Behavioral health leaders are confronting a structural mismatch: demand keeps outpacing capacity even as Medicaid pressures, workforce shortages and emergency department boarding intensify. A growing consensus holds that adding beds and providers alone won’t close the gap — what’s needed is better coordination across the continuum of care.
During a webinar hosted by Becker’s Healthcare and sponsored by Iris Telehealth, five executives spanning clinical care, behavioral health and strategy discussed how health systems can move from reactive crisis response to proactive, connected care.
The panelists included:
- Carolyn McEkron-Bragg, clinical director at Southern Regional Medical Center (Riverdale, Ga.), part of Prime Healthcare
- Jennifer Cullen, president of behavioral services at Beth Israel Lahey Health (Cambridge, Mass.)
- Jason Betts, DNP, RN, director of patient care for emergency and behavioral health services at Emory Healthcare (Atlanta)
- LalithKumar Solai, MD, vice chair of clinical services in the department of psychiatry and behavioral sciences at the MUSC Health (Charleston, S.C.)
- Laura Bauer, vice president of strategy at Iris Telehealth
Below are four takeaways from their conversation.
Note: Quotes have been lightly edited for length and clarity.
1. You can’t add your way out of the access gap
The panelists agreed that demand consistently absorbs new capacity. Ms. Bauer described a familiar loop in which health systems hire more providers to clear a backlog, only to watch demand rebound. “It’s a cycle,” she said. “Demand is always going to outpace capacity.”
The implication: orchestration — directing patients to the right care setting, at the right time — matters more than raw supply.
2. The shift from ‘find a placement’ to ‘manage a pathway’
Ms. McEkron-Bragg said rising acuity, payer authorization hurdles and long ED boarding have prompted a redesign of how her team moves patients through care. “The pressure is forcing us to move from finding a placement to managing a pathway,” she said — meaning earlier identification, clearer triage and discharge planning that begins the moment a patient arrives.
Dr. Betts made a parallel case from the ED. “We associate those that are up walking around as fine, and those that can’t breathe as not fine,” he said. “How do we bring attention to the fact that this person is in a crisis and emergent at this point in time — and they actually need a lot of resources to be able to get them past where they’re at and onto a better road of healing?”
3. Getting proactive means meeting patients before the crisis
Several leaders pointed to embedding behavioral health services into existing care moments. Ms. Bauer cited service-line integration — assessing oncology patients before a mastectomy, or couples before in vitro fertilization — to surface mental health needs before they reach crisis level.
At MUSC, Dr. Solai described “bridge clinics” built to keep patients engaged during long waits for specialty appointments without spawning new backlogs. Ms. Cullen highlighted data transparency initiatives that display ED boarding and available inpatient beds statewide. She also pointed to AI-enabled care navigation as a way to close gaps between levels of care.
4. ROI runs deeper than throughput
Beyond faster ED throughput, panelists framed behavioral health investment around patient loyalty, provider retention and payer negotiation. Ms. Cullen noted that preventive models, such as collaborative care embedded in primary care settings, can reduce demand on higher-acuity services. Dr. Solai described negotiating daily rates with Medicaid and commercial payers to sustain new EmPATH units that divert patients from inpatient care.
What this means for behavioral health leaders
The through-line was that capacity and coordination are not the same thing. As Ms. McEkron-Bragg put it, the future of behavioral health “is not just more services, it’s better connected services.”
For leaders, that reframes the central question from how to add capacity to how to route patients through it.
At the Becker's Fall Behavioral Health Summit, taking place November 4–5 in Chicago, behavioral health leaders and executives will explore strategies for expanding access to care, integrating services, addressing workforce challenges and leveraging innovation to improve outcomes across the behavioral health continuum. Apply for complimentary registration now.
