The greatest growth opportunity in behavioral health isn’t just about scale — it’s about reach. J.R. Greene, founder and vice chair of the board of directors at Brentwood, Tenn.-based Psychiatric Medical Care, told Becker’s that he sees rural hospitals, emergency departments and aging patients as key frontiers for behavioral healthcare delivery. Through hospital-based outpatient models, telehealth psychiatry and payer collaboration, its approach aims to close the longstanding access gaps.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Where are you seeing the greatest growth opportunities in behavioral health — and what strategies are you using to pursue them?
J.R. Greene: Far too many hospitals, especially critical access and rural hospitals, lack enough psychiatric providers to meet the current and increasing demands for behavioral health treatment. We see many opportunities to help them fill that gap. One of the most needed services is intensive outpatient programs for older adults who are experiencing mental health challenges like depression and anxiety. Another big opportunity is supporting emergency departments and inpatient units that historically couldn’t recruit on-site psychiatrists.
We’re pursuing those opportunities with two strategies. The first is through hospital-centered partnerships. We build geriatric intensive therapy programs inside a hospital’s walls, under the hospital’s brand, so that care is integrated with local primary and specialty care rather than siloed. The second strategy is telehealth staffing models to help emergency departments, clinics and even jails that need behavioral health providers. By tapping into our network of psychiatric providers and therapists through telehealth, we can help systems scale services quickly and sustain them in communities where recruitment has been a long-standing challenge.
The demand for behavioral health services is rising everywhere, but the biggest opportunity, and the biggest need, is in the places that have historically been left behind, rural America. Our mission is to bring world-class behavioral health to those communities so people don’t have to leave home to get help.
Q: How are you partnering with payers or health systems to expand access and improve continuity of care?
JG: We partner with hospitals first, because they’re the anchor for care in their communities. Our model puts behavioral health programs inside the hospital’s walls and under its brand, so patients see it as part of their trusted local health system.
On the payer side, we’re focused on reducing fragmentation. We work closely with commercial and government plans to align reimbursement with value, making sure there’s coverage for intensive outpatient and partial hospitalization programs, and telepsychiatry in emergency and inpatient settings. Those conversations often include sharing our outcomes data so payers can see reductions in readmissions, shorter emergency department boarding times and better patient-reported outcomes.
Most importantly, we bridge the gap between levels of care. Our hospital-based teams, like Senior Life Solutions and our telepsychiatry network, all use shared protocols and hand-off processes. That lets a patient move from an emergency department visit to an inpatient unit to an intensive outpatient program/partial hospitalization program, often without leaving the community and without falling through the cracks.
These partnerships only work because we stay flexible and data-driven, always willing to tailor solutions to the needs of the local hospital and the patients they serve.
Q: What lessons can other healthcare organizations learn from behavioral health providers about patient engagement and retention?
JG: There are a few lessons we’ve learned that I think apply to any part of healthcare. First, meet people where they are, not just physically, with telehealth or flexible schedules, but emotionally. You need to have empathy and understanding.
Second, focus on the relationship, not the transaction. We take time to explain why the treatment matters and show people their progress along the way. That sense of partnership keeps them coming back.
At the end of the day, people stay engaged when they feel seen, supported and confident that someone’s walking the journey with them.
