Each year, we face the proverbial mirror toward readers and show the stories that garnered the most attention by listing our most-read stories of the year. Unsurprisingly, articles that inform vital functions of a behavioral health professional’s work life dominate the mix. Still, some of our coverage crossed over into the wider newsreading public’s media diet, and that includes our most read story.

For example, many of the stories below touch on developments in the federal regulatory and payer scenes — in at least one case, a story landed at the intersection of the two. Many of which have a sense of drama to them. At the very least, there is drama for those who are interested in the epic of behavioral health.

Still, these stories reflect the wide impact of the industry itself, its contemporary industries and the very real yet unseen forces on the lives of millions of Americans. Each informs their specific topic but also reveals a jot of deeper truth about the behavioral health industry and American life in general.

(The following includes only articles published in 2024 and excludes top-performing year-in-review or executive forecast articles.)

Headspace Axes 13% of Workforce, Transition Therapist Network to Part-Time and Contract Roles

Headspace is, to state the obvious, immensely popular among consumers, is well-known among major corporations as buyers of similar products and services, and was something of a darling for the venture capital-tech entrepreneur class. Headspace itself is the product of a $3 billion merger and has raised immense amounts of capital in the process, including $105 million in debt capital. 

So, it was notable to see a company that has reached such altitude experience this kind of turbulence. But put in context with hindsight, it might have been expected.

Digital health companies have had a hard time raising capital and competing in a very competitive wellness and health world. On top of that, GLP-1s are taking up a lot of oxygen in a lot of rooms, and the urgency for mental health services induced by the pandemic is clearly fading.

Further, there has been something of a mini-recession with the wider tech world, a world that Headspace is part of, for the better part of 2024. 

Biden Administration Launches New Multi-State Social Worker Licensure Compact Program

The interest in the Biden administration’s investment into something as wonky as aid in developing licensing compacts shows a crying need to streamline regulations in the behavioral health industry.

So often, patient and provider populations don’t evenly break across state lines. In fact, many major American metros see substantial parts of their community on either side of the borderline. The interest in this news shows the reality of this fact and the hope that improved licensing could increase access or ease of access to care.

Biden Administration Releases ‘Historic’ Final Rule on Behavioral Health-Physical Health Parity

While not the panacea or silver bullet the industry craves, the Biden administration finalized rules requiring payers to do more to show they are complying with federal parity laws. The rules also close some loopholes from previous regulations.

The parity issue is the frontline of the overarching contention of the industry that its services are not duly appreciated by the payer system. Questions of industrial fairness and top-line revenue impact all behavioral health providers, making one of the few universal narratives of industry.

Retreat Behavioral Health Closes Following Prolonged Financial Struggles, Death of 2 Executives

The untimely deaths of people are inherently dramatic. Just as the parity issue is a universal narrative for behavioral health enterprises, death is the universal heritage of all humanity.

In this case, the deaths of the Retreat Behavioral Health executives corresponded with the death of the company itself. In addition to the tragedies of the deaths, hundreds of patients and employees were found unmoored from the company seemingly overnight. 

Supreme Court Rejects UnitedHealth Appeal, Boosting Behavioral Health Providers’ Standing with Insurers

The high court of the land is the terminus for what can feel like a neverending slog of litigation. Its decisions can be profound. But sometimes, its inaction can be incredibly meaningful. Add a very powerful entity in the form of a leading payer in UnitedHealth Group (NYSE: UNH) into the mix and you get a high-interest article. In this case, the Supreme Court did not take up a case from lower courts about how health plans assess claims.

This decision creates a binding precedent in the U.S. Court of Appeals for the Tenth Circuit. It reinforces existing law and case law that require health plans to take the input of patients’ clinicians seriously. It also highlights the importance of health plans meaningfully engaging with clinicians and members when assessing claims.

Buprenorphine Prescribing Gaining Ground at Community Health Centers

Research from earlier in the year found buprenorphine use among patients seen by community health centers increased by 27 times. Between 2016 and 2021, the percentage of patients receiving buprenorphine increased from 0.5% to 1.4%. More clinicians prescribed the medication-assisted treatment medication, up from 8.9% to 37.5% during that time frame.

Several medication-assisted treatment (MAT) regulations over the last several years have incrementally loosened regulations around buprenorphine, a trend that was accelerated by the pandemic.

How California’s New Health Care Minimum Wage Law Will Impact Behavioral Health Operators

Here’s another universal narrative within the behavioral health industry: workforce challenges.

A large portion of the behavioral health industry is compensated by the hour and at rates that are comparable to many other sectors, such as food, hospitality and logistics/shipping. The pricing pressure from the government of one of the largest economies on the planet was itself substantive. But it also made for a thing to watch due to the copycat tendencies of state lawmakers.

What made this story especially interesting was its specificity to health care. This unique targeting stood out among any number of concurrent workforce issues. Some wondered if such a law would seep out into other states.

Acadia Healthcare Faces Scrutiny Over Patient Holds

The drama of scandal and a well-known entity: Those are the makings of a story that will get read. On top of the horror of the incidents described by the New York Times expose, it illustrates two great fears of well-intentioned behavioral health executives — that they may hire the person who harms patients and the organization or that otherwise seemingly innocent plans would go awry.

Plus, the interest in the story benefits from the historical and cultural holdovers of the era of the asylums. While these prejudices about psychiatric hospitals hold sway today, the failure of the deinstitutionalization movement to consequently replace psych hospitals with community-based assets and modernize the hospitals leads to a poorly understood system that doesn’t align with what the country needs.

Discovery Behavioral Health Trims Residential Care To Shift Business Strategy

As one of the larger providers in the nation, Discovery Behavioral Health lived out the trend of payers and patients significantly lessening their value assessment of residential facilities and increasing their interest in lower-cost outpatient care settings.

The move also somewhat derisked the company from the exposure of the so-called “six-bed” residential model, a model that only truly works when the facilities are full all the time, a practical impossibility.

Wilderness Therapy Industry’s Decline Accelerated by Embark Behavioral Health’s Exit

Controversy and certain youth mental health sectors have gone hand in hand for some time. The wilderness therapy space has long been on the decline. But youth and family behavioral health services giant Embark Behavioral Health hastened that decline with the closure of its division.

The move, on top of getting the company away from a long-vilified treatment modality, is part of a more encompassing refresh of the company — complete with new capital — into a provider of outpatient and more clinical residential services.