Behavioral health leaders are observing a shift: industry needs are becoming more complex, intersecting with social, digital and physical health factors in new ways. While awareness and demand for services continue to grow, infrastructure, training and access have not kept pace. From early intervention to workforce well-being, the field is moving toward more integrated, proactive models of care — with an emphasis on meeting patients where they are and preparing for needs that traditional systems weren’t built to address.
Editor’s note: These responses have been lightly edited for clarity.
Question: The definition of behavioral health need is expanding — from workplace burnout to adolescent distress and aging populations. What emerging patient population or behavioral health challenge do you believe the industry isn’t yet prepared for — and how should leaders begin responding?
Scott Baker. Executive Vice President of Growth and Partnerships, Array Behavioral Care (Mount Laurel, N.J.): As tech‑ and AI‑enabled mental health solutions expand, one emerging population the industry is not yet fully prepared to support is behavioral health professionals themselves. While digital tools such as machine learning for clinical decision support and AI‑enabled scribes hold enormous potential to improve the efficiency, quality and accessibility of behavioral care, many clinicians remain wary of these innovations. This is especially true in behavioral health, where care is often viewed as a relational art form that resists quantification. Fears of being replaced by technology, combined with limited understanding of how these tools actually work, can contribute to skepticism and resistance.
To address this challenge, behavioral health leaders must help clinicians reframe technology as a support system rather than a threat. Through evidence‑based change management, training and transparent communication, leaders can demonstrate how these tools can bridge longstanding gaps between mental, physical and substance use treatment, helping clinicians across disciplines stay informed about a patient’s overall health and support more comprehensive, coordinated care. This is particularly critical in substance use care, where stigma and limited training often lead clinicians to overlook or avoid these issues.
Clinicians will be more likely to embrace technology when they see it as an ally in achieving their own clinical goals and values. For example, machine learning can help surface relevant data and prompt timely interventions, supporting more integrated, patient‑centered care. It can also help delegate tasks appropriately and reserve specialists for complex cases, optimizing care delivery while protecting clinician well‑being. Similarly, AI‑enabled scribes can reduce documentation burdens, enhance therapeutic engagement and streamline workflows.
Ultimately, success will depend not only on innovation itself but on thoughtful leadership that centers the clinician experience and ensures technology serves as an enabler of human connection — not a replacement for it.
Quatiba Davis. Chief Clinical Officer, ABA Centers (Fort Lauderdale, Fla.): From an applied behavior analysis standpoint, one of the most critical yet underserved emerging populations the behavioral health field is not adequately prepared to support includes neurodivergent individuals who are only now — often in adolescence or adulthood — gaining access to accurate, unbiased diagnoses.
These individuals, many from historically marginalized or overlooked communities, have long been underserved due to systemic inequities, cultural stigma and diagnostic overshadowing. As awareness grows and stigma lessens, more people are actively seeking clarity and validation about their behavioral health needs. However, the infrastructure to provide high‑quality, individualized support rooted in evidence‑based practice often lags behind this demand.
ABA offers a framework grounded in observable behavior, data analysis from assessments and individualized treatment — qualities especially critical when supporting individuals newly navigating their diagnosis journey. ABA has the potential to provide clarity, consistency and meaningful change. However, to meet this moment, the field must evolve:
- Services must be accessible to adults and communities historically excluded from early intervention models.
- Practitioners must be trained to approach assessment and intervention with cultural responsiveness and humility, ensuring that diagnoses and support are not filtered through biased assumptions.
- Leaders must challenge the rhetoric that conflates popular mental health trends with empirically supported treatment, advocating for practices that are both compassionate and scientifically grounded through research.
- Collaboration across multiple disciplines must be prioritized to ensure a holistic view of behavioral health that respects both lived experience and measurable outcomes.
As we look ahead, behavioral health leaders should be prepared not only to expand services but also to build trust — especially among those newly empowered to seek answers. ABA can and should be part of that solution, bridging empathy with analytics across all demographics.
Rachel Dalthorp, MD. Executive Medical Director, Specialty Services, LifeStance Health (Scottsdale, Ariz.): While we’re making progress in recognizing diverse populations in crisis, I believe the industry remains unprepared for the long‑term consequences of missed opportunities to intervene early in the course of illness. I’m especially concerned about the growing population of individuals with untreated or undertreated episodes of illness — particularly PTSD, bipolar disorder and major depression. When these conditions go unrecognized or inadequately treated, they can cause lasting changes in brain function and emotional regulation. The longer the illness continues, the more difficult recovery becomes. With each additional episode, the likelihood of full remission declines. Treatment‑resistant illness occurs not only because our therapeutics fail but also because we intervene years too late, when the burden of illness has affected the patient’s ability to function and the brain’s capacity to heal.
Addressing this challenge requires moving from reactive crisis management to proactive prevention and early intervention. We need predictive analytics and risk stratification as standard practice so we can identify at-risk individuals before their first major episode — not after their third or fourth. I’ve seen this work in maternal mental health: when we screen women during pregnancy, educate them about warning signs and schedule follow-up at two weeks postpartum, we catch postpartum depression early as opposed to waiting for symptoms to become more severe. I recommend leaders begin by advocating for reimbursement models that reward prevention and early detection — rather than crisis stabilization alone — and investing in infrastructure for population-level screening.
Omar Fattal, MD. System Chief for Behavioral Health, NYC Health + Hospitals (New York City): One of the most pressing — yet least prepared for — behavioral health challenges is the growing population of adults with serious mental illness (SMI) and homelessness who develop frailty and cognitive decline much earlier than their peers. Many begin to experience geriatric conditions such as cognitive impairment and mobility limitations well before reaching old age, yet they are often overlooked by systems designed for older adults, including those offering advanced care planning and palliative care.
We already struggle to engage, stabilize and house individuals with SMI, but when frailty is added to the picture, the gaps in our continuum become glaring. Shelters and supportive housing rarely accommodate people needing both psychiatric care and help with daily living, while hospitals and nursing homes are ill-equipped for long-term, recovery-oriented care. As a result, many end up “living” in the hospital — or cycle between hospitals, the streets and temporary placements, deteriorating with each move.
Addressing this gap requires more than adding new beds; it demands rethinking how behavioral health, medical and housing systems intersect. We need specialized housing with embedded behavioral health and medical supports, and a workforce trained to care for adults with psychiatric illness and early-onset frailty. In the end, the question isn’t simply “Where do these patients fit?” but rather, “What kind of system do we need to build so that they finally do?” Without that shift, we risk creating a new cohort of “unplaceable” patients — people whose needs are visible to everyone but met by no one.
Tracey Izzard. Vice President of Behavioral Health Services, Sentara Health (Norfolk, Va.): Behavioral health is no longer a specialty service that sits on the sidelines of healthcare — it is a foundational component of population health and system performance. Treating it as an “add-on” to physical care is a luxury the industry can no longer afford. True integration of behavioral and medical care will define the next era of high-value healthcare delivery.
One of the most urgent and under-recognized emerging populations is those experiencing what we might call “digital distress.” Social media and AI‑driven engagement platforms are contributing to new forms of anxiety, body image disturbance, attention dysregulation and social disconnection. This phenomenon is affecting adolescents most visibly, but it is increasingly spanning adults and older populations as digital immersion deepens. The provider community is not yet fully prepared to assess or treat the complex, tech-induced distress that now shapes many patients’ emotional and behavioral landscapes.
The first and most effective response is to embed behavioral health within primary care, making it a natural part of the healthcare experience. Routine behavioral health screenings, coupled with warm handoffs to embedded therapists, collaborative care teams or external providers, help identify issues early and treat the whole person — not just their physical symptoms. Integration normalizes behavioral care, reduces stigma and measurably improves physical health outcomes.
At the community level, co-located behavioral health hubs in schools, primary care offices and community centers offer another proven model. These hubs can provide therapy, navigation and family support in one place, addressing both early distress and the social determinants that influence long-term health. Leveraging certified peer specialists and community health professionals further extends the workforce, improves engagement and increases the likelihood of sustained recovery.
To stabilize the system itself, healthcare organizations must invest in workforce well-being. Creating programs that promote psychological safety, train staff in recognizing mental health crises and support open dialogue about stress and burnout are critical. A workforce that feels safe and supported is better equipped to deliver compassionate, effective care — and less likely to exit the field.
Finally, leaders must prepare for a new generation of behavioral health demand that sits atop long-standing systemic gaps. The expectations of constant connection and instant validation fueled by social media and AI can intensify social anxiety and distress across all ages. Current diagnostic frameworks, including the DSM‑V, were not built for this digital era. Providers need new training, new models and new partnerships to keep pace with how technology shapes emotional health.Christina Mayfield, MSN, RN. Director of Behavioral Health Services, Mary Greeley Medical Center (Ames, Iowa): First, we are seeing children experience emotional and behavioral health needs at much younger ages, yet resources for early intervention remain extremely limited. We need to invest in developmentally appropriate prevention and support services that reach children and families before crises emerge.
Second, across all settings, patients are presenting with higher acuity and more aggressive behaviors. Staff injuries and assaults are becoming alarmingly common and too often accepted as part of the job. Leaders must prioritize workforce safety through improved staffing ratios, de-escalation training and systemic approaches to violence prevention. Supporting the well-being and safety of those providing care is essential to sustaining behavioral health services long term.
Paul Rains, MSN, RN. System Senior Vice President of Behavioral Health at CommonSpirit (Chicago, Ill.) and President at St. Joseph’s Behavioral Health Center (Stockton, Calif.): The most significant challenges that lie ahead are with the aging population with serious mental illness, as well as those whose chronic conditions may be well managed now but whose future behavioral health treatment needs are uncertain. The true impact of cuts to Medicaid and Medicare is yet to be seen.
Christin Ray, MBA, RN. Executive Director for Behavioral Health, AdventHealth: The intersection of aging, chronic disease and behavioral health is an emerging challenge the industry isn’t fully ready for. At AdventHealth, we are working to embed behavioral health into our primary care practice settings, using early screening and training our teams to support adults holistically. Leaders can respond by prioritizing integrated, patient‑centered care that addresses the whole person.
Matthew Ruble, MD. Chief Medical Officer, Discovery Behavioral Health (Irvine, Calif.): My main area of concern is always in the preventive medicine realm.
The post‑COVID surge in physical, behavioral, cognitive and mental sequelae is still not fully understood. The impact of COVID on emotional and behavioral problems among preschool children was reviewed in a 2024 meta-analysis. It defined a threefold increase in these problems. Our behavioral health treatment capacity is already insufficient.
Childhood vaccination exemption is another concern. Vaccines have saved 154 million lives worldwide since 1974 and prevented more than 508 million cases of illness (averaging four illnesses per child), 32 million hospitalizations and 1 million deaths.
Measles, mumps and other nearly eradicated childhood illnesses are seeing a significant increase in prevalence. The U.S. is not prepared for the deaths, physical complications or mental disabilities caused by these infections.
Robert Trestman, MD, PhD. Professor and Chair of the Carilion Clinic and Virginia Tech Carilion School of Medicine Department of Psychiatry and Behavioral Medicine (Roanoke, Va.): Currently, the demand for psychiatric services of all types outstrips our ability to deliver them consistently and equitably. With the expansion of the Affordable Care Act through EPTC and Medicaid, more people have had access to care. The care delivered is compensated, though often not at the full cost of delivery.
In the upcoming months and years, it’s likely many people will lose insurance coverage. The crisis we will face is increasing demand from those who are uninsured and cannot pay for needed treatment. This is a challenge the field must address.
Arpan Waghray, MD. CEO at Providence’s Well Being Trust (Renton, Wash.): One of the most underrecognized challenges is the impact of loneliness across all ages. While this issue has long been associated with older adults, we are now seeing its reach extend across generations — including adolescents and young adults who are increasingly relying on social media for validation rather than authentic human connection.
While social media provides the appearance of connection, it often conceals deeper isolation that can seriously affect mental health — leaving individuals feeling more alone despite constant online engagement.
Adding to the concern is the rising use of generative AI as a substitute for companionship. People facing loneliness may turn to AI tools for comfort or emotional support, but these systems lack the ability to truly understand and navigate complex human emotions. Initial interactions might feel supportive, leading individuals to increasingly rely on AI instead of fostering human relationships or seeking professional help.
Behavioral health leaders must address key questions as we confront this trend: Are we ready for a future where AI acts as a trusted confidant for vulnerable individuals? How can we ensure ethical boundaries and promote genuine human connection in a digital world?
To tackle this challenge, behavioral health leaders should adopt a multidisciplinary approach that includes clinical expertise, technology governance and community-driven strategies to combat loneliness and foster healthier, more connected societies.
