Trust in Healthcare: Building Bridges in Behavioral Health

June 29, 2026

Melissa Fors Shackelford, Author and Keynote Speaker, Marketing & Growth Advisor

Joshua Bennett-Johnson, Subject Matter Expert

Tom O'Connor, Publisher

Trust has always mattered in healthcare. But now, it can no longer be assumed. This shift is especially sharp in behavioral health. Here, trust often determines whether someone walks through the door at all.

After nearly 15 years in behavioral health and 20 years in healthcare overall, I’ve seen this play out across various settings: residential care, outpatient care, telehealth, peer recovery, digital tools, and clinician training. The question remains: why do some people seek help while those who need it most don’t? The short answer is trust. The longer answer lies in the numbers and the operational moments where trust is won or lost.

The Landscape of Trust

Recent data provides two useful perspectives. The 2026 Edelman Trust Barometer Special Report on Trust and Health shows the big picture: trust in institutions is strained, skepticism is rising, and people are more selective about whom they listen to on health issues. Meanwhile, Newsweek's "Most Trustworthy Companies in America 2025" ranks individual healthcare and life sciences companies based on their trustworthiness among customers, employees, and investors.

Together, these reports tell a clear story. Edelman reminds us that healthcare now operates in a climate of distrust and skepticism. People still seek expertise and guidance, but they are quicker to question authority. Trust has become harder to earn and easier to lose.

Behavioral Health: The Numbers Speak

In behavioral health, the numbers tell a compelling story. According to the most recent SAMHSA National Survey on Drug Use and Health, of the 52.6 million Americans who needed substance use treatment in 2024, only about one in five received it. Among the 21.2 million adults living with both mental illness and a substance use disorder, just 14.5 percent received treatment for both. SAMHSA's own list of reasons why people don’t seek care points to stigma. The cost of low trust in this field is measured by the number of people who never walk in.

Newsweek's rankings illustrate how this plays out in real time. Trust manifests in practical ways: whether people believe what organizations say, how leadership behaves, and whether employees are treated fairly. Some healthcare organizations excel in this area, even in a challenging environment. Others fall short. Behavioral health organizations face the same scrutiny. Every signal weighs heavily because their patients arrive with histories of being judged, dismissed, or surprise-billed by the very systems they are now asked to trust again. For many, the walk through that door is rarely a first attempt.

The takeaway is simple. Healthcare trust isn’t just about reputation. It’s built through everyday experiences, clear communication, and consistency between values and actions.

Bridging the Gap: Supporting Individuals with SUD Beyond Treatment

Trust Is Built On Everyday Experiences

In behavioral health, trust is built through everyday interactions. It’s the moment a patient calls and the front desk picks up. It’s how a clinician introduces themselves on a telehealth screen. It’s the peer specialist who follows through on a 7 AM check-in. It’s the intake that doesn’t feel like an interrogation. It’s the discharge plan that actually gets followed up on.

The language used to describe people in care is crucial. Person-first phrasing, accurate framing of return to use, and careful descriptions of medication for opioid use disorder all matter. It’s also about whether what an organization markets matches what a patient experiences from intake through billing to follow-up. Misalignment in any of these moments is the fastest way to lose trust at scale.

What sets behavioral health apart from an annual physical or sore throat appointment is that none of this is optional. No blood test confirms a diagnosis. No imaging study tells you whether treatment is working. Recovery from substance use, healing from trauma, and managing depression or anxiety all depend on a person disclosing what’s actually happening inside them. Disclosure depends on safety. Safety depends on trust. In behavioral health, clinical work and trust-building work coexist.

The Role of Organizations in Building Trust

This is the work I do with clients at Shackelford Strategies. I advise treatment programs, peer recovery networks, telehealth providers, and digital health companies on building trust at scale. It’s also the central argument of my book, Harnessing Purpose: A Marketer's Guide to Inspiring Connection.

Trust is visible, measurable, and currently tied to choice. For healthcare organizations, especially in behavioral health, the question isn’t whether trust matters. It’s whether they’re building it on purpose. The patients we serve are watching for the answer in everything we do, every day.

Conclusion: A Call to Action

As we navigate the complexities of healthcare, let’s remember that trust is not just a buzzword. It’s a lifeline. It’s the bridge that connects patients to the care they need. We must strive to earn that trust every day.

If we can create environments where individuals feel safe to share their struggles, we can foster healing and recovery. Trust is not given; it is earned through consistent actions and genuine care.

Let’s commit to being the change we wish to see in the world of healthcare. Together, we can build a future where trust is the foundation of every interaction.

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Read Melissa's bio by checking her icon at the start of this article.

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