Demand for behavioral healthcare keeps outpacing the workforce available to meet it, particularly among older adults juggling mental health, medical and cognitive needs all at once. Leaders in the field say the path forward runs through earlier intervention, stronger regional partnerships and technology that extends limited staff rather than replacing the therapeutic relationship.
Becker’s asked behavioral health leaders two questions: What are the top trends affecting behavioral health right now and why, and where do you see the best opportunities for expanding access to behavioral healthcare in the next few years? Their answers covered workforce shortages, the link between behavioral and physical health and the specific needs of aging patients.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What are the top trends affecting behavioral health right now?
Shekh Ali. CEO, Valley Cities Behavioral Health Care (Kent, Wash.): First, the shift to value-based and prospective payment models — most visibly through the CCBHC movement. Organizations like ours preparing for the Section 223 demonstration are learning that this isn’t a billing change, it’s a fundamental transformation of how we staff, measure, and deliver care. It rewards outcomes and comprehensive access rather than volume, and it will separate organizations that treat it as a finance project from those that treat it as an organizational redesign.
Second, the growing fragility of public funding streams. Medicaid reserve shortfalls and flat per diem rates are colliding with rising acuity and rising costs, and inpatient and crisis services — detox, intensive inpatient — are absorbing the worst of it. We can’t keep asking safety-net providers to run essential 24/7 infrastructure on payment models built for outpatient volume.
Third, the workforce crisis has matured from a hiring problem into a design problem. The question is no longer “how do we recruit more clinicians” but “how do we build career pathways, deploy peers and non-licensed staff meaningfully, and structure compensation around measurable impact.”
Vaibhav Vyas, MD. Associate Medical Director of Ramapo Ridge Behavioral Health and Gracepoint Partial Hospitalization Program at Christian Health (Wyckoff, N.J.): One of the biggest challenges in behavioral health today is that demand continues to grow faster than our ability to meet it. Patients are presenting with increasingly complex needs that often involve a combination of mental health conditions, substance use, chronic medical issues, cognitive concerns and significant life stressors. We see this frequently among older adults, where depression, anxiety, grief, dementia, caregiver stress and medical illness often overlap. At the same time, workforce shortages across psychiatry, nursing, social work, psychology and counseling continue to make access more difficult, requiring healthcare organizations to think differently about staffing, care coordination and team-based care.
Another important trend is the growing recognition that behavioral health and physical health are deeply connected. For many patients, particularly older adults, behavioral health concerns do not exist in isolation. Symptoms can be overlooked or attributed to aging or medical illness, which can delay treatment. We’re seeing greater collaboration among behavioral health providers, primary care physicians, specialists, rehabilitation teams and senior services, leading to earlier intervention and better overall outcomes.
Technology is also playing an increasingly important role in expanding access. Telebehavioral health, remote monitoring and AI-supported tools are helping providers reach more people and stay connected beyond traditional office visits. For individuals who face transportation, mobility or other barriers to care, these innovations can make treatment more accessible while supporting, not replacing, the therapeutic relationship.
Angie Denton. Regional Director Business Development, Acadia Healthcare:
1. Increasing acuity and complexity of patients — especially adolescents and young adults. Behavioral health providers are seeing higher-acuity patients than we were just a few years ago. Anxiety, depression, suicidality, substance use, and co-occurring disorders continue to drive demand, particularly among adolescents and young adults. What is most notable is that the need has not normalized post-pandemic—it has become the new baseline. Utilization continues to increase, and providers are managing more complex clinical presentations that require a higher level of coordination and specialized services.
2. Workforce shortages are becoming the primary access barrier. The greatest challenge facing behavioral healthcare is no longer demand—it’s capacity. Across psychiatry, therapy, nursing, and addiction treatment, workforce shortages continue to limit access. Many communities remain underserved, forcing hospitals, emergency departments, and community providers to search for available treatment options.
3. Behavioral health is moving upstream into medical and community settings. Behavioral health is increasingly being integrated into primary care, specialty medicine, schools, and community-based settings. Health systems and payers are recognizing that behavioral health cannot operate separately from overall healthcare. Providers are looking for collaborative partnerships that improve early identification and intervention.
Jo Cantriel, RN, BSN. Director of Quality and Safety, Osage Beach (Mo.) Center for Behavioral Health: First coverage for behavioral health. Many insurance companies are limiting or eliminating benefits for Mental Wellness coverage including Intensive Outpatient Programs.
Second-Respite care for Care Givers who provide care for dementia/Alzheimer’s or other patients with severe mental illnesses in the home setting. This type of care leads to potential abuse or neglect when care givers are not given the opportunity to care for themselves or their immediate families due to decreased benefits for care for their loved ones.
Third-qualified health care professionals that are caring for the mentally ill. When they are in an acute care psychiatric facility, we need to provide holistic care and not focus on just the mental illness factor, but what is contributing to the problem. Determining the underlying issue, like dealing with behavioral tendencies and not just pushing medications but intensive psychotherapy to determine the triggers for the behaviors.
Vaibhav Vyas, MD. Christian Health, Associate Medical Director, Ramapo Ridge Behavioral Health & Gracepoint Partial Hospitalization Program (Wyckoff, N.J.): One of the biggest challenges in behavioral health today is that demand continues to grow faster than our ability to meet it. Patients are presenting with increasingly complex needs that often involve a combination of mental health conditions, substance use, chronic medical issues, cognitive concerns, and significant life stressors. We see this frequently among older adults, where depression, anxiety, grief, dementia, caregiver stress, and medical illness often overlap. At the same time, workforce shortages across psychiatry, nursing, social work, psychology, and counseling continue to make access more difficult, requiring healthcare organizations to think differently about staffing, care coordination, and team-based care.
Another important trend is the growing recognition that behavioral health and physical health are deeply connected. For many patients, particularly older adults, behavioral health concerns do not exist in isolation. Symptoms can be overlooked or attributed to aging or medical illness, which can delay treatment. We’re seeing greater collaboration among behavioral health providers, primary care physicians, specialists, rehabilitation teams, and senior services, leading to earlier intervention and better overall outcomes.
Technology is also playing an increasingly important role in expanding access. Telebehavioral health, remote monitoring, and AI-supported tools are helping providers reach more people and stay connected beyond traditional office visits. For individuals who face transportation, mobility, or other barriers to care, these innovations can make treatment more accessible while supporting, not replacing, the therapeutic relationship.
Q: Where do you see the best opportunities for expanding access to behavioral healthcare in the next few years?
Tina Jackson. Chief People Officer of Beaufort (S.C.) Memorial Hospital: The greatest opportunities for expanding access to behavioral healthcare in the next several years will come from meeting patients where they are, intervening earlier and building stronger regional partnerships. Workforce availability will remain one of our greatest challenges, which means simply adding traditional behavioral health services will not be enough. We must explore innovative workforce models, strengthen educational and community partnerships and strategically expand the use of telebehavioral health to extend the reach of limited resources. Too often, patients with behavioral health needs encounter fragmented systems and ultimately present in the ED because there is nowhere to go. By committing to greater collaboration between health systems, schools, law enforcement, emergency medical services and community organizations, we can help build a connected continuum of care. The future of behavioral healthcare access is not simply about adding beds or programs, but it is identifying needs earlier, reducing barriers to care and creating stronger connections.
SA: The biggest opportunity is treating behavioral health crisis and addiction services like the essential public infrastructure they are — what I call a “firehouse” model. We don’t pay fire departments per fire; we fund readiness. Standing capacity for detox, crisis stabilization, and intensive treatment should be funded the same way, and payers at the county and state level are starting to be open to that conversation.
Beyond that: CCBHC expansion is the single most promising vehicle for comprehensive, integrated access — same-day care, care coordination, and services that don’t depend on a person’s insurance status. And there’s real opportunity in proactive Medicaid outreach and retention, making sure people already eligible for coverage don’t fall through administrative cracks at exactly the moment they need care.
VV: The greatest opportunity is to continue building a behavioral health continuum that is accessible, coordinated and flexible enough to meet patients’ changing needs. What constitutes the “right” care can look very different depending on the individual and where they are in their treatment journey. Expanding access requires a full spectrum of services, from outpatient counseling to partial hospitalization, intensive outpatient programs and inpatient care, along with strong coordination between those levels of care. When that continuum functions well, patients can access support earlier, move more smoothly between settings, and receive care that is tailored to their needs.
I also think that there is a particularly important opportunity in serving older adults. As our population ages, the need for specialized geriatric behavioral healthcare will continue to grow, yet access remains limited in many communities. Older adults often face a unique combination of behavioral health, medical, cognitive, functional and caregiving challenges that require a coordinated approach. At Christian Health, Ramapo Ridge’s specialized geriatric behavioral health services, together with our broader continuum of senior living, rehabilitation, skilled nursing and outpatient support, reflect the kind of integrated model that will become increasingly important in improving access, outcomes and quality of life for this growing population.
AD: From a business development perspective, I see the greatest opportunities in three areas:
1. Building stronger community-based access points. Patients are often identified long before they ever reach a behavioral health hospital. Schools, primary care practices, urgent care centers, EMS agencies, law enforcement, foster care systems, and community mental health providers are seeing behavioral health needs daily.
The opportunity is to create stronger pathways between these organizations and behavioral health providers through education, streamlined referral processes, rapid response protocols, and ongoing partnership development. The organizations that become the most trusted community resource will see sustained referral growth.
2. Expanding adolescent services and early intervention programs. The demand for adolescent behavioral health services continues to outpace available resources. Many communities still have limited options for youth experiencing mental health crises, depression, anxiety, trauma, and substance use concerns.
This presents a significant opportunity to expand services focused on adolescents and families, while strengthening relationships with schools, pediatricians, counseling practices, DCS agencies, and community organizations. Early intervention not only improves outcomes but also reduces future healthcare utilization and crisis presentations.
3. Developing integrated partnerships with health systems and primary care. Behavioral health can no longer function as a standalone service line. The future belongs to organizations that effectively integrate with hospitals, health systems, primary care groups, and specialty providers. Primary care remains one of the largest unmet access points for behavioral healthcare.
The opportunity is not simply expanding beds or programs—it’s creating a seamless pathway between medical and behavioral healthcare. Organizations that position themselves as strategic partners rather than referral destinations will be best positioned for long-term growth.
Jo Cantriel, RN, BSN. Director of Quality and Safety, Osage Beach (Mo.) Center for Behavioral Health: More intensive outpatient programs, intensive daycare programs for dementia patients, expansion of rehab services for patients with Parkinson’s disease, autism centers and more early childhood mental wellness programs, especially for trisomy babies and children. I think we have missed the boat for a long time by not starting to work with children before the behavioral problems start. We have only tried to fix it with medications and not with proper therapy.
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.
