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Wearable technology holds promise for improving mental health care by enabling continuous, objective monitoring of physiologic parameters. Building on decades of psychophysiology research, wearables can provide an additional source of measurement for implementing measurement-based care in learning mental health systems. This review describes wearable use across inpatient and outpatient settings, identifying gaps and opportunities in clinical care and research. While widely studied in outpatient, wearables hold immense potential for in inpatient settings. Advancements needed include user-centered design, better understanding of complex populations and settings, and use of modern analytical methods to generate clinically actionable mental health insights for all.