Clinicians in behavioral health are increasingly expected to monitor patient progress between visits. That’s often when symptoms shift, crises develop, or early warning signs go unnoticed. At the same time, patients are increasingly managing their health outside traditional settings—on smartphones, through wearables, and with digital tools that track sleep, mood, activity, and substance use triggers.

As care moves beyond the clinic and into patients’ daily lives, Remote Patient Monitoring (RPM) offers a way to stay connected, track meaningful changes, and intervene before small setbacks become serious issues.

RPM holds transformative potential for behavioral health by providing clinicians with actionable insights that support more personalized and proactive care. This blog explores and emerging best practices in RPM and its impact on behavioral health.

What is Remote Patient Monitoring (RPM)?

RPM is a healthcare delivery method that uses digital technologies, such as wearables, sensors, and mobile apps, to collect and transmit patients’ health data from outside traditional clinical settings to healthcare providers in real time.

Originally developed for managing chronic medical conditions (think of tools that help monitor blood pressure or blood sugar from home), RPM has been shown to improve treatment adherence, reduce emergency department visits, and support timely care interventions. Reimbursed under Medicare since 2019, RPM is now widely recognized as a valuable tool for enhancing care continuity, particularly in managing complex or high-risk patients across diverse medical specialties.

RPM in behavioral health involves monitoring biometric, behavioral, and emotional health data outside of clinical settings. Unlike acute medical conditions where metrics like blood pressure or glucose have clear clinical thresholds, RPM in behavioral health involves more nuanced indicators—mood, sleep, activity, stress, craving—and must take into account factors like engagement, stigma, and trust.

Why RPM Matters in Behavioral Health

In recent years, especially during the COVID-19 pandemic, behavioral health providers began adapting RPM to better support mental health, substance use recovery, and overall well-being. As access to in-person services diminished, digital tools began bridging the gap—allowing providers to monitor clients’ symptoms, treatment adherence, and psychosocial stressors outside of clinical settings. But extending care beyond clinic walls was just one change driving this shift, as well as:

• Increased demand: More people are seeking behavioral health services, and there aren’t always enough clinicians to go around.
• Accessible technology: Smartphones, apps, and connected devices make it easier for people to participate in care from home.
• Focus on outcomes and prevention: Behavioral health is moving toward proactive care—not just responding to crises but preventing them. RPM can support that by catching early warning signs.
• Patients want flexibility: Many patients appreciate having ways to check in that fit into their lives, especially if travel, stigma, or scheduling is a barrier.
• Addressing disparity: RPM has potential to enhance access, engagement, and early intervention, particularly for high-risk and underserved populations.

For patients, remote monitoring means their care doesn’t stop when the appointment ends. It helps them feel seen, supported, and in control of their progress. For clinicians, it means more consistent insights, fewer surprises, and a better chance to intervene early—before a small issue becomes a major one.

What the Research Says

Recent research shows that RPM can be especially valuable in behavioral health when it’s used to catch early signs of worsening symptoms, enhance personalized care, support self-management, and improve coordination among providers. These features are especially relevant in behavioral health, where conditions like depression, substance use, PTSD, or serious mental illness often fluctuate between visits and require dynamic monitoring and flexible interventions.

However, studies also highlight real-world challenges. Common barriers include too much data with no clear process for reviewing it, limited staff capacity, unclear reimbursement, and gaps in digital access and literacy. These issues are often even more pronounced in behavioral health settings, especially in rural areas where infrastructure and staffing are stretched thin.

Despite these challenges, RPM remains a promising but underused tool. To work well in behavioral health, it needs to be more than just a tech solution—it must fit into clinical workflows. Behavioral health organizations and technology vendors alike must design solutions that are flexible, person-centered, and responsive to the realities of both providers and patients.

Examples of RPM in Behavioral Health

1. Wearables for Monitoring Sleep, HRV, and Physical Activity: Wearables enable continuous, non-invasive tracking of physiological data such as sleep patterns, heart rate variability (HRV), step counts, and activity levels. In behavioral health, these metrics can serve as proxies for emotional distress, relapse risk, or changes in psychiatric symptoms. They can help in a variety of ways, like detecting early warning signs of mood shifts in bipolar disorder (e.g., decreased sleep preceding mania).
2. Mobile Apps for Mood Tracking, Journaling, and Symptom Self-Reporting: Mobile apps allow patients to actively input mood ratings, sleep quality, medication adherence, or journal thoughts and feelings. Examples may include daily mood tracking for depression and anxiety, CBT-based exercises for insomnia, or journaling for trauma processing. They facilitate self-awareness, pattern recognition, and often include psychoeducation and therapy tools.
3. Passive Sensing for Detecting Behavioral Change: Passive sensing refers to data collected without active patient input, using smartphone sensors, voice, or text behavior. These tools detect subtle behavioral and cognitive shifts that may signal symptom worsening or relapse, such as detecting digital behavior patterns (screen time, social withdrawal, movement) in youth mental health or predicting relapse risk in SUD based on behavioral deviations.
4. Geofencing and Digital Contingency Management for Relapse Prevention: Geofencing uses GPS or location tracking to identify if an individual enters high-risk zones (e.g., liquor stores, areas with past drug use). Digital contingency management uses incentives (rewards, reinforcement) to promote desired behaviors such as therapy/appointment attendance, medication adherence, physical activity, or completing a CBT program.

Best Practices and Recommendations

While there is no single national standard for RPM in behavioral health, organizations such as SAMHSA (Digital Health Strategy), the American Psychiatric Association (App Evaluation Framework) and the American Telemedicine Association (2022 RPM Toolkit) have issued interim best practice recommendations, including:

• Clinical Integration: RPM tools should be used as extensions of care—not stand-alone solutions. Clinicians have to be able to interpret data in context and integrate insights into treatment planning.
• Patient-Centered Design: Clients should be involved in the selection, onboarding, and feedback process for any RPM solution. Usability and digital literacy must be considered in order to avoid drop-off.
• Data Security and Consent: All platforms must be HIPAA-compliant, with transparent policies around data use, storage, and patient consent.
• Equity and Access: RPM strategies must be designed with an equity lens, addressing language barriers, device access, and culturally relevant content.

Call to Action

The implementation of RPM in behavioral health settings requires thoughtful planning and cross-functional coordination. While primary care and chronic disease management have embraced RPM for years, behavioral health systems have been slower to adopt these tools at scale. This delay is not due to lack of relevance, but rather due to deeper system challenges: limited interoperability, regulatory complexity, workforce strain, and an underinvestment in digital infrastructure. These are solvable barriers—but they require leadership, intentional design, and a commitment to equity.

By embracing RPM, behavioral health providers can:

• Bridge the gaps between sessions through mood tracking, symptom monitoring, and passive behavioral insights.
• Detect early signs of crisis or relapse that would otherwise be missed in traditional care models.
• Support stepped care by tailoring intensity and frequency of services to real-time client needs. (See related resource: Embracing Measurement-Based Care)
• Engage patients as active participants in their own care, increasing shared decision-making, accountability and agency.
• Enable whole-person care by integrating biometric, behavioral, and social determinants data into treatment planning.

Final Thoughts: Continuous, Connected, and Person-Centered Care

The future of behavioral health demands a paradigm shift—from episodic, visit-based models to a system of care that is continuous, connected, and person-centered. In a landscape shaped by rising acuity, fragmented services, and persistent disparities, RPM represents more than a technical innovation—it’s a structural reimagining of how we can better engage, support, and empower individuals in their health journeys.

Content provided by Dr. Jorge R. Petit, Chief Clinical Advisor