The move toward integrated physical and mental healthcare is accelerating, driven by the need for truly patient-centered care. An integrated approach dismantles the traditional silos in healthcare, leading to improved patient outcomes and cost efficiencies.
What’s more, increased public awareness of diverse mental health conditions is fueling demand for specialized services, especially those for treating autism spectrum disorder, bipolar disorder, and treatment-resistant depression. A 2022 survey conducted by the Keiser Family Foundation found that 90% of U.S. public feel there’s a mental health crisis.
In 2024, Mental Health America’s report, which ranks all the states plus Washington, D.C., on 15 mental health access and prevalence measures, found:
- Nearly 24% of adults experienced a mental illness in the past year
- Over 5% of adults reported serious suicidal thoughts
- Over 13% of kids (ages 12-17) reported serious suicidal thoughts
- One in five kids had at least one depressive episode in the past year (yet over 56% received no treatment)
- Over 17% of adults and nearly 9% of kids experienced a substance use disorder
There’s a dearth of treatment options in this country. It often takes months to get an appointment with the right specialist, and there’s no guarantee they’ll accept your (or any) health insurance. There’s also no guarantee that the available professional in any area is the right fit.
One solution? Certified community behavioral health clinics (CCBHCs) which deliver comprehensive services to individuals with complex needs, including those with intellectual and developmental disabilities. CCBHCs offer states a pathway to enhance their citizens’ behavioral health by:
- Strengthening community-based mental health and substance use disorder services
- Fostering closer collaboration between behavioral and physical healthcare providers
- Promoting the broader adoption of proven treatment methods
- Expanding access to quality care for all
While designed to serve anyone seeking assistance, these clinics are expected to be especially beneficial for:
- Individuals with serious mental illnesses or severe substance use disorders
- Children and adolescents experiencing significant emotional disturbances
- Individuals with co-occurring mental health, substance use, or physical health conditions.
Here’s the challenge: These clinics operate within the community, and right now, there aren’t nearly enough facilities to meet everyone’s needs. One factor contributing to the shortage? “NIMBYism.”
What is NIMBYism?
Coined in the 1970s, “NIMBY” is shorthand for Not In My Backyard. This label carries dual meaning, reflecting differing perspectives. In one context, it describes residents’ resistance to large-scale corporate or government developments that could potentially diminish living standards or negatively affect property values. Corporations, construction unions, and contractors promoting those projects often favor this interpretation.
Conversely, social service and environmental justice advocates employ the term to highlight a perceived lack of social responsibility. They argue that opposition to locating social service facilities within certain neighborhoods often stems from class, racial, or disability-based biases.
The pejorative nature of NIMBY arises partly from the socioeconomic backgrounds of those frequently labeled with it. Because those who raise environmental concerns often come from middle or lower-income brackets, project proponents may use “NIMBY” as a divisive tactic. This label creates a dilemma for those it targets: it suggests they’re either indifferent to placing potentially harmful facilities in communities (especially disadvantaged communities) or willing to forego job creation associated with such projects.
Mitigating NIMBYism and addressing community concerns
Study after study (and 2025 predictions from the World Economic Forum, among others) agree that increasing access to mental health care is imperative. In the U.S., you may wait two months or longer for an appointment with a qualified healthcare professional. One in 5 Americans has a mental illness, and symptoms can begin manifesting by age 14.
Mental health conditions strain community well-being. Increased hospital admissions and financial hardships are common. Over 580,000 people in the U.S. lack housing, and more than 20% of those people have severe mental illness. The cost of lost earnings resulting from untreated mental health conditions annually? More than $193 billion.
This health landscape is undergoing a profound evolution, including these developments:
- The field is moving beyond one-size-fits-all solutions toward frameworks designed for distinct demographic groups, including youth mental health initiatives, geriatric behavioral health programs, culturally responsive care for diverse communities, and specialized services for LGBTQ+ individuals.
- We’re witnessing substantial growth in programs designed to reach populations with historically limited access, including rural communities and economically disadvantaged urban areas.
- The boundaries between behavioral health and other mental disciplines continue to blur. Coordinated care models connect mental health services with primary care, creating more comprehensive treatment pathways.
So how can those healthcare professionals who want to open clinics address this very real Catch-22 situation? The key is education.
When discussing opening behavioral health services within residential neighborhoods, people rarely argue that those needing help don’t deserve it. But a more nuanced resistance emerges — a preference for locating those essential services to the outskirts, away from neighborhoods and community centers. This desire for separation stems from hypothetical “what ifs” like lower property values, property damage, increased crime, etc.
These arguments and opposition regularly lack actual data, “which especially in cases of mental health issues show that the lack of access to services and the imposition of distance from support systems are clear predictors of poor mental health outcomes.” When services are accessible to those who need them, these people get better.
Championing your project
Talk about the goals of the clinic and its commitment to being a good neighbor and accentuate the positives, like the creation of jobs and the fact that people will receive the treatment they need to heal and stay well. Share positive outcomes (evidence that your program works) and ask current or former patients to share their success stories.
The Advocates for Human Potential, Inc.’s “How to Engage, Communicate with, and Include the Community in the Development of New Behavioral Heatlh and Housing Infrastructure,” is a fantastic resource to look for inspiration.
As you plan, focus on developing messaging appropriate for your community stakeholders. Be relevant and focused. Remain consistent and authentic. Use visuals, and tell your story. Explain:
- The scope of the problem you hope to solve
- The population or numbers you plan to serve and the services you’ll provide
- The outcomes you anticipate
- Your approaches to making the built space and its amenities appropriate
Anticipate and address community concerns, like safety, traffic, property values, noise, privacy, design, and stigma. Prepare for difficult questions and have concrete answers for them.
- How and who is funding this project?
- Who will provide oversight?
- Who will operate your program? What are their credentials and experience?
- What evidence can you provide that your approach works?
- How will you address concerns from the community and deal with urgent needs?
- Why here?
It is possible to address and mitigate NIMBYism once you recognize that emotional response often outweighs logical reasoning in shaping public opinion. Gaining community acceptance for a proposed behavioral health facility hinges on demonstrating its feasibility, championing transparency, ensuring accessibility and appropriate management, and fostering a sense of inclusivity for all stakeholders. Acceptance also hinges on the stakeholders’ attitudes, acceptance, and reassurance that the new relationship will be based on communication, collaboration and cooperation, integrity, respect, and trust.
Are you a commercial real estate investor or seeking a specific property to meet your company’s needs? We invite you to talk to the professionals at CREA United, an organization of CRE professionals from over 90 firms representing all disciplines within the CRE industry, from brokers to subcontractors, financial services to security systems, interior designers to architects, movers to IT, and more.
