Why We Need to Rethink Private Practice Mental Health Care

For more than a century, outpatient mental health care has relied on an outdated model that assumes a single provider, working alone, can meet all the needs of a person seeking help. This solo-practitioner approach dates back to Sigmund Freud’s original practice, and while nearly every other area of medicine has evolved, behavioral health care has remained largely the same. It’s no surprise that this model is falling short. 

Demand for mental health care has never been higher — and while technology like AI may improve collaboration and efficiency, it can’t yet replicate the effectiveness of expert clinicians operating as a team. Today, the best solution to meet this demand is an integrated system that connects care and drives better outcomes. 

Outpatient care is notoriously fragmented, making it nearly impossible for individual providers to deliver truly coordinated support. To serve patients better, we need to reimagine a system where therapists, psychiatrists, primary care providers, and other specialists work together to support the whole person. When care teams share insights and align on treatment, patients get the right support at the right time. This kind of integrated, outcomes-driven care improves access, increases accountability, and lays the foundation for value-based models that truly reward better health, not just more services. 

So why are we still holding on to a system that leaves so many people waiting, struggling, and slipping through the cracks? The future of mental health care can’t rest on the shoulders of solo providers doing everything alone. We need a collaborative model where multiple providers work together to help people truly get better.

Behavioral health as a ‘team sport’

When patients are left to find, connect with, and coordinate between therapists, psychiatrists, and primary care providers on their own, the lack of communication can lead to real negative consequences. Often, one provider is focused on medication while another handles emotional or behavioral support. Without integration, these efforts can unintentionally work against each other. Patients are left feeling like the physical and mental aspects of their care are disconnected, and that can mean less effective treatment.

For example, a therapist might be working with a patient using exposure therapy, where the goal is to help the patient experience anxiety and work through it, rather than avoid it. At the same time, a prescriber, unaware of this therapeutic approach, may adjust the patient’s medication to suppress their anxiety. Without real-time coordination, the very symptom the therapist is working to address is being medicated away. 

Research shows that communication between providers and comprehensive, coordinated treatment are key drivers of patient satisfaction. These factors are central to integrated care models. One of the most effective ways therapists and prescribers can collaborate is by developing a shared treatment plan that adapts over time. Many people prefer to start with therapy, but for some, therapy alone isn’t enough. When therapists and prescribers work together by starting with therapy and then introducing medication if needed, it builds trust, keeps the patient engaged, and often leads to better outcomes.

The shortcomings of the traditional private practice model

Because private practice therapy often operates in isolation, access to peer consultation and real-time clinical collaboration is limited. This can create gaps in care, especially when therapists need coverage for time off or crises arise. Many therapists lack access to specialists such as psychiatrists, primary care providers, or clinicians with other expertise. For example, someone with expertise in anxiety or depression may not have experience in substance use or trauma, making it harder to address comorbid conditions or the full spectrum of a client’s needs. Without a diverse clinical network, patients risk receiving incomplete care. 

In more complex cases, like when a patient initially needs CBT for ADHD and later requires trauma-focused treatment, a single provider may not have both specialties. Without coordination across providers, the most pressing issue may not be addressed first, leading to fragmented care and slower progress.

Other medical specialties don’t operate this way. The most innovative primary care models of the past two decades are built on team-oriented, multi-specialty collaboration. Mental health care should be no different.

The burden on patients

Due to poor communication between providers, patients often bear the responsibility of managing their own care. And when someone is grappling with mental health challenges, that coordination can often be too much to take on. Recently, I stepped in to help a loved one access the care she needed in another state. Despite being a clinician with years of experience and a wide professional network, it still took me hours of research, coordination, and advocacy to find a therapist with the right expertise and background, identify a prescriber, confirm they were both in-network, check reviews for quality, and connect the dots between providers. 

If it was that hard for me, someone who lives and breathes this work, imagine how impossible it feels for a person without that background, especially someone already struggling with depression. It’s a system that places enormous pressure on individuals at their most vulnerable. And the impact isn’t just on the patient. Families are often left worrying, unsure how to help or where to turn next. No one should have to navigate care alone, especially not in a moment of crisis.

Supervision and quality assurance

A team-based model adds critical layers of oversight that help prevent misdiagnoses and ensure patients get the right care at the right time. Even the most experienced clinicians can miss subtle cues, especially in complex cases. With strong clinical supervision and a dedicated quality assurance team, behavioral health providers can track outcomes, monitor trends, and review individual performance in a more consistent, structured way. This helps flag missed opportunities, guide targeted training, and support continuous improvement across the care team, in turn leading to more accurate diagnoses and more effective interventions.

The power of collaboration in mental health 

A clinician on my team recently requested book recommendations and local support group information for a newly divorced father. Within minutes, they had a tailored list of resources from trusted colleagues — something a private practice therapist might have spent hours researching. This kind of real-time collaboration not only saves time but ensures patients get comprehensive, thoughtful support.

A truly collaborative behavioral health team includes:

• Therapists to provide direct patient care
• Prescribers to support medication management
• Care coordination and navigation to connect patients with resources and care transitions (stepping up or down in care)
• Crisis services for urgent intervention
• Partnerships with primary care providers to ensure whole-person care

Integrating behavioral and physical health care leads to better mental health outcomes and should be a priority in healthcare models. We can’t keep expecting solo clinicians to do it all.

The future of mental health care is collaborative

Our current approach to mental health care is outdated and falling short for the people who need it most. We should be making it easier for people to get better, not harder.

No single provider should be expected to do everything, and no patient should have to navigate a fragmented system alone. A team-based model makes care more accessible, more effective, and more supportive for both patients and the providers who care for them.

Mental health care works best when it’s connected. When providers can share responsibility, communicate openly, and coordinate care, people are more likely to get the support they need at the right time and in the right way.

Photo: LoveTheWind, Getty Images

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