Senior Counsel

How behavioral health teams guide members to care. May 13, 2026 Nearly a quarter of U.S. adults live with at least one mental health condition, and a growing number of people are seeking help. Yet even those with insurance can have trouble navigating care because they often aren't as familiar with their behavioral health benefits as they are with their medical benefits. Identifying in-network treatment and resources can be an overwhelming task, especially during a mental health dilemma. "They don't really know what their policies include," says behavioral health care coordinator Carmela Rupe. "I'm explaining the basics of insurance," she says, adding she often steers individual and family plan members toward in-network care and resources to help them find new providers and access covered in-person treatment centers to help control their conditions. Rupe is among teams of care coordinators at Blue Cross and Blue Shield of New Mexico providing behavioral health education, guidance and resources to help members find the care they need. Licensed in behavioral health care, they assist members seeking treatment for conditions, including anxiety, depression, substance misuse and autism, and avoid scammers targeting vulnerable people. "An insurance company is not necessarily viewed as the primary resource for behavioral health information," says Scott Bender, BCBSNM's executive director for behavioral health operations. "Many people will go to the internet to do a search or ask their friends and family for references. But that's a service we provide specifically in behavioral health." Although insured adults are more likely to receive mental health care than those without coverage, they still had difficulty accessing services, according to KFF. The health care policy nonprofit found nearly 45% of insured adults with mental health concerns could not get the mental health treatment they thought they needed. Depending on the plan, member resources include digital behavioral health tools and access to virtual and in-person providers. In 2025, BCBSNM launched a digital mental health hub available on the member account portal to improve resource access. More than 35,000 members have used the hub to find providers and educational tools. BCBSNM also has invested in Headway, a technology-enabled platform that connects and expands access for members to a diverse, national network of licensed therapists and psychiatrists. Care coordinators can offer guidance to appropriate levels of care, no matter whether members already have a diagnosis or are seeking treatment for the first time. They may also collaborate with other teams to coordinate medical care and medication compliance. "Seeking care can be very confusing," says Dr. Ella Williams, senior executive medical director for behavioral health. "There's just such a lack of knowledge about what's available to them. We want to increase people's awareness about the types of treatment and care that's covered." Rupe often reaches out to members to better coordinate their care if they've had at least two inpatient treatment admissions a year. She also ensures members receive their prescribed medications to maintain their physical and mental health. "We're real people who have been trained as masters-level individual clinicians," she says. "Our ethics as clinicians guide us. We want to help members get what they need." That expertise builds credibility with members, says Amy Wiley, a behavioral health case management coordinator. "Some members have never navigated the systems that are available to them," says Wiley, who's helped many members new to seeking behavioral health care. "They're overwhelmed because they don't know what they have." She always tries to provide members with educational information to help increase awareness, ease frustration and build trust. "We try to match members with the services they need," Wiley says. "We are really lucky in that we can spend more time with members to really dive in, ask questions and help take some of the legwork out of helping them find resources."

How behavioral health teams guide members to care. May 12, 2026 Nearly a quarter of U.S. adults live with at least one mental health condition, and a growing number of people are seeking help. Yet even those with insurance can have trouble navigating care because they often aren't as familiar with their behavioral health benefits as they are with their medical benefits. Identifying in-network treatment and resources can be an overwhelming task, especially during a mental health dilemma. "They don't really know what their policies include," says behavioral health care coordinator Carmela Rupe. "I'm explaining the basics of insurance," she says, adding she often steers individual and family plan members toward in-network care and resources to help them find new providers and access covered in-person treatment centers to help control their conditions. Rupe is among teams of care coordinators at Blue Cross and Blue Shield of Illinois providing behavioral health education, guidance and resources to help members find the care they need. Licensed in behavioral health care, they assist members seeking treatment for conditions, including anxiety, depression, substance misuse and autism, and avoid scammers targeting vulnerable people. "An insurance company is not necessarily viewed as the primary resource for behavioral health information," says Scott Bender, executive director for behavioral health operations. "Many people will go to the internet to do a search or ask their friends and family for references. But that's a service we provide specifically in behavioral health." Although insured adults are more likely to receive mental health care than those without coverage, they still had difficulty accessing services, according to KFF. The health care policy nonprofit found nearly 45% of insured adults with mental health concerns could not get the mental health treatment they thought they needed. Depending on the plan, member resources include digital behavioral health tools and access to virtual and in-person providers. In 2025, BCBSIL launched a digital mental health hub available on the member account portal to improve resource access. More than 35,000 members have used the hub to find providers and educational tools. BCBSIL also has invested in Headway, a technology-enabled platform that connects and expands access for members to a diverse, national network of licensed therapists and psychiatrists. Care coordinators can offer guidance to appropriate levels of care, no matter whether members already have a diagnosis or are seeking treatment for the first time. They may also collaborate with other teams to coordinate medical care and medication compliance. "Seeking care can be very confusing," says Dr. Ella Williams, senior executive medical director for behavioral health. "There's just such a lack of knowledge about what's available to them. We want to increase people's awareness about the types of treatment and care that's covered." Rupe often reaches out to members to better coordinate their care if they've had at least two inpatient treatment admissions a year. She also ensures members receive their prescribed medications to maintain their physical and mental health. "We're real people who have been trained as masters-level individual clinicians," she says. "Our ethics as clinicians guide us. We want to help members get what they need." That expertise builds credibility with members, says Amy Wiley, a behavioral health case management coordinator. "Some members have never navigated the systems that are available to them," says Wiley, who's helped many members new to seeking behavioral health care. "They're overwhelmed because they don't know what they have." She always tries to provide members with educational information to help increase awareness, ease frustration and build trust. "We try to match members with the services they need," Wiley says. "We are really lucky in that we can spend more time with members to really dive in, ask questions and help take some of the legwork out of helping them find resources."