Women’s Invisible Load is Also a Barrier to Care

Women are disproportionately likely to be the primary caregivers in their households, the emotional anchors in their relationships and the ones absorbing the logistical weight of daily family life. Those roles aren’t without purpose or reward, but the cumulative weight of holding them all at once takes a toll that rarely gets named. That kind of exhaustion doesn’t show up on a lab panel. It accumulates in the background of daily life, in the mental work of tracking everyone’s schedules, absorbing the emotional needs of family and colleagues, managing finances and keeping the household running.

Most women don’t think of the mental load of these responsibilities as a health issue. They think of it as Tuesday.

Our new consumer survey, The Invisible Load Index, surveyed 1,000+ women ages 18+ and found that many women’s stress is being recognized in healthcare settings but not consistently addressed with concrete support. The data shows a consistent relationship between the mental load women carry and their behavioral health, and it raises harder questions about why so many women who recognize that toll still aren’t getting support for it.

Here’s what the data shows, and what a more responsive care model could look like.

The scope of the problem

Seven in ten women said ongoing stress and daily responsibilities affect their mental health at least a moderate amount, and 39% said the impact rises to “a great deal” or “a lot.” Only 9% reported no impact at all.

A big part of what’s driving that toll is that women aren’t just managing their own lives. Nearly half of women (49%) said they always or very often feel mentally responsible for anticipating or managing the needs of others, including children, partners, parents and colleagues. Another 80% said it happens at least some of the time.

The responsibilities women pointed to burdening them most frequently were financial management and planning (50%), household logistics (41%) and providing emotional support to family or friends (37%). Unlike a project with a deadline or a problem with a solution, these responsibilities don’t resolve. They just continue, and simply opting out isn’t realistic for most women.

Why burnout isn’t getting treated

Forty-seven percent of women in our survey said they experienced burnout or emotional exhaustion often or very often over the past 12 months, and 75% felt it at least sometimes. While this prevalence signals a clear need for care, seeking treatment is complicated.

Women and those around them have largely accepted this exhaustion as normal rather than a symptom to address. In fact, over 40% of women said burnout is treated as normal at home, work and in their social circles. When chronic stress is absorbed into cultural expectations, it stops feeling like a medical issue to bring up with a provider. It just feels like life.

This dynamic directly alters healthcare-seeking behavior. More than a third of women (39%, rising to 43% when excluding non-applicable responses) have delayed or avoided behavioral healthcare due to caregiving responsibilities, time constraints or emotional load.

Among women whose mental health is heavily impacted by daily stress, that number climbs to 59%. Ultimately, the responsibilities driving the most acute need are the exact ones making it hardest to seek help.

Providers are seeing the problem but not solving it

Most women who discuss stress with a healthcare provider feel heard. In fact, 86% said their provider recognizes the impact of daily responsibilities on their mental health, and 57% felt comfortable bringing it up initially. That’s a meaningful foundation.

Where things break down is what happens next. Despite that recognition, 30% of women received no specific solution or treatment for their stress. Among those who did, the most common response was prescription medication (23%), followed by lifestyle recommendations (19%). For a significant portion of women, validation is where the clinical response ends.

This gap between recognizing a patient’s invisible load and knowing how to structurally respond to it isn’t necessarily a reflection of provider indifference. Primary care providers are stretched thin, behavioral health referrals lack clear pathways and a 15-minute appointment leaves limited room to address chronic stress.

Disrupting this cycle of validation without treatment requires care models that give providers something concrete to offer.

What women are asking for

Our survey didn’t just capture where the system falls short. It also asked women what would actually help, and their answers point toward a care model that meets them where they’re at rather than adding to their load.

What does that look like? When asked what would make a difference, women prioritized:

  • 32%: Easier access to affordable mental health services through existing providers
  • 25%: Routine mental health check-ins during major health milestones
  • 22%: Flexible care delivery options like telehealth or hybrid care
  • 20%: Integrated behavioral health support as part of routine medical care

Read together, these preferences describe a model built around integration and accessibility. Women want to avoid separate referral pathways that require them to coordinate another appointment, navigate a new provider relationship and carve out time they simply don’t have. They aren’t asking for more; they want behavioral health support to show up inside the care they already receive.

This is a powerful signal for health systems. Embedding behavioral health into existing clinical workflows, offering flexible access points and building proactive check-ins into key health milestones are all within reach.

How Iris can help

Our Service Line Behavioral Health Integration model is designed to address exactly the kind of gap this data describes. For women’s health programs specifically, it embeds therapy, psychiatry and family support into the patient journeys women are already navigating — fertility, pregnancy, postpartum care, NICU stays and perimenopause — with behavioral health support built in at the moments along those journeys where it’s most needed.

To learn more about how Iris can help your organization build a more integrated approach to women’s behavioral health, visit iristelehealth.com.

ED Wait Times for Mental Health Patients Are Rising — Here’s How On-Demand Telepsychiatry Can Help

A recent Becker’s Hospital Review article highlights a critical — and growing — concern in emergency departments (EDs) across the U.S. as patients presenting with behavioral health needs often wait hours longer than those with physical health needs.

According to the article, at some hospitals, average ED wait times for mental health patients exceed 13 hours, with facilities in New York, California, and Colorado topping the list. This prolonged delay in care not only impacts patient outcomes, but places significant stress on already overextended emergency teams.

At Iris Telehealth, we see this as more than a workflow issue — it’s a call to action to ensure patients in crisis receive timely, compassionate, and expert psychiatric care.

Where We Fit In: Iris Telehealth’s On-Demand Services

Our On-Demand Services (ODS) model is purpose-built to address the exact issue Becker’s is spotlighting. By connecting hospitals and health systems to a dedicated pod of licensed behavioral health clinicians, we help bridge the gap between need and access.

With Iris’s ODS model, EDs can:

  • Shorten wait times for behavioral health evaluations by offering 24/7 access to board-certified psychiatrists and PMHNPs.
  • Prevent unnecessary inpatient admissions through timely triage and assessment.
  • Alleviate staff burnout by providing reliable psychiatric coverage.
  • Streamline care with clinicians trained to integrate into your existing EMR and workflows.
  • Support throughput and discharge goals, improving care for all patients.

The Financial Impact of ED Boarding

Extended ED stays for behavioral health patients don’t just delay care — they also carry a steep financial cost. It can cost hospitals up to $2,000 per hour per bed to board a patient in the ED. When psychiatric patients remain in ED beds for 12 or more hours waiting for evaluation or placement, those are beds that can’t be used for other acute medical needs — resulting in tens of thousands of dollars in lost revenue per patient. Multiply that across multiple patients, and the numbers add up fast.

By providing timely telepsychiatry evaluations, Iris helps hospitals optimize bed utilization, reduce unnecessary admissions, and recapture revenue that might otherwise be lost to prolonged psychiatric boarding. Our model not only improves patient care — it supports the financial sustainability of emergency departments nationwide.

Why This Matters

When mental health patients wait more than half a day to be seen, it’s not just a scheduling issue — it’s a breakdown in access to care. The longer someone in crisis waits for help, the more likely their symptoms are to escalate, leading to avoidable hospitalizations or repeat ED visits.

By partnering with Iris Telehealth, hospitals can ensure these patients receive high-quality, timely care, day or night, without sacrificing operational efficiency or staff well-being.

Let’s work together to change the trajectory of mental health care in the ED.

Learn how Iris’s On-Demand Services can reduce wait times and support better outcomes.

Explore On-Demand Services

The AI Revolution in Mental Health: 65% of Parents Embrace AI Assessment Tools

Survey reveals the perception gap and strategic opportunities for AI in behavioral health care

Healthcare organizations face a growing demand for mental health services, but there are too few providers to meet the need. Could AI help bridge this gap? We recently conducted a consumer survey that reveals nuanced perspectives across different demographics.

Parents show notably higher comfort levels with AI mental health tools, with 65% feeling comfortable using AI assessment tools before speaking with a human provider. Nearly half (47%) of men also demonstrate receptiveness to AI treatment recommendations compared to 36% of women.

Despite this promising receptivity among certain groups, meaningful concerns exist about privacy and the preservation of personal connection in mental healthcare delivery. Our vision centers on AI as a behind-the-scenes assistant that handles operational tasks, rather than technology attempting to deliver therapy directly to patients. This approach is embodied in Iris Insights, our platform that enables data visualization and operational analytics to support behavioral health services.

AI offers valuable opportunities to enhance mental health services while maintaining the fundamental human elements of care. By understanding both openness and concerns, health care organizations, including health systems and community-based health centers, can develop thoughtful integration strategies that leverage technology to improve access and efficiency.

Patient privacy and the trust factor

Trust forms the foundation of mental health care. When someone shares their personal health information and emotional experiences with a provider, that disclosure depends on confidence that their information remains private and that the professional genuinely understands their experiences. A patient discussing their anxiety symptoms, for instance, must feel secure that sharing vulnerable details about panic attacks or traumatic experiences won’t lead to judgment or privacy breaches before they disclose these critical details. Without that trust, the patient could struggle to open up.

Our survey shows that 70% of individuals expressed significant worry about the privacy and security of their mental health data when using AI-powered tools. This concern stands out against a backdrop of increasing healthcare data breaches and heightened digital privacy awareness.

Confidence in AI’s capabilities remains limited. Only 18% of survey participants believe AI tools are “very reliable” for providing mental health support. This skepticism could reflect both the novelty of these technologies and uncertainty about their performance compared to traditional care.

Three key concerns about AI mental health tools emerged consistently in our findings:

First, 60% of people worry about losing empathy and connection in their care journey. For about 44% of patients in a separate study, having an in-person therapeutic relationship with a human provider is important to them. This widespread concern highlights why AI should enhance rather than replace human clinicians.

Second, our survey found that 55% question the accuracy of assessments or recommendations that AI might provide. Without clear evidence of reliability or clinical validation, many hesitate to trust algorithmic judgment on something as personal as mental health.

Third, 36% express concern about potential bias in AI algorithms that could affect care quality. This awareness reflects growing public discourse around AI ethics and representation.

General perceptions around AI in mental health tilts toward caution, with 40% opposing its use compared to 32% supporting it. The remaining participants maintain a neutral stance, suggesting they could be persuaded either way based on how these tools develop.

For healthcare organizations considering AI integration, these findings highlight the importance of transparent implementation that addresses privacy concerns, demonstrates reliability, and preserves therapeutic connection throughout the care experience.

Strategic opportunities for integration

Our survey reveals that AI acceptance varies significantly by function. While only 18% believe AI tools are “very reliable” overall, comfort levels increase substantially when discussing specific applications like appointment scheduling or administrative support. This function-specific pattern, combined with demographic receptivity, points toward several practical pathways for healthcare organizations to integrate AI meaningfully into their behavioral health services.

Integration with existing platforms shows strong potential. One-third of survey participants indicated they would be more likely to use AI-powered mental health tools if they were incorporated into services they already use, such as telehealth platforms or health insurance portals. This suggests embedding AI capabilities within familiar systems could be more effective than launching new standalone applications that require additional adoption steps.

Based on these findings, healthcare organizations might consider these promising applications:

  • Administrative assistance: AI can optimize scheduling systems, reduce paperwork, and identify utilization patterns to inform resource allocation. This keeps AI focused on operational tasks rather than clinical decision-making while ensuring patients receive timely care based on provider-determined priorities.
  • Information management: AI can assist with gathering and organizing pre-appointment information, helping clinicians prepare while keeping all clinical evaluations and treatment decisions in the hands of licensed providers.
  • Targeted engagement: Custom approaches could help reach populations showing higher receptivity to technology-assisted care models, particularly parents and men who demonstrated greater openness in our survey.

These opportunities highlight AI’s true potential in behavioral health care: as a supportive tool that amplifies clinical expertise rather than attempting to replace the irreplaceable human judgment essential to quality care.

Building the human-AI partnership in mental health care

For AI to gain broader acceptance in mental health care, our survey identified several key factors that could significantly increase consumer trust. When asked what would make them more comfortable with AI-powered mental health tools, survey participants highlighted these top factors:

  • Professional collaboration (39%): Mental health experts should be deeply involved in creating, training, and validating AI tools, ensuring clinical expertise is incorporated into technology development.
  • Data privacy (35%): Robust encryption, clear retention policies, and transparent data governance must meet or exceed healthcare compliance standards for sensitive mental health information.
  • Algorithmic transparency (34%): Providing clear explanations of how AI makes assessments or recommendations to avoid “black box” decision-making that operates without accountability.
  • Human accessibility (32%): Ensuring seamless transitions to human clinicians when needed, in order to reinforce continuity of care and promote patient confidence in the technological support system.
  • Institutional endorsement (27%): Approval from established healthcare organizations could lend credibility and reassurance to consumers considering AI-powered tools.

What might this human-AI partnership look like in practice? Consider an example where a telehealth platform uses AI to analyze appointment patterns. The system identifies that certain visit types consistently run longer than scheduled, creating cascading delays throughout the day. By flagging this pattern, the AI supports schedulers and clinicians in making informed adjustments to improve patient experience without removing human judgment from the equation.

How Iris is shaping the future of AI in behavioral health care

At Iris Telehealth, we view these survey findings as confirmation of our approach to technology integration. Rather than pursuing AI as an end itself, we focus on applications that enhance operational efficiency while preserving clinical judgment.

This philosophy comes to life through Iris Insights, our data visualization platform that addresses the very concerns highlighted in our survey. By focusing on operational metrics rather than clinical decision-making, we’ve helped partners achieve 38% improvement in depression symptoms over eight weeks while maintaining the human connection patients value. The platform exemplifies how AI can meaningfully support behavioral health care when implemented with attention to privacy and transparency. Our commitment to this technology is also exemplified in our recent evolution of Iris Insights and its risk-stratification analytics capabilities.

Want to learn how your organization can thoughtfully incorporate AI to enhance behavioral health services while maintaining the human connection patients value? Contact us today to learn more about our services.

Reflections from NatCon25: Connection, Conversation, and Chalk

Thank you to everyone who stopped by the Iris Telehealth booth at NatCon25 in Philadelphia! It was a powerful few days of connection, conversation, and reflection — and we’re grateful to have shared that space with so many of you.

Drawn Together: Real Voices, A Shared Vision

One of the highlights of our booth was our “Drawn Together” Chalk Wall — a collaborative installation where we invited attendees to respond to three prompts:

  • What’s a piece of meaningful advice from your past?
  • What’s the biggest challenge you or your organization is facing today?
  • What is your hope for the future of behavioral health?

The responses were heartfelt, wise, and refreshingly real — creating a collective snapshot of where we’ve been, what we’re navigating now, and where we hope to go together.

From the past, attendees shared advice like:

  • “Take the trip!”
  • “Do work that makes you happy.”
  • “Whatever you decide, it’s the right choice.”
  • “Give yourself and others grace.”

When asked about the biggest challenge today, themes like funding instability, rural access, stigma, and threats to Medicaid were recurring — a powerful reminder of the systemic pressures organizations face.

And for the future, hope took many forms:

  • “No more stigmas.”
  • “Sustainability.”
  • “Free services.”
  • “Culturally-centered and accessible care for all.”
  • “MHFA for everyone.”
  • And one especially poignant entry: “It won’t be needed.”

These boards were more than a fun visual — they became a moment of connection in the chaos, reminding us why this work matters and who we’re doing it for.

Together, these contributions painted a picture of a field that’s both resilient and determined — working through real obstacles while still dreaming big.

An Evening of Community at Iron Hill Brewery

We also want to extend a special thank-you to everyone who joined us for our dinner event on Monday evening. It was wonderful to gather outside the convention center and share a meal with leaders and colleagues who are just as passionate about the future of behavioral health as we are. Your presence, energy, and ideas helped make it one of our most meaningful events to date.

And the Winner Is…

Congrats to the winners of our LEGO LOVE statue raffle! We’ve reached out to notify them directly — and while not everyone walked away with a prize, we truly appreciate everyone who entered (and stopped by to say hello).

Gratitude to the National Council for Mental Wellbeing

Finally, a big thank-you to the National Council for Mental Wellbeing for hosting such a timely and important gathering. In a moment when change is constant and uncertainty is high, it was reassuring — and energizing — to spend time with others who are navigating those same shifts with purpose, creativity, and care.

Want to keep the conversation going?

Visit our conference resource page to explore more about Iris Telehealth, our services, and the value of our partnership!

Medicare Telehealth Flexibilities Extended Through September 2025: What It Means for Behavioral Health

A Critical Win for Telehealth Providers and Patients

This past weekend, President Trump signed the Continuing Resolution (CR) to fund the government through September 30, 2025. Along with securing federal funding, this bill extends several key Medicare telehealth flexibilities that were set to expire at the end of March — a crucial win for providers, patients, and the broader healthcare system.

These policies have shaped how healthcare organizations deliver and access virtual care over the past five years. The extension signals that telehealth remains a critical component of modern care delivery, particularly for behavioral health services in underserved communities.

Key Telehealth Provisions Extended

Under the new legislation, the following Medicare telehealth flexibilities will remain in place:

  • Expanded eligibility for telehealth services
  • The removal of geographic restrictions and expanded originating sites allow more Medicare beneficiaries to access care remotely.
  • Continued support for FQHCs & RHCs
  • Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) can continue delivering telehealth services, ensuring access in historically underserved areas.
  • Delayed in-person visit requirements
  • The bill postpones the requirement for an in-person visit before receiving mental health telehealth services, reducing barriers to care.
  • Face-to-face telehealth encounters for hospice eligibility
  • Telehealth can still be used for hospice recertifications, maintaining continuity for patients with serious illnesses.

Additionally, the bill extends funding for community health centers, teaching hospitals, and national service corps programs, which play a key role in supporting behavioral health workforce expansion.

Why This Matters for Behavioral Health

These extensions are not just policy updates — they directly impact patient care, clinician burnout, and healthcare equity. Behavioral health providers have relied on virtual care models to improve access, efficiency, and outcomes, particularly in rural and underserved areas.

Yet, the uncertainty surrounding permanent telehealth policies remains a challenge. As Congress continues to evaluate the future of these flexibilities, healthcare leaders, including those at Iris Telehealth, are advocating for long-term stability in telehealth legislation.

Industry Leaders Call for Permanent Telehealth Protections

While this extension provides temporary relief, many organizations are urging lawmakers to take permanent action. The College of Healthcare Information Management Executives (CHIME) and nearly 100 other organizations recently sent a letter to Congress emphasizing that returning to pre-pandemic telehealth policies is not an option:

“Acting now to extend the policies initially enacted under the pandemic through the end of the year (at minimum) will bring much-needed stability to patients and clinicians. The deadline for the end of these policies comes at a time when patients are struggling with inflationary pressures, clinician burnout, and record-setting Baby Boomer retirements.”

For providers and patients, telehealth has proven its value. The ability to connect with specialists, manage mental health conditions remotely, and reduce strain on emergency departments is vital for the future of care delivery.

What’s Next for Telehealth Policy?

The next step is ensuring these telehealth gains don’t disappear in 2025. While the CR extends these flexibilities through September of this year, there is growing pressure for Congress to act before these flexibilities expire to provide certainty and stability for the industry.

At Iris Telehealth, we remain committed to advocating for policies that empower providers and improve patient access. We will continue to monitor and provide updates on legislative changes, industry movements, and what this means for behavioral health organizations.

Stay Informed

As these discussions evolve, Iris Telehealth will keep you updated on policy changes, best practices, and industry insights to help your organization navigate the future of behavioral health care.

How Leveraging Actionable Data Across Behavioral Health Services Revolutionizes the Patient Journey

Delivering efficient and financially sustainable behavioral health services can be a significant challenge for health systems. However, with the right data tools and strategies in place, health systems can better position themselves to optimize their workflows, better support their patients and providers, and transform their behavioral health service lines.

By honing in on data tracking and visualization, organizations can ensure their behavioral health programs are operating to the highest standards and delivering the best possible patient care.

 

Data tells a story and helps identify opportunities for improvement

Tracking behavioral health data enables healthcare organizations to identify opportunities for improvement and continuously build upon and optimize their action plans.  



“We use data to impact the patient journey throughout the healthcare continuum. Behavioral health touches a lot of different specialties and patients from a lot of different areas. When I think about data-driven insights, I think about measurement-based care where we’re doing more with surveys and capturing trends. Data driven insights evaluates both patient and program trends.”
Zack Buckareff, Director of Product, Iris Telehealth


Data tracking ensures health systems aren’t just meeting immediate needs, but also laying the groundwork for long-term improvement.

One way of conducting data collection could be leveraging behavioral health surveys or looking at claims data to better understand that patient’s journey. These insights highlight patient prescriptions, whether their prescription was filled, or if the patient frequents the emergency department (ED).

There are also standard screenings that some regulatory bodies require – like PHQ-9 for depression or GAD-7 for anxiety. However, the data most critical to improving outcomes depends on the community and the patient population.




“To be actionable, you have to be able to identify what you can take action on. The question becomes, how do you know what action to take? That’s where data comes in. Data helps you identify opportunities for improvement, track progress, and continuously build on your action plan to sustain success.”
Yara Nielsenshultz, RN, MS, CPHQ, Executive Director of Quality


 

While measuring patient and program performance against internal metrics, it’s also important to look at national benchmarks. When your organization looks outside of its own bubble, you can set better metrics and drive conversations around where you’re landing compared to your peers.

Putting all this information together provides a pulse on the patient experience and outlines how a health system’s programs and services are performing overall.

 

How health systems can overcome common barriers to effective data use with visualization tools

While there are many benefits of data-driven care, many health systems face significant obstacles in fully leveraging their data. Due to fragmented workflows, human error, and stigma, behavioral health often lags behind other specialties.

While health systems have troves of behavioral health data, it can be challenging to know exactly what to do with it. However, streamlining processes and investing in tools that integrate data from multiple sources, can help make data accessible and accessible for all stakeholders.

For example, visualizations are incredibly useful for behavioral health data and can transform complex datasets into clear, actionable insights. Dashboards linked to EMRs can help monitor trends, such as patient no-show rates, and make efficient adjustments to improve outcomes.



“[Data visualizations like] dashboards are really great because they allow you to see patterns, identify opportunities, and monitor progress. Once you’ve met your goal, it’s important to check the dashboard periodically to confirm you’re maintaining success. It’s about being proactive and staying on top of changes in real time.”
Yara Nielsenshultz, RN, MS, CPHQ, Executive Director of Quality


While tools like spreadsheets help communicate what’s going on in the patient journey, visualizations bring the stories to life.

 

The future of behavioral health lies at the intersection of technology and care

The future of behavioral health lies at the intersection of technology and care – here’s how we’re seeing trends shaping up in the new year:

  • AI and predictive modeling: These tools can help identify at-risk patients and prevent costly emergency department visits.
  • Behavioral health integration: Connecting behavioral health with specialties like endocrinology or oncology can provide robust, wrap-around care for patients and a reduction in total cost of care or health systems.
  • Ethical innovation: Leveraging data is an essential part to improving key performance metrics, but it must be done responsibly. It’s vital to ensure AI and other technologies are used responsibly, maintaining patient trust and safety.

By staying ahead of these trends, health systems can revolutionize care delivery and ensure behavioral health receives the attention it deserves.

 

Where Iris fits in

Transforming the behavioral health patient journey starts with data. By embracing actionable insights, streamlining workflows, and adopting innovative tools, health systems can deliver the efficient, sustainable care their patients need.

Want to learn how your organization can leverage data to help your patient population? Contact us today to learn more about our services!

Lessons from Healthcare Leaders on Optimizing Provider Scheduling and Show Rates

This month, Iris Telehealth hosted a webinar with community health leaders to discuss how they’re optimizing provider scheduling and driving operational improvements.

Julie Rayne, Behavioral Health Manager at Worcester County Health Department, and Cynthia McAfee, Director of Operations at Golden Valley Health Centers, lent their expertise and insights into how they’re creating sustainable workflows, assessing the benefits of virtual care to support this work, and driving operational improvements.

Patient no-shows and provider scheduling complexities are key challenges in healthcare operations

No-show rates are a consistent challenge in healthcare, with 37% of medical groups reporting increased rates in 2023.

While the reasons behind these rates vary, a 2017 report from the American Hospital Association found that 3.6 million people did not have a ride to their clinician’s office, citing transportation as the third leading cause of missed medical appointments.

Echoing these statistics, McAfee shared that patients at Golden Valley often miss appointments due to transportation, homelessness, or family situations.

In addition to mitigating no-shows, Golden Valley and Worcester Health must also manage provider schedules and workflows, ensuring full schedules, consistent support, and specialized treatment that enables momentum in care.  

Fortunately, by leveraging evidence-based care models and data insights, Golden Valley and Worcester Health have made meaningful strides and improvements for behavioral health patients in their communities.

Leveraging evidence-based care models increased Worcester Health’s no-show rates by 12%

According to the National Alliance on Mental Illness (NAMI), 70% of patients who seek mental health care drop out after their first or second visit, underscoring the importance of engagement from the very beginning of treatment.

To improve engagement and no-show rates, Worcester Health leveraged multiple grants to increase their evidence-based practice models and ensure their providers had the right specializations and concentrations to best support their patients.

As a result of this focus on evidence-based clinical optimizations, Worcester Health’s show rates have increased by 12%.

Reflecting on this increase, Rayne shared that clients were more invested in Worcester’s services because of the increased access to the most in-demand specializations. 

 “Our show rates increased tremendously because clients were more engaged in the services and felt more invested. We focused on our community and the needs assessment and determined what was lacking in our evidence-based models. Then, we sent our therapists to get certified in those models.”
Julie Rayne, Behavioral Health Manager, Worcester County Health Department

 

Rayne shared that Worcester has also optimized caseloads, ensuring patients were getting seen at the frequency they needed to maintain momentum in their treatment. They were also mindful of creating a balance between caseload optimization and size, ensuring caseloads weren’t getting too big while also ensuring schedules were full.

Worcester analyzes this data monthly, looks at schedules daily, and works within their EHR to ensure confirmations and appointment reminders for patients.

Additionally, to help ensure consistent visits, Worcester asks patients to sign a treatment contract. If they miss three appointments in a row, they are discharged from services and must be readmitted.

Worcester also has a grant-funded program that enables them to send a social worker or case manager into patient homes to meet with them and explore their barriers to care.

This wrap-around care enables Worcester to learn if there are additional services patients might need without affecting their provider schedules or no-show rates.

Balancing patient convenience with operational efficiency is a core strategy for future success  

Improving scheduling accuracy and being mindful of not overbooking providers is a critical component of an organization’s operations.

For Worcester, Rayne shared they run weekly no-show reports to identify patient patterns. They also look at the dynamics of a patient’s life and how that might impact their provider’s schedules.

For instance, if a young patient stays with their grandparents for the summer, they plan for that change in the provider’s scheduling, as it provides an opening for other patients to be seen during that time.

Golden Valley uses “MyChart” to allow patients to send messages to their provider rather than requiring the back and forth of a telephone call.

In the new year, Golden Valley is also investing in iPads to leverage in their waiting room to help improve delays and get patients seen more quickly, noting that check-in time matters to the psychiatrist experience.

Then, to help with check-ins and workflows, Golden Valley implemented, “reverse scheduling,” where a Medical Assistant meets with the patient out front, checks them in, and communicates with them at the end of their visit as well.

Start small, build on success, and center patients in your strategy

Patients are the heart of every organization and working with partners who put people first is a key part of any strategy.  

Reflecting on their largest operational improvements, McAfee shared that working with Iris Telehealth has allowed Golden Valley to make improvements at the clinical level.

 “Iris has been excellent in working through and putting together a dashboard that we couldn’t put together fast enough through EPIC reporting. We have great relationships with providers, center managers, and the clinical supervisor of the medical assistants.”
Cynthia McAfee, Director of Operations at Golden Valley Health Centers

 

For Rayne and her team at Worcester, a big operational improvement that has impacted show rates has been their target case management program. This approach helps Worcester learn and solve why a patient might be missing appointments.

Rayne also shared that the therapists Worcester has leveraged through Iris has been instrumental to their teams.

“I can’t say enough about our Iris therapists and the way they micromanage their own schedules and balance it. If they have a client they want to see, they reach out to them. If someone no-shows, they get the client in to ensure they’re getting the services they need.”
Julie Rayne, Behavioral Health Manager, Worcester County Health Department

 

Prioritizing communication and a deep knowledge of your patient population delivers results

McAfee shared that her top piece of advice for organizations tackling this work is to remember that it’s their obligation to do research to increase access, noting that research needs to include understanding of referral sources and identifying clinical locations based on that geography and access.

For Golden Valley, they looked at referral sources, geography, and where the patients were coming from. Then, they tried to make sure they had a 12-month run rate because of the calendar year and the summers.

“We brought in one provider at a time, and it allowed us to learn our processes, workflows, and what wasn’t going well. Then, we could adapt them before the second provider joined. Those are probably the biggest common denominators – keeping lines of communication open – with your care teams and vendor, Iris Telehealth.
 If you don’t have those open lines of communication, the ability to take a criticism and turn it into an opportunity, there’s no way you can help patients.”
Cynthia McAfee, Director of Operations at Golden Valley Health Centers

At Worcester, they’ve found great partnership opportunities within their community. Whether that’s local social services, parole and probation, juvenile services, schools, or doctor’s offices, they ask for evaluations and recommendations from them twice a year.

Worcester consistently analyzes how things are going with their supervisors and clerical staff and reviews agency-wide client feedback annually.

Learn more about how virtual care can optimize scheduling

We are grateful for the time these leaders shared with us! Thank you for your partnership and for all the incredible work you are all doing to care for your community and support your clinicians!

Weren’t able to make it to the webinar? You can watch the full conversation here. If you’d like to learn more and figure out the next steps to integrating virtual care into your organization, you can contact us here.

The Transformative Impact of Virtual Behavioral Health Integration: A Specialist’s Perspective

Over the past decade and a half, the field of behavioral health has undergone significant changes. However, one transformation stands out among the rest: the integration of virtual behavioral health services into primary care settings. This groundbreaking shift is not only changing the way we provide care, but it is also fundamentally altering patient outcomes and reshaping the structure of our entire healthcare system.

 

Virtual care breaks down traditional barriers to behavioral health access

The traditional model of separate physical and behavioral healthcare has long created unnecessary obstacles for patients. Consider this: when a primary care physician identifies signs of depression during a routine visit, the traditional referral process often results in only 50% of patients actually following through with behavioral health appointments. The reasons are numerous: stigma, transportation issues, wait times, and the challenge of navigating multiple healthcare systems.

Virtual behavioral health integration dissolves these barriers. By embedding behavioral health services within primary care settings and leveraging technology for delivery, we’re seeing remarkable improvements in both access and outcomes.

 

Virtual care enables timely intervention and improved outcomes

Virtual behavioral health integration brings several key advantages:

Immediate Access

The integration of virtual care into primary care services allows for immediate access to behavioral health specialists during a virtual visit when mental health concerns are identified. This timely intervention not only prevents conditions from worsening but also reduces the risk of patients falling through the cracks. 

Additionally, for organizations without local access to behavioral health specialists, the use of virtual care can address these gaps and provide long-term strategic benefits for both providers and patients. By utilizing virtual care, primary care providers have a seamless connection to behavioral health specialists for patient referrals, enabling them to collaborate on medication dosages and facilitate referrals to higher levels of care.

Increased Engagement

Virtual care removes geographical constraints and time barriers. Patients can connect with specialists from their homes, workplaces, or any private space. This convenience has led to a marked decrease in no-show rates—clinics have experienced a 29% reduction in missed appointments after implementing virtual integrated services. 

Enhanced Collaboration

Virtual platforms enable seamless communication between primary care providers and behavioral health specialists. Doc-to-doc consults and referrals lead to more coordinated care plans and better management of complex conditions, creating a more holistic patient experience and increasing patient satisfaction.

 

Behavioral health integration creates significant cost savings for health systems

The benefits of virtual behavioral health integration extend beyond individual patient care to affect entire health systems:

Cost Reduction

By addressing behavioral health issues early and in conjunction with physical health, health systems see significant cost savings. Studies show that patients with untreated behavioral health conditions typically incur 2-3 times higher medical costs than those receiving appropriate care.

Resource Optimization

Virtual integration allows health systems to maximize their behavioral health resources. Specialists can serve multiple primary care locations without travel time, increasing their availability and effectiveness. 

Improved Population Health Management 

The data collected through virtual platforms enables better tracking of population health trends and outcomes. This information helps health systems allocate resources more effectively and develop targeted interventions for high-risk populations. 

 

Effective behavioral health integration drives real-world outcomes like decreased LOS and wait times

 At Iris, our own experience driving virtual behavioral health integration with our partners has shown: 

  • 96% reduction in patient wait times  
  • 38% improvement in depression symptoms over eight weeks of care 
  • 80% decrease in emergency department length of stay  

Additionally, emergency department visits for behavioral health crises decrease by up to 14.2% when virtual integrated care is available. 

Perhaps most significantly, virtual behavioral health integration is catalyzing a cultural shift in how we think about healthcare delivery. The artificial separation between physical and mental health is dissolving, replaced by a more holistic, patient-centered approach.

As we continue to evolve our healthcare delivery models, virtual behavioral health integration will play an increasingly central role. The future likely holds even greater integration of digital tools, artificial intelligence for risk prediction, and expanded capabilities for remote monitoring and intervention.

The integration of virtual behavioral health services into primary care isn’t just a temporary solution or a pandemic-driven necessity—it’s a fundamental reimagining of how we deliver comprehensive healthcare. By breaking down traditional barriers, improving access, and enabling true collaboration between providers, we’re moving toward a more effective, efficient, and equitable healthcare system.

For health systems considering implementation of virtual behavioral health integration services, the evidence is clear: this approach not only improves patient outcomes but also strengthens the entire healthcare ecosystem. The initial investment in technology and workflow redesign is far outweighed by the long-term benefits in terms of both patient health and system efficiency.

Our challenge now is not whether to implement these changes, but how to accelerate their adoption and ensure they reach all populations who could benefit from them. 

If you’d like to learn more about Virtual Clinic and how you can integrate behavioral health into your organization’s primary care service line, please reach out today.

The Time is Now to Sustainably Scale Behavioral Health Integration

Behavioral health integration is not a new idea. It started to garner mainstream traction in the 1970s, and in 2024, nobody disputes the impact of integrating mental and physical health.

It is unquestionably the right thing for patients and total cost of care.

The last fifty years have brought innovative ideas, pilots, and learnings — but as an industry, we have yet to drive widespread adoption and success. At Iris Telehealth, we believe that’s going to change. The data, care models, and technology have evolved to make driving scalable and sustainable clinical and financial outcomes possible. 

Let’s talk about what we’ve learned as an industry, where we’re going, and why the time is now to drive widespread adoption of behavioral health integration. 

 

Why hasn’t behavioral health integration lived up to the hype yet?

In entrepreneurship, there is a maxim that the success of any business comes down to 5% having the right strategy and 95% having great execution.

With behavioral health integration (BHI), the strategy needed to find success is no different. By integrating the right resources into a patient’s care team, we can drive better outcomes and total cost of care. 

However, the biggest challenge to date is scalability. There are no doubt great experiences, data, and outcomes. But results have been difficult to scale across patients of higher acuities, within rural geographies, and with financials that incentivize their organizations to invest over the long haul.

From our conversations with customers, too many have given up, or have stopped scaling their programs because they run into operational or financial roadblocks that prevent them from achieving their ultimate mission. 

 

So, how can we overcome this challenge to solve behavioral health integration?

There are a few key evolutions in the market that have changed the game: the ability to integrate virtual care locally, to algorithmically identify the patients that need care the most, and the development of care models that are financially sustainable.

Virtual care in behavioral health is a game changer. The unfortunate reality is that 70% of counties in our country do not have a licensed child psychiatrist and 60% do not have a licensed psychiatrist.

Additionally, virtual care allows you to leverage resources across geographies to ensure they’re being used efficiently so smaller populations can still receive great care. 

Virtual care has to be part of the story, but it comes down to the “how.”  

The answer is dedicated virtual care teams with local integration. There must be trust between virtual and in-person teams with shared goals, technology platforms, and communication mechanisms.  

The on-site teams must truly see the virtual providers as an extension of their teams – something that can only be established if the virtual providers know the local culture, are operating on the same technology platforms, communicate constantly, and have aligned goals.  

The second critical ingredient is utilization of data to measure and drive success. Data has unlocked our ability to determine “who should receive care” and “when.”

The reality is some patients are at higher risk of escalating than others, and the data exists within EMRs to intelligently prioritize who should get care first.

This process could mean prioritizing the referral queue to ensure patients in highest need care first or it could mean proactively identifying patients that need care, even if they have not been referred.

The data, algorithms, and technology are all there, we just have to do the work.

Finally, we have decades of learning around the optimal care model that we should apply going forward. Navigation assessments must be part of the story to ensure each patient is getting clinically appropriate care from a provider working top-of-license.

We need to incorporate short-term care models as clinically appropriate.

There must be a care team approach to ensure patients of all acuities can receive the best care for their specific needs. And, a need to collaborate with the broader team, and community providers, to ensure patients are receiving continuous, quality, whole-person care. 

If we do all these things, the financials follow – both on a fee-for-service basis and from a total cost of care perspective. We have proven that it is possible to deliver great clinical care while delivering a positive operating margin for our partner health systems. 

 

So, what’s next for behavioral health integration?

We cannot give up on the idea of behavioral health integration.

If we take the learnings we’ve had as an industry over the last few decades and apply them, we can absolutely scale BHI across entire populations in a way that delivers sustainable financials and fantastic clinical outcomes — all while increasing patient and provider satisfaction. 

We believe Virtual Clinic is the answer to behavioral health integration.

Our Virtual Clinic approach leverages a cross-functional care team to ensure patients who need help first, get seen first. They’re able to get the appropriate care plan for their needs and are supported throughout their care journey. Virtual Clinic integrates behavioral health services into unique patient journeys to ensure their mental health is always supported.

If you want to learn more about this service and how we can help your organization address behavioral health needs in a financially sustainable way, feel free to contact us today.

You can also learn more about our services here and read our case study to see them in action.

How Virtual Providers Benefit from Behavioral Health Integration

Iris clinicians facilitate top-quality behavioral health care – averaging 2.3M patient encounters every year. We are proud of the work our providers do every day to fill care gaps and support healthcare organizations across the country by providing their communities with timely access to exceptional care.

Every month, we sit down with one of our providers to spotlight the amazing work they’re doing every day and the impact they’re making on the communities they serve. This month, we’re sitting down to talk with Iris LCSW, Elizabeth McErlean!

Q. What do you love about being a telehealth provider?

A. I love being a telehealth provider because it feels like I have more hours in my day to live.  Going to an in-person job, there’s a lot of time that gets sucked into travel and having to get up and get ready.

I have my morning routine that I would normally go through if I was working outside the home, so I keep work and home separate. I have my office in a separate place that I use only for telehealth.

I really like the solemn serenity that I get working from home. I live by myself, so it’s quiet. It’s just me and the dog. I can take lunch whenever I want. I don’t have to worry about somebody else using the microwave.

I guess “freedom” sums it up. I like the freedom of working from home.

Q. What impact have you seen telehealth services make at the clinic where you serve?

A. I am working with a Federally Qualified Health Center. They provide almost all the same services of any healthcare provider. There are two sites – one in Machias and one in Eastport. They have pediatrics, dental, psychiatric medication prescribing, and general practitioners.

I am at one site a couple days and at the other site a couple other days. It’s very interesting because the other therapist who’s there is also from Iris — we both reside in North Carolina, and we’re both at this clinic.

They’re in Maine and very remote. I provide (and the other clinician provides) collaborative care with the psych med prescribers and general practitioners.

Therapy is very different than the medical side. Sometimes medical professionals don’t really understand the difference of therapy – our approach is different, and our perspective is different.

Working with primary care providers, pediatricians, and nurses has not only helped the clients have an in-house therapist referral, but it also helps educate them on what therapy can help with.

There are certain guidelines, and I can’t practice outside my scope. For example, I can’t see somebody who struggles with eating disorders – I’m not trained or have experience in eating disorders.

It’s helping the medical professionals understand how therapy is not an extension of them, but it’s in addition to them to provide wraparound care.

Q. How does telehealth support holistic care?

A. The team I work with is great – they’re very open to communication and want to collaborate. They’re very good at having meetings with the practitioner.

The organization is good and very open. They want the best for their clients, and everybody wants the best for their patients. So, everybody’s very respectful.

Q. How does telehealth foster connection with patients virtually?

A. It’s not the same because when I was in person, I could see a lot of body language. And one thing I could see was how they came from the waiting room back to my office. I could see how they were doing through their posture and their gait.

From the standpoint of telehealth, having art behind me has been helpful. I have a picture of a Van Gogh’s Starry Night and two smaller starry nights that my son painted when he was younger. So, I have three starry night paintings and people love that. It’s a great talking point.

If I was in a private practice, I may not be able to personalize my office quite as much because the business personalizes that. The other piece is my dog – she’s almost always there and I think it helps create a more relaxed atmosphere so that patients almost feel like they’re coming into my home.

Do we need to have boundaries to make sure that we don’t become friends? Yes, that’s my responsibility to be aware of that. And of course I am, but I think it gives the client a little bit of comfort. Especially when I work with kiddos – they like seeing the dog.

Q. What is the most rewarding part of your job?

A. The most rewarding part of my job is the flexibility and ability to learn about different places, cultures, and people without traveling or moving there.

I’m originally from Wisconsin, so the first placement I had was in a clinic in Iowa. It was very similar to Wisconsin. So, I felt comfortable with that.  I was very excited to go to Maine. It’s in the eastern-most part of the United States. It’s very remote.

It’s completely different – it’s a lobster fishing culture, so it’s very different from Wisconsin culture that I grew up with in the Midwest. And it’s very different from southern culture that I live in now – so only telehealth allows me that.

As social workers, we love to hear people’s stories, to hear where they come from, who they are, and what makes them tick.

Q. Why do you think telehealth is the future of mental health care?

A. Because you can reach people where they’re at. For example, at the clinic in Maine, I recently had a video call with someone in their child’s school parking lot because they were getting off work and they had to go to their child’s parent-teacher conference.

So, we were able to see each other through telehealth. It was obviously a private place and confidential.

I think telehealth relaxes people, too, to be in their home and be able to do therapy. There would be some clinicians that would say they’re not sure it’s appropriate for everyone struggling with mental health, but for the vast majority, I think telehealth can really be helpful.

We can reach so many people with telehealth in a shorter period of time because the transition from one client to another is much easier from our perspective – it’s just a couple clicks and you’re onto the next one – versus maybe you’re sharing office space with somebody, and you have to schedule things differently or you go out and get them.

Q. Anything you’d like to offer from your experience as a telehealth provider?

A. I came to social work later in life – it’s like a final career for me. I’ve only been doing it 10 to 15 years. I’ve worked at a lot of places – a court system, for example – some places have been supportive, and some places haven’t been.

I have a situation at Iris where they made me feel so supported and validated – I have never felt that way from any other employer. They get it – they’re supportive of their clinicians. I love the communication.

Everybody that I encounter is so warm and friendly, supportive and caring and they don’t expect us to sacrifice ourselves to help our clients.

We want to help the clients, but it’s important to have self-care and I take care of myself too. If I’m not in a good place, I can’t help the clients. And so, I really do get that feeling from Iris.

At Iris, we believe our providers should be respected, valued, and applauded for the work they do, and we couldn’t be prouder to say, “thank you” to our very own Elizabeth McErlean. If you’d like to learn more about working for Iris Telehealth, contact us today.