Integrated care to address co-occurring mental health conditions has long been a mainstay of substance use treatment at Hazelden Betty Ford, but now people can access stand-alone services for mental health. TOGETHER magazine caught up with Hazelden Betty Ford's Leslie Adair, PhD, to learn more. Why has Hazelden Betty Ford expanded outpatient mental health services beyond addiction-related care? Expanding our outpatient mental health services allows us to meet more people where they are by creating more access points to care. When someone is struggling and reaching out to us, we want to be able to say, "C'mon in, let's talk and let's help you figure this out" rather than having to turn them away because we don't have a way to help them within our current system. Adding mental health services as another distinct level of outpatient care across our organization opens more doors to healing for more people, thanks to donor generosity. We also know from experience that mental health services are an important resource for loved ones of our patients. It's not uncommon for partners, parents or siblings who participate in our Family Program to approach counselors about their own struggles or concerns. By having outpatient mental health services, assessments and therapy readily available within the same system of care, we make it easier for loved ones to find the answers and help they need. What level of demand are you seeing for these new services, and what kinds of issues and conditions are clinicians seeing the most? The demand for mental health services continues to grow. We saw high levels of depression and anxiety prior to the Covid-19 pandemic, and those levels are now soaring. Data released by the Centers for Disease Control in early 2021 show Americans are experiencing four times the level of depression and six times the level of anxiety as compared with 2019 data. The pandemic has intensified all of the conditions that can exacerbate substance use and mental health issues—isolation, uncertainty, relationship problems, grief. People are chronically stressed. These are the most common types of issues and challenges our mental health clinicians are helping people address. We recognize that stigma, shame and isolation prevent people with substance use disorders from seeking and receiving the care they need and deserve. Is stigma a significant barrier to mental health care as well? As a culture, I think we've made more inroads with acceptance for mental health issues than we have for addiction problems. We very often see people who want to come in and talk about their depression or their anxiety; never mind that they're drinking a bottle-and-a-half of wine every night, which is likely exacerbating or contributing to the depression or anxiety. We see the reverse less often and I think that is because the stigma of addiction is still a stronger barrier to accessing care. This is part of the reason we're expanding mental health services. We know people feel more comfortable leading with a conversation about a mental health issue or relationship problem than a conversation about substance use, and we needed a place where they could do that within our care continuum. The COVID-19 pandemic has accelerated the availability of telehealth care and counseling. Do you see a return to more in-person services in the future or continued growth of telehealth services? Research tells us that both digital and in-person options are needed. For one example, when you look at the ways different demographic groups access health care, younger generations are far more digitally inclined and transactional in terms of seeking a specialist to help resolve a specific issue or concern. This population is less attracted to the idea of traditional therapy where you enter into a longer-term relationship with a therapist. We need multiple ways of accessing care to meet the needs of different individuals. At this time, all of our outpatient mental health services are offered via telehealth. Going forward, I anticipate offering both virtual and in-person options in states where we have brick-and-mortar facilities and virtual-only services in states where we do not have a physical presence. With outpatient mental health services now available in six states—and six more on our roadmap by early 2022—our plan is to continue to expand this level of care. The need out there is immense and urgent. We're committed to reaching and helping as many people as possible. Psychologist Leslie Adair, PhD, LP, is the former the national executive director of mental health for Hazelden Betty Ford, providing operational oversight of outpatient mental health services system wide. We're Here For You Hazelden Betty Ford currently offers virtual outpatient mental health services in California, Minnesota, New York, New Jersey, Washington and Wisconsin. Visit HazeldenBettyFord.org/RecoveryGo to learn more.