Mental illness, options for treatment and the connections between behavioral and physical health are still misunderstood, according to behavioral health leaders.
Becker’s asked 28 leaders what they consider to be the biggest misconception in behavioral health. All of the leaders featured in this article are speaking at Becker’s Behavioral Health Summit, set for June 19-20 at the Swissotel in Chicago.
Responses have been lightly edited for length and clarity.
Question: What is the biggest misconception in behavioral health?
Tammer Attallah. Executive Clinical Director, Behavioral Health Clinical Program at Intermountain Health (Salt Lake City): One of the biggest misconceptions in behavioral health is the emphasis on access to behavioral health care, rather than focusing on access to effective care. Effective care should be grounded in evidence-based practices and measurement-informed care.
Measurement-informed care involves using data and metrics to track and evaluate treatment outcomes. This approach ensures that the care provided is not only accessible but also effective in achieving positive outcomes for patients. It is crucial for consumers to be informed about the different types of providers and understand the importance of expecting clear treatment outcomes through measurement-informed care.
By shifting the conversation from mere access to behavioral healthcare to access to effective care, we can ensure that patients receive the highest quality of care that leads to measurable improvements in their well-being.
Joe Austerman, DO. Section Head, Child and Adolescent Psychiatry at Cleveland Clinic: I believe that the biggest misconception continues to be that mental health problems are a deficit in character or a lack of intolerance for psychosocial stressors. Although our environment does significantly shape and influence us. Mental health concerns have neurobiological underpinnings and should be managed as such. We never, and should not, blame someone for having cancer. Why is it that we see it as a personal failing if they suffer from depression or anxiety?
Funda Bachini, MD. Psychiatry Division Chief at Phoenix Children’s: One of the biggest misconceptions in behavioral health is the idea that a child’s mental health struggles are somehow the result of bad parenting, a lack of discipline or personal weakness. We don’t blame families when a child has asthma or epilepsy, yet there’s still this lingering notion that mental health conditions are behavioral choices rather than medical conditions with biological underpinnings. While there are external factors that affect our mental health, the same can be said of physical health issues and the reality is that mental and physical health are inseparable. We know depression is just as physiologic as diabetes, that trauma literally changes brain architecture and conditions like ADHD and anxiety have well-documented neurobiological roots. And yet, families still encounter stigma, feeling like they need to “fix” their child’s behavior rather than understanding that these are medical conditions requiring evidence-based treatment — just like we would for any other health issue. As behavioral health professionals, we need to lead the charge in shifting this narrative. Mental health isn’t separate from physical health — it is physical health. The more we reinforce this in our work, the closer we get to breaking down stigma and ensuring kids get the care they need without shame or blame.
Dawson Ballard. Coding Auditor and Educator at Rush University Medical Center (Chicago): I think the biggest misconception in behavioral health is the stigma attached. Many people are afraid to seek behavioral health services out of fear of being ostracized or judged. Society needs to do better to help erase this perception.
Jason Barker. CEO of ABA Centers (Fort Lauderdale, Fla.): The biggest misconception in autism care is that it’s a short-term intervention with a quick fix. Autism is a lifelong condition and meaningful progress requires ongoing, consistent treatment tailored to each individual’s evolving needs. Too often, families face the challenge of interrupted care due to funding limitations or shifting policies, when in reality, sustained support is essential for long-term success. True behavioral healthcare for autism isn’t about short bursts of treatment, it’s about building lifelong skills that empower individuals to thrive.
Melissa Bowker-Kinley, MD, PhD. Vice President, Medical Affairs, Child and Adolescent Services at MaineHealth Behavioral Health (Portland): One of the biggest misconceptions in behavioral health is the belief that mental and physical health are separate. This can lead to fragmented care. In reality, they are closely linked; mental health issues like anxiety and depression can contribute to physical problems such as heart disease and diabetes, while chronic physical illnesses can impact mental health. Recognizing this connection is crucial for holistic care. Integrating behavioral health into primary care improves outcomes and ensures comprehensive support for both mental and physical health.
Derek Bullard. CEO at Already Autism Health (Charlotte, N.C.): A common misconception regarding behavioral health is that the term “behavioral health” only applies to severe or persistent mental illness, when in fact, behavioral health covers a wide array of symptoms, diagnosis and behaviors. Anxiety, depression, ADHD, and support for persons with autism, and other more commonly known diagnoses fall under behavioral health.
This misconception can have a negative impact on funding and services for people both on the milder end of the behavioral health spectrum to those suffering from debilitating symptoms. Everything from delays in care, funding and adding to the stigma of those suffering.
Ashish Buttan. Vice President, Physician Partnerships and Ambulatory and Chief Ambulatory Performance Officer at Children’s Hospital Los Angeles: Some assume that mental health isn’t as “legitimate” as physical healthcare. In truth, behavioral health is integral to overall well-being, and integrating these services with primary care and physical health leads to more holistic care and better outcomes.
M. Justin Coffey, MD. Professor of Psychiatry at Geisinger; Chief Medical Officer at Workit Health (Ann Arbor, Mich.): One major misconception is that people with behavioral health conditions are not capable of designing their own care, that their illness in some way disqualifies them from sitting at the healthcare design table. The truth is the exact opposite. Individuals with lived experience of everything from addiction to depression have deep expertise in the way care could and should be delivered and what quality looks like and how it should be defined. I’ve seen first hand how empowering patients to be health care designers can result in real transformation.
Corey Cronrath, DO. Chief Medical Officer at Mental Health Cooperative (Nashville, Tenn.): The biggest misconception about mental health is that people who struggle with it can’t be successful. In reality, mental health challenges don’t disqualify someone from achievement — they’re often part of the journey. Many high performers manage anxiety, depression or trauma while excelling in their fields. Strength isn’t the absence of struggle, it’s the ability to keep going in spite of it.
Nikita Duke, DNP, PMHNP-BC. Vice President of Operations-Behavioral Health at Fast Pace Health (Franklin, Tenn.): I would say there are two big misconceptions about behavioral health. The first is the thought that having a behavioral health issue is the result of weakness or lack of wanting to try. Some of the strongest and most driven individuals have issues with behavioral health. We know behavioral health issues stem from genetic, environmental, physical, and other factors which are beyond a person’s control. This misconception hinders people from reaching out for treatment. The second major misconception is the perceived separation between behavioral and physical health. In fact, untreated behavioral health issues can lead to decreased energy and motivation, potentially resulting in deterioration of physical health. Conversely, physical health problems and associated losses can contribute to the development of behavioral health issues. Recognizing the interconnectedness of physical and behavioral health issues is crucial to improve the quality of care and health outcomes of patients.
Ken Dunham, MD. Executive Director Medical Operations for Behavioral Health at Sentara Health (Norfolk, Va.): I believe that many health systems are missing out on the reimbursable innovations that are newly possible in the behavioral health space. CMS has made multiple positive changes in reimbursements that will reward systems that invest in the right BH services. As these services are picked up by other payers, we will see a significant change in scope and type of care provided in the BH landscape. Significant areas that health systems can develop to augment reimbursement for BH innovations include: safety planning interventions, health behavior and intervention services, digital mental health treatment devices and even traditional psychotherapy services (due to the expansions on payment as well as expansion of workforce providers). For health systems with provider groups, it is important to note that psychotherapy and HBAI services will have their CPT work values increased by around 19% over the next three to four years.
Omar Fattal, MD. Deputy Chief Medical Officer and System Chief of Behavioral Health at NYC Health + Hospitals: The biggest misconception in behavioral health is the belief that there is a single treatment or approach that works for everyone — and that alternative methods are ineffective or “wrong.” In reality, different individuals and communities benefit from different interventions, and it’s essential to have access to a broad range of options that are tailored to their needs, circumstances and preferences.
Closely related to this is the tendency to separate medical and social factors as though they exist in isolation. Behavioral health outcomes depend on the interplay between these elements. Even the best treatment plan and provider won’t be effective if someone lacks stable housing, just as securing housing without access to medical or behavioral healthcare can make it difficult to sustain recovery. True progress requires an integrated approach that recognizes the essential connection between clinical care and social determinants of health.
Sam Huber, MD. Medical Director, HARP Behavioral Health Adult Services at MVP Health Care (Schenectady, N.Y): An important feature of behavioral health for people to recognize is that it is not just one thing. Behavioral health isn’t only therapy or psychiatry or hospital treatment or medications. What we might consider behavioral health covers a huge range of concerns from hearing voices to memory problems to being a better parent. There are short-term and chronic conditions, acute and episodic concerns, differing developmental trajectories and overlapping symptoms. Some episodes or conditions have identifiable causes or temporal relationships, and others do not have an obvious or direct cause. Similarly, an individual’s service journey is rarely linear. Treatment needs usually change over time and someone might leapfrog from primary prevention to acute crisis intervention without passing through a gradual escalation of symptoms or services. Because the range of behavioral health conditions is so wide and covers the entire lifespan, and because treatment needs and treatment journeys tend to be non-linear, a comprehensive and high-quality behavioral health system must be flexible, adaptive and broad.
Tracey Izzard-Everett. Vice President of Behavioral Health Services at Sentara Health (Norfolk, Va.): The biggest misconception about mental illness is that it can only be treated with medication. Therapy can produce incredible results. Never underestimate the recovery value of a therapeutic alliance.
Christina Mayfield, MSN. Director, Behavioral Health Services at Mary Greeley Medical Center (Ames, Iowa): The biggest misconception about behavioral health is that the behaviors associated with mental health conditions are intentional or under the individual’s control. Because mental health issues often don’t have visible physical symptoms, people may mistakenly believe that the person is choosing to behave in a certain way. This misunderstanding diminishes the seriousness of the condition. In reality, mental illness is just that — an illness. It deserves the same level of care, treatment and understanding as any physical health condition.
Patricia McClure-Chessier. Chief Healthcare Executive Leader at Streamwood (Ill.) Behavioral Healthcare System: One of the major misconceptions in behavioral health is easy access to care. Access to mental healthcare services has improved, but that does not mean the intricacies within the system have been resolved. There are several factors hindering access to behavioral health care. For example, resources in rural areas continue to be scarce due to health insurance limitations and restrictions. Staffing and provider shortages are also barriers, which inhibit access. There is a huge staffing and provider shortage in healthcare across the industry, which impedes access. Geography also plays a huge role in access to care. In rural communities, a person seeking care may have limited to zero options for care. These factors play a huge role in easy access to care, which contributes to the misconception.
Russ Micoli. Vice President of Behavioral Health Services, Business Development and Strategy at Virtua Health (Marlton, N.J.): The biggest misconception about mental health and substance use disorders is that they are a you, they or them problem. The same applies to addressing these complex challenges and how to approach solutions. Our behavioral health and well-being affect every aspect of our lives. While much has been discussed and written about solutions, real progress requires us to recognize this as a shared responsibility. It’s up to all of us — you and me.
Bonnie Moore, RN. Director of Inpatient Behavioral Health Services at Children’s of Alabama (Birmingham): A common misconception is that prioritizing your mental health is only necessary for those who are facing challenges.
Our culture puts a high priority on the importance of physical health. Society tends to praise those who actively take care of their physical well-being. Those who hit the gym, eat healthy or participate in regular physical activity are typically admired. In contrast, mental health often doesn’t get the same level of attention or positive recognition. Individuals who choose to focus on mental well-being through therapy, self-help, “mental health days” or medications do not enjoy the same level of admiration.
However, mental health is crucial to overall health. The mind and body are interconnected; one cannot thrive without the other. Mental health influences our ability to cope with stress, interact with others and manage our emotions. Just like physical health requires regular attention and care, so does mental health. Working on physical well-being does not indicate an underlying physical weakness, nor should actively focusing on mental wellbeing suggest anything other than a desire to experience mental wellness.
Studies have linked strong mental well-being with reduced risk for chronic diseases and improved life expectancy. Good mental health enables better decision-making, emotional resilience and healthier habits, all contributing to a longer and more fulfilling life. We should encourage everyone to take steps to support their mental health, just like they would for their physical health — whether through therapy, mindfulness practices or simply making time for rest and relaxation.
Lisa Pearson. Vice President of Behavioral Health at Chase Brexton Health Care (Baltimore): One of the biggest misconceptions in behavioral health is believing it’s like physical health/medical. Behavioral health moves on a continuum but not linear and requires a different financial model than medicine and more communication with the community on expectations in care.
Leo Pozuelo, MD. Chair of Psychiatry and Psychology at Cleveland Clinic: While seeking mental health wellness is much more in vogue and destigmatized, there is this perception that the field of behavioral health is stagnated in offering options. Not true.
- Psychopharmacology is advancing from “me too”-type medications to novel approaches and targets. For example:
- The advent of ketamine, and in the future, psychedelics, all hold much promise.
- GLP-1s for addiction.
- In interventional psychiatry
- Rapid protocols for TMS will enhance care for many patients.
- Network mapping will allow better targeted therapies, which will allow precision psychiatry.
- Short-term evidence based psychotherapies abound, which can be made easier to access for patients. For example:
- Telehealth has been a game changer for access.
- Incorporation of wellness, wearables and exercise.
- Care paths are being developed that will elucidate which treatments are best at which point during the patient’s trajectory.
- AI will help predict best responses to acute treatments.
- Outcome data will allow clinicians and patients to be better informed on how to stay well.
In summary, the future of behavioral health is bright. Of course, how to operationalize the care, bring it “just in time” to the patient and continue discovery and innovation are key pillars of success in equating behavioral health wellness to physical health wellness.
Ujjwal Ramtekkar, MD. Chief Medical Officer at LifeStance Health (Scottsdale, Ariz.): Misconception: The only path forward to solving the mental health crisis is better medications and therapy modalities.
The truth is, the next breakthrough in behavioral health won’t be another medication or therapy. While medications help manage symptoms, they don’t replace patient-centered behavioral interventions, skill-building or comprehensive care. The real opportunity lies in improving how we deliver care to ensure the treatments we already have reach the people who need them.
This means integrating mental health into primary and specialty care, leveraging measurement-based approaches to track treatment effectiveness and expanding digital tools to close care gaps rather than simply increasing access for those who are already engaged. It also requires reforming payment models to incentivize long-term outcomes over volume and investing in workforce innovations so clinicians can focus on helping their patients get better.
As healthcare leaders, we must work together toward building a system of care that delivers precision medicine effectively, equitably and at scale.
John Santopietro, MD. Physician-in-Chief of the Behavioral Health Network and Senior Vice President at Hartford (Conn.) HealthCare: The biggest misconception on behalf of the general public is underestimating how effective behavioral health treatment is. One reason for this is that our work is less precise than other medical specialties. We don’t yet have a blood test to diagnose bipolar disorder, for instance. However, if patients access good care in a timely way, 60% to 80% recover. We’ve been in business for over 200 years for a reason. It’s a message we in BH need to amplify — the more we do, the more people will reach out for help.
Jim Serratt. CEO at Parkside Psychiatric (Tulsa, Okla.): Two misconceptions: First, clinicians are interchangeable.
Reality: Therapeutic relationships depend on trust, identity and relational style. Treating clinicians as plug-and-play leads to disconnection and turnover. By creating environments that downplay the importance of the individual, we risk identifying our agencies and hospitals as impersonal. We will no longer be desirable or reliable employers to a workforce seeking meaningful work.
Second: Self-care solves burnout.
Reality: Burnout is systemic. No amount of meditation, yoga or other self-care activities that we push out to staff as remedies can fix moral injury or constant administrative strain. This misconception wrongly puts the burden on staff instead of systems. We as leaders have to own the faults in our systems and practices that create impossible emotional challenges for our workforce. If we listen carefully, our staff, those entrusted to us, will give us the pathway to support their engagement without the stress and loss inherent in the overtaxed human service environment.
By understanding and proactively dealing with this misconception, we can move to a more engaged resilient workforce and expect better outcomes for those entrusted to our care.
Becky Stoll. Senior Vice President of Crisis Services at Centerstone (Nashville, Tenn.): It is assumed, by those seeking behavioral health services, that the clinicians providing their care are trained and skilled in the most up-to-date, evidenced-based practices. This assumption is far from reality. The science to service gap in behavioral health, estimated to be 15 to 20 years, is far too wide. Unfortunately, the interventions and tools known to be effective do not reach those on the front lines providing care.
Robert Trestman, MD, PhD. Professor and Chair of Psychiatry and Behavioral Medicine at Carilion Clinic and Carilion School of Medicine, Virginia Tech (Roanoke): There are so many misconceptions regarding psychiatry and behavioral health. One is that medications will fix everything. Another is that medications will fix nothing. One misconception is that people can’t change. The other is that we can change people quickly and easily. The truth lies in a balance of these many misconceptions. Psychiatric illnesses are treatable, and we can substantially reduce suffering and improve people’s ability to function and to thrive. But it requires both access to care, competent care, and the engagement of the patient in the process of care.
Arpan Waghray, MD. CEO, Providence’s Wellbeing Trust (Renton, Wash.): One of the biggest misconceptions in behavioral health is the belief that it operates independently from physical health. The reality is that behavioral and physical health are deeply interconnected, and understanding this relationship is vital for delivering optimal care to our patients. Here are four key reasons why integrated care is crucial for supporting patients, communities, caregivers, and health care systems:
- Comprehensive care approach: Recognizing the integration of behavioral and physical health allows for a more holistic care strategy. By addressing both behavioral and physical health together, we can improve overall health outcomes, enhance patient satisfaction and contribute to a more effective healthcare system.
- Early detection and intervention: Integrated care enables early identification and intervention for behavioral health conditions, preventing them from escalating into more severe conditions. A proactive, preventative approach minimizes the need for emergency interventions and costly specialized treatments.
- Efficiency and cost savings: Treating behavioral health alongside physical conditions reduces emergency room visits, hospitalizations and duplication of services. By embedding behavioral health into primary care, healthcare systems can achieve cost savings while ensuring efficient, continuous care coordination.
- Patient-Centered Approach: Embracing a patient-centered model fosters a holistic understanding of a patient’s health needs, promoting better communication, trust and adherence to treatment plans.
By embracing the interconnectedness of behavioral and physical health, we can deliver comprehensive, patient-centered care that offers hope, healing and well-being for all.
Jill Wiedemann-West. CEO of People Incorporated Mental Health Services (Eagan, Minn.):
The most damaging misconception in behavioral health is that it is simply about managing symptoms. This narrow view ignores the profound impact of social determinants, environmental factors, and individual psychology. Behavioral health is not just about “toughing it out.” It is a complex interplay of personal resilience, professional intervention, therapeutic support, and community connection. This misconception fuels stigma, preventing individuals from seeking crucial help and deepening their struggles.
At People Incorporated, we are dedicated to shifting this narrative. We emphasize that seeking support is a sign of strength and a vital step toward individual and community well-being. We are committed to providing comprehensive resources and fostering a holistic approach to mental health, dismantling the myths that impede progress and healing.