A Path Forward: How Network Design Can Help Solve the National Behavioral Health Crisis


An obligation and an opportunity – a national moment on behavioral health

We spend a lot of hours at Dialog working to create an inflection point in the growth curve of some of the world’s best brands. But one of the areas in our work that we are most excited about is the potential in behavioral health.

In a world of such abundance, by any measure, we are failing. 

If you suffer from a mental illness or behavioral health challenge in this country, there’s a nearly 50% chance you’re not currently being treated. This, despite the fact that we know the incalculable cost it has on personal lives and the future of communities as a whole.

The challenges to the system are overwhelming. Demographic changes are driving demand in both volume and complexity, even as budgets are flat or declining. On the business side, market and regulatory expectations are consistently in flux, creating substantial risk and erecting barrier after barrier to innovation.

This means that despite a rush of innovation, digital or otherwise, behavioral health needs continue to largely languish untouched  by the new ideas and efficiencies so necessary to success. And sadly, it ensures those most in need will continue to have less access and fewer choices.

Empathy and access: a widening gap

Sadly, rather than respond with a well-funded, integrated behavioral care framework, the task is left to an uneven patchwork of private and public providers working to give people and population consistent access to quality behavioral health services. And, as needs grow and dollars decline, it’s these front-line experts and advocates that make the critical difference to the lives of those who suffer and the families and communities who share these burdens. Without their dedication, the fight would have been lost long ago.

But, even in the face of these dramatic shortfalls, something is in motion. Even as organizations struggle to adapt and evolve, the narratives at the edge are changing. The stories of suffering and triumph are moving from the shadows into the mainstream, even as stigma persists. We are becoming more confident and compassionate in our ability to talk about choices and challenges as people and communities.

An inescapable national moment

Two rising American political stars help make this point. One, Republican senator Ben Sasse, has written a New York Times best seller that, in part, establishes loneliness and disconnection as a critical comorbidity that aggravates a host of chronic conditions and impacts longevity more than smoking and heart disease.

Given the traditional (and perhaps stereotypical) Republican focus on bootstraps and forbearance, Sasse’s advocacy for richer socioemotional lives can be seen as a bellwether (even if his votes don’t always bear it out).

Across the aisle, Texas senatorial hopeful Beto O’ Rourke makes cost savings an integral part of his call for community mental health investments. O’Rourke has made the issue a staple in his many stump speeches, highlighting the enormous cost of delivering mental health services through the state’s current largest provider: county jails.

Like Sasse, O’Rourke works partially against brand, focusing both on community need but also on cost sustainability. It’s another sign of healthy, honest, articulate discussions about something that matters.

These discussions in Texas and Nebraska are merely the high-profile public face of something that’s been happening for a while. Whether Sasse’s advocacy pays off in legislation or Beto makes the Senate, the conversation is shifting. Even in a bitterly divided Washington, both sides united to pass a bill to combat the opioid epidemic with a stunning 98-to-1 majority.

A complex challenge demanding a collaborative approach to innovation

If we have indeed achieved real momentum on the issue, the next task is helping illuminate a path forward. Ultimately, success is best achieved through a framework that empowers resource-constrained communities and providers to collaborate in meaningful new ways. A foundational strategy that integrates digital, clinical and personal engagement solutions in pursuit of better outcomes.

We have long been proponents of the power of a form of systems thinking we call network design.  We’ve been lucky enough to use the art and science of network thinking to help clients in diverse industries from engineering to agriculture. But if ever there was a challenge that seems custom-built network design tools and thinking, it’s behavioral health. Specifically, network design lets us:

  • Fully map the complexity of the challenge, identifying stakeholders and measuring relationships
  • Better understand what incentivizes behavior and influences decision-making for consumers, patients, payors, providers and advocates
  • Design win-win relationships that elevate people, organizations and communities
  • Optimize organizations for maximum innovation, resilience and growth

We’ve seen what network thinking can do in other industries, and we’re positive it can make an enormous contribution here as well.

A personal cause and passion

We don’t just come to behavioral health with a different set of tools and talents. Like every family and community in the world, our lives are shaped by the mental and behavioral health challenges of those we love. That’s why we’re committed to bringing network design to the fight: to enable an integrated, innovative approach to healing the whole people and populations.

We believe ultimately that getting mental and behavioral health right will not only lift the lives of millions, but create new opportunities for creativity and collaboration inside a market that will only continue to grow in both size and complexity.

More to come

We’ll be talking a lot about the power of network design in healthcare. Follow us here and on LinkedIn and Twitter to learn more.