Hospital leaders across the United States are increasingly sounding the alarm about behavioral health challenges in hospitals. A new report from the American College of Healthcare Executives (ACHE) highlights the ongoing struggles hospitals face in providing adequate mental health and substance use disorder (SUD) care.
The survey, which included responses from 281 hospital CEOs, underscores the complex mix of factors that continue to strain behavioral health systems, even as awareness of mental health and addiction issues grows.
Behavioral Health and Addiction Are a Rising Concern
Behavioral health and addiction services ranked as the third largest area of concern for hospital executives in the ACHE survey. While physical health services often dominate hospital priorities, the survey shows that behavioral health challenges in hospitals remain critical.
Among the CEOs surveyed:
- 78% reported that the lack of appropriate facilities and programs in the community was a significant barrier to providing effective behavioral health care.
- 77% highlighted the lack of funding as a major limitation in their ability to expand services and meet patient needs.
These statistics reflect an ongoing trend observed in previous surveys. In both 2021 and 2022, hospital leaders also cited facility shortages and funding gaps as top obstacles in addressing behavioral health challenges in hospitals.
Insufficient Reimbursement and the Opioid Crisis
Beyond facility and funding shortages, 70% of CEOs indicated that insufficient reimbursement for behavioral health and SUD care remains a pressing issue. This financial imbalance can limit hospitals’ ability to hire specialized staff, expand programs, or adopt innovative treatment models.
Additionally, the high prevalence of opioid addiction and related conditions continues to challenge hospitals nationwide. Over half of CEOs (51%) said opioid-related issues strain their organizations’ resources. Addressing the opioid crisis is a critical component of mitigating behavioral health challenges in hospitals.
Staffing Shortages Amplify the Crisis
While behavioral health concerns are prominent, staffing shortages are the top concern for hospital executives across all departments. According to the ACHE survey:
- 90% of CEOs reported a shortage of registered nurses as a significant challenge.
- Financial pressures, including rising operational costs and limited reimbursement, ranked as the second biggest concern.
Deborah J. Bowen, president and CEO of ACHE, emphasized the need for both immediate and long-term solutions:
“Hospitals need to take both long- and short-term measures to address critical workforce issues so they can continue to provide safe, high-quality care now and in the future. Longer-term solutions include strengthening the workforce pipeline through creative partnerships, such as those with colleges to grow the number of nurses and technicians. More immediate solutions include supporting and developing all staff, building staff resilience, organizing services to reflect the realities of the labor market and exploring alternative models of care.”
These workforce challenges are particularly acute in behavioral health, where staff burnout and high demand have created unprecedented strain on behavioral health challenges in hospitals.
The Behavioral Health Workforce Crisis
Behavioral health providers have been grappling with staffing shortages since the COVID-19 pandemic, which exacerbated workforce gaps and increased the need for services. According to a Behavioral Health Business survey, 53% of behavioral health insiders reported that staffing was the number one challenge facing the industry in 2023.
The shortage of qualified professionals, including psychiatrists, psychologists, social workers, and nurses, directly affects patient access and quality of care. Many patients face long wait times for appointments, limited treatment options, and fewer community-based programs, all of which contribute to worsening outcomes and reinforce behavioral health challenges in hospitals.
The Need for Strategic Investment
The ACHE report makes it clear that hospitals cannot address these issues alone. Strategic investments in behavioral health infrastructure, funding, and workforce development are critical to ensuring access to high-quality care. This includes:
- Expanding community-based behavioral health facilities to reduce the reliance on hospital-based services.
- Increasing reimbursement rates to make behavioral health programs financially sustainable.
- Partnering with colleges, universities, and training programs to build a pipeline of qualified behavioral health professionals.
- Exploring alternative care models, such as telehealth, mobile crisis units, and integrated care programs.
These efforts are essential to reduce behavioral health challenges in hospitals and ensure that patients receive timely, effective care.
Conclusion
The ACHE survey highlights a persistent reality: hospital CEOs are deeply concerned about the state of behavioral health care. Facility shortages, funding gaps, inadequate reimbursement, and workforce challenges continue to hinder access to critical services.
As the nation grapples with rising rates of mental health disorders and substance use, hospitals, policymakers, and communities must collaborate to address systemic barriers. Without meaningful action, the gap between patient needs and available care will continue to widen, perpetuating behavioral health challenges in hospitals.
Behavioral health care is no longer a peripheral concern—it is central to the health of communities, the sustainability of hospitals, and the well-being of millions of Americans. The findings from ACHE serve as both a warning and a call to action: the time to invest in facilities, funding, and workforce development is now.
