This chapter explores the transformation of mental health governance from nation-state-bound systems to borderless digital ecosystems. It examines how historical constraints—shaped by industrial-era priorities and post-war welfare models—continue to influence current approaches to mental healthcare. The chapter highlights the limitations of traditional governance in addressing today’s complex challenges and shows how emerging technologies not only disrupt legacy boundaries but also enable new models of care delivery. By tracing this evolution, it lays the foundation for understanding why digital behavioral health frameworks based on the 5P Model—predictive, preventive, personalized, participatory, and precision based—are essential to building more equitable, accessible, and effective systems of care.