In some institutions, behavioral health patients do not necessarily receive exactly the same treatment for the same illness. Choices, including the prescription of psychotherapy, often depend upon clinic culture, region, or individual practitioner preference. Eighty percent of mental health care is now delivered in primary care offices. Even in an integrated delivery system, there is no standard way of deciding when a patient belongs in a specialty clinic, where psychotherapy is common, versus primary care, where it is not. When we assert that our patients should receive mental health services at parity, we do not know whether we are asserting for them to receive treatment that is highly effective or not.