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Behavioral telehealth is transforming the way rural communities navigate mental healthcare challenges. There are many immediate benefits of telehealth that result in expanding access and improving the quality of care.

How telehealth improves access to care in rural communities

Telehealth allows small rural hospitals and clinics to provide quality healthcare services locally and at lower costs, which benefits rural patients since they are no longer required to travel long distances to access specialty care. Avoiding patient transfers is critical for both small hospitals and provider viability in rural areas. It also helps tertiary care centers keep beds open for patients in need of critical care.

Using telehealth to provide specialty services is more feasible for rural healthcare facilities than staffing those facilities with specialty providers. Telehealth makes a wider range of healthcare services available to rural communities via telemedicine, including:

Effective healthcare services and programs administered through telehealth technology in rural communities include:

Programs supported by telehealth offer new methods for improving healthcare access and quality by extending the reach of healthcare services, improving the ability of rural providers to address a broader range of medical conditions, and facilitating collaboration between professionals with limited access to their colleagues. Provider Bridge, a program funded by HRSA and HHS, and managed by the Federation of State Medical Boards, is a platform that connects healthcare providers with state agencies and healthcare organizations to increase patient access to telehealth. The National Emergency Tele-Critical Care Network (NETCCN) is another collaborative resource project that has emerged as a result of the COVID-19 pandemic, providing surge support by virtually connecting providers to a clinical-technical team trained in critical care assistance.

Challenges of telehealth in rural communities

Despite the promise telehealth holds for improving access to healthcare services in rural areas, there are policy barriers and infrastructure inadequacies that must be overcome.

Insurance Reimbursement

The issue of Medicare reimbursement is commonly cited as a major challenge for telehealth programs, including concerns related to geographic and originating site restrictions, provider restrictions, and service restrictions.

Individual state Medicaid programs vary in their guidelines regarding reimbursement for telehealth services. The 2019 National Rural Health Association (NRHA) policy brief Telehealth in Rural America elaborates on barriers to telehealth and provides policy recommendations to increase access to telehealth. Reimbursement by private payers for telehealth services can also vary. Some health insurance companies reimburse for telehealth services, while others do not.

In response to the COVID-19 pandemic, the U.S. Department of Health and Human Services implemented temporary policy changes to increase flexibility in offering telehealth services, including reimbursement. These changes address many of the barriers described above, but those barriers may return if changes in telehealth policy are rescinded after the public health emergency ends.


The 2013 NRHA policy brief, Streamlining Telemedicine Licensure to Improve Rural America, describes how the current physician and therapist licensure system places burdens on physicians wanting to expand their practice to rural areas. Physicians who wish to practice across state lines must be licensed by the professional licensing board in each state where they are delivering care to patients.  Actions states have taken to ease licensure barriers and the associated burden are:

In 2021, the Federation of State Medical Boards, with the support of HRSA and HHS, launched Provider Bridge, a platform that facilitates license portability to allow providers to submit credentials and treat patients in high-demand areas via telehealth. Supporting licensure compacts helps to expedite the process for qualified service providers to be licensed to practice in multiple states.


Affordable broadband is required to support telehealth programs, health information technology, and health information exchanges, all of which increase access to and the quality of healthcare. Traditionally, healthcare facilities needed broadband to provide telehealth services, but with modern applications of telehealth such as remote patient monitoring and e-visits, broadband is also necessary in patients' homes. Many rural communities do not currently have access to internet connection speeds that support efficient transmission of data to provide telehealth services. The broadband gap has the potential to lead to a new set of health inequities due to disparate access to telehealth. The 2021 report Broadband Today: Rural America's Critical Connection discusses the importance of broadband access to rural business, telehealth, and remote work opportunities.


Nearly 1 in 5 adults in the U.S. experiences a mental disorder within any given year according to the National Alliance on Mental Illness. Yet, the misconceptions, myths, and cultural stigma associated with mental illness are significant barriers that keep people with mental health disorders from seeking and receiving treatment in rural areas. Factors that may influence rural residents to avoid seeking care include such issues as:

While there are drawbacks to small communities when it comes to mental health, there are positives as well. The close-knit nature of rural communities can also mean that residents are more likely to rally around each other and provide community support in times of need. A strong external support group can help facilitate a person's success in treatment and also help support the family's efforts in attending to the care seeker.

Suicide: a rising rural mental health concern

Suicide continues to be higher in rural counties and the gap between rural and urban suicides has widened over time. A 2017 CDC report, Trends in Suicide by Level of Urbanization — United States, 1999–2015, discusses possible causes for the geographic disparity:

Graph of Suicide Rates
Source: Trends in Suicide by Level of Urbanization — United States, 1999–2015, MMWR (Morbidity and Mortality Weekly Report), 66(10), 270-273, 2017.

According to a 2020 report from the CDC, from 2000 to 2018, the rural suicide rate increased by 48% while urban rates increased by 34%. In 2018, the suicide rate in rural counties was 19.4 deaths per 100,000 compared with urban counties at 13.4 deaths per 100,000.

Additional information regarding the impact of suicide in rural communities can be found in Understanding the Impact of Suicide in Rural America.

A positive impact on rural healthcare providers

Telehealth use in rural areas can reduce a provider's feelings of isolation and burn-out, and subsequently improve provider retention. Telemedicine: Changing the Landscape of Rural Physician Practice highlights testimonials from healthcare providers practicing in rural areas throughout the U.S.

Healthcare systems with the infrastructure and staffing to support telehealth services impact how rural providers are able to provide patient care by giving them access to:

A positive financial impact on rural facilities and communities

The financial impact of implementing telehealth services in a community can vary, depending on the type of healthcare service or services to be offered using telehealth and the patient population. Anticipating Economic Returns of Rural Telehealth, a 2017 NTCA—The Rural Broadband Association report, describes telehealth potential benefits including the following quantifiable benefits:

The report also lists nonquantifiable benefits:

It would be easy to point to insufficient funding, discrimination towards people with mental health issues, and mismanagement of treatment centers as the biggest problems in mental healthcare, today. However, inaccurate and superstitious beliefs about mental health treatment and treatment techniques may be an even bigger issue. Every year, widely held stigmas against various treatment techniques prevent patients from receiving the care they need, held by either or both the patient and/or provider.

To be clear, research confirms that discrimination against the mentally ill does still exist and is not an uncommon occurrence. One of the most common stigmas held around the mentally ill is a fear of being violently harmed or manipulated by them. This stigma could not be more wrong - unfortunately enough, people with a mental health illness are far more likely to be victims of violence than perpetrators of violence. And that violence generally occurs due to a lack of appropriate care, not due to the presence of their illness.

Stigma against mental health treatment is easily seen when looking at electroshock therapy. This is one of the most stigmatized treatments for mental health patients. What images and ideas does the simple mention of electroshock therapy bring to mind for you? It’s no wonder that there is extreme resistance to receiving this treatment considering the ideas from movies, tv, and primitive forms of the treatment that people hold. However, electroshock therapy has a clinically proven 80% efficacy rate in treating depression, and only six facilities in the entire country offer it. This is a great example of the divide between perception and reality of certain treatments, and how we may be losing out on highly efficacious treatment plans for patients because of stigma.

It’s not just patients, families, and the public at large that hold unproductive ideas about treatments, even therapists hold stigmas against clinically proven treatment modalities. Many therapists relate to their craft as more of an art than a science and are resistant to learning and implementing clinically proven therapies such as CBT. This can lead to very messy experiences for clients, who, for example, pay over $60,000 for inpatient treatment to end up not actually receiving relevant treatment techniques and protocols for their diagnosis.

The stigma against treatment for mental illness often comes down to variations of these two beliefs:

1. Mental illness is a social construct, and all treatment is a vast marketing conspiracy

People who share this belief often cite tribal or non-western societies, asking why they neither have names nor, seemingly, issues with mental illness in their communities. An example of this is seen from the modern Shaman, Malidome Some, who describes how for his people of the Dagara tribe, the onset of mental illness is good news; a sign a healer is being born. There is a sense that because other parts of the world don’t describe mental illness, our experience of it must be a sign of a sick society. This belief places the burden of treatment on progressive social change and leaves mentally ill individuals with very few options other than to move to a new culture (which is generally not an option) or to relate to themselves as fundamentally wronged, oppressed, and alienated from their culture. Even if this is true, neither of these options tends to be helpful for someone going through a potentially chaotic and terrifying experience during the onset of mental illness.

When more people are receiving essential care for cancer or diabetes, that is seen as a wonderful thing; people are getting the help that they need. However, when more people are receiving medication for depression or bipolar disorder, it is seen as a scandal. This stigma against medication is not unfounded - the OxyContin scandal is one recent example of the failures of pharmaceutical intervention and was a public health tragedy. The process of rebuilding trust between pharmaceutical companies and the public will likely take time and reform. Unfortunately, this lack of trust in medication does stop patients from receiving potentially life-saving care.

2. People with mental illness need to work harder to feel better, and not expect insurance to subsidize laziness

People who share this belief, often believe that life is hard and it's rough for everyone. There is a pick yourself up by the bootstraps mentality and an understanding that even when it feels impossible, you have to (and you can) keep your head down, try harder and keep going. This belief is incredibly empowering and speaks to the unlimited and beautiful potential of the individual, however, it overemphasizes an individual's role in recovery and under-emphasize the importance of medical intervention. Although this is an empowering sentiment, it stops many people from receiving life-saving care. This attitude can drastically minimize the seriousness of mental illness, and leave those struggling alone and unable to reach out for resources. This attitude also can prohibit policy changes that would allow for insurance to subsidize acute mental illness the same way we subsidize acute physical illness. The lack of care options for those who need it results in increased disability and shortens the life span of people with a diagnosis on average by 30 years.

In short - making sense of mental health is currently very challenging. We have many different cultural attitudes, values, and complex social systems at play as we try to come together to take care of our loved ones. One way we can support each other in making sense of this field is through respectful dialogue with those who have different beliefs than we do. If you encounter a worldview or belief that is different from your own, we recommend...

The problems with our current diagnostic system

The current diagnostic system for mental disorders is documented in the DSMV, the diagnostic and statistical manual for researchers and clinicians. Currently, our diagnostic system for mental illnesses is based on symptom tracking. To receive a diagnosis, you must present with a specific set of symptoms, and clinicians will use these sets of symptoms to match you with a diagnosis. For example, to have a depression diagnosis, you need 5 out of 9 symptoms. This means that two people who have depression may only share 1 symptom. For researchers and clinicians, this makes developing a standardized treatment protocol, or doing research about depression becomes very challenging when as little as 1 symptom is shared between clients. Our available diagnostic tool is very imprecise and does not allow for precise treatment, or for the practice of "precision medicine."

Because our diagnostic tool is based on symptom tracking, our treatment protocols are organized around symptom relief. This can still provide life-changing support to patients however symptom relief often doesn't often lead to full recovery. We need to find a deeper cause to diagnose from so that we can more effectively treat these disorders.

One example of how diagnostic improvement transformed medical care is found in Cancer treatment. Cancer is now only partially diagnosed based on location (such as breast, bone, or brain cancer), it is now also diagnosed based on the molecular structure of the cancer cells. This has completely transformed cancer treatment and allows doctors to treat cancer with greater precision and specificity.


There was hope, in mental health, for gene therapy to be the next great diagnostic tool. This was especially true for diagnosing bipolar and schizophrenia. Currently, these disorders have more heritability than cancer and are easier to identify in DNA tests than most physical illnesses. The heritability of bipolar and schizophrenia has surpassed the heritability of cancer, diabetes, and hypertension.

The problem with genomics as a reliable diagnostic tool is that it is so complicated. It’s not as if it is 1 genome variation that leads to bipolar disorder - it is 200 variations. Each of the variations are subtle and none alone can be considered causal. The variations are considered increased risk factors at best. Because it is so complex, making a family tree is just as useful as taking a DNA test.


We've also explored brain imaging as a path to more precise diagnostics.

Currently, mental health disorders do not have any observable brain lesions. We can't take an image of a brain and see if someone has bipolar or anxiety. However, there is potential for more research on "circuit" abnormalities as related to mental health disorders.

Our brain is a complex network with 128 billion neurons connected as a single, massive, and flexible structure. As described by Lisa Barret, in 7 1/2 lessons about the brain, these neurons are grouped into clusters, and the clusters serve as "hubs" of communication across the brain. These neurons and their communication pathways, which we often call "circuits", are changing instantaneously and continuously. If one of these clusters "goes down" problems can occur that are associated with depression, schizophrenia, dyslexia, chronic pain, dementia, Parkinson's, and many other disorders.

One such circuit is the default mode network. This is a communication network in the midline of the brain that is not obviously connected anatomically yet seems to synchronize, especially when the brain is not engaged in a task. Some people call it the daydreaming circuit. Individual variation in the default mode network suggests it may be one of many functional circuits important in mental illness. Could the circuit approach yield more precise diagnostic categories? The current data on this theory isn’t consistent or specific - however, it is worth exploring.

Additionally, fMRI's provide not just imaging of structure but also activity and connection info on the brain. Currently, there are hopes that it could be useful in diagnosing depression. Through fMRI' studies we have identified different "sub-types" of depression, and have begun to notice differences in brain networks for other mood disorders. There is a possibility that with time and more research, this diagnostic method could be useful in a clinical setting.

Rebelling against labels

Many people these days, are resistant to labels and are anti-mental health diagnostics. Because our current diagnostic system is so poor, mental health diagnostics as a whole now have a bad rap. In part, this is because mental illness starts at a young age - most people experience the first symptoms of mental illness before the age of 25. During the teen and young adult years, one's ego or identity has not fully formed and so there is easy identity confusion with diagnostic labels. Meaning, that the diagnosis can easily become conflated with the patient's identity. Rather than “I have” it becomes “I am”. This is a normal confusion for teens and young adults to make and rebellion against those labels is a common response for patients of this age.

This rebellious sentiment paired with increasing distrust in mental health treatment options (such as medication), has created a belief that labeling human suffering pathologizes normal variation and medicalizes the human experience. Of course, just because we use a medical approach to define the problem does not mean we won't use a social or relational approach to solving it. These negative attitudes against labels and categories for mental health may be a larger challenge against progress in the field of mental health than biology itself.

Why we need a diagnostic system

Without an accurate classification mechanism, we cannot establish reliability and validity in the field of mental health. We are currently unable to do accurate research, give exact treatment protocols or establish reliable, high-quality care for clients. Because of this, it is easier for insurance companies to not make mental health treatment a priority for coverage and we end up paying for avoidable long-term disabilities and putting the burden of care on families and communities. Creating a deeper and more exact diagnostic tool would positively transform the field.

The current lack of measurement-based care

If you were to break your arm and go to a hospital, you would see a doctor and receive a standard treatment protocol for your arm that likely wouldn’t be too different from what any other doctor or facility would recommend. Your recovery would be monitored, and you would have next steps provided for you at each stage of your recovery.

Unlike physical medicine, in mental health recovery the treatment outcomes, protocol, and follow-up procedures are often not measured, precise or standardized across the field. In fact, it is extremely rare for therapeutic outcomes to be measured by therapists and mental health centers.

Why aren't we measuring therapeutic outcomes?

Currently, when outcomes are measured, those measurements are not risk-adjusted or standardized, and so they are only relevant for that single practitioner.

Part of why outcomes are not measured is because they can be very difficult to measure.

There are patient-reported outcome measurement tools such as PHQ-8 or 9, the EDEQ (Eating Disorder Questionnaire), the ASI-LITE (Addiction Severity Index), the OQ-45.2 and many professionals use a patient satisfaction survey. These tools are not perfect, but they have proven to be statistically and clinically reliable. Many of us who are collecting this data wisely use it to measure ourselves.  Where we see internal deficiencies, we try and improve.  If nothing else, the data collected serves as one of several pieces of feedback that we can use to better support our patients. These surveys tell us if their mood has improved over time, if they are satisfied with their relationships, employment, friendships, etc.

Unfortunately, outcomes need to be standardized and risk-adjusted in order to mean much to anyone else outside of an individual practitioner.

Standardization means we are all using (and publishing) the same tools for the same patients in the same way at the same time.  For example, If we are using the EDE-Q and our friends across the street are using the EAT-26 (another tool used to measure eating disorder progress), for instance, the two cannot be compared against one another and therefore any comparative analysis is useless.  After we can all agree on which tool to use, we must standardize how we use it. Are we asking questions in an email or in person? Are we asking them at the same time during recovery (2 days post-treatment or 30 or 265?). If these points aren't standardized, we can assume the results cannot be accurately compared. Agreeing on which tools and how we use them is a process that we hope will happen soon.  Once we all agree, this is fairly straightforward.

Risk adjustment is a bit more complicated.  Risk adjustment takes into consideration the underlying health status of the patient being measured.  The more complicated the patient’s condition, the “riskier” they are and therefore the more resources will be needed to treat them effectively.  Further, the more complicated the patient, generally the less improvement we might expect to see, or at the very least the improvement in a complex patient will look different.  For example, imagine if an addiction facility publishes a 75% abstinence rate at 360 days post-discharge. However, they generally treat patients who have never been in treatment before, are relatively young, have not struggled with the disease for a long time and who do not have any co-occurring depression, anxiety, or trauma. But what if another provider with older clients, whose patients have generally been in and out of treatment their entire lives, and have a host of medical co-morbidities uses the same tool, measures the same way, and yet shows a 55% abstinence rate? Would we say this provider is producing lower quality work because their abstinence rate is 55% as compared to 75%? Probably we would not. In fact, we might say the opposite; namely, that the first provider could possibly be doing better. However at first glance, that 75% might look fantastic.

Some of the ways we can begin introducing risk adjustment can be by asking:

Once we finally have standardization and eventually some form of risk adjustment model, the outcomes some of us collect will be far more valuable to patients, their families, and their insurance companies. Once we are able to measure value, we can transform our insurance and healthcare system from a system that is centered on quantity (aka fee for service) to quality. This transition has proven in many other areas of medicine at major health institutions to align the interests of the patient, provider, and payer and results in improved quality at a lower cost.

In general, some data is better than no data - however, if you see data published online, take it with a grain of salt. It is likely not a great indicator of the quality of the program. At least for now!

Accreditation is an additional way we try to measure quality

Because there is a lack of measurement-based care across all mental health centers, it is very challenging to hold providers accountable for providing quality care. Although these centers are often highly regulated, many regulations exist for ensuring the physical safety of clients, which is of course essential but is not aimed at the goal of providing high recovery results.

One way we’ve attempted to tell the quality of centers apart is through accrediting institutions such as JCAHO. Making sure the facility you're attending is JCAHO accredited can be an assurance of the quality of the facility, however not always!

The future of mental health is measurement-based

The lack of measurement-based care in mental health care is contributing to the high cost of care, confusion in care navigation, and diagnostic confusion. Without the ability to track which protocols are working best under what conditions, we aren't able to enhance the quality of the field. Without data collection, it is challenging to learn from our mistakes and make educated steps forward. Insurance companies are able to get away with extremely low reimbursement rates in part because clinics aren't able to provide precise metrics. Measurement-based care is the future of our mental health system - introducing even some simple practices could transform our mental health care landscape. We are optimistic that through virtual care, we can begin to innovate in this domain.

In the US we currently have 1 trained therapist per 20 people in need. According to NIMH, this is more than enough therapists to ensure that every person in need of care can receive the appropriate treatment for their illnesses.

If this is the case, why are so many people still not getting the care that they need? Why are we in a mental health crisis if we have the workforce to successfully address it? The answer to these questions is multi-faceted, but in many ways comes down to logistical failures in the workforce and resource organization.

5 problems with our mental health care system that we can start to fix.

  1. Uneven distribution of workers

There is a large geographic disparity in services and a variety of distribution of therapists across the states. Even within a single state, therapists typically reside in urban, more liberal areas, leaving many rural populations without care. Patients in rural parts of the country regularly have to drive anywhere from 45 minutes to three hours to find the care that they need. Additionally, 54% of counties in the US do not even have a psychiatrist.

An illuminating microcosm of the issue can be found in rural centers located in small however wealthy mountain towns in Colorado - such as Estes Park. Therapeutic taff can not afford to live within 45 minutes of any facility located in Estes Park without receiving low-income housing support or living off of additional outside income. Finding therapists willing to make the 45-minute drive or re-locate, exacerbates the already challenging issue of finding properly trained therapists. A teen center in this location recently had to close down, and since, there has been an abject lack of mental health care services for the rural population of Larimer County, and the situation does not seem to be getting any better.


2. Lack of adequate training for therapists

Most therapists are not equipped to work with severe mental illnesses, eg. bipolar disorder, schizophrenia, DID, or addiction. Many graduate-level schools for therapists do not adequately teach how to treat these illnesses, or how to even engage with these patients in a way that is not counterproductive to their recovery. 60% of schools that train students to become licensed counselors require no supervision training for clinically proven therapies such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT). In addition, 40% of therapists do not work with people who have a mental illness diagnosis and desperately need help - instead, working exclusively with high-functioning clients who want to expand their potential and increase their self-awareness. It is a therapist’s own prerogative as to who to work with, and the choice of many therapists to not work with mentally ill patients exacerbates an already dire situation.

Furthermore, Master’s programs in psychology are woefully under competitive and not taken seriously by academics in the field. Many people join Master's programs with a prior Bachelor’s degree in an unrelated liberal arts degree. It is not competitive or rigorous training. The education generally takes two-three years to complete - and for someone receiving medical training, studying one of the most complex and least-understood aspects of the medical field, the human mind - is completely inadequate. Entering the workforce under-educated, leaves many extremely well-intentioned and loving therapists unequipped to treat their clientele, and causes high levels of burnout and stress for the therapists. And it’s not just Master's students, mental health care workers who have a Bachelor's degree in psychology also experience the same issues, being woefully under-prepared for any field work, and usually needing to be completely re-trained in order to work directly with clients.

The bottom line is that universities are failing to prepare students to work in mental healthcare, with devastating effects for those with mental illnesses, therapists and healthcare workers in the profession, the reputation of scientists working in the field, and the centers dedicated to caring for ill patients.


3. Fragmented care

Currently, patients can go to nine different therapists with the same symptoms and walk out of each of their offices with nine different diagnoses and nine different treatment recommendations. Mental health diagnostics are extremely imprecise and depending on the type of mental health professional seen, wildly different treatment plans may be prescribed for a patient. To a certain degree, this is unavoidable considering the many different types of mental health professionals, including psychiatrists, marriage and family counselors, psychiatric nurse practitioners, addiction counselors, art therapists, equine therapists, cognitive psychologists, social workers, and more. However, because of the vast differences in training, and the lack of an overarching psychological map with a place for each, it is not always obvious which professional to see. This is a major issue for those who desperately need treatment, especially if they do not have the money or time to see multiple professionals and find the right fit. And even if seeing multiple professionals is an option, or admittance into a psychiatric care center is a part of the equation, professionals do not communicate vital health records with each other, leaving a potentially invaluable route to finding correct treatments off the table. Not only does this disorganization negatively impact the mental and financial health of those who need help the most, it leads to an estimated yearly loss of one billion dollars in our healthcare system.

This fragmentation in the field is confusing and burdensome for clients and caregivers alike and puts an undue burden on the patient and their families as they navigate the complexity of conflicting diagnoses and treatment plans, as well as the fickle world of insurance.


4. Cost

Currently, 57% of therapists do not accept insurance. And even when professionals do accept insurance, insurance still may not cover essential mental health treatment. Currently, insurance companies decide when mental health treatment should end without consulting with care providers. Often, inpatient treatment ends after 30 days when long-term care (4-9 months) is required for safe recovery. Private facilities usually run 15% below capacity due to insurance complications, reducing the overall access to treatment for those who need it.


5. Not enough long-term care centers

Our long-term care centers are at capacity with long waitlists. In the 1950's, we had on average 340 inpatient beds per 100,000 people, we now have 17 per 100,000 people. Currently, it takes, on average, three months for people with a mental illness to find and receive the care that they need, which is often too late when you are dealing with a severe addiction, suicidality, or a delusional patient. Usually, during that three-month period, families, communities, and care workers, who are unequipped to support the patient, end up expending large amounts of energy to prevent the worst from occurring, draining themselves and those around them. This can lead to feelings of helplessness from the caseworkers, overwhelm and fear in families, and typically, an increase in symptoms in the patient.

In addition, the long-term care centers we do have are mismanaged. Currently, 22% of the patients in long-term care centers do not actually have a mental health diagnosis. Only 10% of the patients in inpatient care are diagnosed with schizophrenia, with 21% having a personality disorder or type of neurosis. This is troubling because we estimate that 60% of people with a mental illness are not receiving care for their condition. We must find a way to get the right people to the right places for treatment.


De-fragmenting a disparate and loosely connected set of healthcare systems, shifting insurance policy and views on treatment, more effectively training our workforce, and creating more accessible care options is a lot of work to do, and will not be accomplished overnight. However, more deeply understanding the factors contributing to our ineffective models of mental health care accelerates and enables the creation of the solutions that will be required for us to provide care and treatment to those who need it. And despite the size of the task, it is a necessary and worthwhile endeavor.