Medicaid Cuts, ICE Guidance, and Words That Matter

Each week brings new conversations about mental health, technology, and care. Between Sessions gathers what's worth your attention - so you can stay informed without adding to your workload.

A Stateline investigation published March 23 reports that 126 hospitals shut down inpatient psychiatric units between 2023 and 2024, and the Medicaid funding cuts in last year's federal spending legislation are projected to intensify that trend starting in 2028.

👉 Why it matters: As inpatient units continue to close, knowing which facilities near you still accept your patients' coverage - and having that information before a crisis - is becoming a basic part of clinical preparedness.

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Civil rights organizations sent a detailed memo this week to 400+ Michigan healthcare providers, outlining staff rights and protocols if immigration enforcement officers arrive at a clinical site - following the federal reversal of protections that had discouraged ICE activity in healthcare settings.

👉 Why it matters: The memo's framework - document requests in writing, route law enforcement to legal counsel, don't volunteer patient information - is a useful template for any practice developing its own written policy to protect both staff and patients.

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A Psychiatric Times analysis published earlier this month covers a randomized controlled trial comparing six months of DBT to six months of SSRIs for suicidality in BPD: DBT reduced suicide-related events and self-injury more effectively, while the SSRI group had significantly lower rates of active MDD at the end of treatment.

👉 Why it matters: For patients with BPD and comorbid MDD, the data support a combination approach - DBT for suicidality, medication for comorbid depressive symptoms

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A peer-reviewed study published in JMIR Formative Research examined a year of an AI documentation tool across 1,500+ clinicians: 94% of full-time providers used it weekly, quality ratings exceeded 97%, and clinicians completed more sessions without logging more hours.

👉 Why it matters: This large-scale study of an AI scribe in a digital mental health context suggests these tools can reduce documentation burden without disrupting clinical capacity.

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A new open-access study published March 23 in the Journal of Mental Health found that the specific words used to describe people with mental health conditions - along with how the causes of those conditions are framed - measurably affect how much prejudice others hold toward them.

👉 Why it matters: Person-first language in intake forms, psychoeducation, and how you describe diagnoses to patients actively shapes how others perceive and treat them.

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An 11Alive Investigates report published March 27 found that while Georgia's Insurance Commissioner announced nearly $25 million in parity violation fines against insurers in January, none of that money has been collected - and insurers have not been required to disclose whether they've filed appeals or corrective action plans.

👉 Why it matters: Fines that aren't enforced don't change network behavior - if you're in-network in Georgia, the access barriers those violations were meant to address are likely still in place.

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"The Best of Times in Turning 80," by H. Steven Moffic, MD - a psychiatrist approaching 80 reflects on a single weekend that shifted his lens from loss toward relationship, renewal, and what still matters.

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This week, Berries shared two resources for your practice and wellbeing.

Podcast: Nicole Liloia, LCSW turned business strategist for therapists, joins Kym Tolson on why overworking feels protective - and what it takes to interrupt the cycle without losing patients or income. Thirty-seven minutes.

→ Listen to our podcast

Meditation: Julie Ela Grace recorded a 14-minute guided meditation for mental health professionals on releasing the weight of patient outcomes - grounding the distinction between doing good work and being responsible for every result.

→ Try our meditation

Free CE (NBCC course): Berries Academy's course, The Promise of AI for Mental Health Professionals, now offers free NBCC CE credits - covering ethics, privacy, documentation workflows, and how to evaluate AI tools in your practice. 

→ Earn your free CE

The gaps this week are real - in inpatient capacity, in enforcement, in the systems meant to support the people you see. You're the part of the system that's actually showing up. 

As always, thank you for your truly important work.

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This newsletter is intended for informational and educational purposes only. It does not constitute clinical, legal, or regulatory guidance. Clinicians should rely on their professional judgment and applicable standards of care when integrating any technology into practice.