Executives Reflect on a Slow Year for Mental Health

2024 was a year of slow progression for the behavioral health industry as it moved towards the new normal after multiple years of disruption brought on by the COVID-19 pandemic.

Conversations about value-based care continued to dominate the space. However, most providers remained dependent on the traditional fee-for-service model.

M&A in behavioral health was sluggish overall. Still, mental health continued to be a priority for investors and lawmakers, signaling a move towards more deals in the coming year.

The year also saw a number of changes in behavioral health workforce structures. Many behavioral health operators moved away from hiring fulltime therapists, instead opting for contractors.

Behavioral Health Business reached out to executives in mental health treatment to learn what they

“One of the most surprising developments in 2024 was the significant shift in staffing models across many behavioral health companies. Many organizations moved away from the traditional full-time W-2 employment model in favor of more flexible 1099 contractor arrangements and part-time W-2 positions for therapists. This pivot was driven by several factors, including financial pressures, a tight labor market, and the changing preferences of behavioral health providers.”

–Natalie Schneider, CEO Fort Health

“One surprise in 2024 was the accelerating shift in responsibility for mental healthcare. This year brought significant progress, with schools and states taking a more active role by adopting models like student health insurance plans with in-network providers—a notable departure from the traditional employer-driven approach. Policies such as the Bipartisan Safer Communities Act played a critical role in supporting this trend, enabling school-based entities to offer Medicaid assistance more effectively. Another unexpected development was a cultural regression in body positivity, influenced by the widespread adoption of GLP-1 medications. While these drugs have shown promising benefits for physical health, their unintended mental health impacts for some individuals highlight the importance of balancing these outcomes thoughtfully.”

–Julia Bernstein, COO, Brightside

“Though we still have a ways to go when it comes to integrating physical, behavioral, and social care and increasing the access everyone has to quality care, I do believe that the behavioral health industry is moving in the right direction. With the increase in value based payment models and the utilization of behavioral health integration codes, we should start to see access to behavioral health and related social care improve.

With the recent DEA ruling which will extend substance prescribing for certain medications like Buprenorphine through telehealth for at least another year, I’m optimistic that legislators will continue to act thoughtfully and re-evaluate the potential impact that barriers like required in-person exams have on lower-income populations. The requirement of an in-person visit to receive necessary medications may deter interested individuals from seeking treatment and create barriers due to transportation challenges or lack of scheduling availability.”

–Ruby Mehta, Head of Behavioral Health at Cityblock

“The behavioral health industry in 2024 has remained a high priority across the broader healthcare landscape. While deal-making activity has slowed compared to previous years, health plans, states and counties have demonstrated a steadfast commitment to addressing behavioral health needs. The industry continues to emphasize innovation, with organizations exploring novel ways to enhance access, integration, and outcomes in behavioral care. This sustained focus underscores the growing recognition of behavioral health as a critical component of holistic healthcare.”

–Matt Miller, Chief Growth and Development Officer, Connections Health Solutions

“2024 felt like a continuation of 2023 in a lot of ways. Provider organizations are still grappling with how to create unique value in a crowded field, and it’s becoming clearer that care quality and clinician experience are what will matter most in the long run. There are plenty of models out there, but the ones that succeed will be the ones that truly prioritize delivering better outcomes and supporting their clinicians to do their best work.”

–Alex Katz, CEO and Founder, Two Chairs

“It’s been a year of growth and transformation across the industry, driven by advancements in technology like AI and a greater emphasis on quality over accessibility. Virtual care models have solidified their role in providing scalable, high-quality mental health care, especially to underserved populations. However, physician shortages continue to highlight the need to attract new talent into the workforce.

What stood out was the accelerated view on quality as compared to accessibility alone. While accessibility remains an area of focus, there has been a dramatic shift to ensuring that access is to high quality provider groups with demonstrated outcomes. The continuing shift in public perception toward viewing mental health as integral and necessary to overall health was also a welcome surprise.”

—Robert Krayn, Co-Founder and CEO of Talkiatry

“”In 2024, the behavioral health industry has demonstrated remarkable resilience and growth. With a stronger emphasis on patient-centered care and integrated care models, the focus has shifted toward providing holistic treatment that supports both mental and physical health. There’s also a growing recognition of the importance of in-person care as individuals seek deeper, more personal connections with their providers.”

“I was intrigued by the shift back towards in-person care. Despite the rapid advancements in telehealth, there’s been an evident demand for face-to-face interactions, as people value the trust and personal engagement that in-person behavioral health services provide. However, it’s also been disappointing to see the Veterans Administration, for the second year in a row, make substantial reductions to reimbursement for Veterans Administration outpatient behavioral health services. This decision has created additional barriers for Veterans seeking the care they deserve.”

–Wayne Cavanaugh, CEO, Family Care Cente

“We are witnessing a major shift in the behavioral health industry, as mental health companies move from the first generation of online health solutions to a new era driven by data and personalization backed by supportive company leadership. Today’s workforce needs both the access to effective mental healthcare and leaders who understand the diverse array of mental health experiences and their nuances. Creating a workplace where employees thrive requires a commitment beyond quick fixes. It means building a culture that supports mental health at every level—from HR teams to leadership. As we look to 2025, the need for proactive, meaningful mental health support has never been clearer.”

–Karishma Patel Buford, Chief People Officer, Spring Health

“In response to the growing need for mental health support, we witnessed an increasing number of employers this year—from corporate settings to school districts—implementing wellness programs and taking part in awareness-raising initiatives. Even though there is still more work to be done to support ‘whole person health’ and expand access to high-quality behavioral health care, the industry is headed in the right direction. Notably, the expansion of AI into mental healthcare is offering another avenue for subclinical support, providing people with accessible, on-demand tools that complement traditional care models and meet individuals where they are.”

–Dr. Jenna Glover, Chief Clinical Officer, Headspace

“I’m looking forward to finding additional ways to remove administrative burden from healthcare providers on the ground who are providing direct patient care. Over and over again, I see our industry think we can solve the problem of high-quality healthcare with a new process, administrative layer or flashy new technology but the reality is that it often just adds cost without getting at the root issue.”

–John Voith, CEO, InStride Health