What Is the Mental Health System?

This page describes how the mental health care system in the United States is generally structured. It is not medical advice.

The “mental health system” is not one unified structure. It is made up of different types of organizations devoted to mental health care: private mental health practices, community mental health organizations, hospital systems, and others. Organizations offering mental health care often have unique practice structures and processes, and not all organizations offer the same mental health services and have the same kinds of providers. This page briefly explains common mental health services, types of providers, and practice settings. It also briefly explains how people generally enter and move through the mental health system, and provides an introduction to billing and insurance in mental health care.

Types of Services

Mental health care consists of several types of services. Therapy - also called counseling or psychotherapy - is talk-based care focused on mental health concerns. Psychiatry is a branch of medicine focused on mental health, and psychiatric providers commonly prescribe and manage mental health medications. Psychological testing involves structured evaluations using standardized tools. In practice, a person may receive one or more of these services, sometimes from different providers.

Types of Providers

Multiple types of licensed professionals work within the mental health system. There are medication prescribers, such as psychiatrists, nurse practitioners, and physician assistants. There are therapists and counselors, social workers, licensed professional counselors, and marriage and family therapists. Additionally, there are many other types of providers who offer other services. Different providers hold different licenses that determine which services they can offer.

For more information about providers and their credentials, visit Mental Health Providers, Explained and What Do The Letters After a Provider’s Name Mean?

Levels of Care

Mental health services are organized into levels of care based on intensity. Common levels of care include outpatient care, Intensive Outpatient Programs (IOP), Partial Hospitalization Programs (PHP), and Inpatient care. Entry into the mental health system can happen at any level of care, depending on the circumstances.

For more information about levels of care, visit Levels of Care, Explained

How People Enter and Move Through the System

People enter the mental health system in multiple ways - through self-referral, referral from a provider, or through emergency or legal processes. Movement through the system occurs through referral, self-referral, and transfer processes. Many factors influence how someone enters and moves through the mental health system, including provider availability, insurance coverage, location, and organizational processes.

For more information about referrals, visit What Is a Referral?

Insurance and Billing

Insurance plays a significant role in how mental health care is accessed and paid for. Whether a provider is in-network or out-of-network, whether a service requires prior authorization, and how payment processes happen can affect care. Not all mental health care organizations or providers accept all insurances, and billing costs may be difficult to determine prior to the appointment.

For more information, visit Mental Health Insurance and Billing, Explained

Want to Learn More?

The Mental Health System Toolkit‍ is a structured reference that documents how the mental health system is organized. It includes a detailed review of the provider types, levels of care, care processes, billing processes, and more - in plain language, with graphics.