Bonnie T. Zima, MD, MPH is a child psychiatrist and health services researcher. She is the Associate Director of the UCLA Center for Health Services and Society and Professor-in-Residence (Child and Adolescent Psychiatry) in the UCLA Department of Psychiatry and Behavioral Sciences at the David Geffen School of Medicine. Her research focuses on the unmet need for mental health services among high risk child populations (i.e., homeless, foster care, juvenile justice) and the quality of mental health care for children enrolled in Medicaid-funded outpatient programs.
Dr. Zima is a standing member of the Steering Committee for the National Quality Forum’s (NQF) Behavioral Health Measures Project, a past member for the NQF Child Outcomes and Child Health Projects, and member of the APA Council on Quality. She led the first statewide study on quality of publicly-funded outpatient child mental health care which developed and reported adherence to 121 quality indicators. Guided by this research, Dr. Zima led a five-year NIMH-funded study that examined the quality of care and 18-month clinical outcomes among 546 children receiving care for ADHD in primary care and specialty mental health clinics within one of the nation’s largest managed care Medicaid health plans. Building upon this work, she was recently awarded a state contract (as Co-PI) to develop in partnership with the State, a performance measurement system for children receiving mental health care in Medi-Cal funded outpatient programs. The overarching goal is to improve the quality of care for children through improved monitoring of the care delivered and how it relates to clinical outcomes that are meaningful to parents, provides and agency leaders.
In addition, Dr. Zima is Principal Investigator (PI) of MH2™, Mobile Health for Mental Health, a web-based application to optimize stimulant medication treatment for children with ADHD served in publicly-funded mental health programs. She is also PI on a five-year study to develop and pilot test integrated care models for children in two Chicago-based programs serving low-income children in high crime neighborhoods. Further, Dr. Zima is Co-Investigator on a three-year PCORI-funded randomized trial of a telehealth intervention to provide mental health services to children served within a network of federally qualified health care centers in Los Angeles County (PI: Coker).
Her research has received all three national research awards from the American Academy of Child and Adolescent Psychiatry (AACAP). Dr. Zima is a member of the Institute of Medicine’s Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders, AACAP’s Work Group on Research, Co-Chair of the Mental Health Work Group for the CHIPRA-AHRQ Center of Excellence for Children with Complex Health Care Needs (PI: Mangione-Smith), and a Distinguished Fellow of the American Psychiatric Association and AACAP.
Mobile Health for Mental Health, MH2™, is a web-based application that optimizes early stimulant medication treatment for children with Attention Deficit Hyperactivity Disorder (ADHD) through improving communication between the parent, teacher, and prescriber. Pilot-testing is underway at Augustus Hawkins, a community mental health clinic that serves predominantly low-income children and families in South Central Los Angeles and San Fernando Child and Family Guidance Center.
The goal of Healthy Minds, Healthy Children, Healthy Chicago (H3) is to develop a a trauma-informed integrated care model to improve the prevention, early detection and treatment of child mental health problems. The main aims of the project evaluation are: 1) to describe the feasibility and acceptability of the care model by describing the care processes delivered; and 2) evaluate whether the care model is promising by tracking improvement in clinical outcomes in the child and primary caregiver over time (i.e., 3, 6, 12 months). The main care processes are: child mental health screenings, on-site brief mental health interventions, referral to specialty mental health, and if part of the care model, the detection of need for primary care in the affiliated specialty mental health program. For the child, the main clinical outcomes are mental health problem symptoms, health related quality of life, depression and high risk behaviors (youth only), functioning, and academic achievement. For the primary caregiver, the clinical outcomes are caregiver stress, probable depression, resilience and empowerment. The final selection of the clinical outcomes was guided by feedback from the clinical providers and community advisory board.
Zima BT, Karno M. Child psychiatric epidemiology: methodologic challenges and future trends. Current Opinion in Psychiatry. 1993;6:280-283.
Buckner JC, Bassuk EL, Zima BT. Mental health issues affecting homeless women: implications for intervention. Am J Orthopsych. 1993;63:385-399.
Zima BT, Wells KB, Freeman HE. Emotional and behavioral problems and severe academic delays among sheltered homeless children in Los Angeles County. Am J Public Health. 1994;84:260-264.
Bussing R, Menvielle E, Zima BT. Relationship between behavioral problems and unintentional injuries in U.S. children. Arch Pediatr Adolesc Med. 1996;150:50-56.
Zima BT, Wells KB, Benjamin B, Duan N. Mental health problems among homeless mothers: relationship to service use and child mental health problems. Arch Gen Psychiatry. 1996;53:332-338.
Zima BT, Bussing R, Forness SR, Benjamin B. Sheltered homeless children: their eligibility and unmet need for special education evaluations. Am J Public Health. 1997;87:236-240.
Bussing R, Zima BT, Belin TR, Forness SR. Children who qualify for LD and SED programs: do they differ in level of ADHD symptoms and comorbid psychiatric conditions? Behavioral Disorders. 1998;23:85-97.
Zima BT, Forness SR, Bussing R, Benjamin B. Homeless children in emergency shelters: need for prereferral intervention and potential eligibility for special education. Behavioral Disorders. 1998;23:98-110.
Forness SR, Ramey SL, Ramey CT, Hsu C, Brezausek CM, MacMillan DL, Kavale KA, Zima BT. Head Start children finishing first grade: preliminary data on school identification of children at risk for special education. Behavioral Disorders. 1998; 23:111-124.
Bussing R, Zima BT, Perwien AR, Belin TR, Widawski M. Children in special education programs: attention deficit hyperactivity disorder, use of services, and unmet needs. Am J Public Health. 1998: 88:880-886.
Bussing R, Schoenberg NE, Rogers KM, Zima BT, Angus S. Explanatory models of ADHD: do they differ by ethnicity, child gender, or treatment status? J Emotional and Behavioral Disorders, 1998;6:233-242.
Bussing R, Zima BT, Belin TR: Variations in ADHD treatment among special education students. J Am Acad Child Adolesc Psychiatry. 1998;37:968-976.
Forness SR, Cluett SE, Ramey CT, Ramey SL, Zima BT, Hsu C, Kavale KA, MacMillan DL. Special education identification of Head Start children with emotional or behavioral disorders in second grade. Journal of Emotional and Behavioral Disorders. 1998; 6:194-204.
Bussing R, Zima BT, Belin TR. Differential access to care for children with ADHD in special education programs. Psychiatric Services. 1998;49:1226-1229.
Zima BT, Bussing R, Bystritsky M, Widawski M, Belin TR, Benjamin B. Psychosocial stressors among homeless children: relationship to behavior problems and depressive symptoms. Am J Orthopsychiatry. 1999; 69:127-133.
Cluett SR, Forness SR, Ramey SL, Ramey CT, Zima BT, Brezausek CM, Kavale KA. Head start children at third grade: preliminary special education identification and placement of children with emotional, learning, and related disabilities. J Child Family Studies. 1999; 8:285-303.
Zima BT, Bussing R, Crecelius G, Kaufman A, Belin TR. Psychotropic medication treatment patterns among school-aged children in foster care. J Child Adolesc Psychopharmacology. 1999; 9:135-147.
Zima BT, Bussing R, Crecelius G, Kaufman A, Belin TR. Psychotropic medication use among children in foster care: relationship to severe psychiatric disorders. Am J Public Health 1999:89; 1732-1735.
Zima BT, Bussing R , Freeman S, Yang X, Belin TR, Forness SR. Behavior problems, academic skill delays and school failure among school-aged children in foster care: their relationship to placement characteristics. J Child and Family Studies 2000:9; 87-103.
Zima BT, Bussing R, Yang X, Belin TR. Help-seeking steps and service use among children in foster care. Journal of Behavioral Health Services & Research 2000:27; 271-285.
Bussing R, Zima BT, Perwein A. Self-esteem in special education children with ADHD: relationship to disorder characteristics and medication use. J Am Acad Child Adolesc Psychiatry 2000;39:1260-1269.
Stein BD, Zima BT, Elliot MN, Burnam MA, Shahinfar A, Fox NA. Violence exposure among school-aged children in foster care: relationship to distress symptoms. J Am Acad Child Adolesc Psychiatry 2001; 40:588-594.
Kataoka S, Zima BT, Dupre D, Moreno K, Yang X, McCracken J. Mental health problems and service use among female juvenile offenders: their relationship to criminal history J Am Acad Child Adolesc Psychiatry 2001; 40: 549-555.
Rogers KM, Zima BT, Powell E, Pumariega AJ. Who is referred to mental health services in the juvenile justice system. Journal of Child and Family Studies 2001; 10:485-494.
Sexson S, Sargent J, Zima BT, Beresin E, Cuffe S, Drell M, Fox G, Dugan T, Kim WJ, Matthews K, Sylvester C, Pope K. Sample core competencies in child and adolescent psychiatry training: a starting point. Academic Psychiatry 2001;25:201-213.
Bhatara V, Vitiello B, Hoagwood K, Zima BT. Trends in combined pharmacotherapy with stimulants for children. Psychiatric Services 2002; 53:244.
Bussing R, Zima BT, Gary FA, Garvan CW. Use of complimentary and alternative medicine for symptoms of Attention Deficit Hyperactivity Disorder. Psychiatric Services 2002;53:1096-1102.
Bussing R, Zima BT, Gary FA, Garvan CW. Barriers to detection, help-seeking and service use for children with ADHD symptoms. Journal of Behavioral Health Services & Research 2003;30:176-189.
Bussing R, Zima BT, Gary FA, Mason DM, Leon CE, Sinha K, Garvan CW. Social networks, caregiver strain, and utilization of mental health services among elementary school students at high risk for ADHD. J Am Acad Child Adolescent Psychiatry. 2003;42:842-850.
Zima BT. Wife, mother, academic psychiatrist: an enriching balance. Academic Psychiatry. 2003;27:222-224
Bhatara V, Feil M, Hoagwood K, Vitiello B, Zima BT. National trends in concomitant psychotropic medication with stimulants in pediatric visits: practice versus knowledge. Journal of Attention Disorders. 2004;7:217-225.
Sargent J, Sexson S, Cuffe S, Drell M, Dugan T, Ferren P, Kim WJ, Stubbe D, Zima B, Brown T. Assessment of competency in child and adolescent psychiatry training. Academic Psychiatry. 2004;28:18-26.
McMillen JC, Scott LD, Zima BT, Ollie MT, Munson MR, Spitznagel E. Use of mental health services among older youths in foster care. Psychiatric Services. 2004;55:811-817.
Raghavan R, Zima BT, Andersen RM, Leibowitz AA, Schuster MA, Landsverk J. Psychotropic medication use in a national probability sample of children in the child welfare system. J Child Adolesc Psychopharmacology. 2005;15:97-106.
Bussing R, Zima BT, Mason D, Hou W, Garvan CW, Forness SR. Use and persistence of pharmacotherapy in elementary school students with ADHD. J Child Adolesc Psychopharmacology. 2005;15:78-87.
McMillen C, Zima BT, Scott L, Auslander W, Munson M, Ollie M, Spitznagel E. Prevalence of psychiatric disorders among older youth in foster care. J Am Acad Child and Adolescent Psychiatry. 2005;44:88-95.
Zima BT, Hurlburt M, Knapp P, Ladd H, Tang L, Duan N, Wallace P, Rosenblatt A Landsverk J, Wells K. Quality of publicly-funded outpatient specialty mental health care for common childhood psychiatric disorders in California. J Am Acad Child and Adolescent Psychiatry. 2005; 44:130-144.
Knapp PK, Hurlburt M, Kostello EC, Ladd H, Tang L, Zima BT. Child sociodemographic and common childhood psychiatric diagnoses in Medicaid encounter data: are they valid? J Behavioral Health Services Research.2006;33:444-52.
Raghavan R, Leibowitz AA, Andersen RM, Zima BT, Schuster MA, Landsverk J. Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system. Children and Youth Services Review. 2006:28:1482-1496.
McMillen JC, Fedoravicius N, Rowe J, Zima B, Ware N. A crisis of credibility: professionals’ concerns about the psychiatric care provided to clients of the child welfare system. Administration and Policy in Mental Health. 2006 [Epub ahead of print].
Smith K, Siddarth P, Zima B, Sankar R, Mitchell W, Gowrinathan R, Shewmon A, Caplan R. Unmet mental health need in pediatric epilepsy: insights from providers. Epilepsy and Behavior. 2007.
Zima BT, Bussing R, Tang L, Zhang L, Ettner SE, Belin TR, Wells KB. Quality of care for childhood ADHD in a large managed care Medicaid program. J Am Acad Child and Adolescent Psychiatry. 2010;49(12):1225-1237.
Zima BT, Mangione-Smith R. Gaps in quality measures for child mental health care: An opportunity for a collaborative agenda. J Am Acad Child Adolesc Psychiatry.2011;50:735-737.
Bussing R, Zima BT, Mason D, Garvan C. Receiving treatment for attention deficit/hyperactivity disorder: do adolescent views matter? J Adolescent Health. 2011;49(1):7-14. Epub 20 Oct 2010.
Bussing R, Porter P, Zima BT, Mason D, Garvan C, Reid R. Academic outcomes trajectories of students with ADHD: Does exceptional education status matter? J Em Behavioral Disorders. 2012;20(3): 131-143. Epub 8 December 2011.
Bussing R, Zima BT, White KA, Meyer JM, Mason DM, Garvan C. ADHD knowledge, perceptions and information sources: perspectives from a community sample of adolescents and their parents. Journal of Adolescent Health. 2012:51: 593-600. DOI information: 10.1016/j.jadohealth.2012.03.004 Epub March 2012.
Zima BT, Murphy JM, Scholle SH, Hoagwood KE, Sachdeva RC, Mangione-Smith R, Woods D, Kamin HS, Jellinek M. National quality measures for child mental health care: background, progress, and next steps. Pediatrics. 2013;131(3): S38-49.
Martin A, Drell JM, Gleason MM, Althoff RR, Zima BT. Hats off: journal awards 2012. J Am Acad Child and Adolesc Psychiatry. 2012;51(12):1335-6.
Zima BT, Bussing R, Tang L, Zhang L. Do parent perceptions predict continuity of publicly-funded care for attention-deficit/hyperactivity disorder? Pediatrics. 2013;131(3): S50-9.
Kataoka S, Podell JL, Zima BT, Best K, Sidhu S, Bates-Jura M. MAP as a model for practice-based learning and improvement in child psychiatry training. J Clin Child Adolescent Psychology. 2014;43(2):312-22. doi: 10.1080/15374416.2013.848773. Epub 2013 Nov 18.
Rodday AM, Parsons SK, Correll CU, Robb AS, Zima BT, Saunders TS, Leslie LK. Child and adolescent psychiatrists’ attitudes and practices prescribing second generation antipsychotics. J Child Adolescent Psychopharmacology. 2014;24(2):90-3. doi: 10.1089/cap.2013.0133
Murphy M, McCarthy A, Baer L, Zima BT, Jellinek M. Alternative national guidelines for treating attention and depression problems in children: Comparison of treatment approaches and prescribing rates in the United Kingdom and the United States. Harvard Review of Psychiatry. 2014;22(3):179-92.
Bardach N, Coker T, Zima B, Murphy JM, Knapp P, Richardson L, Edwall G, Mangione-Smith R. Common and costly pediatric hospitalizations for mental health disorders. Pediatrics.2014;133(4):602-609.
Barnert E, Perry R, Azzi V, Shetgiri R, Ryan G, Dudovitz R, Zima B, Chung P. Incarcerated youths’ perspectives on protective and risk factors for juvenile offending: A qualitative analysis. Am J Public Health. 2014 Dec 18:e1-e7.
Rodday AM, Parsons SK, Mankiw C, Correll CU, Robb AS, Zima BT, Saunders TS, Leslie LK. Child and adolescent psychiatrists’ reported monitoring behaviors for second-generation antipsychotics. J Child Adolescent Psychopharmacology. (in press).
Mikesell L, Bromley E, Young AS, Vona P, Zima B. Clinician and client perspectives on information management in mental health services: developing a communication-centered epistemic model of shared decision making. Health Communication (In press).
Zima BT. Measuring Access to Care: An Innovative, Practical, and Partnered Approach. J Am Acad Child Adolesc Psychiatry. 2016 May;55(5):355-6.
Hoagwood KE, Kelleher K, Zima BT, Perrin JM, Bilder S, Crystal S. Ten-year trends in treatment services for children with Attention Deficit Hyperactivity Disorder enrolled in Medicaid. Health Affairs 2016: 35(7): 1266-1270. DOI: 10.1377/hlthaff.2015.1423.
Perrin JM, Houtrow A, Kelleher K, Hoagwood KE, Stein R, Zima BT. Supplemental security income benefits for mental disorders. Pediatrics. 2016: e20160354. DOI: 10.1542/peds.2016-0354.
Archangeli C, Marti FA, Wobga-Pasiah EA, Zima B. Mobile health interventions for psychiatric conditions in children: a systematic review. Health Information Technology for Child and Adolescent Psychiatry issue of Child and Adolescent Psychiatric Clinics of North America. 2016: http://dx.doi.org/10.1016/j.chc.2016.07.009 DOI: 10.1016/j.chc.2016.07.009.
Zima BT, Rodean J, Hall M, Bardach N, Coker T, Berry J. Psychiatric disorders and trends in resource use in pediatric hospitals. Pediatrics. 2016;138(5): e20160909. DOI: 10.1542/peds.2016-0909.
Doupnik K, Lawlor J, Zima BT, Coker TR, Bardach N, Hall M, Berry JG. The influence of comorbid mental health conditions on pediatric hospital utilization. Pediatrics. 2016: e20162416. DOI: 10.1542/peds.2016-2416.
Houtrow AJ, Zima BT. Framing childhood mental disorders within the context of disability. Disability and Health Journal: 2017;10: 461-466 DOI: 10.1016/j.dhjo.2017.04.006
Cohen E, Hall M, Lopert R, Bruen B, Chamberlain LJ, Bardach N, Gedney J, Zima BT, Berry JG. High expenditure pharmaceutical use among children in Medicaid. Pediatrics. 140(3) e:20171095. DOI: 10.1542/peds.2017-1095.
Pulcini CD, Zima BT, Kelleher KJ, Houtrow AJ. Poverty and trends in three common chronic disorders. Pediatrics. 2017; 139 (3): e2016253.
Contreras S, Porras-Javier L, Zima BT, Soares N, Park C, Chung P, Coker TR. Development of a telehealth-coordinated intervention to improve access to community-based mental health care. Ethnicity & Disease. 2017 (in press)
Zima BT, McCreary M, Kenan K, Churchey-Mims M, Chi H, Brady M, Davies J, Rompala V, Leventhal B. Development and evaluation of two integrated care models for children using a partnered formative evaluation approach. Ethnicity & Disease. 2017 (in press)
Gay JC, Zima BT, Coker TR, Doupnik S, Hall M, Rodean J, O-Neill M, Morse R, Rehm KP, Pally A, Berry JG, Bardach N. Post-acute care following hospitalization for children with primary mental health conditions. J Pediatrics. 2018;193:222-8. DOI: 10.1016/j.jpeds.2017.09.058.
Doupnik SK, Lawlor J, Zima BT, Coker TR, Bardach NS, Rehm KP, Gay JC, Hall M, Berry JG. Mental health conditions and unplanned hospital readmissions in children. Journal of Hospital Medicine. (in press)
Myers KM, Cummings JR, Zima BT, Oberleitner R, Roth DE, Merry SN, Bohr Y, Stasiak K. Asynchronous telehealth tools to improve access and quality of mental health care for children and adolescents. J Technology in Behavioral Sciences. (in press)
Mikesell L, Marti FA, Guzmán JR, McCreary M, Zima BT. Communicative uses of mHealth technology during early ADHD stimulant medication titration in-office visits. J of Applied Communication Research. (in press)