Serious mental illness (SMI) requires more than short-term solutions—it calls for sustainable, evidence-based models that address barriers to access, adoption, and impact. This discussion explores how data, innovation, and payer-provider collaboration are reshaping SMI care across the age span, while ensuring that proven interventions reach those who need them most. Key Takeaways: Defining SMI and evidence-based care across populations—and understanding what truly works. Lessons from the startup and investment landscape: where innovation has succeeded and fallen short. Strategies for aligning payers, providers, and technology to scale sustainable, measurable impact. Expanding equitable access to evidence-based care for underserved and high-need communities.