Bid on the decision, not the diagnosis
Searches like symptoms of depression or what is bipolar disorder carry enormous volume and almost no intent to book. They are cheap for a reason. Most mental health accounts we inherit are spending the majority of their budget there.
The queries that produce calls contain a decision: treatment, program, therapist near me, IOP, psychiatrist accepting new patients, plus a payer or a city. Cutting the informational terms and moving that budget to the decision terms usually lowers cost per call before anything else is touched.
Payer terms are the cheapest high-intent inventory in the category
Someone searching a plan name plus therapy plus a city has already decided to get care and is now solving for coverage. The click costs less than a general therapy term and the caller is further along.
Those searches demand a landing page that answers the coverage question directly. Sending payer traffic to a general contact page wastes the click. Each in-network plan gets its own page and its own ad group.
The restrictions you inherit
Google prohibits personalized advertising based on a user's inferred mental health status. That removes health-based remarketing lists, similar-audience expansion built from them, and most of the audience layering a general media buyer would set up on day one.
Campaigns run on geography, keyword intent, device, and time of day. Creative and landing page quality carry the difference, which is why performance in this category tracks how good the pages are.
Crisis queries need a different answer than an ad
Searches around suicidal ideation and acute crisis surface Google's own crisis resources, and they are not queries to buy. Bidding into them puts an ad in front of someone who needs 988, not an intake line.
We build those into negatives and make sure crisis resources are visible on every clinical page on the site. It is the right thing to do and it keeps the ad account out of policy trouble.
What the report says
Cost per call, cost per qualified call, and where your CRM supports it, cost per scheduled assessment by campaign and keyword. Not impressions, not click-through rate, not a conversion count that includes anyone who visited the contact page.
Getting there takes dynamic number insertion on landing pages and the ad platform connected to your intake system. That work happens in month one, which is why month one looks like setup rather than results.