The demand for quality behavioral care in hospitals has never been more urgent. As hospitals grapple with surging mental health needs and increasing complexity, it's crucial to ensure every patient receives the right care for their needs. 

Consider this scenario: A patient arrives to the ED and is medically cleared by the ED physician. But there is no psychiatrist available to evaluate the patient’s behavioral health concerns, including thoughts of suicide.  

The ED doc admits them in the interest of safety. Without an inpatient bed available, the patient endures a long wait time. They may be sedated, and they likely aren’t receiving treatment to advance their care. As a result, they can languish or their condition may worsen, which isn't good for them, for staff, or for other patients awaiting care.   

This scenario is not uncommon. Research shows ED visits for mental health diagnoses have soared, with lengthy stays and long wait times becoming more common: 

  • Between 2017 and 2019, the percentage of ED visits lasting 4 hours or more was higher for adults with mental health disorders. 
  • A national study between 2009 and 2015 found mental health ED visits were more likely to result in admission or transfer, and to last over 6 or 12 hours (with higher wait times for admissions and transfers).  
  • Half of all mental health-related hospital admissions and 60% of hospital discharges are associated with repeated ED visits for the same or similar concerns. 

How to create the right solution beyond behavioral staffing 

Timely access to quality behavioral care can streamline ED operations, reduce unnecessary admissions and length of stay, and improve throughput and bed availability.  

While staffing for specialists in mental health may seem like the answer, it's not always feasible or effective given the highly competitive recruitment landscape for behavioral health clinicians. Organizations may face major challenges in hiring and retaining talented candidates. 

The best option is a comprehensive virtual behavioral health solution designed to improve clinical outcomes for patients and operational efficiency for hospitals. Through a virtual care model, hospitals benefit from timely access to a team of psychiatrists for psychiatric assessment, care, and risk-informed disposition recommendations. 

Virtual psychiatry can help enhance care and improve outcomes, but choosing the right partner is important to making a meaningful difference,  

Providing quality behavioral care for improved outcomes 

From completing patient assessments within the ED to meeting Zero Suicide requirements, Array can serve as a strategic support for achieving behavioral care and organizational goals. Our psychiatrists specialize in managing acute psychiatric patients and deliver high quality, evidence-based care rooted in best practices.  

We provide:  

  • Psychiatrist-led assessment and level-of-care determination: Array psychiatrists evaluate the level of risk and make informed treatment and disposition decisions, allowing patients to be quickly directed to a clinically appropriate and effective setting.  
  • Specialty interventions and management: Array psychiatrists prescribe medication and initiate stabilizing treatments according to established protocols. They virtually reassess patients daily to advance their care and determine if they are safe to discharge. 
  • Proactive safety planning and care management: Array clinicians consider behavioral health resources available in your community and engage with your care coordinators to make more informed disposition decisions. This helps facilitate timely, safe, and effective care transitions. 

“At Array, we don’t just rubber stamp disposition decisions. Rather, our clinicians will take the time to thoroughly assess the patient, treat the patient if needed, and recommend a disposition that aligns with their level of risk. Our psychiatrists actively manage patients from the initial consult through disposition and safety planning,” said Dr. Mark Alter, Chief Medical Officer of Acute Care at Array. 

Array clinicians can restart home medications and initiate stabilizing treatment as needed. They reassess risk and disposition daily to determine if safe discharge is possible. “This proactive care approach transforms the patient’s journey and measurably reduces reliance on psychiatric inpatient resources and length of stay,” said Dr. Alter.  

Informing better patient disposition decisions 

Array provides more than just clinicians; we're partners committed to excellence in behavioral care. Our industry-leading quality program ensures safety and standardized care at every step.   

Our protocols help ensure the most risk-aware, least restrictive level of care disposition recommendation. By managing behavioral health patients throughout their stay, staff and resources can be freed up and redirected to other areas of priority. 

“With Array, you can access a perspective that extends beyond how the patient is presenting to onsite healthcare staff. We collect patient collateral, including their history and information from close relatives. This data better informs risk stratification and treatment decisions, optimizing the use of scarce behavioral health resources,” said Dr. Alter. 

Reducing inappropriate admissions affects patient care and hospital revenue. By providing rapid access to the right level of psychiatric care for behavioral patients, resources can be pivoted to other priority areas of care and to patients requiring prompt attention, like those presenting with stroke, acute myocardial infarction, or sepsis.  

Research shows that even a one-hour reduction in overall ED boarding time could result in $9,693 to $13,298 of additional daily hospital revenue by capturing patients who left without being seen and diverted ambulances.  

One study found that, mainly due to typically longer length of stays among psychiatric patients awaiting specialist care, the financial impact of psychiatric boarding accounted for a direct loss of $1,198 in revenue (compared to non-psychiatric admissions). 

Unburdening overstrained hospital staff 

Array clinicians follow the Zero Suicide Model and screen for suicide in all encounters, which supports Joint Commission requirements. In the process, lives can be saved. “Suicide screening needs to become a part of routine primary healthcare, like listening to someone’s heart,” said Dr. Alter.  

Array’s impact extends beyond the ED.  For more than two decades, Array has been a pioneer in psychiatric telemedicine and an advocate for expanding access to behavioral and psychiatric care for all.  

Through innovative service models and strategic partnerships across the system of care, we're breaking down siloes, overcoming fragmentation, improving outcomes, and making more meaningful connections to care.   

Join us in our mission to transform behavioral healthcare. Together, we can make a difference—one patient, one community at a time.  

Is your hospital experiencing surging behavioral health demand? Across the country, already strained healthcare providers are seeing heightened concerns about suicidality, more complex cases, and a rise in pediatric presentations.

When ED physicians feel ill equipped to make behavioral care decisions, they may opt for admitting patients and erring on the side of caution. However, this can lead to reduced bed turnover, treatment delays, patients leaving without being seen, and poorer patient outcomes.

The highest quality care solution? Connect with behavioral care that is beyond a staffing option and provides comprehensive, consultative services. Advance patient outcomes with evidence-based, industry-leading care while meeting strategic objectives.

Download our illustrated one-pager to find out how Array works differently, tailored specifically to your immediate needs and long-term strategy.

Telehealth is not just an option but a strategic requirement to meet the escalating demand for behavioral care. In an op-ed for MedCity News, Jamie Evans, MD, MPH, Medical Director of OnDemand Care and Clinician Engagement, writes that the mental health crisis among children and youth is on the rise.  

The crisis has become glaringly evident in gridlocked emergency rooms across the country. In certain regions, suicidal thoughts have become the primary reason for children’s ED visits.    

Dr. Evans joins other medical and mental health experts calling for urgent and necessary action. A “mental health moonshot” can address the community-based and systemic barriers affecting children’s mental wellness, including:   

  • Increasing access to telehealth services 
  • In-school resources 
  • Expanded insurance and Medicaid coverage 
  • Clinician diversity and bias training for specialists  

Telehealth has emerged as a lifeline to help connect youth with vital mental health resources—from hospital, to community, to home.  

It's time to take action and ensure that mental healthcare is accessible, equitable, and effective for all. Let's work together to protect our children's wellbeing and give them the support they need to thrive.

Read the full article here: 'Why Telehealth is Vital for Addressing the Children’s Mental Health Crisis Affecting Emergency Departments Nationwide'

Reducing Mounting Pressure on Emergency Departments Across the Country

Working within already strained hospital emergency departments (EDs), healthcare providers, ED physicians, and nurses are observing increasing rates of patients with mental health concerns or disorders such as anxiety, panic, and depression. The data reflects a surge of patients with mental health concerns in hospital waiting rooms and hallways: between 2007 and 2016, the proportion of ED visits for mental health diagnoses increased from 6.6% to 10.9%. Mental health concerns were further exacerbated during the COVID-19 pandemic.  

A Mental Health Crisis Reaching EDs 

This mental health crisis is reaching across younger and older groups: 

  • Mental health visits in pediatric EDs increased by 8% annually between 2015 and 2020, compared with an increase of 1.5% annually of all other ED visits.  
  • Adolescent girls are facing unprecedented rates of persistent sadness, suicidal thoughts, and sexual violence. 
  • Among older generations, an estimated 20% of people 55 years or older experience some type of mental health concern and older men have the highest suicide rate of any age group.  

A patient with behavioral health needs who presents to the ED may face exceptional wait times or be inappropriately admitted due to a dearth of psychiatric specialists. One-third of Americans live in areas that lack access to psychiatrist. And pediatric psychiatrists are so difficult to access they are like “unicorns,” reported one pediatric primary care provider.  

The mental health crisis is escalating costs for hospitals and potentially contributing to staff burnout. ED doctors and nurses are faced with supporting patients’ mental wellbeing in urgent situations, while also handling the influx of patients with critical or life-threatening physical conditions.  

Disproportionate Costs of Mental Health Care in EDs 

Alongside strain on treatment capacity, visits to the ED generally result in high costs—to the tune of an estimated $8.3 billion per year according to a 2019 analysis 

Once at the ED, patients with mental health concerns tend to stay longer in hospital waiting and treatment rooms. ED wait times for a patient with behavioral health concerns are on average two hours longer and patients are six times more likely to be transferred to other facilities, according to a University of Pennsylvania nationwide study. A 2012 study found patients with mental health needs wait an average of 3.2 times longer than other ED patients.  

Regardless of whether they are admitted, transferred, or discharged, the average length of stay (Los) for patients with mental health concerns is significantly higher than for other patients (according to the same UPenn study). A 2017 NIH brief also reported that ED visits with a routine discharge to home tend to be less common for mental and substance use disorders (80.9% compared with 70.3% of other visits).   

Wait time in hospital beds, hospital transfers, and extended inpatient care costs for patients with behavioral health needs are adding up. A 2017 NIH study found inpatient visits for ED patients with mental and substance use disorders represented a larger portion of costs for that population (12.5%), compared with inpatient admission costs for all ED visits (9.4%).   

The National Mental Health Care Landscape 

Patients with mental health concerns are sometimes presenting to the ED due to long waits to access psychiatric services through community or primary care referrals. Median wait time for psychiatry appointments outpaces wait times for referrals to all other specialties—landing at 73 days, which is more than 10 weeks.  

 The problem is local and national in scope, especially affecting rural populations. More than half of U.S. counties lack a psychiatrist, causing patients to have to seek care outside of their communities. Virginia’s Joint Legislative and Audit Commission found that, between September 2021 and July 2022 among 40 public providers, an average of 33 adults and 10 children were awaiting behavioral health care services daily.  

 Beyond the hospital walls, lack of mental health care services has societal costs. The White House has reported lack of mental health care is linked to poorer educational outcomes for school-aged children, impacts on families and parenting, and higher rates of homelessness and incarceration.  

Why are We Telling this Story? 

If you are reading this as a healthcare provider or hospital administrator, you have seen firsthand the urgent need for more timely access to psychiatric services. You are likely well aware of the rising tangible and intangible costs associated with care delays.  

We are telling this story again because it doesn’t need to end with frustration and a persistent lack of resources. There are solutions available, supported by technology that can be within a healthcare provider’s reach.  

Increase Access and Support Onsite Hospital Providers 

The situation facing EDs across the country is daunting, but expanding access to behavioral health care via telehealth can reduce the burden on healthcare organizations, payers, and providers alike.  

Expanding research evidence points to telehealth’s effectiveness. Supported by emergency legislation, telehealth emerged as a more commonplace healthcare delivery method during the COVID-19 pandemic.  

Data collected since the height of telehealth usage during the pandemic suggests the method could be a “trusted approach” to some health care services, particularly behavioral health care, with populations showing high levels of satisfaction. And studies show telemental services like telepsychology are just as effective as in-person visits. 

At Array, we strongly believe telemedicine is medicine. Telepsychiatry is a solution that can stem issues facing EDs across the country, while focusing on enhancing quality and continuity of care. Healthcare providers can plug into the power of virtual behavioral health through a consultative, psychiatrist-led care approach.  

Timely access to a psychiatrist through telehealth has been shown to:  

  • Lower costly inappropriate admissions,  
  • Decrease hospital wait times,  
  • Improve ED throughput,  
  • Reduce risk and liability, and 
  • Improve patient experience.  

Additional benefits include: 

  • Filling gaps in care resources, 
  • Buttressing continuity of care and extending treatment to community and home, and  
  • Easing the overwhelm on healthcare providers. 

Array Can Help 

We know this story is bigger than us, but we want to be part of the solution. We want to see more patients accessing the treatment they need using available and effective technologies. Our aim is to expand equitable access to quality behavioral health care in acute, outpatient, and at-home settings.  

Array has been a pioneer in this space by offering telehealth services informed by industry-leading quality standards. In response to a need, Array’s Executive Chief Medical Officer James Varrell first offered telehealth services to a rural hospital in the late 1990s.  

Today, Array serves as a partner to over 150 acute care facilities across the country—providing services in EDs, as well as outpatient and inpatient units. Learn how we can design a behavioral health solution for your hospital by engaging clinicians with the expertise and experience you are looking for.  

We hope to connect you with a customized solution. Talk to us today to ensure the wait for quality behavioral healthcare is over—for you and for your patients.  

Schedule a brief introductory chat with one of our specialists. 

Not ready to reach out yet?  

Did you know? Array’s virtual outpatient behavioral health practice is an option for post-discharge follow up care or preventive outpatient care for patients presenting with mild to severe anxiety, depression, trauma, mood disorders, comorbid nonactive substance use, and a list of other concerns. 

Learn more by exploring our research-backed white paper on how behavioral care telehealth teams can help improve ED throughput and patient outcomes. 

Patients with mental health concerns are increasingly relying on EDs for care. This is problematic because it not only leads to increased boarding, but also puts additional strain on ED resources and staff that are already stretched to capacity.

Virtual behavioral health care teams can also help support strained and overextended onsite staff in the ED and help curb clinician burnout, which costs the U.S. an estimated $4.6 billion annually.

For more than 23 years, Array Behavioral Care has partnered with hospitals and health systems across the country to design telepsychiatry solutions that use scarce resources wisely by ensuring quick, safe throughput and the proper use of available ED beds and resources.

The article titled 'The Emergency Department Boarding Crisis: Virtual Behavioral Health Solutions Can Ease the Gridlock' outlines how on-demand telepsychiatry can help reduce boarding and improve care for psychiatric and medical patients alike. Read the full article here.

The COVID-19 pandemic sparked an influx of demand for mental health care. People struggled with depression, anxiety, social isolation, and fearful conditions brought on by the pandemic. In 2020, more than one in three Americans reported the pandemic having a serious, negative impact on their mental health. As COVID has lingered, so too have high anxieties.

This has increased the pressure on the already strained mental and behavioral care field. Simply put, there is a supply-demand imbalance. There is limited availability for patients to find treatment from licensed professionals. Access is at the heart of the problem: more than one-third of Americans live in areas that lack adequate access to mental health professionals.

Telebehavioral care—when direct clinician-to-patient care is delivered online—has helped reduce these treatment gaps. The pandemic has shown that when widespread adoption is possible, telebehavioral care brings immense value for both increasing patient access and supporting healthcare professionals through virtual collaborative care.


Telebehavioral Care in Homes, Hospitals, and Primary Care Offices

Telehealth has been a vital resource for people across the country, especially for those who have needed mental health support that’s covered by their insurance provider. Telebehavioral health has been a lifeline for patients everywhere, including underserved patients – like the thousands of children living in rural and urban communities who don’t have access to a child psychiatrist.

The expansion of mental telehealth provides a bridge between those who are seeking help and those who are available to provide help. Insurers like Aetna are doubling down on evidence-based telebehavioral health by providing mental health services to members in all 50 states. An expansion like this benefits patients at home by helping them schedule time with a licensed psychiatrist, therapist, counselor, or psychologist in as soon as two days. Telebehavioral care has also provided support for healthcare professionals and hospitals nationwide.

When mental health providers aren’t available and people are experiencing a mental health crisis, patients often turn to the only remaining available resource: the emergency department. To alleviate this pressure, recently hospitals in rural communities like Sidney Health Center in Montana and VCU Tappahannock in Virginia have increased their on-demand telepsychiatry services for patients and support for onsite staff. Meanwhile, United Physicians, an independent physician organization of 2,000 providers in Detroit, has already made it halfway to its treatment goals in just three months in part due to virtual collaborative care.


Telebehavioral Care: A Solution to Find and Deliver Mental Health Help

The increased availability and access to at-home behavioral care was made possible by laws and regulations that were temporarily changed or adapted to accommodate widespread telebehavioral health treatment. This increased legal flexibility also stretched to clinicians as many states temporarily removed the requirement that forced mental health providers to be licensed in the same state where their patients reside. Bill proposals in states like New Jersey are important for giving patients and doctors the incredibly valuable tool of telehealth for good.

The rising demand for mental health professionals isn’t predicted to go away any time soon. Array is a covered insurance benefit for 87 million people and counting, proving insurers are responding to the increased need for mental health services by expanding telebehavioral care as a covered benefit for their members.


By: Geoffrey Boyce

Telehealth’s adoption has skyrocketed over the course of the pandemic. Although telehealth was a lifeline for many and filled in the gaps in our healthcare system, you cannot help but wonder where do we go from here? Despite its accelerated adoption, will telehealth have the same staying power after the public health emergency ends? The evidence and anecdotes point to a resounding ‘yes,’ especially when it comes to behavioral care.

Over the past 13 years in the industry, I’ve witnessed firsthand how telehealth has transformed the delivery of behavioral care. Research has long proven that telebehavioral care is just as effective as in-person care and checks out with higher retention rates. The COVID-19 crisis created an opportunity for telehealth to demonstrate its value without some of the traditional challenges that once limited its widespread adoption.

Telebehavioral Care Became Dedicated to Patients

In early 2020, many laws and regulations were either temporarily instituted or suspended to promote, encourage, and legalize virtual treatment for behavioral health conditions. HIPAA flexibilities, 1135 waivers, and interstate allowances rolled out so that people could continue with their behavioral care provider, or pick up a new one, amid worsening mental health conditions nationwide. Even the DEA temporarily lifted multi-state registrations and the Ryan Haight Act fell under an exemption, which allowed psychiatrists and other prescribers to issue controlled substance medications without the usual requirement of seeing them in person – critical for both child psychiatry and addiction medicine.

The temporary telehealth allowances focused on making sure that patients could be seen at home. That is why industry groups, such as the American Telemedicine Association, are advocating at the federal and state levels to keep and expand these laws. Nearly 75% of providers say that no or low reimbursements would hinder them from offering telehealth after the pandemic if the current expansions do not remain.

Yet as waivers expire, and we emerge from home with a new location-agnostic reality, we must realize that telebehavioral care’s place has to be where the patient is — everywhere. Telebehavioral care’s place is in the home, the hospital, the PCP’s office, the community clinic and more. To truly serve patients’ mental health needs, telehealth regulation must support care across the now-expanded continuum.

The story of one New Jersey mother illustrates the need for expanded access to telebehavioral care. Despite having at-home virtual care and medication for her adolescent son struggling with autism spectrum disorder and suicidal tendencies, this mother ended up in an emergency department to save her son from suicide twice.

Patients in Need

The first time, she and her son waited for days in an emergency bed for her son to be seen by a social worker, not a psychiatrist — a common occurrence as hospitals shoulder the burden of the nationwide mental health crisis amid a shortage of behavioral care professionals. On the mother-son pair’s second visit, the hospital had implemented a telepsychiatry program that allowed her son to be seen in just a matter of hours by a psychiatrist who evaluated him and sent him home with a concrete treatment plan and next steps.

The second visit was made possible by legislation that allowed for the psychiatrist to see the patient virtually along with the appropriate authority to make the right placement decision, while also requiring reimbursement for that care. These hospital EDs are just one setting in need of behavioral care support. Data shows that one out of every four primary care visits in the U.S. are for mental health conditions. FQHCs regularly serve populations with higher incidences of behavioral care needs. In short, pro-telehealth legislation does not just expand patients’ access to behavioral care clinicians, it expands other providers’ access too.

Telehealth is a lifeline for so many of the patients that are often left behind by our healthcare system. It is crucial to extend the telehealth-friendly regulations well after the COVID-19 crisis has passed so that there can be broader, timelier, and more convenient access to the scarce resource of behavioral care. Ensuring that physicians, psychiatrists, clinics, hospitals, and other healthcare providers offering telehealth continue to be paid and allowed to practice virtually is one of the ways that our industry protects telehealth’s future and secures a permanent place for the vitally important behavioral care Americans need — wherever and however they need it.


Geoffrey Boyce
CEO, Array Behavioral Care

Geoffrey Boyce is the CEO of Array Behavioral Care, the leading telepsychiatry service provider in the United States with a mission to transform access to quality behavioral care. Boyce is a leader in telemedicine advocacy, education, and reform initiatives. He serves as a national voice promoting telemedicine and telepsychiatry and regularly interacts with state and local healthcare regulators and administrators. In 2017, he received the Industry Leader Award from the American Telemedicine Association and is currently an active participant in several ATA Special Interest Groups and Workgroups including: the Telemental Health SIG and the controlled substances prescribing and telehealth workgroup. He also serves on the advisory board of directors for the Mid-Atlantic Telehealth Resource Center (MATRC). In 2018, he was appointed to the New Jersey Telehealth Review Commission. Boyce frequently speaks about the potential of telemedicine and the best practices for establishing new programs.

This week kicks off the American Telemedicine Association’s first Telehealth Awareness Week. The theme of the virtual event is “Telehealth is Health” — a sentiment that rings true now more than ever.

Telehealth adoption has skyrocketed over the past year-plus and will undoubtedly become a permanent fixture in healthcare. In a March 2021 survey of Americans, 61% of people had tried a telehealth appointment. And between 2019 and 2020, provider visits nationwide delivered via telehealth jumped from 0.3% to 23.6%. Interestingly, the care specialty that grew in telehealth adoption the most, according to a McKinsey & Company report, was psychiatry.

Telebehavorial Care for More Holistic Care

During the COVID-19 crisis, a larger average share of adults spoke up about needing help with their mental health: 4 in 10 adults reported anxiety or depressive disorder, an increase from 1 in 10 in the year prior. While the COVID-19 pandemic has compounded an underlying national mental health crisis, it surfaced another significant challenge: a shortage of mental health specialists who are available to provide care. Behavioral health clinicians can only meet 27% of patient needs across the U.S.

This “perfect storm” of limited supply and increased demand has placed a substantial and untenable strain on mental health clinicians. However, it’s not only therapists, psychologists and psychiatrists who are shouldering the toll of the high demand for mental healthcare. Primary care providers (PCPs) are feeling it too.

As a confidant and trusted advisor, PCPs are frequently the first point of contact when patients seek mental health help. Serving as the “medical home” for a patient, PCPs play an important role in addressing both physical and mental health care needs by bringing in behavioral care specialists. But with the rising needs among patients and short supply among professionals, finding the right specialist for a patient is challenging.

Two-thirds of primary care physicians report having trouble getting psychiatric services for patients. It can take several weeks or months for a patient to be seen by a local mental healthcare professional. Relying on referrals to in-person professionals presents a challenge as patients often sit on long waitlists and symptoms worsen. Additionally, it also contributes to keeping mental and physical health siloed, which goes against the numerous studies that have shown that outcomes improve when the two are aligned.

Fortunately, there is a way to achieve holistic, coordinated care: telehealth.

At the intersection of primary care and behavioral health services is the perfect opportunity for telebehavioral care. As an effective alternative to referrals for in-person care, PCPs can refer a patient to a virtual behavioral health provider. In comparison to a referral to a local behavioral health specialist, a patient can see a virtual behavioral health specialist much sooner — in hours or days instead of weeks or months. The remote modality also eliminates geographical barriers, delivering patients a wider selection of mental health providers tailored to their mental health challenges.

Beyond improving referral follow-through and care coordination, many PCPs are bringing telebehavioral care in-house through collaborative care models. Breaking traditional siloes, the collaborative care approach integrates a behavioral health care manager at the practice level to identify and treat patients with mental health challenges. Bringing these professionals in via telehealth widens access not only for the PCPs but also for patients, as the care managers can virtually tap into a wider array of specialists, such as psychiatrists or professionals with condition-specific skills. Telebehavioral care models have been proven to reduce symptoms, and ultimately help improve overall patient health, by providing PCPs with the support needed and addressing the gap between high demand and low supply in the nation’s mental health crisis.

The benefits of telehealth at this point can’t be denied. But the benefits of telebehavioral health can’t be ignored. As we all settle into the new normal of healthcare, we must ensure that telehealth’s place in behavioral care is championed. It expands access. It helps our PCPs. It works for patients. And it’s absolutely critical to overcoming our nation’s mental health crisis in the era of COVID-19 and beyond.

Mental health plays a central role in our overall health and wellbeing. It affects the decisions we make and impacts how we show up at home, in social settings, and even at work. So, when an employee or someone in their home begins to experience mental health challenges, they benefit from knowing their employer genuinely cares about their mental, not just physical, health and wellbeing.

Yet historically, employers and even the government have not held mental health at the same status as physical health. Evidence of that is plentiful, including that in 2020 there remained no dedicated mental health category for Schedule A federal reporting that self-funded employers must perform. Those services most often fall under the “Health (other than dental or vision)” bucket, while dental and vision each have their own categories. If our teeth and eyes can receive special attention, shouldn’t our minds?

As we enter “The Great Resignation” fueled by pandemic stress, self-funded employers are in a unique position to recognize their employees’ mental health needs, differentiate themselves, and improve their businesses by investing in practical, accessible mental health treatments for their teams. It’s not just good for business; it’s the right thing to do.

The impact of the mental health crisis on employees and their families

We are a nation living in a behavioral health crisis. Each year nearly 25% of adults suffer from a diagnosable behavioral health condition such as depression or substance abuse, according to the National Institute of Mental Health (NIMH). Though cases were on the rise before 2020, the COVID-19 pandemic pushed the issue to the forefront. An August 2020 survey by the CDC revealed 40% of adults reported they had struggled with behavioral health or substance use in the previous 30 days. Sadly, the growing number of mental health challenges is expected to linger post-pandemic.

For employers, this means a significant number of employees, or their dependents, will experience challenges. Perhaps they already are. And when an employee is struggling with their mental health, it negatively affects their performance, productivity, engagement, hindering them from bringing their best self to work. The issue is only magnified if employees feel their employers aren’t prepared to help.

The costs of mental health in the workplace

Uncared for behavioral health conditions affect, first and foremost, the individual suffering. And their individual challenges have a financial impact on their employer too. One study of Quest Diagnostics revealed that in the course of a year, the six most common mental health conditions cost the company $12 million, their largest health cost by far compared to other physical conditions, largely for inpatient stays and emergency visits. This means that for the nearly 6,000 employees that visited a care facility, their mental states deteriorated to the point that emergency treatment was necessary. But the costs of these employees’ struggles started to tally long before they sought treatment.

Just looking at depression alone, employers lose 200 million workdays each year at a staggering cost of $17 to $44 billion. At a more granular level, the average employee suffering from depression misses nearly five workdays and experiences 11.5 days of reduced productivity in a three-month period.

Extrapolate that to a full year, across a large workforce, across multiple mental health conditions, and it’s clear that the impact is profound.

As behavioral health needs spike, every employer has both the responsibility and the power to provide the support their teams desperately need.

Utilizing virtual mental health care options

Empowering employees to care for their mental health can recoup some of the losses that come along with prevalent mental illness. But it can also be a differentiator for employers to help attract, engage, and retain talent, particularly in today’s tumultuous environment. Recent reports reveal that 40% of employees are considering changing jobs in 2021, and 25% are actively planning a change. The greener pastures that employees are in search of are better pay, richer benefits, and better work-life balance.

These desires indicate that employees are stressed and looking for employers to support their wellbeing, not just their work product. Fortunately, employers are acting and investing in corporate wellness programs, which include mental health benefits, to care for their teams. In fact, 53% of employers surveyed by the National Alliance of Healthcare Purchaser Coalitions said they are now offering special emotional and mental health programs in response to the pandemic.

As workspaces become more remote, there’s an opportunity for employers to increase access to in-network mental health services through telehealth. Telebehavioral health care frees employees to connect with specialists who can evaluate, diagnose, and treat behavioral health disorders from anywhere without the need to take time off from work to fit into tight appointment windows, travel long distances for appointments, or arrange for childcare. So, they can work from home and also receive care from home too. Plus, with in-network providers that offer specialized care, employers can open the door to scarce resources, such as child and adolescent psychiatry, for employees and their dependents.

Employers have the resources at the ready to help employees through these tough times and help their organizations stand out as employees seek better situations. All they have to do is implement the right benefits and educate employees on their options to begin the path to better wellbeing.

By adopting high-quality, telebehavioral health care, employers can protect the emotional wellbeing of those who are suffering, and in turn, increase productivity, reduce absenteeism, and build a more positive workplace culture. Telebehavioral care is not only good for employees and businesses; it’s a vital approach to address and start resolving America’s mental health crisis.

It has been a year like no other and that’s particularly true for the telemental health and telepsychiatry industries.

Unfortunately, mental health need has spiked during COVID-19, which has brought on the removal, at least temporarily, of nearly every barrier that previously limited telehealth.

While telehealth advocates have preached that telehealth is health, in 2020, we saw that come to fruition, particularly within the behavioral health space. You’d be hard pressed to find a behavioral health clinician today who has not held a remote session. So, what does this mean for the future?

The 6 trends we predict to see in 2021

As we look into the year to come, here are six trends we predict to see in 2021.

  • Care for clinicians - Our health care workers, including mental health care clinicians are the heroes of the year, shouldering the burden, stress and pain of so many. This sacrifice comes at a cost. The burnout and fatigue clinicians are feeling are real and measurable. Employers are pouring resources into mental health support programs for their teams. In 2021, we predict these types of programs to finally become a permanent priority.  
  • Crisis Intervention Teams expanding their reach by leveraging telehealth - As many communities have look closely at their police programs and funding in 2020, we anticipate a rise in crisis interventions teams or mobile crisis units that can bring trained mental health experts into the community to better respond to individuals in crisis. CITs, paramedic teams or even law enforcement can have more robust in-the-field support by leveraging remote behavioral health clinicians who can help assess risks and direct individuals to the appropriate level of care and support.  
  • Collaborative Care The connection between physical and mental health is indisputable, and payers across the country are doubling down on programs that help bring mental health care clinicians into individual’s primary care treatment teams. This is most efficiently done via telehealth. We anticipate major growth in this segment in 2021.  
  • Treatment teams in crisis settings - As the strain on mental health care clinicians worsens, it is vital to make the highest and best use of all mental health resources. Accordingly, we are beginning to see modifications to crisis telepsychiatry programs that layer in different levels of remote behavioral health clinicians to help with screening, triage and care. This trend, paired with a newfound desire for behavioral health clinicians to work remotely (at least for part of their week), means we expect to see more and more remote telepsychiatry teams serving all settings of care.  
  • Focus on disparities - 2020 put an important and needed lens atop healthcare disparities. We are seeing new telehealth organizations pop up that specialize in telemental health for populations with social, economic and/or environmental disadvantages and more focus placed on these efforts from existing telemental health players. One size does not fit all when it comes to mental health care, and determining the most effective ways to reach and appropriately address the needs of underserved populations must be a priority for all in 2021 and beyond. 
  • Telehealth regulations WILL change permanently 2020 was a regulatory sandbox for telehealth. Regulators moved incredibly quickly to greenlight any and every regulation that increased access to care via telehealth – however most of this year's changes were/are temporary and dependent on the public health emergency. As the CMS administrator, Seema Verma delivered what some consider the telehealth quote of the year: “The genie's out of the bottle on this one I think it's fair to say that the advent of telehealth has been just completely accelerated, that it’s taken this crisis to push us to a new frontier, but there's absolutely no going back." 

We are ready for permanent action

The telepsychiatry industry predicts and respectfully calls for regulators to make it happen. Here’s the short list:  

  • Reimbursement - by CMS and by every private payer for all aspects of mental health care regardless of the modality, including audio-only encounters. It must happen and it must expand.  
  • Simplified Licensure - In late November, a group of Congressmen introduced a bill (HR 8723) that would prevent states from receiving some forms of HHS funding unless they’ve joined the interstate medical licensure compact which makes it easier for physicians to use telehealth to treat patients across state lines. This bill showcases a sentiment we expect to follow us well into 2021. Unnecessary hoops to jump through in order to serve patients must go. 
  • Appropriate Controlled Substance Prescribing via Telehealth We must enact permanent policies to ensure access to behavioral health services via telehealth in order to address the opioid epidemic and other widespread behavioral health conditions. We call for the DEA to make a permanent and long-promised option for controlled substance prescribing via telemedicine under the Ryan Haight Act.

About the Author: Olivia Boyce, MPH is the chair of the American Telemedicine Association’s Telemental Health Special Interest Group and a Vice President at Array, the leading national telepsychiatry organization and a long time telehealth advocate.

About Array

Array Behavioral Care (formerly InSight + Regroup) is the leading and largest telepsychiatry service provider in the country with a mission to transform access to quality, timely behavioral health care. Array offers telepsychiatry solutions and services across the continuum of care from hospital to home with its OnDemand Care, Scheduled Care and AtHome Care divisions. For more than 20 years, Array has partnered with hundreds of hospitals and health systems, community healthcare organizations and payers of all sizes to expand access to care and improve outcomes for underserved individuals, facilities and communities. As an industry pioneer and established thought leader, Array has helped shape the field, define the standard of care and advocate for improved telepsychiatry-friendly regulations. To learn more, visit

If you are in crisis, call 988 to talk with the National Suicide Prevention Lifeline, text HOME to 741741 to connect to a free crisis counselor, or go to your nearest emergency room.