CHICAGO, August 26, 2026 — New research released today by Array Behavioral Care, the nation’s leading virtual behavioral health provider, points to a health system that struggles to deploy the capacity it has and match it to patients’ needs, with the emergency department (ED) absorbing the consequences. Array’s Behavioral Health Reality Gap: 2026 Report includes insights from a survey of 253 hospital and health system leaders and 261 clinicians across the U.S.
The research uncovered that all (100%) hospital and health system leaders believe their behavioral health capacity meets or exceeds current demand and 83% of them believe their behavioral health models are sustainable. But frontline clinicians paint a different picture: 95% said system constraints, such as capacity pressures, staffing shortages, or a lack of step-down options led them to make a clinical decision they weren’t fully comfortable with in the past year. Ninety-eight percent (98%) of clinicians directly observed a patient’s condition worsen due to care coordination failures or discharge gaps. For ED clinicians specifically, 67% reported patients are matched to the wrong care level – with 35% who said patients receive less intensive care than clinically necessary and 32% said patients receive more care than clinically necessary.
Beds, budgets, and staffing levels tell you the health system’s capacity, but those metrics don’t tell you whether that capacity is reaching patients. When there’s no reliable step-down option, clinicians make calls they aren’t fully comfortable with and patients, who could be treated elsewhere, end up back in the ED. In other words, EDs are left to absorb the consequences when patients can’t access the right care at the right time.
Additional key findings from the survey include:
Behavioral health patients who don't need the ED are filling it.
Once in the ED, patients wait 7 hours or more.
Clinical information doesn’t follow the patient.
Over 1 in 5 patients go back to the ED within 30 days.
Clinicians mull cutting hours or quitting.
Virtual Care Can Stop the ED's Revolving Door
Array’s survey findings suggest virtual behavioral health creates the greatest value when it is embedded into existing care teams and workflows rather than deployed as a standalone access solution.
Eighty-four percent (84%) of clinicians surveyed say virtual behavioral health produces better patient outcomes than in-person care for similar acuity levels. When asked where virtual behavioral health could have the greatest impact, clinicians pointed to intervening with high-risk patients early enough to prevent crisis escalation (19%), embedding behavioral support directly into primary care workflows (18%), and catching patients after discharge before they return to the ED (17%).
Hospital and health system leaders most often identified lower cost per encounter or cost per episode of care (23%), reduced ED wait times or faster psychiatric evaluations (22%), and reduced clinician burnout or staffing strain (19%) as the key.
To learn more about the capacity and care continuity challenges facing both health systems and patients, view Array’s full Behavioral Health Reality Gap: 2026 Report.
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About Array Behavioral Care
Array Behavioral Care is the nation’s leading virtual psychiatry and therapy practice, delivering high-quality behavioral health services through a fully integrated continuum of care from hospital to home. Array partners with hospitals, health systems, community organizations, and payors to provide timely, expert treatment that meets the needs of patients where they are with the Right Care, Right Time, Right DoseSM. As an established leader with more than 25 years of experience in telepsychiatry, Array sets the standard for excellence by offering innovative solutions that improve access, enhance outcomes, and support seamless care delivery. Its Epic-based EHR platform is eliminating system-wide gaps in mental health treatment. Learn more about how Array is transforming behavioral health at www.arraybc.com.
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