Stepping Into the Future of Behavioral Health: Opportunities, Challenges, and Possibilities

To improve our practices of today and to overcome the problems that confront us at present, the behavioral health field must anticipate what the future is likely to bring. Such foresight is particularly important right now because of the changes and disruptions that have occurred due to the COVID-19 pandemic over the past 3 years. We begin by recounting major developments in the mental health field since the founding of the National Institute of Mental Health (NIMH) more than 70 years ago, including some firsthand experiences of the senior author. Subsequently, we review the present situation of the behavioral health field with particular attention to the effects of COVID-19 and our current workforce crisis. Likely future scenarios are then described in two principal domains: clinical developments and community developments. Clinical developments over the next decade are likely to include much more self-directed, integrated, virtual, and personalized care. Community developments are likely to include self-empowering community interventions, better population health management, new collaborations with public health, and continued efforts to address stigma. To increase the probability of the future described, several facilitators are also outlined to create the conditions under which expected future developments can be expected to flourish. These include addressing the behavioral health workforce crisis, modernizing behavioral health clinical training, fostering opportunities for cross-sector work, fostering opportunities to engage in policy issues, creating centers of excellence for innovation in behavioral health, and fostering an integrated framework that undergirds behavioral health. The future we have described holds considerable promise for the behavioral health field and for all who suffer from mental or substance use conditions. We must begin working today to turn this potential future into tomorrow's reality.