The conversation around behavioral health care in the United States has never been louder than it is today. The COVID-19 pandemic, a rising mental health crisis, and ongoing concerns around substance use disorders (SUDs) have brought behavioral health into the spotlight. But while public awareness has grown, real systemic improvements have lagged behind. According to Rob Marsh, senior vice president and chief operating officer at Kindred Behavioral Health (KBH), the industry is still in the early stages of building true access, continuity, and collaboration for behavioral health services.
Marsh shared his perspective during a recent webinar hosted by Foley & Lardner LLP, where he highlighted the need for greater alignment between behavioral health and physical health care systems. His central message was clear: behavioral health continues to operate in silos, with fragmented systems that make it hard for patients to get the seamless care they need.
The Problem of Care Continuity
Marsh drew a powerful comparison between physical health care and behavioral health care. In physical health, continuity is often built into the care process. If a patient suffers a cardiac event, they are supported by a well-established network: acute hospital care, cardiac rehab, home health services, medication follow-up, and outpatient check-ins. This creates a connected “ecosystem” designed to support recovery and prevent relapse.
Behavioral health care, on the other hand, often lacks this kind of structured system. Patients move between providers and levels of care — such as inpatient, outpatient, therapy, or medication-assisted treatment — with very little coordination. The result is that many patients “fall through the cracks,” losing touch with their providers, discontinuing treatment, or facing barriers in accessing follow-up services.
“The systems that we have within behavioral health are so disjointed, with very little continuity between one level of care and another,” Marsh explained. “That’s where patients really get lost.”
This lack of continuity is more than an inconvenience; it can mean the difference between recovery and relapse. Behavioral health conditions, especially serious mental illness and substance use disorders, require long-term management. Without ongoing support, many patients end up cycling through emergency departments, inpatient admissions, or criminal justice systems instead of receiving consistent care.
Technology as a Bridge
One major reason for this disconnect is the slow adoption of technology within behavioral health. In physical health care, hospitals and medical providers have received significant federal support to implement electronic medical records (EMRs) and other health IT tools. These systems make it easier to track patients across different levels of care, share information between providers, and monitor progress over time.
Behavioral health providers, however, have largely been excluded from such federal funding initiatives. As Marsh pointed out, many behavioral facilities are still using paper charts to document patient care. This not only makes collaboration more difficult but also hinders the industry’s ability to collect and analyze outcomes data.
“It just goes to show you that there’s a lot of work yet to be done when it comes to behavioral health and the application of technology,” Marsh said. “The majority of providers are still using paper charts in order to track the treatment of patients throughout their care experience.”
At KBH, Marsh and his team are working to change that by investing in new digital solutions. The company is developing a care manager module designed to help track patient utilization of services. For example, if a patient fails to refill an essential prescription, the system can alert the care management team, who can then reach out to identify and resolve potential barriers.
The goal, Marsh explained, is to prevent patients from slipping through the cracks and to provide proactive support that increases their chances of long-term recovery.
The Role of Integrated Care
Beyond technology, true continuity of care also requires collaboration across different types of providers. Behavioral health is often separated from physical health, both in how services are delivered and in how they are financed. This separation can result in missed opportunities for early intervention and holistic care.
Sarah Ahmad, senior vice president of product innovation and head of Magellan Health Studio, emphasized the importance of integrated care models. She described approaches where licensed behavioral health professionals work directly with primary care physicians, supported by care managers who stay engaged with patients.
“You’re providing that licensed clinical practitioner to the primary care physician, but also providing a care manager to the member or patient,” Ahmad explained. “They interact through telemed … to get the support that member or patient may need throughout their care.”
In this model, primary care physicians — often the first point of contact for patients — are empowered to identify behavioral health needs earlier and coordinate care more effectively. Meanwhile, patients benefit from having a consistent care manager who helps them navigate the system and stay engaged with treatment.
Telehealth as a Catalyst
One of the silver linings of the COVID-19 pandemic has been the accelerated adoption of telehealth in behavioral health. Virtual therapy, medication management, and digital support platforms have given patients new ways to access care while reducing barriers such as transportation, scheduling, and stigma.
Telehealth also supports care continuity by making it easier for providers to maintain regular contact with patients, even across geographic distances. Ahmad noted that incorporating telemedicine into integrated care models strengthens engagement, keeping patients connected to their providers and treatment plans.
However, while telehealth has created new opportunities, the industry still faces challenges in ensuring equitable access. Not all patients have reliable internet or digital literacy, and reimbursement policies for telehealth vary by payer and state. Expanding telehealth beyond the pandemic will require long-term policy solutions and continued investment from both public and private stakeholders.
Building Toward a More Cohesive Future
Marsh’s baseball metaphor captured the current state of the industry well. When it comes to access, behavioral health may be in the “early innings.” But when it comes to collaboration and care continuity, Marsh argued, “we’re still in the parking lot.”
To move forward, behavioral health providers, payers, and policymakers will need to work together to:
- Expand access to technology and EMR adoption in behavioral health.
- Promote integrated care models that link behavioral and physical health services.
- Invest in care management and coordination tools to keep patients engaged.
- Support policies that ensure sustainable telehealth access beyond temporary emergency waivers.
- Prioritize outcomes tracking and accountability to strengthen long-term recovery.
For KBH, these priorities are at the center of its work. By investing in technology and focusing on care coordination, the organization is aiming to create better experiences and outcomes for patients. But as Marsh emphasized, the broader behavioral health industry must embrace these changes as well.
“We’re at a critical moment in behavioral health,” he said. “There’s tremendous awareness, there’s growing demand, and there’s opportunity. But we’ve got to take the next steps to make sure patients don’t fall through the cracks and that behavioral care is treated with the same urgency and continuity as physical health care.”
Conclusion
The challenges facing behavioral health today — from fragmented systems to technology gaps — are significant. Yet the opportunities to improve are equally great. Leaders like Marsh and Ahmad are calling on the industry to prioritize care continuity, embrace technology, and foster collaboration across disciplines.
If these steps are taken, behavioral health can move beyond its fragmented past and toward a future where patients receive consistent, coordinated, and compassionate care — a system that finally matches the critical importance of behavioral health in overall well-being.
