Girl with her head down of the desk

Kana Enomoto shares that we’re seeing a “drive to more access to care and also seeing lower levels of stigma related to mental illnesses and substance use disorders. With increased access, however, we are exacerbating what were already really difficult workforce challenges.”

The McKinsey Health Institute is a non-profit entity within the McKinsey firm that is focused on humanity, adding 45 billion extra years of higher quality life over the next decade. Their focus areas include brain health, healthy living, infectious diseases, equity and health, healthcare worker capacity, healthy aging, and sustainability and health. We spoke with Kana Enomoto, Manager Director at the McKinsey Health Institute, to hear about their ongoing initiatives, research, and thought leadership. You can find the entire conversation with Kana here.

Growing Momentum in Behavioral Health

"There is growing momentum in behavioral health care towards these shifts." Chart follows.

The behavioral health system in America needs leaders as it transforms. There are 50 million Americans who experience a mental illness, and it takes an average of 11 years from the onset of mental illness symptoms to treatment. The silver lining of COVID-19 is that the past two years have brought on an increased appreciation of behavioral health, leading to a decrease in stigma. 

In our discussion, Kana emphasized these growing shifts in behavioral healthcare, including: 

  • high demand for behavioral healthcare, 
  • concern around low provider supply, 
  • increased digital solutions as a complement or alternative to in-person care, 
  • scaling community-based crisis care, 
  • focus on prevention in schools and workplaces,
  • and addressing parity, quality, and equity in behavioral health.

She noted that we’re seeing a “drive to more access to care and also seeing lower levels of stigma related to mental illnesses and substance use disorders. With increased access, however, we are exacerbating what were already really difficult workforce challenges.” We’ve also seen incredible digital health innovations “that are complementing and providing alternatives to in-person care so that we’ve been able to keep pace with increased demand to some degree.”

Provider Shortage


"There is a persistently limited behavioral health provider supply."

As Kana explains about the above graphic, “there’s some really clear kind of hotspots for where there’s significant need, where we’re grossly understaffed, and really, I think the moral of the story is that there’s nowhere that has a sufficient number of mental health providers per 100,000 population.” This follows the data that 64% of counties in the United States have a shortage of all mental health providers. Additionally, 60% of people in the US live in a county with a shortage of Psychiatrists.

Furthermore, the public sector is finding it challenging to retain clinicians. Kana explains, “a national council survey, where 82% of public sector providers are saying that it is very or somewhat difficult to retain their employees, and 97% are saying that it’s very difficult to recruit new employees. And so when we’re seeing the growth, a lot of that growth that we’re seeing is on the commercially insured population side.” Even with growth on the commercially insured population side, only 40% of Psychiatrists accept any form of insurance. 

The McKinsey Health Institute has a few strategies for addressing the stark provider shortage. These strategies include expanding telehealth services for rural communities and other communities with provider shortages and expanding community-based crisis services. 

Youth In Crisis 

Kana mentioned that “four in five working parents in a survey that we conducted expressed concern over their child’s mental health. And 1/3 of these parents were extremely concerned, leading the Surgeon General to issue his advisory on protecting Youth Mental Health – a level of awareness and support across the health spectrum that we haven’t seen before.” McKinsey stated in a recent report that Gen Z reported the least positive life outlook compared to older generations, and 25% of Gen Z respondents reported feeling emotionally distressed. Additionally, the behavioral health system isn’t meeting Gen Z’s expectations.

Kana believes that “with the policies and the funding that came throughout COVID, I think we’re going to see even more school-based mental health services for young people. I think that’s a good thing as long as we can keep up with the workforce demands and the innovation that we need there.” Schools are the first place kids often go for help, but they don’t always have the resources to help their students. However, during COVID, 38 states passed nearly 100 laws to support mental health resources in schools.

Resources to Learn More 

The McKinsey Health Institute has partnered with other organizations to create resources that the public can use. One of those resources is the Crisis Resource Need Calculator, which allows states and counties to estimate the cost of crisis care system needs. Additionally, the Vulnerable Populations Data Hub gives state and county-level information about vulnerable populations. Each state or county can be examined by COVID-19 data, age, behavioral health, pediatric behavioral health, and many other metrics.

You can listen to Kana Enomoto’s entire conversation here.