For patients with treatment-resistant depression, the next step after medication and therapy is increasingly interventional psychiatry. Health systems are adding chairs for transcranial magnetic stimulation, moving to accelerated protocols that shrink weeks of treatment into days, and protecting electroconvulsive therapy programs even as rising costs may push other providers to cut back.
The investments go beyond equipment. Leaders from Allina Health, Endeavor Health, Inova Health, Intermountain Health and Sutter Health told Becker’s interventional psychiatry works best as part of a broader continuum of behavioral healthcare, with dedicated care coordination, clear referral pathways and outcomes measurement behind it.
The question: Where is your health system investing in interventional psychiatry, and where are you seeing results?
Editor’s note: Responses have been lightly edited for clarity and length.
Eric Alcera, MD. President, Behavioral Health Service Line at Inova Health System (Falls Church, Va.): At Inova Health, we are investing in a comprehensive neuromodulation strategy that expands access to evidence-based treatments for patients with treatment-resistant depression and other serious psychiatric conditions. Rather than viewing interventional psychiatry as a single program, we have focused on building a continuum of care that includes ECT, TMS, Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) and esketamine (Spravato), integrated within our broader behavioral health service line.
One of the primary drivers of these investments is the growing need for effective treatment options for patients who have not responded to traditional therapies. We also recognize the importance of providing multiple pathways to recovery, since no single intervention is right for every patient.
This year, we launched TMS services and have continued to expand our neuromodulation capabilities across the health system. We are also investing in the infrastructure needed to improve access, reduce geographic barriers and create regional centers of excellence for advanced psychiatric treatment.
We measure success through several lenses: patient access, time to treatment, continuity across levels of care, clinical outcomes and patient experience. Beyond traditional symptom improvement, we are focused on creating a seamless journey for individuals with complex psychiatric needs by integrating neuromodulation with psychotherapy, medication management and other behavioral health services.
One lesson we have learned is that interventional psychiatry programs are most successful when they are embedded within a larger behavioral health ecosystem. Advanced treatments can be transformative, but their impact is greatest when combined with coordinated care pathways, measurement-based practice, and a commitment to making innovative therapies more accessible to the communities we serve.
Tammer Attallah. Executive Clinical Director, Behavioral Health Clinical Program at Intermountain Health (Salt Lake City): At Intermountain Health, we view interventional psychiatry as part of a broader continuum of behavioral healthcare, with the goal of matching patients to the right level of treatment based on their clinical needs. Our services include ECT, TMS and ketamine-based treatment for patients with severe or treatment-resistant conditions.
We are also increasingly focused on outcomes, not simply treatment volume, and our TMS program is tracking outcomes above national averages. The larger opportunity for health systems is to connect these advanced treatments to a broader continuum that identifies needs earlier and matches patients to the appropriate intensity of care. Ultimately, success isn’t about offering more treatments; rather, it’s about helping more patients get to the treatment most likely to help them get measurably better.
John Lacci, MD. Psychiatrist at Swedish Hospital (Chicago), and Joshua Straus, MD. Division Director of Neuromodulation and Medical Director of Transcranial Magnetic Stimulation and Treatment-Resistant Mood Disorders at Endeavor Health (Evanston, Ill.): At Endeavor Health, we are investing deeply in interventional psychiatry. Our focus is to expand access to the most effective, evidence-based treatments as we continue to develop comprehensive behavioral health services across the communities we serve.
Our health system has a longstanding foundation in interventional psychiatry, with long-established ECT programs at Evanston and Linden Oaks hospitals, alongside TMS services at multiple locations. At Evanston Hospital and Linden Oaks Hospital, ECT and TMS have been integrated into psychiatric care for many years, serving patients across the continuum from inpatient hospitalization and intensive outpatient programming to traditional outpatient treatment. These programs continue to demonstrate that interventional treatments available within a coordinated system of psychiatric care help many patients reach remission.
Our health system also provides access for selected patients to implanted vagus nerve stimulation for difficult-to-treat depression. Plans are in development to incorporate access to neurofeedback treatments and accelerated TMS protocols. With FDA approval of psychedelic drugs anticipated in coming years, we plan to develop programming that includes them.
We have recently expanded TMS access to additional communities, including our new behavioral health center in Palatine, Ill., which also increased intensive outpatient and partial hospitalization program capacity in 2026.
A major focus of our current investment is the expansion of behavioral health services at Swedish Hospital, a community hospital serving Chicago’s North Side and surrounding neighborhoods. Between late 2026 and early 2027, we are introducing intranasal esketamine (Spravato), TMS and IOP/PHP services. This expansion represents an important step toward bringing specialized psychiatric treatments closer to patients who might otherwise face geographic, logistical or financial barriers to accessing this care.
Our broader goal is to create a more accessible and integrated continuum of psychiatric treatment, allowing patients to move between outpatient care, interventional treatments and higher levels of support according to their clinical needs. This is particularly important for individuals with treatment-resistant depression and other complex psychiatric conditions.
One of our most important lessons is that successful interventional psychiatry programs require more than offering individual procedures. They depend on multidisciplinary collaboration, effective referral pathways and integration with existing psychiatric services.
Ultimately, our investments reflect a commitment to making advanced psychiatric treatments more accessible, not only at specialized centers, but within the community hospitals where patients already receive their medical and psychiatric care.
Mary Beth Lardizabal, DO. Vice President, Mental Health and Addiction Clinical Service Line at Allina Health (Minneapolis): Allina Health is building a strong interventional psychiatry service, led by Ryan Coon, MD, the director of our neuromodulation program, as a connected neuromodulation service line (ECT, TMS and esketamine) delivered through our hospital-based clinics. The driver is simple: too many patients with treatment-resistant depression cycle through medications and therapy without relief and need an effective next step.
ECT: protecting a critical service. ECT remains our most effective treatment for severe depression and catatonia, yet it is getting harder to sustain. Hospitals and providers across the Twin Cities have reduced ECT services, driven largely by escalating anesthesia and nursing costs. Meanwhile, Allina’s ECT volume has grown roughly 70% since 2021, from about 300 to more than 500 treatments a month. We remain committed to maintaining this service.
TMS: expanding access strategically. In the last three years we have tripled our TMS capacity, from two chairs to six, placing them deliberately in lower-served parts of the Twin Cities. TMS requires on-site treatment five days a week for at least six weeks, a real hardship for rural patients. That is why we see promise in accelerated protocols such as Stanford’s SAINT, which condenses a course into five days. In a small randomized trial, about 79% of patients reached remission.
Esketamine: a team-based model. Our psychiatrists meet each patient on every treatment day to assess response and tolerability and adjust the plan. Psychologists with specialized Spravato expertise meet regularly with these patients, pairing medication with therapy. Spravato is the only FDA-approved ketamine treatment for treatment-resistant depression.
Nursing care coordinators: the backbone. Nursing care coordinators run our neuromodulation patient panels. They manage referrals, screening and procedural monitoring, and connect with revenue cycle management so patients move from referral to treatment smoothly.
How we measure success. Across ECT, TMS and esketamine, teams track Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Beck Depression Inventory scores. We house this data centrally to compare response and remission rates over time, by treatment location and by patient demographic.
Matthew White, MD. Chair of the Behavioral Health Service Line at Sutter Health (Sacramento, Calif.): We believe interventional psychiatry will play an increasingly important role in behavioral healthcare. It offers new possibilities for patients who have not experienced sufficient improvement with medications, psychotherapy or other standard treatments.
Emerging advanced interventional techniques such as accelerated transcranial magnetic stimulation will play a large part in psychiatry’s future. Beyond accelerated TMS, our investments in patient care include electroconvulsive therapy and traditional TMS. At Sutter Center for Psychiatry in Sacramento, we offer SAINT. This FDA-cleared treatment uses individualized brain imaging to guide precise, noninvasive magnetic stimulation, condensing treatment from several weeks to several days.
Our early real-world experience has been encouraging among a small cohort. Our findings are still very preliminary, so we are continuing to evaluate outcomes as the program grows. We recently have increased SAINT treatment capacity in Sacramento. Additionally, we are expanding access to traditional TMS in other communities we serve, including on the San Francisco Peninsula and in the San Joaquin Valley.
The lesson for health systems is that innovation must extend beyond introducing new technology. It requires thoughtful consideration of each patient who may qualify, strong clinical and operational infrastructure and continued outcomes measurement. Our goal is to build that foundation while responsibly bringing evidence-based advances into community care and making more effective treatment options available to the patients who need them.
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