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Faculty & Staff

Stephen Crystal

Distinguished Research Professor

MA, PhD, Harvard University

Dr. Crystal's research interests include AIDS, long-term care, homelessness, and longitudinal data analysis.

Bio: 

Stephen Crystal (Ph. D., Harvard, 1981) is Board of Governors Professor in the Institute for Health, Health Care Policy and Aging Research and the School of Social Work. At the Institute, he directs the Center for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes, whose programs include the AHRQ-funded Center for Education and Research on Mental Health Therapeutics. He also is Chair of the Institute's Division on Aging and Associate Institute Director for Health Services Research. Dr. Crystal's work, which has resulted in more than 250 publications, includes many widely cited books and research articles on old-age policy and services for the elderly; on the use and outcomes of psychotropic medications and other mental health treatments; on HIV/AIDS care; and on numerous other health care and social policy topics. His work on gerontological policy and inequality has been particularly influential nationally, as the cumulative advantage model of aging which he originally proposed in the 1980s and has developed in a line of subsequent work has contributed to understanding of late-life inequalities and the way in which initial advantages such as educational attainment; social structures; health and economic events over the lifecourse; and public policies interact to shape late-life outcomes. He has also been an important contributor to research on long-term care and mental health among the elderly. His work on mental health services has contributed importantly to understanding problems of healthcare access, quality and disparities in large usual care populations, particularly those served by Medicare and Medicaid. Much of his recent work has focused on prescription drug use in society where he has pioneered important studies on treatment use, safety, and effectiveness, including current work on comparative effectiveness of treatments funded by the FDA and the Agency for Healthcare Research and Quality. In 2009, his contributions to scholarship on health services and outcomes were recognized by his appointment as Board of Governors Professor of Health Services Research at Rutgers University, with the university's Board of Governors citing his "major theoretical, methodological, and research contributions in the fields of aging, HIV care, and behavioral health; his highly influential and social policy scholarship; the impressive rigor of his cross-disciplinary research contributions that have shaped thinking, both in the U.S. and abroad, on issues confronting some of the most vulnerable groups in our society" and for his "numerous and enormously influential books, journal articles, reports, and other publications . and his outstanding contributions to improving decision-making in public policy as evidenced by his frequent invitations to testify before and advise Congress and other policymakers."

Selected Recent Publications: 

Research Articles

Hilt R, Thompson E, Kelleher K, Correll CU, Crystal S, Earls M, Kowatch R, Newton D, Schwartz N, Robb A, Rogalski K, Beck A, Yaroborough BJ, Vitiello B, Simon GE.  Development of a Symptom-Focused Model to Guide the Prescribing of Antipsychotics in Children and Adolescents: Results of the first Phase of the Safer and Targeted Use of Antipsychotics (SUAY) Clinical Trial.  In Press, Journal of the American Academy of Child and Adolescent Psychiatry

Crystal S.  Linking the Levels: Integrating Individual Trajectories, Historical Contingency, and Social Policy Choices in Cumulative Advantage and Disadvantage Research.  Journal of Gerontology, Social Sciences 75(6): 1245-1258, 2020. https://doi.org/10.1093/geronb/gbaa059

Crystal S, Jarrin O, Rosenthal M, Hermida R, Angell B.  National Partnership to Improve Dementia Care in Nursing Homes Campaign: State and Facility Strategies, Impact, and Antipsychotic Reduction Outcomes.  Innovation in Aging 4(3), 2020, https://doi.org/10.1093/geroni/igaa018.

Williams AR, Samples H, Crystal S, Olfson M.  Acute Care, Prescription Opioid Use, and Overdose Following Discontinuation of Long-Term Buprenorphine Treatment for Opioid Use Disorder.  American Journal of Psychiatry. E-pub in advance of print 12/2/19, print publication AJP 177(2):117-124, 2020.  Published with editor’s note and editorial: Connery HS, Weiss RD.  Discontinuing Buprenorphine Treatment of Opioid Use Disorder: What Do We (Not) Know? American Journal of Psychiatry 177(2):104-106, 2020.

Bushnell GA, Crystal S, Olfson M.  Trends in Antipsychotic Treatment of Young, Privately Insured Children.  In press, Journal of the American Academy of Child and Adolescent Psychiatry. Summarized in Murez C, Too Many Kids Still Get Antipsychotics They Don't Need, US News and World Report, November 15, 2020, and in Kuntz L, The Decline of Child Antipsychotic Medications, Psychiatric Times, November 10, 2020.

Stroup TS, Gerhard T, Crystal S, Huang C, Tan Z, Wall M, Mathai C, Olfson M. Comparative Effectiveness of Adjunctive Psychotropic Medications in Schizophrenia.  JAMA Psychiatry 76(5):508-515, 2019.  doi:10.1001/jamapsychiatry.2018.4489

Samples H, Williams AR, Crystal S, Olfson M.  Impact of Long-Term Buprenorphine Treatment On Adverse Health Care Outcomes In Medicaid.  Health Affairs 39(5): 747–755, 2020.  https://doi.org/10.1377/hlthaff.2019.01085

Simmel C, Bowden C, Neese Todd S, Hyde J, Crystal S.  Antipsychotic Treatment for Youth in Foster Care: Perspectives on Improving Youths’ Experiences in Providing Informed Consent.  In press, American Journal of Orthopsychiatry.

Mackie, T. I., Kovacs, K. M., Simmel, C., Crystal, S., Neese‐Todd, S., & Akincigil, A. (2020) A Best‐Worst Scaling Experiment to Identify Patient‐Centered Claims‐Based Outcomes for Evaluation of Pediatric Antipsychotic Monitoring Programs. Health Services Research. Advance online publication. doi: 10.1111/1475-6773.13610

Edelman EJ, Li Y, Barry D, Braden J, Crystal S, Kerns RD, Gaither JR, Gordon KS, et al.  Trajectories of Self-Reported Opioid Use Among Patients with HIV Engaged in Care: Results From A National Cohort Study.  JAIDS 84(1):26-26, 2020.  doi: 10.1097/QAI.0000000000002310

Rosenthal M, Angell K, Poling J, Connolly L, Wec A, Crystal S.  “Medication is Just One Piece of the Whole Puzzle”: How Nursing Homes Change Their Use of Antipsychotic Medications. In press, Journal of Applied Gerontology.

Akincigil A, Mackie T, Cook S, Hilt R, Crystal S. Effectiveness of Mandatory Peer Review to Reduce Antipsychotic Prescriptions for Medicaid-Insured Children.  Health Services Research, e-pub in advance of print, June 21, 2020.  https://doi.org/10.1111/1475-6773.13297

Gerhard T, Stroup TS, Correll CU, Setoguchi S, Strom BL, Huang C, Tan Z, Crystal S, Olfson M.  Mortality Risk of Antipsychotic Augmentation for Adult Depression.  PLOS One 15(9): e0239206, 2020. https://doi.org/10.1371/journal.pone.0239206 16.           Bushnell G, Gerhard T, Crystal S, Olfson M.  Benzodiazepine Treatment and Fracture Risk in Young Persons with Anxiety Disorders.  Pediatrics 146(1), July 1, 2020.  doi https://doi.org/10.1542/peds.2019-3478

Sultan R, Wang S, Crystal S, Olfson M. Cohort Analysis of Antipsychotic Treatment of Youth with ADHD in Attention/Deficit Hyperactivity Disorder.   JAMA Network Open 2(7), July 3, 2019.

Ilomäki J, Bell JS, Chan A, Tolppanen A, Luo H, Wei L, Lai E, Shin J, Paoli G, Pajouheshnia R, Ho F, Reynolds L, Lau K, Crystal S, Lau W, Man K, et al.  Application of Healthcare ‘Big Data’ in CNS Drug Research: The Example of the Neurological and Mental Health Global Epidemiology Network (NeuroGEN).  CNS Drugs, e-pub in advance of print, 2020.  https://doi.org/10.1007/s40263-020-00742-4.

Olfson M, Crystal S, Wall M, Wang S, Liu SM, Blanco C. Causes of Death Following Nonfatal Opioid Overdose.  JAMA Psychiatry 75(8): 820-827, August 2018.  doi:10.1001/jamapsychiatry.2018.1471

Samples H, Williams AR, Olfson M, Crystal S.  Risk Factors for Premature Discontinuation of Buprenorphine Treatment for Opioid Use Disorders in a Multi-State Sample of Medicaid Enrollees.  Journal of Substance Abuse Treatment 95: 8-17, December 2018.

Stroup TS, Gerhard T, Crystal S, Huang C, Tan Z, Wall M, Mathai C, Olfson M. Comparative Effectiveness of Adjunctive Psychotropic Medications in Schizophrenia.  JAMA Psychiatry, e-pub in advance of print, May 2019.

King JT, Perkal MF, Rosenthal RA, Gordon AJ, Crystal S, Rodriguez-Barradas M, Butt A, Gibert C, Rimland D, Simberkoff M, Justice A.  Thirty-Day Post-Operative Mortality Among Individuals with HIV Infection Receiving Antiretroviral Therapy and Procedure-Matched, Uninfected Comparators.  JAMA Surgery 150(4): 343-351, 2015.

Banerjee G, Edelman E, Barry D, Becker W, Cerda M, Crystal S, Gaither J, Gordon A, Gordon K, Kerns R, Martins S, Fiellin D, Marshall B.  Non-Medical Use of Prescription Opioids is Associated with Heroin Initiation Among US Veterans: A Prospective Cohort Study.  Addiction 111(11):2021-2031, 2016.

Park Y, Franklin J, Schneeweiss S, Levin R, Crystal S, Gerhard T, Huybrechts K.  Antipsychotics and Mortality: Adjusting for Mortality Risk Scores to Address Confounding by Terminal Illness.  Journal of the American Geriatrics Society 63(3): 516-523, 2015

Finnerty M, Neese-Todd S, Bilder S, Olfson M, Crystal S.  MEDNET: A Multistate Policymaker-Researcher Collaboration to Improve Prescribing Practices.  Psychiatric Services 65(11):1297-9, 2014.

Vanderwerker L, Olfson M, Gerhard T, Akincigil A, Crystal S.  Foster Care, Externalizing Disorders, and Antipsychotic Use.  Psychiatric Services 65(10), 2014.  doi: 10.1176/appi.ps.201300455.

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