As demand for mental health care continues on its upward trend, many Americans are leaning on someone they already trust for support: their doctor. Research my company did found that nearly 1 in 5 people now seek mental health support from a primary care physician while Gallup recently reported seven in 10 Americans want a health provider to ask about their physical and mental health concerns. It’s a sign of growing recognition of the connection between physical and mental health, but also of a strained system. With cost, access, and insurance gaps steering people to care settings unequipped for complex emotional needs, it’s time to scale collaborative models that meet patients where they are, and connect them to the support they truly need.
As a former emergency and urgent care physician, I’ve seen firsthand how mental health challenges surface in medical settings. Often quietly, as fatigue, pain, stress or sleep issues. And now, as CEO of a national mental health provider, I see how deeply our system continues to route emotional distress into places it’s not designed to be treated.
This is not a burden primary care should bear alone. It’s an opportunity to strengthen the connection between mental health providers and medical professionals and build a care model that reflects how people actually seek help.
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The limits of one-door-in health care
Primary care physicians are already doing the impossible. In an average visit, they’re expected to address complex physical issues, preventive care, screenings, prescriptions, and more, all in around 20 minutes. Layering mental health support on top of that, particularly for patients dealing with depression, anxiety, trauma, or relationship distress, stretches both time and training thin.
That’s not a knock on primary care, it’s a structural reality. Mental health care requires more than brief assessments or one-off prescriptions. It requires time, clinical depth, and continuity; things that even the most capable PCPs can’t always provide in isolation.
The result is that patients aren’t getting the depth of support they need, and physicians are left managing conditions that should be handled by expert mental health professionals. This creates frustration on both sides of the exam room and worse, it delays or derails access to effective treatment.
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Collaborative care is the model — if we invest in it
One approach to bridging the gap between physical and mental health care is the Collaborative Care Model (CoCM). It sees mental health professionals integrated into primary care and medical specialist areas such as kidney disease, heart disease and cancer, so that these patients can more easily be connected to the right kind of support. CoCM encourages a team-like approach to whole person health, and includes case management to support therapy and social issues such as food insecurity and lack of transportation as well as clinical support from both therapists and medication managers who work hand in hand with the medical doctors and their team. Starting with a simple referral during a regular checkup, the result is getting people the help they need, when they need it before they end up in crisis.
When done well, CoCM improves clinical outcomes, reduces symptoms, and even lowers overall healthcare costs. Yet despite its promise, implementation remains inconsistent, often due to lack of reimbursement, infrastructure, or accessible mental health partners.
Mental health professionals don’t need to replace primary care — they need to complement it. The goal is not to remove doctors from the equation, but to support them with timely, specialized care that eases their load and meets the full spectrum of patient needs.
The stakes are rising
While more people are expressing a willingness to seek mental health support, many still face long waitlists, affordability challenges, and limited provider availability. That gap reflects both a cultural shift in openness and an ongoing failure in access design.
When formal behavioral health support isn’t available, people default to what’s familiar: a doctor they trust. That’s understandable. But it’s also why we need to meet this demand with better pathways, not more pressure on primary care.
The right care team, at the right time, can change everything. But we can’t expect our nation’s doctors to carry the weight of a parallel mental health system. They’re already doing more than enough.
As health systems, payers, and providers, we have a collective responsibility to close this care gap, not by shifting the burden, but by sharing it.
That means:
- Expanding reimbursement models for collaborative care
- Investing in digital infrastructure that enables timely referrals and coordination
- Prioritizing partnerships between primary care and behavioral health providers
- Ensuring access to affordable and quality mental health care
Primary care physicians are often the first to hear a patient say, “I’m struggling.” The question is: what happens next?
Let’s make sure the answer isn’t silence, or a waitlist. Let’s make sure it’s the start of real support.
Photo credit: Aleksei Morozov, Getty Images
Dr. Dan Frogel is the CEO of Thriveworks, a leading provider of in-person and online mental health services nationwide. He began his career as an ER physician before pivoting to urgent care. Prior to joining Thriveworks he was the co-founder of CityMD, one of the largest urgent care providers in the northeast.
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