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News|Videos|October 8, 2026

How a Learning Health Network Could Transform Bipolar Disorder Treatment: A Conversation With Andrew Nierenberg, MD

Author(s)Jessica M. Gannon, MD, Andrew Nierenberg, MD

Andrew A. Nierenberg, MD, explains how the Bipolar Action Network uses shared data and improvement science to change how bipolar disorder care is delivered.

“Psychopharm Today” is a video-podcast series, created collaboratively with the American Society of Clinical Psychopharmacology (ASCP), in which members converse about the latest hot topics in psychopharmacology.

Most clinicians cannot say how their patients are doing overall. The Bipolar Action Network aims to change that, according to Andrew A. Nierenberg, MD, the Thomas P. Hackett, MD, Endowed Chair in Psychiatry at Massachusetts General Hospital (MGH) and professor of psychiatry at Harvard Medical School. Nierenberg also directs the Dauten Family Center for Bipolar Treatment Innovation at MGH.

Nierenberg spoke with Jessica Gannon, MD, of the University of Pittsburgh, in this episode of “Psychopharm Today.” He described the network as a learning health network, a model developed at Cincinnati Children’s Hospital that has been used successfully 15 times. In these networks, health care systems collaborate closely, share outcomes data, and apply improvement science to complex conditions.¹

He cited 2 examples. Solutions for Patient Safety brings together about 150 children’s hospitals that share data on hospital-acquired harm. In ImproveCareNow, more than 100 clinics treating about 30,000 young people with inflammatory bowel disease work together to improve outcomes.²

Measuring Outcomes

According to Nierenberg, the first question for any health system is whether better patient outcomes are a priority. The second is whether the system knows its patients’ outcomes, and none of the participating systems did. To keep the burden low for patients and clinicians, the network chose the Clinical Global Impression-Severity (CGI-S) scale as its core outcome measure.

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The data gave Nierenberg his first view of his own clinic’s outcomes. The clinic treats about 425 patients with bipolar disorder. About 30% are doing well and 70% are not. For patients who are not doing well, the network supports structured peer consultation, and the results of each consultation feed back into a shared database.

Network members are also adopting tactics that are common in other areas of medicine but rare in psychiatry, such as previsit planning. With this approach, labs and patient-reported data are collected before an appointment, so the clinician has actionable information during the visit.

Experts by Experience

Patients and family members, whom the network calls “experts by experience,” help redesign care. The network is built as an actor-oriented organization, a model from Øystein Fjeldstad of BI Norwegian Business School, so any member can test an idea without asking permission. Projects led by experts by experience include a mood-tracking app and a tool that stores a patient’s medication history, including response and tolerability.

“They solve the problems we wouldn’t even know about,” said Nierenberg.

Spreading Improvement

The network holds about 3 learning sessions a year, both virtual and in person. Members share network-wide and local projects at these sessions. Nierenberg drew a distinction between traditional quality improvement and improvement science. Improvement science relies on repeated plan-do-study-act cycles and a “science of spread.” Experts in system change advise members to start small, show better outcomes, and let other sites adopt what works.

Health care systems interested in joining can contact the Bipolar Action Network to see whether it is a good fit.

Dr Gannon is an associate professor of Psychiatry at the University of Pittsburgh.

Dr Nierenberg is a professor of psychiatry at Harvard Medical School and a psychiatrist at Massachusetts General Hospital.

References

1. Britto MT, Fuller SC, Kaplan HC, et al. Using a network organisational architecture to support the development of learning healthcare systems. BMJ Qual Saf. 2018;27(11):937-946.

2. Crandall WV, Margolis PA, Kappelman MD, et al. Improved outcomes in a quality improvement collaborative for pediatric inflammatory bowel disease. Pediatrics. 2012;129(4):e1030-e1041.

Oct 14, 2026

Why do people become addicted? When does a habit turn into self harm and what makes recovery so hard? From drugs and alcohol to gambling and social media, join our panel of experts as they explore the causes of addiction, what it looks like in the brain and potential new treatments, including psychedelic therapies.

Panel: Prof Sally Marlow: Professor of Public Understanding of Mental Health at KCL Matt Willis: Musician/actor and podcaster in recovery from addictions Dr Nicky Kalk: Psychiatrist and addiction specialist at Maudsley NHS Trust Prof David Nutt: Director of the Neuropsychopharmacology Unit, Imperial College, London

A Question of Science A Question of Science is a groundbreaking series of panel discussions where experts from different fields respond to your questions, sharing the scientific perspective on society’s most pressing questions. A Question of Science is BBC Studios production for the Francis Crick Institute.

The Francis Crick Institute The Francis Crick Institute is one of the biggest research institutes in Europe. We’re an independent lab and registered charity, and home to more than 1,500 scientists working to understand health, disease and how life works. © BBC Studios / Francis Crick Institute 2026

Denmark has long been considered to be the best governed country by political scientists. Lots of recent evidence to support that view.
Strong economic growth, a budget surplus and both capacity and willingness to increase defence spending to meet much greater threat levels.
In Ireland, we have the economic growth, but government is running an underlying deficit and defence spending is at a bizarrely low level. Let’s be more like Denmark!

Oct 12, 2026 #JamesStavridis#Iran#Trump Build or ban? The data center debate you need to see 👉    • Experts Debate: Data Center Pros and Cons …   A deadly attack on Saudi Arabia.

An American among the victims. And President Trump weighing military retaliation. What are America’s options? On Saturday, Iranian-backed Houthi rebels in Yemen struck Riyadh’s international airport, hitting a passenger terminal and killing at least 12 people, including an American. More than 300 others were wounded in the deadliest attack on Saudi Arabia in over a decade. The airport was struck again on Sunday. With the United States already at war with Iran since February, President Trump is now considering whether to join Saudi Arabia in striking back against the Houthis. Former NATO Supreme Allied Commander Admiral James Stavridis joins Michael Smerconish to explain how the Houthis became a sophisticated military force, the role Iran plays in supporting them, and what a potential U.S. military response could look like. Stavridis also examines three broader options facing the Trump administration in its conflict with Iran — from major military strikes to continued economic pressure and naval blockades. He explains which approach he would recommend, why American military bases remain vulnerable, and how further escalation could threaten energy infrastructure throughout the Persian Gulf. Will the United States join Saudi Arabia in retaliating against the Houthis? And could another round of military strikes widen the conflict with Iran? Watch the full conversation and share your thoughts in the comments. Subscribe to Michael Smerconish for conversations with the people shaping America’s most important debates. #JamesStavridis#Iran#Trump#MiddleEast#Smerconish Vote on today’s poll and subscribe to the daily newsletter at http://www.smerconish.com

Nation & World

Which grade is most important to a child’s development?

Stats suggest high stakes for one year in particular

October 13, 2026 4 min read

Part of theWondering series

A series of random questions answered by Harvard experts.

Pamela Mason is senior lecturer in education at Harvard Graduate School of Education and co-chair of the Teaching and Teacher Leadership Program.

As a literacy researcher, practitioner, and former school principal, I would say that every year is the most important year in a child’s life. When children start out in preschool or kindergarten, they’re so excited about learning and having teachers and friends who they learn with and from. In kindergarten, they learn some pre-reading skills. In first grade, they’re very excited about learning to read, and they start reading a little bit independently with picture books. As they grow older, they are excited about using their reading to learn about other things. All that learning is foundational to literacy because as children are learning to sound out words and attach letters to sounds, they learn to read and write whole words. They also learn to make meaning from both what they’re reading and what they’re writing.

When they move to third grade, that is when we see children make the transition from learning to read to reading to learn, which is why some experts see this grade as pivotal. Literacy pioneer Jeanne Chall wrote the book “Stages of Reading Development,” in which she made that fairly bright line between learning to read and reading to learn. Another reason why third grade is important is because it’s mandated that the students be tested objectively in third grade in many states. We don’t have a national test in the United States, and in some states and some districts, if children don’t meet a certain score on the third-grade test, they may be retained.

“I always tell my literacy interns that their job is to put themselves out of a job.”

There is a lot of focus on the instruction in third grade, and a lot of anxiety on the part of parents. Even though the test is given in third grade, the third-grade teachers can’t teach everything that the children need to know to be successful. It’s a group effort from kindergarten, first, and second, into third grade. The learning and love of learning and student success start in kindergarten, and it’s as much about what a child knows as it is how the child is motivated to know and learn.

Although Chall coined the “learning to read, reading to learn” statement, children are reading to learn before third grade. However, at third grade more of the disciplinary learning comes from being engaged in written text.

The National Assessment of Education Progress and the National Research Council have done reports that show that third grade is a predictor of future academic achievement, high school graduation, and career success. They have the statistics. It just feels that you’re dooming a young learner on the basis of a test score, and I’ve seen children who didn’t do well in third grade and, after getting the extra support that they need, become very successful. I know that there are people building prisons on the basis of third-grade scores in communities, and it feels like a self-fulfilling prophecy. Professionally and personally, that makes me uncomfortable.

In many schools across the country, there are available resources to help third-graders who are struggling. Schools can use reading specialists, who can be supportive of both the teacher and the learners, and literacy coaches who work primarily with the teachers, so they can help the teachers differentiate their instruction, provide some review and reinforcement instruction for children who don’t seem to be moving along at the expected pace. I always tell my literacy interns that their job is to put themselves out of a job; that they work one-on-one with struggling readers to give them the support and strategies to access the curriculum in the classroom and then their intervention work is done.

— As told to Liz Mineo, Harvard Staff Writer

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Two masked men burned down 11 of 17 Starlink antennas in Bulgaria

This comes after two Ships were struck near the Bulgarian shore in the Black Sea.

https://twitter.com/Megatron_ron/status/2110374482862805200/video/1

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We are saddened to learn of the passing of RJ Mitte. As a valued member of the http://BrainHealth.com community and a passionate advocate for disability rights, he inspired countless individuals through his work and voice. Our thoughts are with his family, friends, and those whose lives he touched.

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https://twitter.com/USTechForce/status/2110037882635211175/video/1

Famous British comedian Mr. Bean:

“I’m ashamed on behalf of the UK for allowing Israel to besiege 2 million people in Gaza, cut off their electricity, water and medicine, and then claim to defend human rights.”

https://twitter.com/X_Global_tv/status/2103178042457653715/video/1