Chronic, Not Crisis: Rethinking Behavioral Health Systems
With Luke Bergmann
Stories to Solutions
Interview Recorded On: Jan 16, 2026
Dr. Luke Bergmann's stepfather raised him from the age of one. In his seventies, a lifelong anxiety disorder turned disabling, and his health declined sharply. Bergmann, then San Diego’s Director of Behavioral Health, found a doctor certified in both psychiatry and family medicine — someone who could treat the whole person. But state policy wouldn't allow a psychiatric visit and a physical health visit to be billed the same day. His stepfather didn't want to be split in two, so he stopped going. He died this past May.
It's the kind of story that runs through Bergmann's current outlook on the field. After 15+ years leading behavioral health systems in New York and California, he argues most of what's broken isn't complicated. Inpatient psych facilities, he says, are often run like a "motel chain," incentivized to keep beds full instead of keeping people well. His fix is integration— like a primary care clinic he helped build in Brooklyn where patients with serious mental illness were treated by their primary care doctors with real success. Bergmann now works at Health Management Associates, working to get behavioral health and physical health — the two sides of the system that failed his stepfather — talking to each other.
It's the kind of story that runs through Bergmann's current outlook on the field. After 15+ years leading behavioral health systems in New York and California, he argues most of what's broken isn't complicated. Inpatient psych facilities, he says, are often run like a "motel chain," incentivized to keep beds full instead of keeping people well. His fix is integration— like a primary care clinic he helped build in Brooklyn where patients with serious mental illness were treated by their primary care doctors with real success. Bergmann now works at Health Management Associates, working to get behavioral health and physical health — the two sides of the system that failed his stepfather — talking to each other.
Interview Recorded on: Jan 16. 2026
Dr. Luke Bergmann's stepfather raised him from the age of one. In his seventies, a lifelong anxiety disorder turned disabling, and his health declined sharply. Bergmann, then San Diego’s Director of Behavioral Health, found a doctor certified in both psychiatry and family medicine — someone who could treat the whole person. But state policy wouldn't allow a psychiatric visit and a physical health visit to be billed the same day. His stepfather didn't want to be split in two, so he stopped going. He died this past May.
It's the kind of story that runs through Bergmann's current outlook on the field. After 15+ years leading behavioral health systems in New York and California, he argues most of what's broken isn't complicated. Inpatient psych facilities, he says, are often run like a "motel chain," incentivized to keep beds full instead of keeping people well. His fix is integration— like a primary care clinic he helped build in Brooklyn where patients with serious mental illness were treated by their primary care doctors with real success. Bergmann now works at Health Management Associates, working to get behavioral health and physical health — the two sides of the system that failed his stepfather — talking to each other.
It's the kind of story that runs through Bergmann's current outlook on the field. After 15+ years leading behavioral health systems in New York and California, he argues most of what's broken isn't complicated. Inpatient psych facilities, he says, are often run like a "motel chain," incentivized to keep beds full instead of keeping people well. His fix is integration— like a primary care clinic he helped build in Brooklyn where patients with serious mental illness were treated by their primary care doctors with real success. Bergmann now works at Health Management Associates, working to get behavioral health and physical health — the two sides of the system that failed his stepfather — talking to each other.
See More
See Less
Links to Solutions
Common Sense Policy: When Bergmann's stepfather finally got an appointment with a doctor certified in both psychiatry and family medicine, California policy blocked the visit from covering both conditions on the same day, and he never went back.
Chronic Not Crisis: As director of San Diego County's behavioral health department, Bergmann told his staff they were done talking about crisis and would use a chronic disease model instead, a decision some of his most experienced clinicians pushed back on.
Follow the Money: Bergmann compares the economics of inpatient psychiatric hospitals to a motel chain, an industry built to turn rooms and keep beds full, which means the institutions most responsible for behavioral health care are financially rewarded for keeping people sick.
Meet Our Guest
Dr. Luke Bergmann
Luke Bergmann, PhD, MSW, is a Principal at Health Management Associates, the nation's largest independent healthcare consulting firm, where he works with county behavioral health departments and community health centers across California to build more integrated systems of care. He brings more than 15 years of executive leadership in municipal and county behavioral health, most recently as Director of Behavioral Health Services for the County of San Diego's Health and Human Services Agency, where he led the county's largest department, overseeing its psychiatric hospital, a skilled nursing facility, and a network of community clinics serving people with serious mental illness and substance use disorder enrolled in Medi-Cal. Under his direction, San Diego County established California's first Behavioral Health Population Health Office and built a crisis continuum of seven crisis stabilization units and 44 mobile crisis response teams across the region.
Before California, Bergmann spent nearly a decade in New York City's public hospital system, serving as Assistant Vice President over Behavioral Health for NYC Health + Hospitals, the nation's largest municipal health system, where he led transformation efforts through major shifts in state and federal Medicaid policy. He holds a doctorate in social work and cultural anthropology from the University of Michigan, along with a Master of Social Work, a master's degree in ethnology, and a bachelor's degree in art history and anthropology. At Health Management Associates, he now focuses on bringing county behavioral health leadership and federally qualified health centers into the same conversation, helping both systems navigate the current landscape of Medicaid policy change.
Before California, Bergmann spent nearly a decade in New York City's public hospital system, serving as Assistant Vice President over Behavioral Health for NYC Health + Hospitals, the nation's largest municipal health system, where he led transformation efforts through major shifts in state and federal Medicaid policy. He holds a doctorate in social work and cultural anthropology from the University of Michigan, along with a Master of Social Work, a master's degree in ethnology, and a bachelor's degree in art history and anthropology. At Health Management Associates, he now focuses on bringing county behavioral health leadership and federally qualified health centers into the same conversation, helping both systems navigate the current landscape of Medicaid policy change.
Connect with Millie Christie
Connect to Dr. Luke Bergmann
Org Website: https://www.healthmanagement.com
Dr. Emily Carter
Licensed Clinical Psychologist & Mental Health Advocate
How To Get Involved?
Dr. Emily Carter
Licensed Clinical Psychologist & Mental Health Advocate
How To Get Involved?
Dr. Emily Carter
Licensed Clinical Psychologist & Mental Health Advocate
How To Get Involved?
Dr. Emily Carter
Licensed Clinical Psychologist & Mental Health Advocate
How To Get Involved?
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
