Barrins Bulletin
October 2026
Greetings to Our Colleagues in Behavioral Health!
Dear Readers,
October gives us several opportunities to look at familiar behavioral health challenges from a different perspective.
October is Depression Awareness Month, and our first article looks beyond simply completing a depression screen to consider whether screening is actually leading to appropriate assessment, treatment, and follow-up.
We also explore the growing role of digital technology in behavioral healthcare. Digital tools are no longer limited to scheduling, documentation, and telehealth. Some are becoming part of treatment itself, raising new questions about clinical oversight, regulatory compliance, technology planning, and downtime preparedness.
And in recognition of Healthcare Quality Week, October 18–24, we offer three practical ideas to bring a different conversation to your quality program—including examining the gap between policy and actual practice, learning from near misses, and questioning whether “staff reeducation” really addresses the cause of a problem.
Finally, this month’s Joint Commission update returns to one of behavioral healthcare’s highest-risk issues: environmental suicide risk. Joint Commission has released an updated assessment and mitigation tool that is worth putting in the hands of your safety and environment-of-care teams.
We hope you find something in this month’s Bulletin that prompts a useful conversation within your organization.
Best Regards,
John Berry
RN, MSN, CPHQ, SQIL
Principal Consultant
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For Healthcare Quality Week, try turning a few familiar quality practices on their heads. October 18–24 is Healthcare Quality Week, an opportunity to recognize the professionals who lead quality and safety efforts—and the clinical and operational teams who put…
Depression Awareness Month is an opportunity to look beyond screening rates and ask whether screening is improving care. Nearly 20 million U.S. adults experienced a major depressive episode in 2025, according to the newly released National Survey on Drug Use and….
Digital tools are moving beyond scheduling, documentation, and telehealth. Some are now part of treatment itself—creating new opportunities and new considerations for behavioral health leaders. Technology has been part of behavioral healthcare for years. Electronic…
Joint Commission (JC)
A New Tool for an Old—and Persistent—Behavioral Health Risk
Last month, we discussed Joint Commission’s revised Survey Process Guides and the new companion Survey Tools Guides. The October issue of EC News highlights one of those tools that deserves particular attention from behavioral health organizations: the updated Environmental Risks for Suicide Assessment and Mitigation Tool.
Joint Commission requires psychiatric hospitals, psychiatric units, and BHC organizations to assess the physical environment for features that could be used for self-harm and to document actions taken to eliminate or mitigate identified risks. The updated tool is intended to help organizations conduct that assessment; Joint Commission specifically notes that use of its tool is not required.
One point in the article is particularly important: the environmental risk assessment should be treated as a living document. Joint Commission recommends a thorough assessment when a psychiatric facility or behavioral health unit opens, when space is repurposed or renovated, or when the population served changes. Ongoing evaluation is also expected as the environment changes.
Barrins Perspective
Don’t leave this tool solely with Facilities.
Environmental suicide-risk assessment works best when clinical, safety, facilities, and accreditation leaders look at the environment together. Each sees risk differently.
We recommend downloading the updated tool and comparing it with your current environmental risk assessment process. This is also a good resource to distribute to your Environment of Care or Safety Committee for review.
This new SPG can be found under the JC website under:
> Knowledge Library > Support Center > Survey Preparation
CARF
Behavioral Health Standards Are Open for Your Input
CARF continues to use field reviews to obtain input from providers, consumers, caregivers, payers, regulators, and other stakeholders before introducing or revising standards.
Of particular interest to behavioral health organizations, CARF identifies a Behavioral Health: Gambling Addictions field review planned for October 2026. Its 2026 work has also included field review activity involving trauma-informed care and behavior analytic services.
Barrins Perspective
Field reviews give providers an opportunity to see where accreditation requirements may be headed—and to provide input before standards are finalized.
If gambling addiction services are relevant to your organization, watch for the October field review and consider having the appropriate clinical and accreditation leaders review the proposed requirements.
CMS
Technology-Supported Care Expands Further Into Substance Use Treatment
CMS announced in September that it is expanding its ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions) to include technology-supported care for Medicare beneficiaries with several chronic conditions, including substance use disorders. The expansion is expected to begin in spring 2027.
The development is worth watching because it reflects a broader direction in behavioral healthcare: CMS is increasingly exploring ways technology can support ongoing treatment outside traditional face-to-face encounters.
Barrins Perspective
For behavioral health and substance use treatment providers, reimbursement and technology are increasingly intersecting with clinical practice.
Organizations considering technology-supported treatment should look beyond whether a platform can be reimbursed. Leadership should also consider clinical oversight, documentation, client selection, privacy, staff responsibilities, outcomes, and how the technology fits into the treatment plan.
This pairs particularly well with our October article on digital technology and behavioral healthcare.
Don’t Just Update Your Environmental Risk Assessment—Change the Way You Use It
This month’s EC News offers a useful reminder: your environmental suicide-risk assessment should be a living document, not a survey-preparation document.
At your next safety or Environment of Care meeting, select one client-care area and take the assessment into the environment. Don’t just verify that previously identified risks were corrected.
Ask:
What has changed since we last looked?
Look for new furnishings, replaced hardware, damaged fixtures, cords, equipment, changes in visibility, or anything else introduced into the environment since the last assessment.
A risk assessment completed last year cannot identify a hazard introduced last week.
Barrins & Associates provides regulatory and accreditation consulting services exclusively for the behavioral healthcare industry, including psychiatric hospitals and freestanding behavioral health organizations. We specialize in survey preparation and continuous survey readiness, helping organizations provide safe, compliant, and high-quality care.
Founded in 1999 by Anne Barrins, former Joint Commission surveyor, the firm has built a reputation for practical, experience-driven guidance. Today, Barrins’ leadership includes Julia Finken, former Joint Commission surveyor, former Associate Director of Business Development for the Joint Commission Home Care Program, and Executive Director of Business Development for the Behavioral Healthcare and Psychiatric Hospital Programs, and John Berry, former Joint Commission Resources Principal Consultant and nationally recognized expert in CMS behavioral health regulations and survey readiness.
Inside This Issue
Three Fresh Ways to Look at Quality Improvement
Depression Screening is Common: Are We Getting Enough Value From It?
When Technology Becomes Part of Behavioral Healthcare: Are You Ready?
Accreditor Insights & Updates: JC, CARF, CMS
Don’t Just Update Your Environmental Risk Assessment—Change the Way You Use It
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Director Quality Assurance
State-Operated Local Mental Health
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We’re excited to partner with the following organizations as they work toward accreditation, strengthen compliance, and build a culture of continuous quality improvement. Welcome to Barrins & Associates.
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At Barrins & Associates, we help behavioral health organizations turn compliance into resilience—strengthening systems, supporting staff, and improving care for every patient.
We can assist you to achieve and sustain accreditation and regulatory compliance in adherence to the TJC, DNV, CHIQ, ACHC, CARF, COA, QUAD-A, and CMS, standards for psychiatric hospitals and community behavioral health and human services providers.
Inquire today about our consulting services.
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