Keep Calm & Carry On

An update on people’s behavioral health needs and the way care is delivered.

By Larry Feld, Contributing Writer On Sep 3, 2025

According to Ken Esser, executive vice president of behavioral health at Hackensack Meridian Health, “About one in five adults across this country are suffering from some sort of mental health illness. Half get no treatment whatsoever. When you talk about significant mental health issues, two-thirds are getting treatment, leaving one-third going without.”

While stigma prevents many from seeking help, where you live can impact your ability to find care. Urban areas like Northern and Central New Jersey have ample resources, but more rural areas in New Jersey and across the nation struggle. 

“Access also depends on the level of care that you’re talking about,” says Frank A. Ghinassi, Ph.D., ABPP, senior vice president of behavioral health services at RWJBarnabas Health and president and CEO of Rutgers Health, University Behavioral Health Care.

“Most places in New Jersey have fairly good access to crisis services,” Dr. Ghinassi observes. “However, there’s always room for improvement. There are times when we can move someone in crisis, for example, into an emergency room and into a bed in fairly rapid order. Then there are other occasions when the wait times for a specific kind of bed can be hours or longer.”

As reported in the “State of the Behavioral Health Workforce,” 2024, published by the Bureau of Health Workforce (BHW) in the Health Resources & Services Administration (HRSA) in November 2024, more than one-third of the US population lives in Mental Health Professional Shortage Areas. The report reveals that, in 2023, approximately 59 million US adults (23%) had mental illnesses, and nearly half (46%) did not receive treatment.

And Then There Was COVID

The COVID-19 pandemic put enormous stress on the behavioral health system. However, there were a few positive outcomes from the experience. 

“Since COVID, we have seen a big rise in the recognition of mental health disorders,” reports Dr. Ghinassi. “That drives a rise in the willingness of people to seek [help for] the disorders.”

Greater acceptance, the influx of patients to the healthcare system and quarantine demands imposed by the government led to the meteoric rise in telehealth consultations.

“Telehealth helped individuals more easily access outpatient counseling services and continues to do so,” says Debra L. Wentz, Ph.D., president and CEO, New Jersey Association of Mental Health and Addiction Agencies, Inc., and executive director, New Jersey Mental Health Institute. “It is a great tool that can overcome geographic, medical, family care, and other barriers to access.”

According to the HRSA report, prior to the pandemic, telehealth represented only 1% of services. However, between March of 2020 and August of 2020, it accounted for 40% of all behavioral health outpatient appointments.

Telehealth is also reducing no-shows. “We have found that the show rates for telehealth are higher. You could be doing whatever you need to do in your home right up until the session, and then log on, have the session, and go right back to your day,” notes Dr. Ghinassi. 

While access is an issue, the financial burden of seeking affordable behavioral healthcare is a growing concern. 

Dr. Wentz notes that while programs like the Get Covered NJ marketplace have been helpful, especially for people who did not qualify for Medicaid, subsidies are going to be cut under the One Big Beautiful Bill Act (OBBBA) at the end of the year. As a result, costs will more than double for many, leading to more people being uninsured.

“Private insurance costs have gone up by double digits multiple times, forcing many to choose between healthcare and housing, food, etc.,” Wentz says. 

To complicate matters, a growing number of professionals are opting to stop accepting insurance due to low reimbursement rates.

“The way mental health services, psychiatric, psychological, social work, counseling, and psychotherapy are paid is at a substantially different level than, say, procedural medicine, an office procedure, or a surgery,” notes Dr. Ghinassi. “A lot of behavioral health people say, ‘I don’t take insurance,’ and it’s because the rates are much, much lower. They can’t afford it.”

In spite of these challenges, there is great optimism in the profession. Large hospital networks in New Jersey are learning how to channel resources to maximize the schedules of top-level professionals, while leveraging new technologies, services like telehealth, and counseling for less severe health issues. Mobile apps are also playing a role in self-help, and new drugs like Narcan are helping to reduce the incidence of substance abuse overdoses.

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