Dr. Zein received her dual bachelor’s degrees in Anthropology and Physiological Science at UCLA and worked initially as a healthcare consultant, developing programs that improve healthcare access for vulnerable populations. She returned to school to pursue a Masters in Public Health at Johns Hopkins University; her research foci were disaster response interventions for physical and mental health and the impact of the built environment on public health. During her masters, she worked with the International Rescue Committee in Baltimore to help address the acculturation and psychological stress the Baltimore refugee population faced in resettlement.

Dr. Zein completed her medical training at McGill University. During medical school she continue to pursue interests in global and cultural health, focusing on national and local clinical projects to support refugee and asylum seeker access to medical and mental health treatment as part of CFMS. She was awarded the Mona Bronfman Sheckman Prize in Psychiatry for her work. During her psychiatry residency training at New York University (NYU), Dr. Zein continued pursuing her interest in global mental health, working as a group leader for refugees/asylum seekers in the Bellevue Survivors of Torture program, and the Association for Culture and Psychiatry.

She also became interested in models of Integrated Behavioral Health (IBH) to provide better access to mental health services within primary care and other settings. She founded the Integrated Behavioral Health resident working group and designed a two-year resident training program in the Collaborative Care Model, and developed a Collaborative Care model in one of NYU Langone-Brooklyn's FQHC sites. She completed residency as a chief resident and won awards for Excellence in Resident Teaching as well as for humanism and clinical excellence in the Comprehensive Psychiatric Emergency Program

Dr. Zein completed her Consult Liaison Fellowship at Stanford and has remained as clinical faculty. She previously currently served as an attending psychiatrist on the General, Intensive Care, and ED-Psychiatry Consult service. She currently works as the Psychiatric Director for Integrated Behavioral Health. She initially the model for the Stanford Primary Care Clinic serving Cisco employees and their families. She is currently working on expanding Integrated Behavioral health to other Stanford Primary Care Clinics, and has worked with Stanford's Digital Health Team to start and expand psychiatry e-consults for primary care. She also works as the Behavioral Health Director for Cisco, applying principles of organizational psychiatry and public health to assess company behavioral health strategy and provide support for Cisco employees and their families. Additionally, Dr Zein is part of the Stanford Mental Health lab where she supervises and completes evaluations for refugee and asylum seekers, and teaches Neuroscience and Psychopharmacology for the Psychiatry Residents

Clinical Focus

  • Consult-Liaison Psychiatry
  • Integrated Behavioral Health in Primary and Specialty Care
  • Organizational Psychiatry
  • Psychosomatic Medicine

Academic Appointments

Administrative Appointments

  • Psychiatry Director of Integrated Behavioral Health, Stanford University School of Medicine- Department of Psychiatry and Behavioral Sciences (2021 - Present)

Professional Education

  • Board Certification: American Board of Psychiatry and Neurology, Consultation-Liason Psychiatry (2019)
  • Board Certification, Consult-Liaison Psychiatry, American Board of Psychiatry and Neurology (2019)
  • Fellowship: Stanford University Psychiatry and Behavioral Sciences (2019) CA
  • Board Certification: American Board of Psychiatry and Neurology, Psychiatry (2018)
  • Residency: New York University Psychiatry Residency (2018) NY
  • Medical Education: McGill University Faculty of Medicine (2014) Canada

All Publications

  • Asynchronous Versus Synchronous Screening for Depression and Suicidality in a Primary Health Care System: Quality Improvement Study. JMIR mental health Sattler, A., Dunn, J., Albarran, M., Berger, C., Calugar, A., Carper, J., Chirravuri, L., Jawad, N., Zein, M., McGovern, M. 2024; 11: e50192


    Despite being a debilitating, costly, and potentially life-threatening condition, depression is often underdiagnosed and undertreated. Previsit Patient Health Questionnaire-9 (PHQ-9) may help primary care health systems identify symptoms of severe depression and prevent suicide through early intervention. Little is known about the impact of previsit web-based PHQ-9 on patient care and safety.We aimed to investigate differences among patient characteristics and provider clinical responses for patients who complete a web-based (asynchronous) versus in-clinic (synchronous) PHQ-9.This quality improvement study was conducted at 33 clinic sites across 2 health systems in Northern California from November 1, 2020, to May 31, 2021, and evaluated 1683 (0.9% of total PHQs completed) records of patients endorsing thoughts that they would be better off dead or of self-harm (question 9 in the PHQ-9) following the implementation of a depression screening program that included automated electronic previsit PHQ-9 distribution. Patient demographics and providers' clinical response (suicide risk assessment, triage nurse connection, medication management, electronic consultation with psychiatrist, and referral to social worker or psychiatrist) were compared for patients with asynchronous versus synchronous PHQ-9 completion.Of the 1683 patients (female: n=1071, 63.7%; non-Hispanic: n=1293, 76.8%; White: n=831, 49.4%), Hispanic and Latino patients were 40% less likely to complete a PHQ-9 asynchronously (odds ratio [OR] 0.6, 95% CI 0.45-0.8; P<.001). Patients with Medicare insurance were 36% (OR 0.64, 95% CI 0.51-0.79) less likely to complete a PHQ-9 asynchronously than patients with private insurance. Those with moderate to severe depression were 1.61 times more likely (95% CI 1.21-2.15; P=.001) to complete a PHQ-9 asynchronously than those with no or mild symptoms. Patients who completed a PHQ-9 asynchronously were twice as likely to complete a Columbia-Suicide Severity Rating Scale (OR 2.41, 95% CI 1.89-3.06; P<.001) and 77% less likely to receive a referral to psychiatry (OR 0.23, 95% CI 0.16-0.34; P<.001). Those who endorsed question 9 "more than half the days" (OR 1.62, 95% CI 1.06-2.48) and "nearly every day" (OR 2.38, 95% CI 1.38-4.12) were more likely to receive a referral to psychiatry than those who endorsed question 9 "several days" (P=.002).Shifting depression screening from in-clinic to previsit led to a dramatic increase in PHQ-9 completion without sacrificing patient safety. Asynchronous PHQ-9 can decrease workload on frontline clinical team members, increase patient self-reporting, and elicit more intentional clinical responses from providers. Observed disparities will inform future improvement efforts.

    View details for DOI 10.2196/50192

    View details for PubMedID 38712997

  • Evaluating the Implementation of a Model of Integrated Behavioral Health in Primary Care: Perceptions of the Healthcare Team. Journal of primary care & community health Dunn, J. A., Chokron Garneau, H., Jawad, N., Zein, M., Elder, K. W., Sattler, A., McGovern, M. 2023; 14: 21501319221146918


    OBJECTIVES: This study aims to compare primary care providers and medical assistants in degrees of comfort, confidence, and consistency when addressing behavioral health concerns with patients before and after the implementation of a model of integrated behavioral health in primary care (IBHPC), and evaluate whether these perceptions differ based on increased access to behavioral health clinicians.METHODS: This longitudinal study was conducted at 2 primary care clinics in Northern California while implementing an IBHPC model. The Integrated Behavioral Health Staff Perceptions Survey was administered to assess the comfort, confidence, and consistency of behavioral health practices. Confidential online surveys were distributed to primary care faculty and staff members before and post-implementation. Responses from providers and medical assistants were compared between pre- and post-implementation with linear regression analyses. The relationships between accessibility to behavioral health clinicians and a change in comfort, confidence, and consistency of behavioral health practices were explored using a linear mixed-effects model.RESULTS: A total of 35 providers and medical assistants completed the survey both before and post-implementation of IBHPC. Over time, there were increasingly positive perceptions about the consistency of behavioral health screening (P=.03) and overall confidence in addressing behavioral health concerns (P=.005). Comfort in addressing behavioral health concerns did not significantly change for either providers or staff over time. Medical assistants were initially more confident and comfortable addressing behavioral health concerns than providers, but providers' attitudes increased post-IBHPC implementation. Improved access to behavioral health clinicians was associated with greater consistency of screening and referral to specialty mental health care (P<.001).CONCLUSION: The present study is the first to explore differences in provider and medical assistant perceptions during the course of an IBHPC implementation. Findings underscore the importance of integrating medical assistants, along with providers, into all phases of the implementation process.

    View details for DOI 10.1177/21501319221146918

    View details for PubMedID 36625239

  • Musical Memories-Musical Hallucinations in a Lung Transplant Recipient: Case Report and Literature Review JOURNAL OF THE ACADEMY OF CONSULTATION-LIAISON PSYCHIATRY Zein, M., Sher, Y. 2021; 62 (1): 140-149
  • A Call to Action: A New Era Calls for Incorporating Social Justice Into Consultation-Liaison Psychiatry JOURNAL OF THE ACADEMY OF CONSULTATION-LIAISON PSYCHIATRY Robinson, D. M., Taylor, A. D., Zein, M., Behbahani, K. S., Khandai, A. C. 2021; 62 (1): 157-158
  • Musical Memories-Musical Hallucinations in a Lung Transplant Recipient: Case Report and Literature Review. Psychosomatics Zein, M., Sher, Y. 2020

    View details for DOI 10.1016/j.psym.2020.06.009

    View details for PubMedID 32977990

  • A Call to Action: A New Era Calls for Incorporating Social Justice Into Consultation-Liaison Psychiatry. Psychosomatics Robinson, D. M., Taylor, A. D., Zein, M. n., Behbahani, K. S., Khandai, A. C. 2020

    View details for DOI 10.1016/j.psym.2020.09.004

    View details for PubMedID 33097226