Turning Improved Care Access and Outreach Into Impact: How Hospitals Can Measure and Scale Population Behavioral Health
Digital tools are improving access to behavioral health care at a time when demand is increasing. Individuals can use digital access points to better understand their experiences and take early, practical steps to support their overall well-being. But improving access alone does not solve the challenges of effectively addressing a wide range of behavioral health needs. Hospitals and health systems need tools and resources to know whether their approaches are working and whom their strategies are reaching.
The American Hospital Association and CredibleMind cohosted the AHA Affinity Forum: Advancing Population-based Behavioral Health Inside and Outside the Hospital Walls. This multipart series explored how hospitals and health systems can strengthen prevention and treatment for patients, staff and communities.
The forum’s third session, “Measuring Success and Scaling Impact,” focused on how hospitals and health systems can apply analytics to refine behavioral health interventions and identify scalable models that drive lasting impact on quality indicators, health outcomes and budgets.
Health care experts leading this discussion were:
- Jonathan Adler, M.D. | Assistant Professor, UMass Chan School of Medicine; CMO, CredibleMind
- Nancy Myers | Vice President of Leadership and System Innovation, AHA
- Deryk Van Brunt, Dr.P.H. | CEO, CredibleMind, and Clinical Professor, UC Berkeley School of Public Health
- Debbie Zuerner | Director of Community Engagement, Owensboro Health
Understanding Patterns Within a Population
Hospitals and health systems are beginning to move beyond using traditional clinical metrics and gaining a broader understanding of how people engage with behavioral health support. Digital front doors, assessments and outreach campaigns help generate insights into the behavioral health needs of communities.
For example, Owensboro (Ky.) Health has coordinated digital tools and community-based efforts to reach roughly a quarter of its metropolitan region, including many individuals who had never engaged with behavioral health services before. At California’s Monterey County Behavioral Health Department, a new digital front door tripled access to behavioral health information and resources, while identifying strengths and gaps in the county’s existing support system.
Patterns in behavioral health assessment data further illuminate population needs. People with lower risk scores tend to explore self-guided support, while those with higher risk scores gravitate toward therapy referrals, crisis lines or higher-touch services. This is “what a population system is designed to do,” observed Van Brunt. “It meets people where they are and guides them toward the level of care that makes sense for them. This natural sorting relieves pressure on clinicians and gives hospitals and health systems a clearer sense of how digital tools complement existing services.”
How Individuals Experience Support and How Communities Benefit
Engagement at the individual level provides another measure of impact. At Owensboro Health, community members have completed more than 13,800 assessments in total, and many people spend several minutes exploring tools that align with their needs and learning styles. “People are utilizing this,” noted Zerner, reflecting on the strong and steady engagement with assessment tools across the region. “They’re spending time with it. They’re finding what works for them.”
Across multiple communities in Owensboro Health’s service area, people consistently report improvements in sleep, emotional regulation, communication and stress management. These incremental, early shifts are often the difference between coping and crisis. When individuals can access trustworthy, evidence-based information without barriers, they are better equipped to understand their experiences and take proactive steps.
Using population data and measuring the impact helps hospitals and health systems identify not only who is engaging but also where additional support is needed. Then teams can design more relevant, equitable support at the community level.
Owensboro Health noticed rising engagement by postpartum parents and began collaborating with doulas and OB-GYN teams to distribute easy-to-use tools like QR-coded doula cards that link families to immediate self-care.
Monterey County used community-level data to identify neighborhoods where residents were searching for behavioral health support but not yet connecting with services. Local leaders adjusted their outreach accordingly and deepened relationships with trusted community organizations.
Integrating Behavioral Health Support Into Daily Life
Behavioral health support becomes most effective when it is part of the environments where people live, work and learn. Across regions, hospitals and community partners have found creative ways to embed support where people already are.
For example, student ID badges can link to tools that help cope with stress and grief. Families receiving death certificates for a loved one also receive grief and bereavement resources. Local businesses distribute coasters and stickers that connect people to behavioral health information in familiar settings. Hospital post-discharge packets pair physical recovery instructions with emotional well-being guidance. Doula programs share resources with new parents, providing support during a pivotal and vulnerable transition.
These touchpoints make support feel less clinical and more human. They help normalize the idea that caring for behavioral health should be as routine as caring for physical health.
Community Partnerships Multiply Impact
While digital tools help people begin the journey to get the behavioral health care they need, community partnerships amplify how far the support can reach. Communities that offer digital access and build strong relationships with local organizations see the greatest gains.
Owensboro Health’s multicounty collaborative brings together public health departments, schools, community colleges, shelters, churches and behavioral health care providers. This network creates shared language and shared responsibility. Zerner emphasized, “We cannot hire ourselves out of [the health] provider shortage. We need solutions that help people begin with self-care and then seek additional intervention when they need it.”
South Carolina’s 988 crisis line uses digital tools to support people beyond their moment of crisis. Follow-up messaging connects individuals and families to ongoing resources, reinforcing the safety net well after the initial call ends.
Moving From Insight to Action
The insights surfaced throughout the Affinity Forum discussion series affirmed that hospitals and health systems can help shift behavioral health care from reactive care to proactive, population-level support.
By improving care access and giving people a clear starting point, helping them understand their mental health experiences, connecting them to appropriate care and collaborating with partners who know their communities, hospitals and health systems can reduce crisis situations, strengthen workforce well-being and improve the health of entire regions.
Impact is no longer measured only by the number of appointments or referrals. It is reflected in earlier engagement, stronger relationships, fewer avoidable emergencies, and communities where behavioral health care is accessible long before a crisis develops.
Continuing the Conversation and Taking Next Steps
- Connect with CredibleMind to explore how a population behavioral health model can support a health care organization’s patients, workforce and region.
- Download the Community Coalition and Sustainability Guide for tools and templates to help maintain and expand population behavioral health work over time.
- Watch the AHA Affinity Forum discussion series:
Community Behavioral Health Solutions
Learn more about AHA's collaboration with CredibleMind, which offers ACHI network members:
- An operational design with little setup or overhead required, minimizing demands on staff and IT teams.
- Flexibility to launch in weeks, not months, with customized content and resources, updated often.
- Best-practice toolkits to help increase collaboration and engagement across your communities.
- Dashboard analytics and benchmarking with real-time reporting to guide efforts, gauge needs and mark progress.