Dr. Marion Couch on increasing access to behavioral health, breaking down stigma, and the importance of virtual care

The lingering pandemic and associated stresses have raised the profile of our collective mental health and the importance of seeking support. With more people looking for care, some have found it difficult to find and access treatment.
Portland Business Journal’s Healthcare of the Future event highlights the continuing intersection of technology and health care. In a recent panel on the future of behavioral and mental health, Regence Senior Vice President and Chief Medical Officer, Dr. Marion Couch, joined Edward McEachern, MD, of PacificSource, Derald Walker of Cascadia Behavioral Healthcare, Inc., Chris Bouneff of NAMI Oregon, and Oregon State Representative Tawna Sanchez of the Native American Youth and Family Center for a lively panel discussion.
The conversation covered a range of mental health topics, including the high prevalence of mental illness and low number of providers.
In the United States, nearly one in five people has a mental health condition. What’s more, the need for treatment is expected to rise as the number of psychiatrists falls. In 2025, demand may outstrip supply by 6,090 to 15,600 psychiatrists, according to a 2017 National Council for Behavioral Health report.
Exacerbating the issue, there aren’t enough people going into the mental health profession.
“I was charged to look into what the pipeline is for training new professionals. It’s not going to get better any time soon, probably not within my professional lifetime.” Couch said.
The provider shortage is particularly dire in rural regions, many urban neighborhoods and community mental health centers that often treat the most severe mental illnesses.
Couch also touched on how poor mental health can negatively impact physical health, creating or worsening comorbidities in patients.
“I’ll never forget I was talking to a very senior orthopedic surgeon. He said someone had gone into him to be considered for surgery for osteoarthritis,” Couch said. “And this very prestigious surgeon said, ‘Marion, I’m so tired of operating on patients for depression.’ … When you treat that depression, guess what? Then we don’t have to do other things such as operate for knee pain or hip pain.”
In spite of the challenges in the mental health field today, Couch said a silver lining of the pandemic is the ability to talk about mental health openly. Additionally, virtual care during the pandemic has been widely adopted and is increasing patient access to care.
The expansion of virtual care has revealed some clear benefits, including reducing barriers to care, allowing providers to reach more people in need and delivering self-help tools to help people maintain healthy habits.
All the panelists emphasized the importance of behavioral health and ensuring that people have access to the care they need.