This chapter establishes the theoretical foundation for digital behavioral health governance by tracing the evolution of knowledge distribution—from clinician-centered authority to system-managed protocols and now toward distributed intelligence shared between patients and AI systems. We introduce the Digital Behavioral Health System (DBHS) framework as the structural architecture that enables implementation of the 5P Model, introduced in Chap. 1 and contextualized in Chap. 2 . Drawing from platform ecosystem theory, sociotechnical systems thinking, and learning health systems, this chapter argues that digital transformation is not simply a matter of adopting new technologies but of rethinking how knowledge, responsibility, and governance flow within behavioral health systems. By reframing governance as a dynamic, polycentric, and participatory process, the DBHS framework offers a scalable foundation for ethically aligned, personalized, and cost-effective behavioral healthcare.