Editor’s note: This post was originally published in Behavioral Health News. It reflects a growing reality across behavioral health: expanding access has not consistently translated into meaningful engagement. We’re sharing it here because this shift from access to experience is central to how we think about the future of behavioral health technology.

For years, behavioral health innovation has focused on access. But that was only the starting point. Today, the bigger challenge is engagement—helping people stay connected, supported, and active in their care long after the first appointment.

Across the organizations we work with, this shift is becoming increasingly clear. It also requires a fundamentally different way of thinking about the consumer experience.

The Consumer Journey: Where Engagement Breaks Down

From the consumer’s perspective, the behavioral health journey often begins with urgency—crisis, distress, substance use relapse, family conflict, or psychiatric decompensation. Yet the first digital touchpoints frequently involve lengthy forms, multiple logins, consent documents, and screening tools delivered without context.

Our provider survey data also revealed that providers see significant drop-off during intake and onboarding. Consumers reported feeling overwhelmed by information, uncertain about next steps, and unsure how to communicate questions between appointments. Traditional portals—when used—are often limited to appointment reminders or document access rather than interactive engagement.

This misalignment matters. Research consistently demonstrates that early engagement predicts retention in treatment, which in turn correlates with improved outcomes in both mental health and substance use disorder care (SAMHSA, TIP 42). Yet digital systems in many organizations were not designed to support sustained, recovery-oriented engagement. They were built for administrative efficiency.

The result is a structural gap where consumers spend most of their time outside clinical settings, but digital infrastructure does little to support continuity during those hours and days.

Between Visits: The 99% Problem

Behavioral health treatment is episodic. Recovery is continuous.

Consumers spend perhaps one hour per week in formal sessions. The remaining time, what might be called the “99% problem,” is when coping strategies are tested, social stressors emerge, cravings fluctuate, and motivation shifts.

In our survey, providers acknowledged that between-visit engagement is difficult to monitor. Consumers expressed interest in tools that would allow them to check in, track goals, communicate securely, and access recovery resources without waiting for the next appointment.

This is not a request for automation. It is a request for connection. Digital platforms that fail to integrate these elements into one cohesive experience risk reinforcing fragmentation.

Reframing Digital Engagement as Partnership

If we begin with the consumer experience rather than organizational workflows, a different design philosophy emerges.

Instead of static portals, behavioral health systems can envision collaborative consumer engagement hubs—integrated digital environments that support:

• Recovery-aligned onboarding that introduces services clearly and reduces information overload
• Secure, two-way communication with members of the care team
• Structured mood check-ins and goal tracking that reinforce progress
• Embedded safety planning and harm reduction tools
• Access to peer supports and lived experience guidance
• Navigation assistance for housing, food, transportation, and other social needs

This model shifts digital engagement from passive access to active collaboration. Importantly, such platforms must reflect recovery-oriented principles articulated by the Substance Abuse and Mental Health Services Administration (SAMHSA), including person-centeredness, empowerment, and strengths-based care. Consumers consistently report that feeling heard and understood matters as much as the clinical intervention itself.

When digital systems reinforce these principles, they extend the therapeutic alliance rather than merely documenting it.

Measuring Consumer Engagement Meaningfully

As CCBHC expansion continues nationally and value-based payment models evolve, organizations face increasing expectations to demonstrate measurable outcomes, such as follow-up after hospitalization, retention in substance use treatment, and crisis response effectiveness.

Traditional engagement metrics—such as appointment attendance and portal logins—capture only part of the picture. A consumer-centered engagement hub offers the opportunity to measure more nuanced indicators:

• Completion rates for digital onboarding
• Response patterns to structured check-ins
• Engagement frequency during the first 30 days of treatment
• Utilization of safety planning tools
• Interaction with peer services within digital workflows

Such data can inform early identification of disengagement risk, allowing proactive outreach rather than reactive response. Crucially, these metrics should serve improvement, not surveillance. Transparency with consumers about how data is used is essential to maintaining trust.

Equity and Accessibility

Digital innovation must also address disparities in access and usability. Survey respondents noted differences in digital literacy, language accessibility, and device availability.

A next-generation consumer engagement strategy must therefore include:

• Mobile-first design
• Multilingual interfaces
• Clear, plain-language communication
• Accommodation for varying literacy levels
• Optional hybrid models that blend digital and in-person support

Technology alone does not solve inequity, but thoughtfully designed digital infrastructure can reduce friction and expand access when paired with relational support.

Moving From Portals to Partnerships

Across the behavioral health field, organizations are recognizing that legacy patient portals are insufficient for the complexity of recovery journeys. In response, some behavioral health technology leaders are developing next-generation consumer engagement hubs within their electronic health record ecosystems.

These platforms aim to integrate communication, structured engagement tools, peer support options, safety planning, and measurable analytics into a unified digital experience. Rather than layering features onto outdated systems, the goal is to design around how consumers move through care.

Such efforts reflect a broader shift from transactional access toward recovery-centered partnership.

Redesigning Technology for the Recovery Experience

Expanding access was a critical step forward for behavioral health. The next phase of transformation will be defined by how well organizations support people between moments of care: how they stay connected, sustain engagement, and make the experience feel continuous rather than episodic.

This shift not only requires new tools, but also a different mindset that views the consumer experience as an ongoing relationship, not a series of transactions. Organizations that embrace this approach won’t just improve outcomes—they’ll redefine what effective behavioral health care looks like.

At Cantata, we’re actively work alongside several organizations navigating this shift from portals to partnerships. If you’re rethinking how to create a more connected, consumer-centered experience, we’d welcome the opportunity to share perspectives and continue the conversation.

About the Authors

Jorge R. Petit, MD, authored this post as Cantata’s Chief Clinical Advisor before accepting the role of Executive Deputy Commissioner for the Division of Mental Hygiene at the New York City Department of Health and Mental Hygiene (NYC DOHMH). Dr. Petit is a long-time Board Member and past Chair of Mental Health News Education, the publisher of Behavioral Health News.

Matt Kudish, LMSW, MPA, is a behavioral health consultant, advocate, and Founder of We Better Work LLC. He serves as a consumer advocacy consultant at Cantata, where he provides strategic guidance on consumer engagement, digital health design, and peer-informed technology development.