Behavioral health systems in the United States have historically lagged behind other health care sectors in digital infrastructure, interoperability, and advanced electronic health record (EHR) functionality. However, national evaluations of digital maturity across behavioral health treatment facilities remain limited. We conducted a cross-sectional analysis of 27,957 behavioral health treatment facilities using the 2024 National Substance Use and Mental Health Services Survey (N-SUMHSS). Three dimensions of digital maturity were evaluated: EHR adoption, participation in health information exchange organizations (HIOs), and functional EHR capability. Multinomial logistic regression examined facility characteristics associated with each outcome, and state-level variation in EHR capability was assessed. Approximately half of facilities reported exclusive EHR use, yet only 13.2% actively participated in HIOs and 19.3% reported being unfamiliar with HIO availability. Nearly half demonstrated high EHR capability, although substantial organizational and geographic variation remained. Federal facilities, federally qualified health centers, and combined mental health and substance use treatment facilities consistently demonstrated greater digital maturity in contrast to substance use–only and tribal. These findings provide a national baseline for behavioral health digital maturity and support modernization efforts that prioritize interoperability, workforce technical capacity, organizational integration, and advanced digital capability alongside EHR adoption.
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Das et al. (2026) studied this question.
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