAND, 2018

McBain R, Peterson L, Mahon N, Dully L, Noel B, Wroe E., "Impact and economic evaluation of a novel HIV service delivery model in rural Malawi," AIDS, 131, 2017

McBain R, Jerome G, Warsh J, Browning M, Mistry B, Faure P, Pierre C, Mugunga JC, Rhatigan J, Leandre F, Kaplan R., "Rethinking the cost of healthcare in low-resource settings," BMJ Global Health, 1, 2016

McBain R, Cantor J, Eberhart N., "Estimating psychiatric bed shortages in the U.S. ," JAMA Psychiatry, 2022

McBain R, Wickett E, Mugunga J, Beste J, Konwloh P, Mukherjee J, "The post-Ebola baby boom: a call for health systems strengthening.," Lancet, 388, 2016

McBain R, Cantor J, Bravata D, Whaley C. , "Mental health service utlization rates among commercially insured adults in the US during the first year of the COVID-19 pandemic," JAMA Health Forum, 59, 2023

Languages

English; French; Spanish; Krio

Commentary

Coronavirus Disease 2019 (COVID-19)

The End of the U.S. COVID-19 Public Health Emergency: Q&A with RAND Experts
We asked RAND experts to reflect on the past three years: What were the effects on the United States and around the world, what has changed, what are the most important takeaways, what was done right, and what was done wrong? At the same time, they looked ahead to what might be done to mitigate the health and geopolitical impacts of future pandemics.
May 8, 2023
The RAND Blog
Telemedicine

A Potential Backslide in Mental Health Care for Millions of Americans
The expiration of the COVID-19 Public Health Emergency declaration will have broad-sweeping effects, and one of the most significant is little known: It could begin undoing the expansion of mental health care access for millions of Americans.
Apr 18, 2023
The Hill
Veterans Health Care

RAND Experts on Veteran Mental Health Respond to the White House Mental Health Research Priorities
The White House identified eight research priorities to better manage America's current mental health crisis. RAND researchers highlight why each area is critical for veteran mental health and how RAND is contributing to address them.
Feb 20, 2023
The RAND Blog
Suicide

Will the New 988 Hotline Be a Game Changer for Mental Health or a Missed Opportunity?
Someone dies from suicide in the United States every 11 minutes, a rate that has increased almost 30 percent since 2000. The 988 mental health hotline will launch on July 16, but states need to clear significant hurdles: funding the expanded crisis response system and making sure people know it's available.
Jun 20, 2022
Los Angeles Times
Mental Health Treatment

How COVID-19 Lessons Can Transform U.S. Mental Health Care
It would be a powerful conclusion to the pandemic if Americans reimagined a health system that was resilient against future threats, including the resulting psychological trauma. Policymakers have the opportunity now to cut short the pandemic's long tail of mental illness by taking decisive action.
Jun 2, 2021
The Hill

Publications

Journal Article
Mental Health Emergency Hotlines in the United States: A Scoping Review (2012–2021)
This scoping review describes the current literature on mental health emergency hotlines in the United States, and also identifies gaps in the literature and presents recommendations.
Oct 24, 2022
Report
Psychiatric and Substance Use Disorder Bed Capacity, Need, and Shortage Estimates in California: Merced, San Joaquin, and Stanislaus Counties
In California, Merced, San Joaquin, and Stanislaus Counties sought to understand the gap between capacity and need for behavioral health beds. This report estimates bed shortages by triangulating estimates through multiple modeling methodologies.
Aug 26, 2022
Report
Just in Reach Pay for Success: Impact Evaluation and Cost Analysis of a Permanent Supportive Housing Program
This report examines a Los Angeles County initiative to provide long-term housing and supportive services as an alternative to jail for individuals with a history of homelessness and chronic behavioral or physical health conditions.
Aug 16, 2022
Research Brief
A Los Angeles Supportive Housing Program Interrupted the Cycle Between Jail and Homelessness—and Largely Paid for Itself
This brief examines a Los Angeles County initiative to provide long-term housing and supportive services as an alternative to jail for individuals with a history of homelessness and chronic behavioral or physical health conditions.
Aug 16, 2022
Draft
Preparedness for 988 Throughout the United States: The New Mental Health Emergency Hotline
A mixed methods study on preparedness for the launch of the new three-digit mental health emergency hotline (988) indicates that many agencies are not prepared to meet an increased need, and officials will need to ramp up quickly.
Jun 21, 2022
Tool
Mental Health Emergency Hotlines in the United States: An Evidence Inventory (2012–2021)
This tool provides summary information to policymakers and agency administrators regarding studies on mental health emergency hotlines in the United States.
Jun 2, 2022
Report
Psychiatric and Substance Use Disorder Bed Capacity, Need, and Shortage Estimates in Sacramento County, California
Using an array of data sets and findings from the literature, as well as a survey of treatment facilities, the authors estimated psychiatric and SUD treatment bed capacity and need in Sacramento County for adults and children/adolescents.
May 17, 2022
Journal Article
Ongoing Disparities in Digital and In-Person Access to Child Psychiatric Services in the United States
Although telehealth holds promise for promoting access to child and adolescent psychiatric services, large disparities in overall access to services persists in rural and low-income communities.
Mar 24, 2022
Report
Assessing the Quality of Outpatient Pain Care and Opioid Prescribing in the Military Health System
Pain conditions are the leading cause of disability among active-duty service members. RAND conducted a comprehensive assessment of outpatient care for acute and chronic pain, including opioid prescribing, delivered by the Military Health System.
Mar 16, 2022
Report
Adult Psychiatric Bed Capacity, Need, and Shortage Estimates in California—2021
California, much like many parts of the United States, is confronting a shortage of psychiatric beds. This report presents an evaluation of California's adult psychiatric bed need for 2021 and the coming years.
Jan 18, 2022
Report
Pima County Housing First Initiative: Final Evaluation Report Fall 2021
The authors present the final evaluation of the Pima County Housing First Initiative, which offers permanent supportive housing and case management for individuals who are involved with the criminal justice system and have experienced homelessness.
Dec 29, 2021
Report
Implementation and 12-Month Health Service Utilization and Cost Outcomes from a Managed Care Health Plan's Permanent Supportive Housing Program
This report presents an implementation and outcome study of a permanent supportive housing program—including service utilization and associated costs review—operated by a not-for-profit Medicaid and Medicare managed care plan in Southern California.
Oct 25, 2021
Report
Transforming the Housing Choice Voucher System in California: A Path to Universal Housing?
In this Perspective, the authors review the impact and shortcomings of the housing choice voucher (HCV) program and outline three pathways to transform the HCV system in California that could significantly reduce homelessness across the state.
Sep 29, 2021
Journal Article
The Relationship Between Quality of Housing and Quality of Life: Evidence from Permanent Supportive Housing
This study describes a PSH program administered by a Medicaid managed care plan, serving individuals experiencing homelessness with complex medical histories, and outlines participants' perceptions on the relationship between quality of housing and QOL.
Jun 9, 2021
Journal Article
Who Is (and Isn't) Receiving Telemedicine Care During the COVID-19 Pandemic
COVID-19 has affected telehealth utilization disproportionately. The increase in telemedicine use was greatest among patients in counties with low poverty levels, among patients in metropolitan areas, and among adults compared with children.
Mar 18, 2021
Journal Article
Cost Evaluation of Integrating Local HIV and Housing Data to Facilitate Service Coordination in Four Demonstration Sites
As part of the evaluation of a federal initiative to integrate HIV medical and housing data at four local jurisdictions in the U.S., we estimated the financial costs of implementing data integration occurring from June 2016 to August 2018.
Mar 12, 2021
Journal Article
Perceived Care Coordination Among Permanent Supportive Housing Participants: Evidence from a Managed Care Plan in the United States
The study explored patient perceptions of care coordination in a permanent supportive housing program operated by a large health plan in Southern California.
Mar 12, 2021
Report
Health Service Utilization and Cost Outcomes from a Permanent Supportive Housing Program: Evidence from a Managed Care Health Plan
The authors assess the short-term effects of a permanent supportive housing (PSH) program—operated by a large not-for-profit managed care plan—in Southern California for adult enrollees experiencing homelessness who have chronic health conditions.
Feb 16, 2021
Report
How to Transform the U.S. Mental Health System: Evidence-Based Recommendations
The United States is at a time of promise for historic transformation in mental health care. This report provides recommendations for mental health system change to improve the lives of the millions of Americans in need of care.
Jan 11, 2021
Tool
Mental Health Systems Solutions Explorer
This tool is designed by RAND researchers to help connect mental health systems, policy leaders, and decisionmakers with resources and evidence-based solutions that could help transform the complex mental health landscape in the United States.
Jan 11, 2021
Research Brief
Transforming Mental Health Care in the United States
A RAND team identified three goals for transforming the U.S. mental health care system and pinpointed 15 opportunities to drive systemic improvements in access, use, and quality that would help tens of millions of Americans.
Jan 11, 2021
Journal Article
Stepped Care for Depression at Integrated Chronic Care Centers (IC3) in Malawi: Study Protocol for a Stepped-Wedge Cluster Randomized Controlled Trial
This study will compare the effects of an evidence-based depression care model versus usual care on depression symptom remediation as well as physical health outcomes for chronic care conditions.
2021
Tool
Entry-Level Health Care Workforce: Information and Programs Visualization Tool
This tool provides a visualization of the concepts in "Strengthening the Entry-Level Health Care Workforce: Finding a Path" which reviews strategies, strengthens and expands the entry-level health care workforce, and identifies opportunities for stakeholders.
Dec 17, 2020
Journal Article
Update of Markov Model on the Cost-effectiveness of Nonpharmacologic Interventions for Chronic Low Back Pain Compared to Usual Care
Markov modeling facilitates comparisons across interventions for lower back pain not directly compared in trials.
Dec 16, 2020
Journal Article
Distress, Impairment, and Racial/Ethnic Differences in Perceived Need for Mental Health Treatment in a Nationally Representative Sample
Differences in perceived need across racial/ethnic groups are not attributable to differences in psychological distress and impairment.
Dec 16, 2020
Journal Article
Strengthening the Entry-Level Health Care Workforce: Finding a Path
The goal of this research was to review evidence on promising strategies, strengthen and expand the entry-level health care workforce, and identify potential opportunities for stakeholders to consider.
Dec 15, 2020
Report
The Effect of Blast-Related Burn Injuries from Prolonged Field Care to Rehabilitation and Resilience: A Review of the Scientific Literature
Researchers reviewed literature about blast-related burn injury, which is common among service members and is associated with infection, disability, military discharge, and mortality. Further research is needed on burn prevention and field care.
Sep 21, 2020
Report
Health Service Utilization and Costs at the Outset of a Permanent Supportive Housing Program: Baseline Evaluation Report
This report presents a baseline assessment of an innovative permanent supportive housing program to help address homelessness, examining demographic and clinical characteristics of enrollees and health care service utilization and costs.
Aug 10, 2020
Journal Article
Mental Health Services and Personal Recovery in California: A Population-Based Analysis
This observational study examined personal recovery in a representative sample of adults in California with elevated psychological distress.
May 12, 2020
Journal Article
Mixed-methods Study of Integration of Housing and Medical Data Systems for Enhanced Service Coordination of People with HIV
Improving service coordination through integrated data systems requires a number of complex steps at the organizational, technical, end user, and educational levels. Successful integration includes extensive need for human engagement, training, and buy-in, as well as allowing for sufficient time to complete all steps.
Apr 21, 2020
Journal Article
Growth and Distribution of Buprenorphine-Waivered Providers in the United States, 2007–2017
This study sheds light on the distribution of buprenorphine-waivered prescribers over the past decade. Growth has been rapid in communities affected by the opioid crisis, but slower in rural communities, and those with lower levels of education.
Jan 8, 2020
Journal Article
Growth and Distribution of Child Psychiatrists in the United States: 2007–2016
Despite the increased ratio of child psychiatrists per children over the past decade, a shortage remains, particularly in places with lower levels of income and education.
Dec 1, 2019
Report
Identifying Safety-Net Resources at Health Centers to Prevent Infectious Disease Transmission Resulting from the Opioid Epidemic
This study highlights factors that affect Community Health Centers' ability to reduce infectious disease transmission related to the opioid epidemic.
Jun 18, 2019
Journal Article
Systematic Review: United States Workforce for Autism-Related Child Healthcare Services
The 33 studies reviewed identify multiple workforce-related challenges for families seeking treatment for children with autism spectrum disorder-including lack of primary care providers to serve these children, lack of specialty providers, and sociodemographic and geographic disparities in access to ASD services.
Jun 10, 2019
Report
Evaluation of Technology-Enabled Collaborative Learning and Capacity Building Models: Materials for a Report to Congress
This report examines the quality of evidence for the effectiveness of health care models that connect generalist providers with specialist teams via technology to provide additional training.
Mar 6, 2019
Journal Article
Impact of Project ECHO Models of Medical Tele-Education: A Systematic Review
This systematic review examines the effectiveness of ECHO and ECHO-like medical tele-education models of healthcare delivery in terms of improved provider- and patient-related outcomes.
2019
Report
Practice Expenses Associated with Comprehensive Primary Care Capabilities
To help the Centers for Medicare & Medicaid Services (CMS) reimburse primary care practices for investing in "comprehensive primary care" capabilities, the authors developed and piloted a method for estimating related practice expenses.
Nov 15, 2018
Report
Evaluating Cost Savings Associated with Los Angeles County's Mental Health Full Service Partnerships
This report estimates government spending and cost savings associated with outcomes targeted by Full Service Partnership programs in Los Angeles County: homelessness, criminal justice detention, health care (inpatient and outpatient), and employment.
Oct 29, 2018
Research Brief
Los Angeles County's Mental Health Full Service Partnerships Yield Cost Savings
RAND estimated government spending and cost savings associated with outcomes targeted by Full Service Partnership programs in Los Angeles County: homelessness, criminal justice detention, health care (inpatient and outpatient), and employment.
Oct 29, 2018
Journal Article
The U.S. Opioid Epidemic: One Disease, Diverging Tales
To date, the stigma associated with opioid dependence has had the untoward effect of discouraging treatment-seeking behavior before the occurrence of an adverse event.
Jun 1, 2018
Journal Article
Effect of Age on Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011 to 2015
Older age was the strongest predictor of undergoing potentially inappropriate prescribing (PIP) among individuals who were prescribed opioids. PIP was also associated with risk of adverse outcomes in both older and younger adults.
2018