Becker’s Healthcare Podcast: Expanding Access and Sustainability in Behavioral Health with Stephen Merz
Date: March 3, 2026
Episode Overview
In this episode, Laura Dardo speaks with Stephen Merz, Vice President and Chief Operating Officer at Shepherd Pratt Solutions, about the evolving landscape of behavioral health in the U.S. Merz discusses Shepherd Pratt's efforts to expand access, drive sustainability, address financial challenges, and collaborate with health systems nationwide. The conversation highlights innovative strategies to keep behavioral health programs open, scale effective interventions, and meet the pressing needs of youth and medically complex populations.
Key Discussion Points & Insights
Introduction to Shepherd Pratt and Stephen Merz
[00:58 – 02:24]
- Shepherd Pratt is one of the oldest and largest nonprofit behavioral healthcare systems in the U.S., based in Maryland, with campuses in Towson and Baltimore.
- Shepherd Pratt Solutions extends Shepherd Pratt’s services and expertise to health systems and community agencies outside Maryland to help them improve access and sustainability in behavioral health.
- Quote:
- "Shepherd Pratt is one of the oldest and largest nonprofit behavioral healthcare systems in the country. We started more than 170 years ago under the premise of trying to create a supportive and caring environment for people experiencing mental health care or substance use disorder treatment needs." – Stephen Merz [01:10]
Initiatives to Expand Access and Achieve Sustainability
[02:42 – 05:31]
- Shepherd Pratt Solutions has helped health systems formalize, grow, or launch behavioral health programs, with a focus on avoiding consolidation or closure.
- Example: Worked with a 15-hospital system losing money on its behavioral health line and found they could eliminate up to 90% of losses with operational improvements focusing on access, care continuum, and revenue generation through continuity of care.
- Expanded children and adolescent services in Lansing, Michigan, working with the University of Michigan’s Sparrow Health System.
- Celebrated the groundbreaking of a new behavioral health campus in partnership with WakeMed Health in North Carolina.
- Quote:
- "We identified that this service line could save up to 90% or eliminate 90% of their losses by simply making the system that they had work much better." – Stephen Merz [03:59]
- "There'll be kids care for child and adolescent patients, which is great. We know that 80% of mental health care conditions start in youth." – Stephen Merz [04:42]
Strategies for Making Behavioral Health Programs Work
[06:05 – 08:57]
- Emphasis on integrating behavioral and physical healthcare to support patients with co-occurring conditions.
- Encouraging health systems to “lean in” to care for the most complex, high-acuity patients, recognizing overall improvement in outcomes and cost savings when these needs are addressed.
- Advocates for a “no wrong door” policy—screening all patients for behavioral health needs and ensuring rapid access to care regardless of insurance or other barriers.
- Dispels the myth that behavioral health must be a financial loss.
- Quote:
- "We might say, you know, that patient with behavioral healthcare is also the OB patient, your surgical patient, your oncology patient, your heart and vascular patient." – Stephen Merz [07:11]
- "Behavioral health care doesn't have to be scary. It's something that you can run at scale and not lose money." – Stephen Merz [08:44]
2026 Priorities, Challenges, and National Thought Leadership
[09:11 – 10:39]
- Doubling down on support for complex patients with medical and behavioral comorbidities.
- Leading national awareness efforts to prevent program closures and encourage health systems to seek help before cutting services.
- Quote:
- "Before you close the program, please give us a call because we really are passionate about ensuring that there's access available in every community." – Stephen Merz [10:23]
Major Headwinds: Financing and Youth Access
[11:07 – 13:16]
- Persistent financial pressures and uncertain funding, especially around 340B payments, threaten behavioral health programs.
- Acute lack of access for youth behavioral health; many end up waiting in ERs due to system gaps. Pediatric hospitals often lack behavioral health services, and psychiatric facilities often lack pediatric care.
- Community health needs assessments repeatedly indicate high unmet needs for youth mental health, but providers lack pathways to build services.
- Quote:
- "General acute pediatric hospitals are not equipped with behavioral services. And general psychiatric hospitals don't have the kids services...they unfortunately get stuck in emergency departments, have to wait a long time.” – Stephen Merz [12:02]
Biggest Challenge: Scaling Impact and Spreading Knowledge
[13:24 – 15:27]
- Main obstacle is scaling proven interventions and connecting systems in need with Shepherd Pratt’s resources and expertise.
- Many leaders don’t realize what successful, sustainable behavioral health can look like until they see it firsthand.
- Quote:
- "When people visit our campus, they almost always say, this is amazing. I never knew it could be like this...seeing is believing that when they see this, they know that it's possible." – Stephen Merz [14:43]
Opportunities for Growth and Final Thoughts
[15:47 – 17:34]
- Major opportunity lies in expanding behavioral health in community hospitals and clinics, as only about 1,200 out of 5,000+ hospitals have formalized behavioral health programs.
- Shepherd Pratt aims to partner with health systems nationwide and share its expertise to drive growth and impact.
- Quote:
- "The biggest opportunity is to lean in and recognize that patient care healthcare involves the entire patient and well being is a big part of that. And the mental health care space has got to be with the physical health." – Stephen Merz [16:41]
Notable Quotes & Memorable Moments
-
On structural change:
"Leaning into the higher acuity patient is serving their community in need. And we can usually make a case that by managing that need better, it improves the overall outcomes of care and ultimately reduces the cost of care." – Stephen Merz [07:21] -
On mission and vision:
"Our CEO has a very...grand vision, which is that the world should not suffer and our country should not suffer with the lack of access to behavioral health care in a very pure form." – Stephen Merz [09:36] -
On gratitude for Becker’s role:
"Beckers for the last six or seven years has been very active and explicit about raising behavioral healthcare awareness at its national meetings...just appreciate you so much getting the word out about behavioral healthcare and letting other organizations in the health care ecosystem know that this is important." – Stephen Merz [18:00]
Guidance for Health Systems
- Don’t give up on behavioral health: There are proven pathways to sustainability and access.
- Seek partnerships: Organizations like Shepherd Pratt can help prevent program closure through support, strategy, and operational improvements.
- Integrate care: Behavioral and physical health should be inseparable in patient care strategy.
- Prioritize youth services: Addressing gaps for children and adolescents is critical and currently underserved.
Episode Timestamps
- 00:58 – Shepherd Pratt History and Mission
- 02:42 – Recent Initiatives and Case Studies
- 06:05 – Strategies to Reframe Behavioral Health in Systems
- 09:11 – 2026 Priorities and Thought Leadership
- 11:07 – Headwinds: Financing and Youth Access Gaps
- 13:24 – Challenge of Scaling and Spreading Success
- 15:47 – Organizational Growth and Community Hospitals
- 17:59 – Gratitude and Acknowledgements
Conclusion
This episode provides powerful insights into innovative behavioral health leadership, the importance of sustained access, and practical strategies for U.S. health systems to deliver high-quality mental health care. Stephen Merz delivers an optimistic yet pragmatic blueprint for moving the field forward—emphasizing integration, sustainability, and allyship across the national healthcare landscape.