BHB INVEST: Behavioral Health Marketing Outlook 2024

This article is sponsored by Dreamscape. This article is based on a Home Health Care News discussion with Dan Gemp, president of Dreamscape Marketing. This discussion took place on October 11, 2023 during the BHB INVEST Conference. The article below has been edited for length and clarity.

Behavioral Health Business: Dan, I understand that you put out a survey report in partnership with Behavioral Health Business. It presented in itself a little bit of a problem when it comes to the discourse around marketing and behavioral health. A lot of the issues that we deal with in behavioral health are centralized and there’s a lot of offshoots. We have a much more diffused issue, which makes the challenge in marketing and behavioral health much more challenging, right?

Dan Gemp: It was a little weird. We actually haven’t published this before. A huge thank you to BHB for getting this done with us. We had a huge array, different models, different modalities, different sizes of operators in mental health and SUD and detox who responded to the survey. Not just Dreamscape clients, so we actually can validate some of the data with our own datasets today. Some of it is brand-new information. What was odd? What was the outlier? Thank you all if any of you participated in the survey. People are leaning into tactics for their marketing next year, and are intending to lean into tactics based purely on comfort. Those that are the most comfortable with social media, if you hire a digital marketer for your team that’s comfortable with social media, their intention is to spend the most on social media next year.


Regardless of whether or not it generates the most admissions, growth, brand recognition, and whatnot. Those that are PPC Google Ads wizards intend to spend the most on PPC ads. Same with organic SEO and content marketing or alumni marketing. What was odd, and we were able to verify this from our own client’s data, is people were simply going to invest with what they know. That’s not actually going to be the recipe that yields maximum returns next year.

Were there any other top-line findings that are compelling to talk about before we jump into the biggest challenges?

I think that there’s a trend that’s been going on in this space for a while. A misprioritization of digital marketing. A lot of folks in this space are trying to blend budgets between outreach and traditional sales channels. They’re blending their marketing budget to cover both that and digital. It’s going to create a conflict. You’re going to find that the data sets just add inefficiency. You’re going to find a more expensive cost per admission when you’re looking at traditional and digital channels in the same budget.


What is the biggest challenge facing mental and behavioral healthcare marketers in 2023, which is almost done, by the way?

It’s not cost and it’s not reaching a specific audience. A lot of survey respondents actually did identify that. There’s a serious lack of confidence that we are reaching our audience. Only 4% of respondents actually believe that it’s easy to reach their intended audience. Compare that to our hospital clients. We work with Rush Hospital down the street. They have an 84% confidence that they are reaching their cancer patients who are prequalified as needing cancer care. That was an outlier. It was a bit odd that in our own industry, we don’t feel confident that our own marketing is going to reach our own patient base. It seems to be a conflict. That’s happening now. That’s from this year. We’re focused on the results that are telling us what to do next year to make sure we can refine that and actually speak to and market to our patients.

Why is that? Why is there such a low confidence that marketers will be able to reach their target audiences? At least based on your experience and some of the history that you have in this space.

Yes. Multi-pronged problem. No judgment is being cast here. These are the results of a third-party survey, not the opinions of Dreamscape Marketing. Groups feel very comfortable with these specific channels that they know. They lean into them more and more. When the results do not come back, if you spend the most money on Facebook. Let’s do a quick real-time survey to prove this. How many of you have selected a doctor of any type this year from Facebook?

How many of you have ever selected a medical professional, even a dentist, from Facebook? None of us do.

What if your staff was spending 40% of your marketing dollars in Facebook advertising telling you it’s going to work? What’s happening is the budget’s being deployed, but the confidence isn’t there and the data doesn’t match the budget.

We’ve already highlighted what tools marketers are focusing on. They’re focusing on what’s comfortable. Sure. What else can we talk about in terms of tools that marketers are focusing on today? Are they right? Are they right to focus on that?

Yes. The landscape of marketing tools is changing drastically. It was all just Google Analytics and whatever you could plug into it, call tracking metrics, call rail, any attribution source that pairs with your CRM. The dilemma is AI is coming and everyone’s like, “AI is here.” Do not use AI to generate content. You don’t own it. It’s making it up. Even if it makes a medical claim or steals content from the Mayo Clinic, you’re getting sued. There’s a liability. I’ve had clients come up to me at this event and say, “It must be nice that you can use AI to generate content now.” No. Half of my staff are writers. You still need humans to write your content or you’ll get sued for something. Now, soon, as we teach AI more and more, that marketing tool will become extremely powerful, cost-effective. Your marketing costs will likely come down. Internal costs, agency costs, all the above. You will see Google deploy more and more AI tools on their own platform. Google Ads will both be powered by and managed by AI. That’s scary, but it’s not an existential problem. They’re trying to fix this same set of problems that you have. Tools that are getting outdated, tools that are being deprecated to the old version. Google Analytics is dead. GA4 came out this year. Everyone thinks it’s the same. It’s not. It’s following the European cookie tracking laws. Google used to know that it was you and your phone and what time of day you’re at work, what time of day you’re in your car, what time of day you’re sleeping. Now they just know a general IP address. They don’t track you by name. It’s a little bit more polite. You’re going to find that the tools for tracking change, but they will still have all the same generalizations. They’ll know your interests, your hobbies, your habits. They’re just not tracking and advertising to you as an individual. Thanks to Europe.

The first one I want to address is, how do you navigate conversations on people just spending on what they know versus trying to convince somebody that taking a different tact would actually be effective? Part of it’s got to be getting people okay with what they believe would be sunk costs.

That is about 90% of the conversations I have every day. Is convincing someone that the gap in their marketing mix is their opportunity. You present it as that. It’s an opportunity for tactical growth. You’re saying, “Hey, you’re already deploying these dollars well and you’re focused on that and you seem comfortable with that. What else might we do in addition to that?” Everything in digital marketing, in particular, is in aggregate. More is more. More SEO will yield more results. More PPC spend will yield more admissions unless you’re doing it wrong. More tools will give you more data and you can identify and segment your data more accurately. You don’t need to judge your team members that are overseeing those budgets. It’s where they’re the most confident, so they’re not necessarily wrong, but none of us hired a doctor from Facebook. Challenge them with, “Hey, how can we use that same tool to generate marketing content for a different audience?” Which is one of the other pillars of our survey. Cost is an issue. Audience is an issue. How do you speak to the female head of household who’s either calling for her husband or son on 73% of calls to an SUD treatment center? How do you market to her more accurately? How do you segment your publications or clinical outcomes data so that it’s going to referral partners, people that will actually care about your clinical outcomes data, and take action based on it? That’s what’s going to be trending next year. It’s not about just lifestyle posts on social media that life and sobriety is better. It’s that you can hit an audience that you’re missing now and you present that as the opportunity and you tell your team, “Don’t worry, we’re going to fund that opportunity. We’re going to expand and more is more.”

Previously, before we got to the question about convincing people and working on something other than what they are comfortable with, we were talking about tools. What tools should be focused on when it comes to marketing?

That gives you financial performance metrics. What is the name of this conference again? It’s BHB something? There’s a capital investment you’re making in your marketing. It is an investment. It is the same as real estate. It appreciates in value. Your marketing dollars get more efficient over time when you’re doing it right. The tools in this changing landscape, again, another one of the pillars of the survey, the tools should be yielding actionable cost per something data. It doesn’t have to be perfect. It just has to give you a cost per call. Do you know your exact cost per call? Whether you’re an outpatient psychiatric practice, MAT center, you should have that piece of data readily available every day. Every week, every month. Then you can evaluate. There might be certain marketing channels where your SEO cost per call and your paid ad cost per call, but you’re not really measuring social media directly. It’s more of a brand-building exercise. You’re building a community. You don’t have to measure cost per call. What can you measure? What tool could you use to measure financial value from Facebook communities? I would focus heavily on alumni. I would maybe use third-party apps. I would build an alumni portal and I would measure participation. Now either labor hours or dollars are put into your social presence. You’re investing and you’re measuring the investment through activity. That will yield more referrals, alumni readmissions, brand equity, instead of blame if someone relapses. You’ll actually get good social media reviews instead of being blamed that someone 80, 90% of the time ends up relapsing. Focus on that. Any of these tools that are giving you cost per something and you will do exceptionally well next year.

Is the survey available to conference attendees?

Yes, I have some hard copies up here with me and we do have a QR code to download the PDF version as well. We want this information out there. This is not proprietary to us. Again, the participation levels were awesome. It was primary mental health providers, dozens of the largest operators in the SUD, behavioral health, residential side, standalone detoxes. What was interesting is the responses from each type of group were extremely similar. The averages that our survey is showing were actually the same at a residential mental health facility as it was at a residential SUD facility within single-digit percentages. Very interesting, consistent data. Again, it’s dozens of the largest groups, dozens of smaller startups, one location operators, and then a whole bunch of multi-location groups in the middle that some are big and some are small.

Is the survey specific to healthcare or general marketing?

This is specific to behavioral health and mental health. Hyper niche, only this space. This was not inclusive of our hospital clients. This was not inclusive of media groups. This was just operators.

You did mention being able to really capture a wide spectrum of some of these residential center providers especially. There’s over 30,000 residential centers that do addiction behavior health integrator or just mental health. How do you stand out digitally?

This is a challenge on both reaching an audience and using the right tools. To really stand out digitally, I tell the joke a lot. You don’t have to outperform everyone. You just have to outrun the guy behind you. If you can stay one step ahead of a competitor on paid ads, that means you have to outspend them. I can’t tell you how many groups I’ve talked to here today where they want to do more for less. I want to get all the Google ad traffic and spend 100,000 a month and I just found out my competitor is spending 120. Then you would need to spend 121. I don’t know if it’s just irrational thought or hope from a private equity side that a group can run more efficiently than a competitor, but you’re all at the same auction. Google ads pricing doesn’t change. It only goes up. The inflation post-COVID is about three to 5% a year. If you’re not increasing your budget by 5% next year, you will lose 5% of the leads generated from it next year. Similarly, if you’re trying to stand out on your content, on your brand, I still think that the general public struggles to name two mental health brands.

Go walk out on the streets of Chicago and ask anybody to name two. They could be rehabs, mental health clinics, anything. Most people will say Hazelden Betty Ford, a long time original name in the space and people will struggle to name a second. Even in the space, I think a lot of people struggle to name multiple brands. The largest following of any thought leader in the space is the rapper Eminem. No brand even comes within a million followers, just from the SUD side of things. He has a whole album about it. Thinking about that, where’s the opportunity in that? How do you differentiate yourself? You either are subject to outspending your competitors directly, or you need to highlight your specialties. When we work with hospitals, they’ve been doing this forever. North Shore Hospital here in Chicago, they’re only marketing their neurosurgery division. They put a lot of money into it. That’s their specialty. Cleveland Clinic, they market their second opinion cardiology consults. That’s what they’re putting marketing dollars into. Not just the Cleveland Clinic. We’ve all heard of it. The brand recognition is there. The marketing dollars go into specialty profit centers. You would all do well to identify those. Maybe it’s an adolescent program, a veteran’s program, or an alumni program. I could rattle off a long list for you, but your dollars will go further, and your audience will feel more cared for. You’ll make a more meaningful connection to these audiences that are hard to reach because you’re creating marketing content just for them.

Even single specialty providers have to try to reach multiple audiences, and it only gets much more complicated as you add more specialties within an organization. How can these various and multiple audiences be more effectively reached in the first place?

It’s actually media type, and this actually came in from the survey. If someone was trying to interact with you about your children’s health care, it would be primarily through email and secondarily through text. You’d have to have a pretty robust email and educational campaign from medical providers for your children to reach you and make that connection. Texting, there’s a generation out there called Gen Z. It is their only mode of communication. A phone call is actually an awkward experience for them. We all want them to call our admissions center and be sold something. Millennials will get on the phone. Millennials will call, but we’re getting older. You’ve got this 10-year window of high demand, high patient volume that just wants a text message. Do you take Blue Cross or not? If yes, then I guess I’ll get on a call. If not, I don’t want to talk to you. Think through the channel you’re communicating through, and that’s where you’ll get your efficiency. It should be common sense, but it’s not common practice. We have clients where all of their dollars go into just SEO and PPC. That’s it. They want a contact form filled out or a phone call. Now you have to be concerned with HIPAA compliance, PHI. If you’re texting people, you need the right software and systems, and you want that to be a third-party liability. Be careful and run that through your lawyer. That would be both my biggest advice and what we saw in the survey is that the media itself, text, email, phone. That’s the part that is going to have the highest rate of efficiency, get the right channel for the right audience. You can generalize that by age demographics for the most part.

A lot of the argument that you’re making today with some of these is making sure that there is a greater investment in spending into digital health. Based on the questions you’re giving me here, you’re contending that digital can actually help control your costs too. Can you talk about that?

Yes. This is tough to be a marketing agency guy and talk about this because you’re all underspending on digital marketing. There is more demand online than any other channel for fewer dollars. Even turnover on your outreach teams and turnover on a sales team and trying traditional media, they will all in the long run be way more expensive than digital marketing. However, it’s your best cost-control mechanism. You can assess a specific admission to a specific dollar spent. All of you generally know your cost per patient acquisition regardless of levels of care. MAT models and maybe a few hundred dollars, Medicaid models, a few hundred dollars, detox, 2,000, it fluctuates and scales up through residential care at higher cost points. Digital marketing is one of the few channels that gives you that specificity. You can track an exact click to an exact call and know what that cost was. I’ve been speaking to groups a lot about instead of breaking out a budget into one goal, saying, “Hey, I want to spend this amount of money and hope that it yields this amount of growth in market share.” Set performance tiers that I would be okay with, and it might even be diminishing returns. The first 30% of my census will come from digital, and it’ll be roughly at this cost. The second one-third of my census may be at diminishing returns, but once you’re above your break-even point for operations, there’s actually more margin on every single patient. Instead of saying, “I have to have this exact margin per patient, every single patient,” View it as the way a hotel would. Once a certain number of rooms are full, you’re in profit. Every patient on top of that can be used through any form of marketing, any form of media. It could actually be less cost-efficient and still scale, but you’re controlling your cost on the digital marketing component. That part is predictable, trackable, and tactical. Your traditional media, your branding, your alumni programs, your specialty programs, that can all be in addition to. You’re now filling more total beds if you’re residential, seeing more patients per day if you’re outpatient. It gets very interesting when you start viewing digital marketing as a cost hedge against the salaries of your outreach team. You’d be surprised how close it is dollar for dollar, but what happens when an outreach person goes on vacation? You lose that efficiency for the month. The computer doesn’t go on vacation, Google doesn’t go on vacation, and so it’ll also be a constant, and it makes it more scalable. Whether it’s private equity funding it, or whether you’re pulling this money out of your own pocket, you’re going to find digital marketing gives you that cost control for years to come. AI is going to make it cheaper. Mark my words. You will find your digital marketing gets cheaper over the next three years.

How do you recommend navigating payer rules on marketing with what actually works? Some payers would discourage business to consumers, but a person-centered approach would empower people with the information that you’re marketing. Navigating rules with payers.

I would say that developing these specialty programs, it’s where everyone, again, whether it’s mental health, SUD, everyone in the space feels comfortable developing specialty programs. They didn’t feel confident that they could hit their audiences directly. Creating content is where you’ll find that happy medium. The payers want you to educate your patients directly. If you have a veteran’s program, don’t just slap logos of military branches up there. Educate how your unique trauma-informed care creates a better therapeutic alliance. Put a video of your clinical director not speaking about their approach to medicine in general, speaking about their approach to treating a veteran of the United States military. First responders. It’s not the same as veterans. You should make separate content. You should really boil down your content into unique silos. Then there’s no guilt in advertising. You’re not tricking people into identifying themselves as a certain type of lead. You’re actually educating your patient base so that there’s a more meaningful connection. We have seen zero payers take issue with that. We’ve actually received inquiries recently from several insurance groups about providing that content as a marketing group to the operators. That’s completely new. I think they’re really trying to push value-based care, and so they want to control the message and the cost. Separate conversation. I think you’ll find they are in support of that, of educational content. That’s also really good digital marketing. It ranks well on Google, you make meaningful connections. Just put that contact form at the bottom.

Given current staffing and employment challenges, what trends are you seeing on employment branding and marketing? In short, reaching employees versus reaching patients.

This is a great one. We’ve had more hospital and senior living organizations approach us recently with staffing campaigns. You can run highly effective staffing campaigns. If you’re going to pay a recruiter $20,000 to hire a clinical director, you can spend $10,000 on Google. We do look for jobs on social media. LinkedIn, Facebook. There’s an opportunity to specifically run marketing dollars, even internal staff, towards staffing. Become your own staffing company, especially if you’re multi-location. Then second is building community. You can use AI to generate internal emails. If you’re lacking culture or things feel a little bit cold after bringing on a private equity partner and you’ve lost that personal connection to the founders, whatever that may be, build groups on Facebook. Get your employees to participate in that. Send out newsletters about them. No employee cares about, “The company’s up 8% month over month, year over year, and the Christmas party’s going to be okay this year.” That’s not what they’re looking for. You need to say, “Hey, we just promoted my assistant to an operations role. She just got married, bought a house, bought a car. She’s living the dream this month.” That’s what my team cares about. Not what Dan’s talking about at a work conference thing. Build your community. Use AI for that to keep it cheap and reduce the time needed. They will refer more people to come work for you. Everybody’s got friends. We have found that to be uniquely successful at the treatment centers that have the strongest culture. Retention is way higher because the employees like each other. They’ll refer for free, more people to work there. It’s tough to pull off, but I think if you can succeed in building community, you will build culture.

How should an outpatient therapy practice balance boots-on-the-ground sales work with primary care providers or other referral partners versus digital marketing?

Do an experiment. For an outpatient operator, even a psych practice, spend heavily on digital one month. I mean heavily. If you think you should spend 3,000, spend 7,000, 10,000. The next month, you go out yourself to all your referral partners and just spend time with them. Buy them lunch, build relationships, and just measure which month you do better. For some operators, they’re so likable, they’re in this to save lives, and they’re just the real deal. They will get more personal clinical referrals than digital could ever do for them. Or especially multi-location outpatient operators, spend enough on digital to outpace the other outpatient centers in town, and you’re not generating your own market share, you’re taking theirs. Every patient you get locally is a patient your competitor lost. This industry is very feel-good, patient-first, people-first, but it is direct competition. When you grow in market share, you’re taking it from someone else. Be a little bit cutthroat on that. Especially on local digital marketing, if you’re using local keywords, town-level, city-level keywords. Spend a bunch for a short period of time, get the data you need, and then you go yourself. Don’t just send your outreach rep because they might not care, they might not get the mission. You go yourself and have lunch with three, four, five of your clinical referral partners and measure the difference.

Based on our talk today, what would you like the marketers in our audience to take away?

Again, the pillars of the survey. We’re talking about reaching the correct audience, we’re talking about cost control, which means lean into digital. Whether it’s for staffing or a local pilot test, do way more digital marketing next year yourselves. What could you use ChatGPT for? Just don’t publish content on your websites with it or you’ll get sued. Then the landscape of tools, make sure you’re using software to track everything. I’m saying that very vaguely, I’m not naming specific platforms. For calls, it’s call tracking metrics, CallRail, there’s three or four options total. They’re all good. Use GA for the updated Google Analytics. That’ll help you measure every page of your site if you’re building specialty content for your veterans or for your alumni. You can track that exact page and what people do on it and what they download on it and it gives you good business intelligence. You might want to then staff your outreach teams based on what actions are happening in those program pages. I think that if you’re not using these tools, the action item from today that you should take away is go find them or ask someone who’s digitally savvy about them. We don’t mind telling people all the tools we use or there’s AHREFs and SEMrush to track your websites and SpyFu if you want to spy on what your competitors are spending and then ask me if it sounds right and I’ll tell you if that’s what they’re really spending. There are a lot of tricks to the trade but they’re not expensive and they’re easy to understand. If I told you that the average person clicks on 2.14 pages of your website, does that surprise you, scare you, does that sound confusing? That’s the average. If I told you they only read your blog pages for 11 seconds, do you really care what your blog says anymore or is it okay to put a lot of keywords in it? Think about normal consumer marketing. We’re really just making a retail connection to someone that is looking for that therapeutic alliance. They’re looking to begin a medical process and they’re reaching out to you. It shouldn’t be possible to miss your audience.

They’re reaching out to you. They’ve already self-identified that they have to pay for a service for a condition that is chronic and killing them right should be pretty high conversion rates every time your phone rings with that call. Some simple advocacy. That’s my extended answer to a simple question. I just think that with these four pillars of focus you’ll be surprised how much your own organization is not doing these things or not looking at these things so please do take a survey or download.

Dreamscape Marketing is a full-service digital marketing agency. Dreamscape uses leading-edge technology and proven approaches to add value to your company’s bottom line. To learn more, visit:

Companies featured in this article: