Improving access for severe mental disorders

We’ve all had some experience of struggles with mental health. Maybe you’ve stood by a loved one in a time of need. Maybe you’ve been through tough moments yourself. Too often, illness is only half the challenge, with people forced to wait too long and fight too hard to get the help they need. The simple fact is that mental health services haven’t kept pace with rising demand. The result is a system that waits to step in only when someone reaches crisis, leaving their family under unbearable strain and piling more pressure on our NHS. This needs to change. Today, we’re announcing a major expansion of NHS mental health services so people can get help earlier and closer to home. This includes 100 new community mental health centres, where people with severe needs can walk in without a referral and get support without waiting months. In addition, we’re setting up 59 dedicated mental health emergency departments, giving people in crisis fast, same-day specialist care. Community-led, community-based support is an approach we used to great effect in Greater Manchester. These services will make it much easier for people to get the right support, at the right time, in the right place. Mental health specialists will work alongside GPs, councils, charities and families, and provide direct links to housing and employment support. The first of these new facilities will open their doors and offer their help later this year. We know there’s a profound mental health crisis impacting younger generations. There are those who are quick to criticise young people today, but that’s never been my way. Our country’s future depends on them – and they will have this government’s support. The overwhelming majority of the one million young people not in education, employment or training want the chance to build their future. But poor mental health, combined with a system that can’t keep up, robs them of that opportunity. These new NHS facilities will help get lives moving again. When I spoke outside Downing Street on day one of the job, I promised we’d help people live well. I said we’d invest in success, rather than pay for failure. This is what that promise looks like. And to everyone who’s struggling with their mental health today: don’t give up hope. Help is out there and more is on the way.

Most people with depression or anxiety are stuck between a months-long waitlist and a five-minute video call that vanishes after the first script: Both are failing them. This post shows what a third option looks like when you build care around a real 30-minute visit and follow-up that doesn't disappear: In many major US cities the wait to see a specialist is measured in weeks. In rural areas it often stretches to months. For many people no appointment exists at all. But most people with depression and anxiety do not need to see a psychiatrist to start evidence-based treatment. They need a licensed clinician who can assess their symptoms, prescribe a first-line medication, monitor its effectiveness, and adjust it over time. That is standard medication management. It does not require a specialist. It requires a proper clinical encounter and a follow-up model that does not disappear after the first prescription. The consequences of leaving that gap unaddressed are not abstract. Untreated depression and anxiety do not stay stable. They worsen over time, affecting sleep, work, relationships and physical health. They increase the risk of other conditions developing or escalating. Every week someone spends on a waiting list is a week the condition is going unmanaged. The solution is not to replicate what a specialist does. It is to make evidence-based medication management for depression and anxiety as accessible as any other medical service. A licensed clinician. A proper intake. A 30-minute visit where your doctor has time to listen. Ongoing follow-up built into the model, not optional. The access gap is not a mystery. It is a design choice. And it is one we can make differently.

Americans will see their health insurance premiums more than double in 2026, from $888 to $1,904 annually. But while Washington debates subsidies, we're missing the real crisis — the quality of care our money buys us. Through my own journey with bipolar disorder and addiction, I learned that untreated mental illness doesn't just affect the mind; it ravages the body. Yet our healthcare system still treats them separately, costing us $477.5 billion annually in unnecessary expenses. The solution exists: integrated care that treats mental and physical health together. Research shows it works — better outcomes, lower long-term costs, and healthier patients. In my latest op-ed for The Hill, I outline what must happen next, from employers prioritizing integrated models to policymakers incentivizing quality over volume, to transforming medical education. At The Kennedy Forum, we've set an ambitious goal: by 2033, ensure 90% of Americans with mental health conditions are accurately diagnosed, receive evidence-based care, and achieve recovery. This isn't about politics. It's about recognizing that quality care is better medicine AND better economics. Read the full piece: https://lnkd.in/d2ew6Wzd

I appreciate Monta Knudson's thoughtful perspective on this issue. One of the challenges in conversations about homelessness is that we often look for a single cause and a single solution. The reality is far more complex. Housing is essential. Behavioral health care is essential. Recovery support is essential. For many people experiencing homelessness, lasting stability requires all three. The recent analysis referenced by reinforces what many providers have observed for years: a significant portion of people experiencing homelessness also have complex behavioral health needs. When those needs go unmet, individuals are more likely to cycle through emergency departments, hospitals, shelters, treatment programs, and other crisis systems. At Central City Concern, we see every day that housing alone is often not enough for people with the highest levels of need. The most successful outcomes occur when housing is paired with integrated physical health care, behavioral health services, substance use disorder treatment, recovery support, employment assistance, and ongoing case management. This is not an argument against providing affordable housing as a necessary service. It is an argument for investing in the full continuum of care necessary to help people achieve and maintain long-term stability. One of the key truths is that the needs of many of the folks being served in affordable housing have changed. Those needs have changed faster than the service designs and funding models. The result is a system which is not functioning as effectively nor efficiently as clients and our community need. It's also important to recognize that this challenge extends beyond homelessness services. Statewide analyses continue to highlight significant gaps in Oregon's behavioral health treatment and residential care capacity. To Monta’s point if we want different outcomes, we must be willing to build systems that align housing, health, recovery, and behavioral health resources as interdependent necessities—and invest accordingly.

AI can quietly fix the gaps your clinicians see every day. Mental health waiting lists stretch for months. Women's health concerns get dismissed or overlooked. The system struggles to meet demand. This is where AI-driven platforms step in. Mood tracking tools monitor patterns that might take weeks to surface in traditional therapy sessions. Crisis intervention systems provide immediate support when human resources are stretched thin. Gender-specific health monitoring catches early warning signs that often slip through routine appointments. These platforms offer something your current infrastructure might struggle to provide: accessibility. A woman experiencing postpartum anxiety at 2am gets real-time support. A patient in a rural area tracks symptoms that inform their next specialist visit. Someone hesitant about traditional therapy finds a low-barrier entry point to mental health care. The technology handles what it does best: continuous monitoring, pattern recognition, data collection. Your clinicians handle what they do best: personalized care, complex decision-making, human connection. I spoke with a healthcare administrator last week. She was skeptical about AI in these sensitive areas. After exploring the applications, she realized something important. AI tools free up her clinical team to focus on the patients who need them most. The platforms handle routine monitoring and early intervention. Her specialists tackle the complex cases requiring human expertise. This approach reaches underserved populations who face the biggest barriers to care. It delivers tailored solutions at scale. It turns healthcare from reactive to proactive. The question becomes: how can you integrate these tools to amplify your existing care delivery?

Important new research from Manchester University shows that social prescribing link workers in primary care in the UK are “increasingly supporting patients with the fundamental social determinants of health, especially in socioeconomically deprived areas.”   It says that these patients, who may be experiencing problems with debt, benefits or housing, “commonly also have multiple, complex health needs, including mental illnesses”.    The paper raises challenges around the purpose of link workers in this context, the importance of training and supervision, and wider systematic pressures on public services.   My personal view- this is powerful evidence of the need to invest in social prescribing and increase the numbers of link workers, to ensure we don’t just reach the most complex and those in crisis, but support the wider population of people with health conditions who would benefit from connection to local community groups; a preventative approach. We have around 3300 link workers in primary care in England, which has a population of around 56 million people. That is roughly 1:17,000 patients.   Is it any wonder that they are prioritising people who are most in need?   Those with the most complex issues who face multiple challenges to accessing health and public services, including high anxiety, poor literacy, highly stressful and unstable living situations, relationship breakdowns and deep social isolation. Often problems snowball and people feel overwhelmed and unable to navigate the complicated web of services and support which is available, but which takes patience, digital connectivity and confidence to access. Many people experiencing these challenges cope with them for many years, or slip through the net and only when things are at crisis point are they picked up in places like A and E or housing services. This is who social prescribing is reaching, and finally asking ‘what matters to you?’.   The NHS Long Term Workforce Plan projected that 9000 link workers are needed. If we offered a holistic, preventative service to everyone with a health condition who needs support with confidence and agency to connect to community activities and be creative, physically and socially active, it would be many more.   Having worked in community projects directly with people experiencing challenges like this for many years, I heard the same thing- frustration that public services worked in silos and passed people from service to service without addressing underlying issues. I became an advocate for social prescribing as a solution to these systematic problems; to ensure people don’t ‘fall through the net’ and can access holistic, confidence building, empowering support to improve their own lives, and access the services and help that they are entitled to. With increased investment, this can be achieved for more people, not just those with the greatest need.  https://lnkd.in/eN65UahA

🔓Enabling Digital Mental Health Technologies (DMHT) ⚖️🧠 Due to their scalability, DMHTs have the potential to bridge the gap between demand and the available workforce, especially in systems with long delays or limited capacity. However, to support DMHT adoption and enhance access to mental healthcare—particularly for marginalized populations—it's essential to manage the associated challenges and risks effectively. Regulatory and HTA agencies are key players in this process: regulatory bodies ensure the safety of medical devices and set requirements for market approval, while HTA agencies evaluate cost-effectiveness and overall utility compared to standard care when DMHTs are integrated into health services. The paper identifies key issues impacting adoption pathways, highlighting the importance of establishing nuanced adoption pathways tailored to regulatory standards, particularly for digital interventions intended to improve healthcare systems rather than directly treating patients. 🎯 For instance, certain DMHTs are designed not solely for individual therapeutic purposes but to enhance broader aspects of healthcare, such as access, service integration, and equity. This type of implementation requires a whole-system approach to ensure both effectiveness and safety. Even if a DMHT is initially developed for a specific clinical purpose—such as monitoring a digital biomarker—its ultimate benefit may lie in supporting collaborative care for the condition it addresses. 🛠️ In this context, and considering AI’s growing influence, we should advocate for innovative HTA practices that leverage agile methodologies, like adaptive interventions and micro-randomization trials (MRTs). These methods accommodate the dynamic nature of DMHTs, helping assess the technology in its entirety—encompassing user interface, engagement features, and overall impact—rather than focusing narrowly on its core therapeutic effect. This whole-system perspective is particularly valuable in understanding the multifaceted benefits DMHTs can offer within healthcare ecosystems. 🌐 Another essential factor is collaborative scaling—the notion that, to meet public demand, entire populations may need access to an array of similar devices or multiple functionally equivalent products. As AI increasingly integrates into Software as a Medical Device (SaMD), a comprehensive ecosystem approach becomes vital to support ongoing regulatory adaptation and continuous learning 🔄. This ecosystem approach is crucial for creating a sustainable, scalable framework that not only accommodates DMHT expansion but also ensures that regulatory standards evolve alongside technological advancements. 🔗 https://lnkd.in/dwuhmk4P #DigitalMentalHealth #HealthTechInnovation #TransformingHealthcare #EquitableAccess #AI #FutureOfMentalHealth #MedicalDeviceRegulation #AdaptiveHealthcare #CollaborativeCare #MentalHealthAccess #HTA #SaMD #AIaMD

Historic win for mental health care in Colorado yesterday. It's now much harder for insurers to deny care: No more "arbitrary" treatment cutoffs. House Bill 1002 passed with bipartisan support. Advocates wouldn't take "no" for an answer.   Here's what they won: 1. Equal coverage for mental illness and addiction ↳ Must be as extensive as for physical illness. 2. Medical necessity based on national standards ↳ Insurers follow expert guidelines, not their own criteria. 3. Long-term treatment options protected ↳ Insurers can't limit care to only short-term symptoms. 4. Out-of-network care when needed ↳ Access to non-network providers at in-network costs. Think advocacy doesn't work? Tell that to every Coloradan who'll now get: ↳ The care they need ↳ For as long as they need it ↳ Without fighting their insurer And tell that to Bill Smith, whose team led the fight. He founded Inseparable, a powerhouse mental health advocacy organization with a long list of similar wins.   This is how change happens. Not with hashtags, but with organized,  persistent advocacy that demands better.   The law takes effect January 2026. But the lesson is clear today: When advocates unite and push hard, walls fall. I'm inspired by Bill Smith and Inseparable. They have much to teach us.  ============== ⁉️ What's the next wall we need to break down? ♻️ Share to inspire more advocacy wins. 👉 Follow (Eric Arzubi, MD) for more like this.

"How do we do more, with less?" It's the eternal question in healthcare. The map below shows the imbalance of behavioral health care vs the demand. Right now, the most obvious and proven answer to closing the shortage of care gap in behavioral health is telepsychiatry.   This is another topic we covered at Becker's Healthcare Summit last week.   We can do more - rural hospitals, EDs, and underserved communities get access with telepsychiatry to specialists that they otherwise wouldn't have.   With less - telepsychiatry adds capacity to the same work force by removing commute time and geographic constraints.   But, as I said last week, the main bottleneck to telepsychiatry being fully utilized is not technology but regulatory fragmentation and the lack of a unified cross-state licensing system. The technology has been in place for some time now.   Here are a few other tools that could allow us to do more with less: Ambient AI documentation - The time psychiatrists spend on notes and administrative tasks is time not spent on patients. Tools that reduce that burden don't just improve job satisfaction, they effectively expand the number of patients a clinician can see.   Smarter triage - Not every patient presenting with a behavioral health need requires a psychiatrist. Better routing gets the right level of care to the right patient, so psychiatric expertise is applied where it's actually needed.   Measurement-based care - If a patient is clearly improving, you may not need to see them as frequently. If they're not responding to a treatment, you catch it faster and pivot sooner rather than spending months on something that isn't working. Tracking patient outcomes in real time makes treatment more efficient and effective.   None of these replace the need for more clinicians. But together they stretch the capacity we already have.