Expanding access to primary and mental health care across America—Columbus cornerstone

Across the country, business and government leaders are rethinking what it takes to make health care more accessible and effective. Marathon Health recently convened a series of roundtable discussions to explore how employers, health care providers, and policymakers can partner to expand access to primary care.

Much of the conversation  focused on one of today’s greatest challenges: meeting the growing demand for mental health support. Participants also discussed the ways technology can help bridge care gaps and how integrating mental and physical health within primary care creates a stronger foundation for whole-person well-being.

From Columbus, Ohio, to Richmond, Virginia, and Charlotte, North Carolina, learn how innovative leaders are making a difference in their communities and workplaces. 

Strengthening mental health access and workforce well-being in Columbus

Access to mental health care remains one of the most pressing challenges for employers nationwide. Workforce well-being, retention, and productivity are all at stake, but scalable solutions exist.  

In our Columbus Roundtable, local and national leaders came together to share practical strategies for improving access, strengthening outcomes, and addressing stigma through integrated care models.

Moderated by Nick Fortine of Columbus Business First, the panel featured Dr. Vakharia, MD, Chief Operating Officer at Marathon Health, Jamey Houle, PhD, Director of Sport Psychology and Wellness Services of The Ohio State University Department of Athletics, Erika Clark Jones, MBA, MPPA, Chief Executive Officer of the Alcohol, Drug and Mental Health Board of Franklin County, and former Mayor Michael B. Coleman.

Fortine opened the discussion by asking the panelists how they approach mental health from their unique perspectives. Download the Table of Experts booklet here and read more online about it here.

Public safety net perspective

Clark Jones serves as CEO of the ADAMH Board of Franklin County, a government agency that partners with nonprofits to plan, fund, and evaluate community-based programs for mental health and substance use disorder treatment. “We invest in prevention. We invest in treatment, recovery services, family support services, and housing, because we recognize there are people that cannot live because of their mental illness,” Clark Jones says. 

Currently, she says the organization is laser-focused on providing interventions for people suffering a mental health crisis. For decades, Clark Jones explains how residents in a mental health crisis often end up in the emergency room, or even jail.

ADAMH recently integrated the county's 911 system with the 988 Crisis Line, a national number that connects people in mental health, substance use, or suicidal crises to trained counselors for immediate, confidential support.

“If you call 911, because that's what people have been known to do when their family member is in crisis, they immediately do a warm transfer to 988,” Clark Jones says. “That's been made possible recently because we doubled down with our partners in public safety.” 

The organization also launched mobile crisis response teams, which are clinician-led teams that come out to meet an individual experiencing a crisis.

“We call it ‘Someone to Come.’ Our continuum is someone to call, someone to come, and ultimately somewhere to go if that's what you need,” she says.  

ADAMH recently made a $60 million investment to launch a crisis care center that’s open 24 hours a day, seven days a week for Franklin County residents. 

“No one is turned away with an inability to pay or an insurance status that is unknown, and they receive compassionate, patient-centered care around the clock,” Clark Jones says.

Elite athletics perspective

Houle supports elite athletes at The Ohio State University by providing mental health care that ranges from treating mental illness to coaching athletes on mental focus and team cohesion.

“With athletes, there’s this veneer of having to be perfect, having everything together,” Houle explains. “So, one of the things we try to do is go to their spaces, and we break down the stigma by showing them that I don't look like Freud. They're not laying on a couch. We have these hallway conversations sometimes, these hallway consultations. We're accessible.”

To help lower the stigma and put a face to a name, Houle meets with different teams to introduce his staff and talk about their services.

“What that does is we become real people to them. We're not just some psychologist sitting in the dark office asking about their dreams.”

Houle says despite his efforts, stigma around mental health persists. But the university has powerful backing from a prominent member of the organization.

“Not to brag on our coach, but Ryan Day's whole platform is mental health,” Houle says. “That means one of the highest paid people in the entire state of Ohio is saying mental health is pretty important. That shows his athletes and the other athletes on campus that it's not the biggest deal to come in to see me or my staff.”

Employer perspective

Dr. Vakharia says some of the major health care systems in Ohio have reported wait times of up to nine months for mental health care services.

“The problem is, we can't make people fast enough who are able to provide the type of service that's needed, so we need to be thinking about how do we find better balance between the supply and the demand, and it requires some fresh ideas,” Dr. Vakharia says. 

One of those ideas involves integrating the screening, diagnosis, and management of lower-acuity mental health issues with primary care.

“At Marathon Health, we do about a million visits a month, and about a quarter of those have something to do with mental health,” Vakharia says. “Seventy percent of our mental health care is provided by our primary care providers. That way, we're supporting and saving the specialized services that our mental health professionals offer for the higher-acuity folks.”

Dr. Vakharia highlighted the growing role of digital therapeutics as an exciting development on the horizon. Employees can now use safe, effective mental health apps at home, many of which are FDA-approved and covered by insurance.

“So, talking about scaling, now you have a mental health provider [reaching more folks] because some of it is happening through the use of technology,” he says.

Challenges remain

Clark Jones says ADAMH surveys Ohio residents every five years about their mental health needs. Most recently, 35% of respondents stated they had a need for mental health care and it went unaddressed.

Key barriers in the survey include:

• Their employer's program didn't pay for it
• They didn't know how to do it
• They couldn’t overcome the stigma and the judgment that came with seeking help

“Any time employers can offer more options, it will help our community,” Clark Jones says.

Dr. Vakharia notes that while plenty of great ideas exist, the real challenge is figuring out how to pay for them, and how to make those solutions sustainable beyond pilot programs. He says there’s a strong business case for prevention, supported by decades of evidence. Forward-thinking employers are “swimming upstream,” he says, by investing in prevention as a smarter, more efficient way to use health care dollars.

“It creates more space for you to invest in an expansion of what you think of as prevention, for example, the integration of mental health and primary care as truly respecting the mind and the body being treated together,” he says. “There's absolutely a business case to be made, not just a moral or an ethical case, not just a clinical case.”

Dr. Vakharia says the U.S. spends over $4 trillion annually on health care, yet outcomes continue to fall short.

“There's more than enough money that you all are spending, that the government is spending, on the health of the population, it's just misallocated,” he says. “Today, 4% to 5% goes to primary care.”

Technology opens new doors

Dr. Vakharia emphasized that as technology becomes more integrated into health care, it should strengthen—not replace—the human connection between patients and providers. He explained the goal is to use technology to enhance those relationships, making care more personal and effective, rather than reducing it to a purely digital experience.

“Today, there are FDA-approved apps to treat depression, anxiety, substance use disorder, opiate use disorder, and ADHD,” he says. “There's an FDA-approved video game for kids that actually helps them manage their ADHD. What I see as a start there is how we're thinking about meeting the health care consumer where they are.”

While technology opens new possibilities for care, it must be balanced with a commitment to safety and efficacy. Dr. Vakharia notes that digital tools are highly scalable and cost-effective, allowing health care providers to extend expert support. 

As more people are now using tools, such as ChatGPT, for mental health support and counseling, the wider effectiveness remains unknown.

“We need to go through the official regulatory process to make sure this is safe for the general population,” Vakharia says. “I think it's a very exciting time and we should really be thinking about thoughtfully embracing it, rather than trying to go back to an old model which we've established is not going to meet the needs of today.”

How business leaders can break the stigma

Clark Jones says employers can lead the charge by changing the way they address mental health needs.

“We need to talk about it, not just make people aware, but normalize it, normalize taking action, and learning the skills and acquiring the tools to be well mentally,” she says. “It not only helps, it's not only good for business, it's good for your family, it's good for the community.”

Houle says he leads by example, modeling the behavior he wants his team to follow. He encourages every staff member to take at least one mental health day each month to recharge and prioritize their well-being.

To close out the event, former mayor Coleman mentioned his top takeaway from the panel discussion.

“I've learned mental health is like physical health in many ways, in that you have to get in front of it, deal with it early before it becomes a crisis,” he says. “And that's one of the biggest problems we have in funding, federal, state, local funding, and how businesses operate. This is one of the strengths of Marathon Health—getting in front of it before it becomes a crisis." 

“We talk about budgets and funding and how it costs so much more at the end,” he adds. “But imagine if you started early on, when you start noticing issues with employees, because all of us have some form, some level of mental health.”

Preview this inspiring clip from the Mayor below and watch the complete on-demand recording here.