The COVID-19 pandemic fundamentally shifted how health care systems, public health agencies, and the general population view behavioral health. Before the pandemic, mental health and substance use services were often considered secondary or adjunctive components of broader health care strategies. Behavioral health was seen as a “nice-to-have” rather than a core aspect of population health management. Now, public health agencies and medical providers are increasingly recognizing behavioral health population health as a critical driver of community wellness. The renewed focus on integrated, holistic care, along with rapidly advancing data collection and analytics capabilities, suggests that behavioral health could soon occupy a central role in shaping population health strategies across the United States.
What Sets Population Health Apart?
To understand why behavioral health is gaining traction, it’s important to distinguish population health from traditional care models. Traditional health care typically emphasizes one-on-one patient encounters: a patient visits a doctor, receives a diagnosis or treatment, and follows up as needed. In contrast, behavioral health population health strategies look at large groups of people, focusing on improving outcomes across communities rather than individual patients alone.
Corbin Petro, CEO of Eleanor Health, explained the difference in approach when it comes to substance use disorder (SUD) care:
“In substance use disorder, we often think about somebody getting clean or abstinent. But really, we should be thinking about how we make this whole population better than they were last year. How do we move them along the continuum? Because otherwise, you’ll run into cherry-picking.”
Eleanor Health, which operates on behavioral health population health and value-based payment models, is a prime example of this approach. With roughly $82 million in funding, the company has built a model designed to scale mental health and addiction treatment while focusing on population-wide outcomes rather than individual episodic care.
The Financial Case for Behavioral Health
Integrating behavioral health into population health strategies is not just clinically sound—it also makes financial sense. Currently, behavioral health accounts for only about 5% of total U.S. health care spending, yet it drives roughly 45% of overall health care costs. This disparity highlights the profound influence behavioral health initiatives can have on physical health expenditures and broader health outcomes.
“A population health strategy needs to include addressing behavioral health because you’ll see the impacts across populations in other areas where you’re right-sizing the spend,” Petro said. “For many populations, it should be the leading intervention and the leading relationship.”
By proactively addressing behavioral health issues at a population level, health systems can reduce costs, improve outcomes, and prevent expensive downstream consequences of untreated mental illness or substance use.
Harnessing Data to Inform Behavioral Health Strategies
One of the most powerful tools enabling behavioral health population health is data analytics. The “data revolution” of the 21st century allows providers, payers, and public health agencies to collect, analyze, and act on health data at an unprecedented scale.
Deborah R. Goldfarb, director of behavioral health at Boston Medical Center (BMC), explained how analytics can transform care:
“We look at psychiatric inpatient readmission rates and identify subsets of people who have rapid readmissions. What resources can we provide to that subgroup?”
BMC, a 514-bed academic medical center, serves largely underserved populations, with about 75% of patients coming from economically disadvantaged communities. The hospital leverages population-level analytics to understand which groups are at highest risk and what interventions may be most effective, providing a strong model for behavioral health in practice.
Overcoming Systemic Barriers
Despite the promise of analytics, behavioral health providers face significant systemic barriers. One major challenge is the slow adoption of electronic health records (EHRs). Only 6% of behavioral health providers currently use EHRs, far behind physical health providers. This creates hurdles for integrating behavioral health data into population health strategies and limits the ability to track outcomes, monitor quality, and implement value-based care initiatives.
Jonathan Purtle, associate professor at New York University’s School of Global Public Health, points out:
“It’s been a major issue – and remains a major issue – especially from the quality-improvement and quality-monitoring standpoint.”
Addressing these gaps is essential for behavioral health population health to reach its full potential. Investment in technology, training, and data infrastructure will be crucial.
Addressing Holistic Needs: Physical, Behavioral, and Social
Population health strategies are most effective when they adopt a holistic lens, addressing not only physical and behavioral health but also social determinants of health (SDoH). SDoH—including economic stability, housing, education, food security, and community support—play a significant role in shaping behavioral wellness.
Goldfarb explains:
“We spent a lot of time and resources at BMC on social determinants—housing, transportation, food insecurity, involvement in the legal system, education, employment—because these really impact behavioral health outcomes.”
BMC provides internal resources such as a food pantry and community garden, and it partners with local organizations to connect patients to external supports. By addressing SDoH, providers can improve both mental and physical health outcomes while reducing avoidable hospitalizations—strengthening behavioral health across communities.
Rethinking the Front Door to Behavioral Health
Primary care has traditionally served as the entry point for health care, but it may not always be the ideal pathway for behavioral health services. Some populations—particularly those with substance use disorders or experiencing housing insecurity—may be more effectively served through community-based programs, integrated behavioral health centers, or school-based services.
Goldfarb notes:
“The idea is to create endless doors to access services. Some people, going through primary care, makes sense. But some people aren’t engaged with primary care or don’t want to be engaged in primary care.”
This flexible approach ensures that care is accessible and tailored to the needs and preferences of different populations. Community health workers, school staff, and other trusted relationships can serve as vital connectors, helping individuals access the right care at the right time, which is essential for successful behavioral health initiatives.
Public Health Agencies as Strategic Partners
Historically, public health agencies have focused primarily on physical health, leaving behavioral health largely to specialized providers serving individual patients. However, partnerships between public health agencies and behavioral health stakeholders could be instrumental in advancing behavioral health strategies.
Purtle explains:
“Public health departments, who think about populations, could support behavioral health agencies, which are more used to individual clinical encounters.”
The federal government is already taking steps toward this integration. The rollout of the 988 crisis response line and a $700 million investment in local crisis centers for FY 2023 demonstrate a commitment to elevating behavioral health within the public health framework.
“988 is indicative of a paradigm shift toward parity, elevating behavioral health as a primary focus rather than secondary,” Purtle noted.
Looking Ahead: Behavioral Health at the Core of Population Health
The convergence of advanced analytics, holistic care models, and public health partnerships positions behavioral health as a central component of future health care strategies. Addressing behavioral, physical, and social needs together allows providers to improve outcomes across communities, optimize spending, and strengthen health systems overall.
By shifting from individual-focused care to population-centered strategies, the health care system can tackle behavioral health challenges at scale. Providers, payers, and public health agencies now have an opportunity to ensure that behavioral health is no longer an afterthought but a leading driver of population wellness.
As data, funding, and policy continue to evolve, behavioral health has the potential to transform how we think about care, creating healthier communities and better outcomes for all.
