Report: Hospitals & Health Systems Stymied by Fragmented Care, Inability to Deploy Behavioral Health Capacity Aligned with Patient Need

Hospital and Health System Leaders View Behavioral Health Models as Sustainable, But Frontline Clinicians Report Very Different Reality with Step-Down Gaps and Disconnected Care Pathways

CHICAGO, Aug. 26, 2026 /PRNewswire/ -- New research released today by Array Behavioral Care, the nation's leading virtual behavioral health provider, points to a health system that struggles to deploy the capacity it has and match it to patients' needs, with the emergency department (ED) absorbing the consequences. Array's Behavioral Health Reality Gap: 2026 Report includes insights from a survey of 253 hospital and health system leaders and 261 clinicians across the U.S.

The research uncovered that all (100%) hospital and health system leaders believe their behavioral health capacity meets or exceeds current demand and 83% of them believe their behavioral health models are sustainable. But frontline clinicians paint a different picture: 95% said system constraints, such as capacity pressures, staffing shortages, or a lack of step-down options led them to make a clinical decision they weren't fully comfortable with in the past year. Ninety-eight percent (98%) of clinicians directly observed a patient's condition worsen due to care coordination failures or discharge gaps. For ED clinicians specifically, 67% reported patients are matched to the wrong care level – with 35% who said patients receive less intensive care than clinically necessary and 32% said patients receive more care than clinically necessary.

"Beds, budgets, and staffing levels tell you the health system's capacity, but those metrics don't tell you whether that capacity is reaching patients," said Shannon Werb, CEO of Array Behavioral Care. "When there's no reliable step-down option, clinicians make calls they aren't fully comfortable with and patients, who could be treated elsewhere, end up back in the ED. In other words, EDs are left to absorb the consequences when patients can't access the right care at the right time."

Additional key findings from the survey include:

• Behavioral health patients who don't need the ED are filling it. Seventy-one percent (71%) of hospital and health system leaders say the ED is their community's mental health safety net, while the other 29% say the ED absorbs overflow that should be going elsewhere — not one leader described the ED as free of behavioral health overflow. Half of all hospital and health system leaders (50%) say more than 20% of ED beds are occupied at any given time by behavioral health patients who could be treated in a less intensive setting.
  
  
• Once in the ED, patients wait 7 hours or more. Seventy-four percent (74%) of hospital and health system leaders say behavioral health patients wait, on average, 7 hours or longer before evaluation by a behavioral health professional. Forty-three percent (43%) say patients continue boarding for an average of 13 hours or more after a disposition decision is made.
  
  
• Clinical information doesn't follow the patient. At the clinician level, 39% have no visibility into patient medications, and 37% lack knowledge of prior crisis events or hospitalizations. Thirty-eight percent (38%) know the intended treatment plan when a patient leaves their care but cannot confirm if it actually happens.
  
  
• Over 1 in 5 patients go back to the ED within 30 days. Hospital and health system leaders say an average of 22% of patients are back in the ED within 30 days of discharge.
  
  
• Clinicians mull cutting hours or quitting. Ninety-five percent (95%) are considering reducing their hours or leaving their role due to burnout related to behavioral health patient volume or complexity.

Virtual Care Can Stop the ED's Revolving Door

Array's survey findings suggest virtual behavioral health creates the greatest value when it is embedded into existing care teams and workflows rather than deployed as a standalone access solution.

Eighty-four percent (84%) of clinicians surveyed say virtual behavioral health produces better patient outcomes than in-person care for similar acuity levels. When asked where virtual behavioral health could have the greatest impact, clinicians pointed to intervening with high-risk patients early enough to prevent crisis escalation (19%), embedding behavioral support directly into primary care workflows (18%), and catching patients after discharge before they return to the ED (17%).

Hospital and health system leaders most often identified lower cost per encounter or cost per episode of care (23%), reduced ED wait times or faster psychiatric evaluations (22%), and reduced clinician burnout or staffing strain (19%) as the key.

To learn more about the capacity and care continuity challenges facing both health systems and patients, view Array's full Behavioral Health Reality Gap: 2026 Report. 

About Array Behavioral Care

Array Behavioral Care is the nation's leading virtual psychiatry and therapy practice, delivering high-quality behavioral health services through a fully integrated continuum of care from hospital to home. Array partners with hospitals, health systems, community organizations, and payors to provide timely, expert treatment that meets the needs of patients where they are with the Right Care, Right Time, Right Dose℠. As an established leader with more than 25 years of experience in telepsychiatry, Array sets the standard for excellence by offering innovative solutions that improve access, enhance outcomes, and support seamless care delivery. Its Epic-based EHR platform is eliminating system-wide gaps in mental health treatment. Learn more about how Array is transforming behavioral health at www.arraybc.com.

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SOURCE Array Behavioral Care