Every week, Detroit-based Henry Ford Health’s behavioral health service was seeing 500 to 600 referrals from patients arriving in primary care. Deepak Prabhakar, MD, wanted to make sure those referrals end with the right care, not just an appointment.
The system’s answer was Same-Day Solutions, a model that connects primary care patients who raise a mental health concern with a licensed behavioral health clinician the same day. Henry Ford launched the pilot in July 2025. Since then, the share of referred patients who complete a behavioral health appointment has climbed more than 50% at pilot sites.
The model has also outgrown its pilot footprint. It was live in 14 primary care clinics at its one-year mark and now runs in 24, with a 25th set to open by the end of October, Dr. Prabhakar told Becker’s.
Dr. Prabhakar, chair of the Department of Psychiatry and Behavioral Medicine and medical director of behavioral health services at the 50,000-employee system, said the work starts with a national gap. More than 1 in 5 people in the U.S. has a diagnosable mental health condition, and around half never reach qualified care, according to the NIH.
The cost of a wait list
Primary care is where Henry Ford saw its biggest opportunity. The longer a patient goes without care for behavioral health needs, the more it costs, both in total cost of care and in the patient’s and family’s health and finances, Dr. Prabhakar said. Left alone long enough, many of those patients end up somewhere else entirely.
“A lot of those patients ultimately have worsening disease state, leading to an emergency room visit, which we all know is not [the] best use of resources,” he said. “Quite frankly, emergency rooms are not intended to be managing those kinds of day-to-day crises that come up in individuals with mental health conditions.”
Opening the front door faster is only half the challenge. In communities without a model such as this, patients often wait weeks or months for a first appointment, and the wait can end in the wrong place.
“You will hear that there is a wait list for patients in that community over several weeks, several months,” Dr. Prabhakar said. “At the end of that wait list, still a patient might be aligned with a care provider who may not be able to address their needs.”
He cited an example of a patient in a severe episode of depression or anxiety who may need medication management, yet land with a therapist who cannot prescribe.
1 button, same day
Under Same-Day Solutions, a primary care visit includes screening tools and a clinical interview. If either surfaces a behavioral health concern, whether mild, moderate or severe, the physician presses a single button that links the patient the same day to a licensed behavioral health clinician. No patient is excluded based on severity, Dr. Prabhakar said. The patient is scheduled for a telehealth consultation before leaving the office.
The clinician is embedded in Henry Ford’s behavioral health access operations. That person first assesses whether the need is urgent or emergent and handles any crisis on the spot. Then the clinician routes the patient to the right next step: individual therapy, medication management, a specialty clinic, group treatment, an intensive outpatient or partial hospitalization program, or crisis care in an acute setting.
Close to half of patients never need to leave primary care. Henry Ford runs a collaborative care model in which behavioral health specialists embedded in primary care practices relay guidance from psychiatrists. A physician unsure whether to titrate a medication dose can get an answer without sending the patient out of the clinic. Over time, primary care teams are also getting faster at recognizing when a case is beyond what they can safely manage, Dr. Prabhakar said.
That split is what makes the specialty side workable.
“Instead of facing 100 out of 100, now we are only scheduling 50 out of 100 in appropriate programs,” he said. “So access becomes manageable, it becomes doable, and it’s no longer an impossible task that is generally thought of whenever it comes to behavioral health access.”
Matching, not just scheduling
The early numbers point to a less congested system. Behavioral health referrals rose 22% over the pilot’s first year, yet the number of patients waiting to be scheduled fell by as much as 85% across Henry Ford’s behavioral health services. Referrals to specialty services that were not the right fit dropped 76%, and patients at pilot sites typically complete their first consultation within days of raising a concern.
Dr. Prabhakar credits the jump in completed appointments to alignment. When patients get what they need quickly, and from the right provider, they are more likely to follow through, he said.
“It’s not good enough for behavioral health to say X number of patients needed appointments and all were provided appointments,” he said. “What we need to get at is: Did it actually address their clinical concern?”
‘Demand is through the roof’
The biggest implementation hurdle has been appetite. Primary care teams are lining up to join, in part because the model takes pressure off them: Patients no longer linger in practices that cannot fully manage their concerns.
“As much as it’s good, it might also be a challenge, which is [why] it’s so successful,” Dr. Prabhakar said. “The demand is just through the roof.”
His advice to systems considering a similar approach starts with priorities. Treat access to quality care, not just access, as the goal; and booking appointments is necessary but not sufficient, he said.
“Right care, right place, right time is a mantra that we all live with, and it’s not something that only gets shared in meetings,” he said. “It’s something that we challenge ourselves [with] every morning.”
He also recommends running a local needs assessment. Primary care made sense as the entry point for a mature, integrated system such as Henry Ford. Elsewhere, the front door might be the emergency department, inpatient units or step-down care. From there, systems can work out how to embed behavioral health expertise at the point of care and line up resources downstream. As the model spreads, Dr. Prabhakar urged leaders to protect its fidelity rather than let it drift site by site.
“All of us are in the same boat when it comes to resources,” he said. “None of us are resource rich, and there are never going to be enough resources.”
The payer question
In the long term, Dr. Prabhakar sees reimbursement as the piece still catching up. He framed it as an opportunity rather than a concern, and said advocacy with payers remains a priority for Henry Ford.
“Typically, a payer or a health system is comfortable in charges that are submitted by specialty clinics,” he said. “Here, what we are doing is we are bringing that care further upstream all the way to primary [care].”
Care delivered upstream costs less, he said, but it still costs something. As patient needs, care models and technology push behavioral health closer to the patient, payers will need to adjust how they pay for it.
“Payers need to be nimble to this changing dynamic because it’s still [a] cost when it comes to taking care of patients for the upstream, lower cost — but there is some cost to this.”
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