The year 2022 was a pivotal one for the behavioral health industry, marked by both significant growth and challenging setbacks. Two years after the onset of a world-altering pandemic, the sector continued to adjust to seismic shifts in demand, delivery, and technology. Providers, investors, and policymakers had to navigate a landscape shaped by both long-standing structural issues—such as workforce shortages, high turnover, and complex payer-reimbursement models—and a wave of new developments in digital health and venture-backed innovation, making it a defining moment in behavioral health trends 2022.
Behavioral health in 2022 faced the collision of two very different paradigms: the rapid, risk-taking mentality of venture capital-backed startups and the cautious, patient-centered principles that govern healthcare. The result was a year of experimentation, scrutiny, and learning. Buoyed by $5.5 billion in investments in 2021, new players in the field—including digital therapy platforms, telehealth providers, and retail-style clinics—found themselves under public and governmental scrutiny. Companies like Cerebral faced intense oversight, highlighting the ethical and operational challenges inherent in scaling behavioral health startups. Meanwhile, foundational issues, such as access to care and the implementation of value-based care standards, remained pressing concerns. Here’s a detailed look back at the stories that defined behavioral health trends 2022.
360 Behavioral Health and CARD: Autism Providers Face Mass Layoffs
Among the most-read stories of the year were those detailing layoffs and downsizing at autism treatment providers. The headlines—“360 Behavioral Health, CARD Downsize as Mass Layoffs Hit Autism Providers,” “Why the Massive Investment in Autism Companies Created a ‘Ticking Timebomb,’” and “Large Autism Provider CARD Shuts Down Operations in 10 States”—highlighted a convergence of workforce and payer pressures.
Leading into 2022, autism treatment had become a hotbed of investment. Providers and private equity firms sought to scale national platforms quickly to gain market share and bargaining power with payers. However, workforce shortages, wage inflation, and slower-than-anticipated responses from insurance providers eroded profitability. To relieve pressure on their balance sheets, companies turned to layoffs and market closures. CARD, for example, retrenched from 10 markets to concentrate on 14 locations where it had greater operational density.
These developments were among the most impactful stories when analyzing behavioral health trends 2022, showing the limits of rapid expansion in healthcare and the operational realities that large-scale providers face.
Beacon Health’s Vision: Outpatient Mental Health and Value-Based Care 2.0
Beacon Health Options, a Boston-based behavioral health managed care organization, presented a forward-looking vision for outpatient mental health care at BHB’s VALUE event. Neil Leibowitz, the organization’s Chief Medical Officer, outlined a tech-enabled approach to advancing value-based care, drawing on his experience at Talkspace.
The proposal centered on leveraging artificial intelligence to analyze and transcribe therapy sessions, providing data on outcomes, therapist empathy, and intervention effectiveness. While this approach offered exciting possibilities for improving quality and tracking patient progress, it also generated controversy. Many mental health professionals raised privacy concerns, arguing that recording and evaluating therapy sessions could violate patient confidentiality and undermine the therapeutic relationship. Others worried about payers dictating clinical practices rather than supporting providers.
This development became a key example of behavioral health trends 2022, showing both the promise and the ethical challenges of AI in care delivery.
MIND 24-7: Retail Behavioral Health Comes to the Fore
MIND 24-7 introduced a bold approach to addressing access challenges in mental health care, aiming to become the “Starbucks of Mental Health.” The Scottsdale, Arizona-based startup opened clinics designed to provide all-in-one, always-on care, offering timely access in a sector known for long wait times and limited availability.
The model drew mixed reactions. Supporters praised it as a solution to the persistent problem of delayed care, while critics worried that retail-style branding could trivialize the importance of mental health services. Despite the debate, MIND 24-7 continued its expansion, with three clinics operational and a fourth in development. Its approach remains one of the most-discussed behavioral health trends 2022, highlighting the industry’s exploration of innovative delivery models.
UnitedHealth Group’s Optum Acquires Refresh Mental Health
One of the biggest deals of the year was UnitedHealth Group’s acquisition of Refresh Mental Health, one of the nation’s largest outpatient mental health providers. Founded in 2017 with backing from Lindsay Goldberg & Co., Refresh expanded rapidly under Kelso & Co., growing to over 300 locations across 37 states in just 15 months.
The acquisition illustrates several key trends. First, it highlights the growing role of large payers like UnitedHealth in direct care provision, reflecting a shift toward value-based strategies. Second, it underscores the acceleration of consolidation in behavioral health, with private exits providing lucrative opportunities for investors. Refresh’s rapid growth and Optum’s acquisition made it a defining story among behavioral health trends 2022.
Teladoc’s BetterHelp: Telehealth Mental Health Goes Mainstream
Teladoc Health’s telehealth platform BetterHelp demonstrated the increasing financial significance of mental health services in the digital health sector. In 2022, BetterHelp generated $700 million in revenue, roughly a third of Teladoc’s total revenue. Quarter-over-quarter growth reached 35%, illustrating strong demand for remote therapy services.
However, the model also revealed challenges common to digital health startups. High customer acquisition costs, driven by competition and aggressive marketing, weighed on profitability. CEO Jason Gorevic noted that smaller competitors’ aggressive strategies inflated marketing expenses, creating an economically challenging environment despite robust top-line growth. This trend is another illustration of key behavioral health trends 2022, showing both opportunities and pressures in digital mental health delivery.
Privacy Concerns and Government Scrutiny
Data privacy emerged as a major focus in 2022, with U.S. Senators Elizabeth Warren, Cory Booker, and Ron Wyden sending an open letter to Talkspace and Teladoc. The senators requested information about the companies’ data-sharing practices with tech giants like Google and Facebook, highlighting concerns that sensitive patient information could be accessed by third parties. Media reports confirmed that dozens of telehealth-focused companies shared data with external tech firms, raising ethical and regulatory questions about patient privacy in digital behavioral health.
This scrutiny became a prominent aspect of behavioral health trends 2022, reminding the industry of the importance of trust, transparency, and regulatory compliance.
Cerebral: Shifting Focus to Serious Mental Illness
Cerebral faced ongoing controversy in 2022, prompting CEO David Mou to put “exploratory” expansion plans on hold and focus on treating serious mental illness (SMI). The company also implemented layoffs and faced scrutiny from the Drug Enforcement Administration, highlighting the challenges startups encounter when balancing rapid growth, regulatory compliance, and patient safety. Cerebral’s experience illustrates another facet of behavioral health trends 2022, emphasizing the complexities of scaling startups responsibly in a highly scrutinized environment.
Lessons from 2022
The behavioral health industry in 2022 was defined by rapid growth, innovation, and complex challenges. Technology, telehealth, AI, and retail-style care introduced new opportunities, but they also highlighted ethical, privacy, and operational risks. Workforce shortages, payer dynamics, and the limits of national platform scaling underscored the continuing need for sustainable, patient-centered strategies.
Looking forward, the lessons of 2022 suggest that behavioral health stakeholders must balance innovation with responsibility, growth with quality care, and ambition with regulatory compliance. The analysis of behavioral health trends 2022 provides a roadmap for understanding where the industry has been and where it is headed, ensuring that patient well-being remains central as the sector evolves.
