The Mental Health Evolution

This week Rachel goes solo to talk about something she has been watching unfold in real time — two states making completely opposite decisions about who gets reimbursed in behavioral health, at the exact same moment, with major implications for the mental health workforce pipeline. Rachel owns a multi-state group practice and runs a training institute. She employs clinicians at every stage of licensure — interns, provisionally licensed, and fully licensed — and she has skin in this game. What she is watching happen right now affects every practice that trains the next generation of therapists. The episode starts by defining the three levels of licensure in behavioral health and how insurance has historically treated each one. Then it gets into the two stories happening simultaneously. Blue Cross Blue Shield of Michigan, which holds nearly 70 percent of the state's commercial market, announced that starting March 1, 2027, it will no longer reimburse for services provided by limited licensed clinicians in private practice settings — framing it as a quality of care decision that practice owners across Michigan are pushing back on hard. At the exact same time, Maryland passed HB 1094 and SB 910, signed into law in April 2026, mandating that insurance companies operating in Maryland reimburse for services provided by supervised graduate-level interns starting January 1, 2027. One state is expanding the pipeline. One state's largest insurer is choking it. There is no federal standard. And the question of whether the Michigan decision spreads to other states or other insurers is one nobody can answer yet. Rachel closes with a direct call to action: if you are a practice owner, look at your payer contracts. If you are a pre-licensed clinician, ask whether the practices you are considering have examined this issue. If you supervise, understand that the financial infrastructure supporting that work is not guaranteed. This story is not finished. Resources Mentioned Articles Referenced: New Insurance Policy on Limited Licensed Therapists — Dr. Joel L. Young, Psychology Today (June 2026): https://www.psychologytoday.com/us/blog/when-your-adult-child-breaks-your-heart/202606/new-insurance-policy-on-limited-licensed Maryland Insurance Administration Bulletin 26-14 — HB 1094 and SB 910 (June 2026): https://insurance.maryland.gov/Pages/Bulletins/Bulletin-26-14.aspx Michigan Blue Cross to Limit Mental Health Benefit. Will Thousands Lose Care? — Robin Erb, Bridge Michigan (June 11, 2026): https://bridgemi.com/michigan-health-watch/michigan-blue-cross-to-limit-mental-health-benefit-will-thousands-lose-care/ Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Rachel speaks with Myriam Barthes, co-founder and CEO of Journey Clinical, the largest network of ketamine-assisted psychotherapy trained therapists in the United States. Journey Clinical operates as a collaborative care platform — connecting licensed psychotherapists with a dedicated medical team so that therapists can offer ketamine-assisted psychotherapy to their clients without having to navigate the medical side alone. Myriam came to this work through her own personal experience with ketamine-assisted psychotherapy, which she describes as transformative. Before co-founding Journey Clinical, she worked as an AI strategist and consultant — and she has brought that systems-thinking lens to one of the most complex problems in mental health: how do you take a treatment that is clinically promising, legally available, and genuinely hard to access, and make it actually reachable for patients and the therapists who want to offer it? The conversation focuses on the business and systems side of psychedelic-assisted therapy — how Journey Clinical works, what it actually takes for a licensed therapist to start offering KAP, and what the regulatory landscape looks like right now. Myriam walks Rachel through the collaborative care model, what happens when a client goes through a ketamine session, and why the therapeutic relationship before and after the medicine is as important as the medicine itself. She also shares her perspective on where the field is heading as psilocybin moves closer to FDA approval — and why she believes the infrastructure being built now for ketamine will matter enormously for what comes next. This episode pairs well with our conversation with Will Ratliff of Transcend Health Solutions, which goes deeper into the clinical and medical side of ketamine-assisted psychotherapy. Resources Mentioned Articles Referenced: FDA Moves to Fast-Track Review of Psilocybin and Methylone for Mental Health — CNN (April 2026): https://www.cnn.com/2026/04/24/health/fda-psychedelic-drugs-priority-vouchers What Psychedelics Reveal About the Human Capacity for Healing — Myriam Barthes, Journey Clinical (May 2026) Note: written by guest, published on guest's organization website: https://www.journeyclinical.com/resources/what-psychedelics-reveal-about-the-human-capacity-for-healing Considerations for Potential Future Therapeutic Use of Psychedelic Drugs — FDA/Federal Register (July 2026): https://www.federalregister.gov/documents/2026/07/14/2026-14155/considerations-for-potential-future-therapeutic-use-of-psychedelic-drugs-public-hearing-request-for Psychedelic Drugs and Mental Health — CNBC (July 2026): https://www.cnbc.com/2026/07/19/psychedelic-drugs-mental-health.html Connect with Myriam Barthes: Journey Clinical: https://www.journeyclinical.com Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

This week we are revisiting a conversation Rachel recorded on the original Mental Health Entrepreneur podcast with Will Ratliff, co-founder of Transcend Health Solutions, one of the world's leading IV ketamine-assisted psychotherapy practices. If last week's conversation with Myriam Barthes focused on the business and access side of psychedelic-assisted therapy, this one goes deeper into the clinical and medical side — what the treatment actually looks like, how it works, and why Will built his practice the way he did. Will's path to ketamine therapy is unlike most. He started as an EMT at 18, became a paramedic by 21, and spent his twenties in ambulances, emergency rooms, critical care units, and eventually helicopters as a flight nurse and paramedic. His early expertise in ketamine was entirely medical — pain management, intubation facilitation, emergency care. The mental health application came later, driven by his own experience developing significant PTSD symptoms early in his career and finding himself in a treatment-resistant position after years of trying traditional approaches. When Will started looking at ketamine clinics as a place to do clinical work, what he found troubled him. The way the industry was operating — the lack of psychotherapeutic support, the purely medical model, the absence of ethical grounding — wasn't how he would do it. So he built his own practice from scratch on an extremely small budget, starting with auction furniture and a scrappy commitment to doing it right. The conversation covers how IV ketamine works differently from other delivery methods, why the psychotherapeutic support around the medicine matters as much as the medicine itself, the challenges of getting the medical community to take ketamine therapy seriously, and the business realities of building in a novel market. Will also shares his perspective on what it takes to pursue something that hasn't been done before — and why getting punched in the chin repeatedly is just part of the deal. Note: This episode was originally recorded for The Mental Health Entrepreneur podcast and is being shared here because of its relevance to our ongoing conversations about psychedelic-assisted therapy. We think it pairs well with our recent conversation with Myriam Barthes of Journey Clinical. Connect with Will Ratliff: Transcend Health Solutions: https://www.transcendketamine.com Transcend Ketamine Podcast LinkedIn: https://www.linkedin.com/in/will-ratliff Instagram: @transcendkap Email: [email protected] Phone: 833-313-2512 Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

This week Rachel steps away from the interview format to do something she has been wanting to do for a while — take stock of everything the podcast has surfaced over the last year and pull it into a single, honest conversation about what is actually happening in mental health right now, and what clinicians and practice owners can do about it. The landscape has shifted dramatically. Federal funding for mental health programs is being cut. SAMHSA has faced consolidation proposals. The 988 crisis line has seen reduced funding. School mental health grants have been halted. Insurance companies are finding loopholes in parity law, and federal agencies have signaled they will not enforce the rules designed to close them. AI is moving faster than regulation. And in the middle of all of it, clinicians who went to school to do therapy are trying to keep their practices afloat while the rules of the game change around them. Rachel draws on conversations from across the podcast's history — with health policy attorneys, state delegates, insurance experts, advocacy leaders, and community organizers — to map out what is driving these changes and what the real levers for change actually are. The episode closes with five concrete action steps that any clinician can take this week, whether they have an hour or five minutes, to be part of shaping what the mental health system becomes next. As Sue Abderholden, retired Executive Director of NAMI Minnesota, put it in Episode 23: the mental health system isn't broken. It's still being built. This episode is about showing up to build it. Episodes Referenced: Ep 2 — Real Change: https://pod.link/1724750091/episode/YjMzODkxYmEtYWZkMi00MWJiLTkxMzgtMWMxYTlmZjJkY2Ri Ep 4 — When AI Meets Therapy: Risks, Ethics, and Advocacy with Dr. Ajita Robinson: https://pod.link/1724750091/episode/ZjljYzJlOTEtZDIxZS00NjRhLTkyNzMtOWJhZGVjMTk4Nzcw Ep 7 — Policy Shifts Reshaping Mental Health Care with Cathy Gilbert: https://pod.link/1724750091/episode/ODYxOTRhMjYtNTg4NS00YjNiLTk3ZTQtYWJlZjZhMDY1Zjcy Ep 9 — Understanding Mental Health Parity with Deborah Steinberg: https://pod.link/1724750091/episode/OWQ5YmYzMzMtZmQ5ZS00ZjUyLWFkMDEtZmFiZDdlNmVmNzZh Ep 23 — Building a Mental Health System That Works with Sue Abderholden: https://pod.link/1724750091/episode/OGE2YWJmM2ItY2JkZS00ZTE3LTliZTUtMWI1NDBiMTg0ZjZl Ep 28 — Community Health, Local Solutions with Malcolm Furgol: https://pod.link/1724750091/episode/NzM4ZWNkN2UtZjI1Zi00ZWQ0LTliYTQtZDI0Nzc0ODc2MmZj Ep 40 — When States Step Up for Safety with Delegate Lily Qi: https://pod.link/1724750091/episode/ZGNiYjdiM2MtODY5Yy00YTQzLTlhOTUtNGMzYjE4ZTM1ZmZj Ep 41 — The Coverage Gap Is a Policy Problem with Cara Cheevers: https://pod.link/1724750091/episode/ZDk5N2RmZmYtNDYyYi00ZmVlLTkwYzYtNmIwOWYyZGZkNTc5 Resources Mentioned: Inseparable Workforce Report: https://www.inseparable.us Kennedy Forum Mental Health Parity Index: https://www.thekennedyforum.org Mental Health Insurance Reform Task Force: https://insurancereformtaskforce.org Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Rachel speaks with Nicole Sartini, a licensed clinician, group practice owner, and founder of Build Better Health — a nonprofit think tank that is building the kind of collective provider power that this field has been missing. Nicole came to advocacy the way most providers do: through her own practice. In 2024, after ten years of building Bridge Counseling and Wellness into a 60-provider group practice in Louisville, Kentucky, she watched insurance carve-outs and contract repairing cut her practice's income by 30 percent for the same number of sessions. She started organizing locally — monthly meetings, surveys, conversations with the Kentucky Department of Insurance — and discovered something that stopped her in her tracks: the laws protecting providers from exactly this kind of harm already existed. They just had no teeth to enforce them. What started as a small Kentucky organizing effort has grown into a 50-state coalition with 4,000 providers directly participating. The Mental Health Insurance Reform Task Force is now structured around state-specific pages, state leads, and three national committees — Education, Innovation, and Legal and Legislative — with a team of attorneys tracking litigation opportunities and model legislation based on successful wins in states like Illinois, where HB1085 connected the reimbursement floor to the Medicare rate and raised commercial insurance rates for providers by approximately 30 percent. The conversation covers the two pillars of the Task Force's work: enforcing parity law, and protecting provider independence as insurers and behavioral health platforms consolidate. Nicole walks Rachel through what vertical consolidation actually looks like on the ground — providers being required to credential through third-party platforms to access major insurers, charts being pulled when providers leave, and data concerns that have no adequate legal framework yet. She also shares the Progressive Advocacy Ladder, a step-by-step framework that tells providers and state leads exactly where their state stands and what the next achievable step looks like. And she closes with an invitation: the Task Force meets the second Wednesday of every month at 11am Eastern — and everyone is welcome. Resources Mentioned Articles Referenced: Trump Administration Puts Its Stamp on Mental Health Parity — Mercer (2026): https://www.mercer.com/en-us/insights/us-health-news/trump-administration-puts-its-stamp-on-mental-health-parity/ What Plan Sponsors Need to Know: 2025 Mental Health Parity Report to Congress — Sequoia (May 2026): https://www.sequoia.com/2026/05/mental-health-parity-2025-report/ Behavioral Healthcare Services Market Update — Capstone Partners (March 2026): https://www.capstonepartners.com/insights/article-behavioral-healthcare-services-market-update/ Progressive Advocacy Ladder and National Strategy — Mental Health Insurance Reform Task Force: https://insurancereformtaskforce.org Connect with Nicole Sartini: Mental Health Insurance Reform Task Force: https://insurancereformtaskforce.org Build Better Health: https://buildbetterhealth.org Monthly meetings: Second Wednesday of every month, 11am EDT / 8am PDT Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Rachel speaks with Joanne Frederick, founder and CEO of Government Market Strategies, about something most clinicians never see but feel every single day — the procurement decisions, ownership structures, and administrative design choices that determine who gets credentialed, who gets paid, and who gets left out. Joanne has spent more than 30 years on the inside of the largest government healthcare programs in the country — Medicare, Medicaid, TRICARE, and Veterans Health — helping clients win contracts in excess of 25 billion dollars and watching the same patterns play out across every system she has worked in. Her perspective on the CAQH rebrand to DataSpring is not that of a worried clinician. It is that of someone who has seen this move before and knows exactly what it means when the entity governing a shared infrastructure becomes owned by the people who benefit most from controlling it. The conversation covers the structural conflict of interest created by insurer ownership of the credentialing backbone, why credentialing delays are a revenue problem and a patient access problem as much as an administrative one, and what it would actually take to fix a system that Joanne argues was never designed to serve everyone equitably. She walks Rachel through the TRICARE reforms happening in 2026 and what they reveal about how large government healthcare programs modernize — and don't. And she ends with a call to action that is both practical and urgent: find the people with the courage to say this doesn't make sense anymore, and support them, because they are going to need all the help they can get. This episode also includes a brief ad read for the Foundations of Trauma Therapy course at the Trauma Specialist Training Institute — an eight-week live remote training starting October 20th. Early bird pricing is available through October 6th. Group rates for teams of five or more are available by emailing [email protected] and mentioning the podcast. Featured Training Foundations of Trauma Therapy — Trauma Specialist Training Institute https://www.traumaspecialiststraining.com/trainings/foundations-trauma-therapy Resources Mentioned Articles Referenced: CAQH Rebrands as DataSpring: Under Payer Ownership — Acuity News: https://acuity.news/regulation/caqh-rebrands-dataspring-payer-ownership-credentialing-2026/ 5 Trends Shaping Payer Enrollment and Medical Credentialing in 2026 — Medallion: https://medallion.co/resources/blog/5-trends-shaping-payer-enrollment-and-medical-credentialing-in-2026 These Changes to TRICARE Plans Are Taking Place in 2026 — Military.com: https://www.military.com/benefits/tricare/these-changes-tricare-plans-are-taking-place-2026.html 5 Things We Need To Do To Improve The US Healthcare System — Joanne Frederick, Authority Magazine: https://medium.com/authority-magazine/joanne-frederick-of-government-market-strategies-5-things-we-need-to-do-to-improve-the-us-0dc5ca52aa7a Connect with Joanne Frederick: Government Market Strategies: https://marketstrategiesonline.com Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Rachel speaks with Marcus Schmit, Executive Director of NAMI Minnesota, about what is actually happening on the ground as federal Medicaid funding cuts ripple through the mental health system — and why, despite everything, pessimism is not a strategy. NAMI Minnesota has been a statewide leader in mental health advocacy, education, and peer support for decades. Marcus stepped into the Executive Director role as his state was navigating an extraordinary convergence of collective trauma — the pandemic, the murder of George Floyd, a school shooting, the assassination of a state legislator, and the sweeping immigration enforcement of Operation Metro Surge. The result was a 4,000 percent increase in NAMI Minnesota's social media engagement and helpline calls through the roof. What that moment revealed about the need for mental health information and community connection is now reshaping how NAMI Minnesota thinks about its work. The conversation also digs into the policy crisis facing community mental health providers. The federal Medicaid funding freeze that stopped payments in their tracks is not a future threat — it is already affecting providers across Minnesota and the country. Marcus walks Rachel through what that means for the clinicians, crisis services, and peer support programs that depend on Medicaid reimbursement, and why peer support in particular — one of the most cost-effective tools in mental health care — is often the first thing cut when budgets tighten. He also shares what he believes the path forward looks like: a community-wide response to collective need, with employers, funders, sports teams, and neighbors stepping up together. Resources Mentioned Articles Referenced: Mental Health Providers Say Federal Medicaid Halt Will Lead to More Crisis — MPR News (February 2026): https://www.mprnews.org/episode/2026/02/26/mental-health-provider-federal-medicaid-halt-will-lead-to-more-crisis Medicaid Cuts Threaten Hundreds of Hospitals, New Report Finds — NBC News: https://www.nbcnews.com/health/health-news/medicaid-cuts-threaten-hundreds-hospitals-new-report-finds-rcna265789 State Budget Fallout: Trump Health Funding Cuts — KFF Health News: https://kffhealthnews.org/news/article/state-budget-fallout-trump-health-funding-cuts-obbba/ Medicaid and Social Services Under Pressure — KFF Health News: https://kffhealthnews.org/medicaid/medicaid-social-services-gavin-newsom-california-republican-criticism/ Connect with Marcus Schmit: NAMI Minnesota: https://namimn.org Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

This week's episode is something a little different. Recorded live at the 10-year anniversary celebration of Trauma Specialists of Maryland, this episode turns the tables on Rachel — instead of hosting, she is interviewed by two of her longtime friends and supporters from the Frederick community, Tom Lynch and Karlys Kline.   Tom Lynch spent more than 45 years practicing law in Maryland, most recently with Miles and Stockbridge in Frederick, and has served as chair of the Community Foundation, Frederick Community College, and the Frederick Chamber of Commerce. By his own account, his most important role is supporting the work of his wife, Karlys. Karlys Kline is a community leader and philanthropist who founded the Women's Giving Circle and has served on the boards of more than 42 local nonprofits and businesses. Together they bring a community perspective to a conversation about what it means to build something meaningful in mental health care over ten years.   The conversation covers how Trauma Specialists of Maryland grew from a single practice to seven locations, what Rachel has learned about building a team of clinicians who are genuinely committed to trauma work, and what the next chapter looks like. Tom also shares something personal about his own experience as a patient at Trauma Specialists — a candid and moving reflection on what seeking help looked like for him and what it made possible. It is one of the most powerful moments we have recorded on the podcast.   Foundations of Trauma Therapy — Trauma Specialist Training Institute: Course starts: October 20, 2026 Format: Eight-week live remote training on Zoom Early bird pricing through: October 6, 2026 Group rates for teams of five or more: [email protected] More information: https://www.traumaspecialiststraining.com/trainings/foundations-trauma-therapy   Connect with Trauma Specialists of Maryland: Website: https://www.traumaspecialiststraining.com   Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution   Music by Zach Harrison

Rachel speaks with Sara Bradley, Executive Director of York Day Early Learning in York, Pennsylvania, about a problem most people in the mental health field have never thought about — and that affects millions of the patients they see every day. The American child care system was built around a standard workday. For the nearly 20 percent of workers who work nonstandard hours — overnight shift workers, first responders, healthcare workers, contract workers, and others — that system simply does not work. York Day is one of the very few organizations in the country trying to change that. Founded more than 90 years ago, York Day has spent the last six months piloting a 24-hour early learning program that meets families where they actually are rather than where the system assumed they would be. Sara walks Rachel through what building that program has actually looked like — the surveys, the pivots, the assumptions that turned out to be wrong, and the ones that turned out to be right. What started as an attempt to run a clean second shift became a fully fluid 24-hour model because the community did not need a program with a clean start and stop — it needed one that could absorb the reality of shift work schedules. York Day is now 18 months into a pilot designed to produce a replicable blueprint that other organizations across the country can use. The conversation also covers the behavioral health dimensions of child care access — the chronic stress, anxiety, and depression that parents experience when reliable care is unavailable, the six million children in the United States living with a parent with co-occurring substance use disorder and mental illness, and why for families in recovery, child care is not a peripheral issue but often a direct factor in whether a parent can sustain sobriety. For clinicians, the message is direct: the parents sitting across from you in your office are being shaped by forces that start well before they walk through your door. Resources Mentioned Articles Referenced: When Work Isn't 9-to-5, Child Care Can't Be Either — The 74 Million: https://www.the74million.org/zero2eight/when-work-isnt-9-to-5-child-care-cant-be-either/ How Inaccessible Child Care Affects Families and Early Childhood Educators — University of Michigan School of Public Health: https://sph.umich.edu/pursuit/2025posts/how-inaccessible-childcare-affects-families-and-early-childhood-educators.html U.S. Children Living with a Parent with Substance Use Disorder — JAMA Pediatrics (2025): https://jamanetwork.com/journals/jamapediatrics/fullarticle/2833575 Connect with Sara Bradley: York Day Early Learning: https://www.yorkday.org Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Rachel speaks with Shana Palmieri, Chief Clinical Officer and co-founder of XFERALL (pronounced Transfer-all) , a real-time patient transfer and care coordination platform that is replacing one of the most broken processes in behavioral health — the psychiatric placement referral.   Shana spent years as the Director of Behavioral Health Services at George Washington University Hospital in Washington, D.C., where she watched something that would change the direction of her career. Patients in psychiatric crisis sitting in overwhelmed emergency departments for hours, sometimes days, while her team of highly trained clinical social workers spent the majority of their time making phone calls and sending faxes trying to find them a placement. She co-founded XFERALL to solve that problem directly.   The platform works by replacing the fragmented, paper-based referral process with a real-time digital system. A clinician enters basic patient information, the platform geolocates available, clinically matched facilities across the continuum of care, and within seconds the clinician knows which facilities have a bed and can accept the patient. XFERALL's median response time across the platform is 15 seconds. One county in California cut its average psychiatric wait time from more than two hours to 17 minutes. The national average for psychiatric placement is seven to eight hours or more.   The conversation also goes deep on AI — specifically where Shana believes it belongs in behavioral health and where it does not. She draws a clear line between using AI as an operational tool to reduce administrative burden, surface critical clinical information, and connect a fragmented system, versus using it to make clinical decisions or predict risk in ways that could strip patients of their rights. Her framework is one of the clearest articulations of responsible AI use in behavioral health we have heard on this show.   Resources Mentioned:   Articles Referenced: Children in a Mental Health Crisis Can Spend Days in the ER Waiting for Treatment — NPR (August 2025): https://www.npr.org/sections/shots-health-news/2025/08/15/nx-s1-5502689/pediatric-mental-health-er-boarding-jama-health-forum AI in the Mental Health Care Workforce Is Met with Fear, Pushback, and Enthusiasm — NPR (April 2026): https://www.npr.org/2026/04/07/nx-s1-5771707/mental-health-care-workforce-artificial-intelligence-ai XFERALL Expands Real-Time Patient Transfer Platform in Southern California — PR Newswire (February 2026): https://www.prnewswire.com/news-releases/xferall-officially-expands-real-time-patient-transfer-platform-in-southern-california-after-already-seeing-success-in-the-state-302689675.html   Connect with Shana Palmieri: XFERALL: https://www.xferall.com   Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution   Music by Zach Harrison

Rachel speaks with Stephanie Slowly Little, Executive Director of NAMI Maryland, about the state of mental health care access in Maryland, the funding landscape facing nonprofit behavioral health organizations, and what it actually takes to keep showing up for communities when every turn is making it harder.   NAMI Maryland represents over 60,000 advocates, people living with mental illness, and supporters across the state. Stephanie, a licensed clinical social worker and public health executive with more than 17 years of experience, stepped into the Executive Director role in October 2025 and immediately began navigating one of the most challenging funding and policy environments the behavioral health sector has seen in years. The conversation covers the urban and rural access divide in Maryland, why different reports tell different stories about how well the state is meeting mental health needs, and what telehealth can and cannot solve for communities where geography and provider shortages compound each other.   The most striking part of the conversation is Stephanie's candid assessment of the funding landscape. Everybody is talking about mental health, she says, but nobody is funding it. Every facet of grant and fundraising is challenging right now — philanthropic, foundational, state, and federal. NAMI provides free programs to every person it serves, and yet the organization, like every affiliate across the country, is struggling. She also flags a federal Office of Management and Budget proposal that could give the federal government unilateral discretion to cancel nonprofit grants — a development every behavioral health organization needs to be watching. Despite all of it, Stephanie's message is clear: it is not in times of feast that we do our greatest work.   Resources Mentioned:   Articles Referenced: Mental Healthcare Gaps Persist in MD Rural, Urban Areas — NAMI Metro Baltimore: https://namibaltimore.org/mental-healthcare-gaps-persist-in-md-rural-urban-areas/ The Workforce Report: Bridging the Mental Health Care Gap — Maryland State Snapshot — Inseparable (March 2026): https://www.inseparable.us/wp-content/uploads/dlm_uploads/2026/03/Inseparable-2026WFDevReport-MD-1.pdf Barriers to Health Care for Rural Americans — Rural Minds: https://www.ruralminds.org/rural-minds-in-the-news/barriers-to-health-care-for-rural-americans Community Resources and Hazards Across the Rural-Urban Continuum — JAMA Network Open (April 2026): https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847289   Additional Resource: OMB Proposed Changes to the Uniform Guidance (Federal Grant Rules) — National Council of Nonprofits: https://www.councilofnonprofits.org/trends-and-policy-issues/omb-uniform-guidance   Connect with Stephanie Slowly Little: NAMI Maryland: https://namimd.org   Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Rachel speaks with Dr. Nick Jacobson, associate professor of biomedical data science, psychiatry, and computer science at Dartmouth's Geisel School of Medicine and director of the AIM HIGH Laboratory, about the first clinical trial of a fully generative AI therapy chatbot — and what the results actually show. The access crisis in mental health care is the starting point for understanding why Dr. Jacobson's team built Therabot. In the most well-resourced mental health settings in the United States, there are approximately 35 providers per 100,000 people. In any given year, roughly one in three people will experience a mental health disorder. That means 35 people trying to treat 33,000 — and that is the best case scenario. In low-resource settings and rural areas, the numbers are worse. The result is wait lists that stretch for months, people seeking care at 2am with nowhere to turn, and millions of people who simply go without. Therabot was built over six years by a team of more than 100 people, involving over 100,000 hours of human effort, to deliver evidence-based therapy in a clinically rigorous way. The trial, published in NEJM AI, found significant reductions in symptoms of depression, anxiety, and eating disorders — with effect sizes that mirror what you would see in the best evidence-based trials of human-delivered psychotherapy. Participants also formed a genuine therapeutic alliance with the software, a finding that surprised even the research team. Dr. Jacobson walks Rachel through what that means clinically, how Therabot differs from general-purpose AI tools like ChatGPT, and how the team continuously stress-tests the system to identify and eliminate harmful responses before they reach users. The conversation also covers the policy landscape — specifically a New Hampshire bill that Dr. Jacobson testified against, which he argues would regulate the wrong targets entirely. The bill would impose burdensome review requirements on clinically validated AI tools while leaving general-purpose chatbots — which have no crisis protocols, no outcome tracking, and no accountability — completely untouched. He and Rachel discuss what thoughtful AI regulation in mental health should actually look like, and what clinicians and practice owners should be thinking about as these tools become more widely available. Resources Mentioned Articles Referenced: Many People Now Trust AI with Their Feelings, and Therapists Want to Talk About It — WBUR (May 2026): https://www.wbur.org/news/2026/05/07/artificial-intelligence-therapy-mental-health-care Bill Doesn't Protect NH from AI Harm, It Assures It — Union Leader (January 2026): https://www.unionleader.com/opinion/op-eds/nicholas-c-jacobson-michael-v-heinz-bill-doesnt-protect-nh-from-ai-harm-it-assures/article_b2c5bdf4-aca7-413a-a218-35e6a09de06f.html First Therapy Chatbot Trial Yields Mental Health Benefits — Dartmouth News (March 2025): https://home.dartmouth.edu/news/2025/03/first-therapy-chatbot-trial-yields-mental-health-benefits Connect with Dr. Nick Jacobson / Additional Resources: This Therapist Helped Clients Feel Better. It Was A.I. — New York Times (syndicated): https://onehealthsociety.com/this-therapist-helped-clients-feel-better-it-was-a-i/ How to Build a Therapeutic Chatbot — Psychiatric News: https://psychiatryonline.org/doi/10.1176/appi.pn.2025.09.9.23 AI, Neuroscience, and Data Are Fueling Personalized Mental Health Care — APA Monitor on Psychology: https://www.apa.org/monitor/2026/01-02/trends-personalized-mental-health-care Can 'AI Therapists' Help Save LGBTQ+ People? — Out Magazine: https://www.out.com/health/ai-therapy-for-queer-people AIM High Laboratory at Dartmouth: https://www.nicholasjacobson.com Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Rachel speaks with Dr. Shairi Turner, Chief Health Officer at Crisis Text Line, a nonprofit that provides free, 24/7 text-based mental health support and crisis intervention through a community of trained volunteer counselors. In 2025, Crisis Text Line had more conversations than any year since its founding — over 1.5 million — and the data from those conversations tells a story that every clinician and practice owner needs to hear.   Dr. Turner walks Rachel through how Crisis Text Line actually works: what happens from the moment someone texts HOME to 741741, how volunteer counselors are trained and supervised, and how the organization handles the rare cases — just one percent — where a conversation cannot be de-escalated. She also shares the founding story of Crisis Text Line, born from a moment when a young person reached out for help through a volunteer platform with nowhere else to turn. The conversation covers what the 2025 data reveals about who is reaching out — rural communities, young people, and boys under 14 reporting suicidal thoughts at striking rates — and ends with a direct call to action for clinicians: ask young men and boys how they are doing, and ask clearly.   If you or someone you know needs support, text HOME to 741741 to connect with a live volunteer Crisis Counselor.   Resources Mentioned:   Articles Referenced: 988 Mental Health Help Lifeline Helps Five Million in First Year — NPR (July 2023): https://www.npr.org/sections/health-shots/2023/07/15/1187862144/988-mental-health-crisis-line-gets-5-million-calls-texts-and-chats-in-first-year Why Depression Goes Undetected in Teen Boys — NBC News (June 2024): https://www.nbcnews.com/health/health-news/depression-anxiety-teen-boys-diagnosis-undetected-rcna141649 Annual Trends 2025 — Crisis Text Line: https://www.crisistextline.org/annual-trends/ Additional resource - Crisis Text line Terms and Conditions: https://www.crisistextline.org/terms-of-service/   Connect with Dr. Shairi Turner: Crisis Text Line: https://www.crisistextline.org Text HOME to 741741   Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution   Music by Zach Harrison

Rachel speaks with Dr. Elizabeth Carr, a clinical psychologist and the founder and CEO of Kentlands Psychotherapy in Gaithersburg, Maryland. Elizabeth leads a team of 20 doctoral and master's-level clinicians and has spent over two decades building a community-focused, financially sustainable practice through some of the most disruptive periods in the history of mental health care. A former Navy psychologist and sought-after speaker on practice management, she recently published a piece on strategic positioning during industry upheaval that is the centerpiece of this conversation. The mental health practice landscape is shifting in ways that are affecting practices at every size — but not all in the same direction. Elizabeth describes what she calls the barbell effect: solo practitioners, particularly those operating fully virtual, are being squeezed out by venture capital-backed platforms with enormous marketing budgets and SEO dominance, while large practices that over-expanded during the COVID telehealth boom are now sitting on overhead they cannot fill. Mid-sized, community-rooted practices that stayed nimble are finding themselves in a stronger position — but only if their leaders are paying attention to what's actually happening in the market and willing to respond. Elizabeth and Rachel dig into what that looks like in practice: how to read referral data, when to pivot your service offerings, what AI can and cannot replace in clinical work, and why hyperlocal, in-person, relationship-based care may be the most durable competitive advantage a practice owner has right now. Resources Mentioned Articles Referenced: A Workforce Under Pressure: Preparing the Behavioral Health Workforce for Today and Tomorrow — National Council for Mental Wellbeing (2025): https://www.thenationalcouncil.org/behavioral-health-workforce-under-pressure-preparing-today-tomorrow/ Telehealth and Hybrid Practice Are Here to Stay — APA Monitor on Psychology (2024): https://www.apa.org/monitor/2024/09/telehealth-hybrid-practice Strategic Positioning During Industry Upheaval — Dr. Elizabeth Carr, Kentlands Psychotherapy (January 2026): https://www.kentlandspsychotherapy.com/mental-health-professional/strategic-positioning-during-industry-upheaval/ Connect with Dr. Elizabeth Carr: Kentlands Psychotherapy: https://www.kentlandspsychotherapy.com Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Rachel speaks with Matthew Bergman, founding attorney of the Social Media Victims Law Center, about the landmark KGM verdict — the first social media addiction case in the United States to reach a jury. In March 2026, a Los Angeles jury found Meta and YouTube negligent in the design of their platforms and awarded $6 million in damages to a young woman whose mental health was seriously harmed by her use of Instagram and YouTube beginning at age six. Matthew has spent four years building the legal case that made this moment possible, and the theory at its center is straightforward: this was never about content. It was about a product engineered to be addictive — one that shows kids not what they want to see, but what they cannot look away from.   The conversation covers Section 230 and how the product liability approach found a path around it, the eggshell plaintiff doctrine and why blaming the victim failed in court, and what the verdict actually changes for the thousands of similar cases still working through the courts. Matthew also speaks directly to clinicians: ask about social media. When you see anxiety, depression, eating disorders, or suicidality in young patients, social media needs to be part of the assessment. The youth mental health crisis started in 2012 — when content began being fed to kids algorithmically — and the research establishing a causal relationship has only grown stronger since.   Resources Mentioned:   Articles Referenced: Research Points to How Companies Could Make Social Media Less Addictive for Teens — NPR (March 2026): https://www.npr.org/2026/03/27/nx-s1-5763017/social-media-teens-addictive-design Jury Finds Meta and YouTube Negligent in Landmark Lawsuit on Social Media Safety — NBC News (March 2026): https://www.nbcnews.com/tech/tech-news/verdict-reached-landmark-social-media-addiction-trial-rcna263421 Social Media Addiction Lawsuit Update — Social Media Victims Law Center: https://socialmediavictims.org/social-media-lawsuits/   Connect with Matthew Bergman: Social Media Victims Law Center: https://socialmediavictims.org   Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution   Music by Zach Harrison

In this solo episode, Rachel Harrison takes a break from her usual guest conversations to address something that has been generating a lot of discussion in the mental health community this week: the rebranding of CAQH as DataSpring. If you have been in mental health practice for any amount of time, you know CAQH. It is the credentialing portal most clinicians and practice owners have relied on for years to maintain licensing, training history, liability insurance, and practice information for insurance credentialing — a system designed so that providers enter their data once and it flows out to multiple payers rather than filling out the same paperwork over and over again for each insurance company. But CAQH is no longer the nonprofit utility it once was. In January 2026, the organization converted from a nonprofit and became owned by a consortium of 12 of the nation's largest health plans, including UnitedHealth Group, Cigna, Aetna, Humana, Centene, Elevance Health, and several Blue Cross Blue Shield plans. And this past week, the organization rebranded as DataSpring, powered by CAQH — a change timed to coincide with the AHIP 2026 conference, a major gathering for health insurance executives. Rachel walks through what the rebrand actually means, why the ownership shift matters, and what questions every clinician and practice owner should be asking right now. She covers the concerns being raised in the field — including whether payers will use this platform in ways that benefit their own administrative processes at the expense of providers, whether incomplete data could be used to slow credentialing or delay directory listings, and what oversight exists when the governing board is made up of representatives from the very insurers pulling the data. She is also clear about what we do not yet know: this is a developing situation, independent reporting has not fully caught up, and there is no confirmed evidence yet that providers are being harmed. But the structural shift is significant, and Rachel makes the case that awareness matters even when we do not have all the answers. Resources Mentioned CAQH Rebrands as DataSpring to Power the Next Era of Healthcare Data — Globe Newswire: https://finance.yahoo.com/sectors/healthcare/articles/caqh-rebrands-dataspring-power-next-110700451.html Leading Health Plans Become CAQH Owners to Shape the Future of Healthcare Data — Becker's Payer Issues: https://www.beckerspayer.com/m-and-a/major-insurers-take-ownership-of-former-nonprofit-healthcare-data-organization/ Insurer-Owned CAQH Rebrands to DataSpring — Becker's Payer Issues: https://www.beckerspayer.com/leadership/insurer-owned-caqh-rebrands-to-dataspring/ When Payers Own the Data: What CAQH's New Structure Means for Provider Revenue and Credentialing — Ventra Health (private company blog; read with that context in mind): https://ventrahealth.com/blog/when-payers-own-the-data-what-caqhs-new-structure-means-for-provider-revenue-credentialing/ Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Rachel Harrison speaks with Dr. Nick Shumate, a psychiatrist at the Division of Digital Psychiatry at Beth Israel Deaconess Medical Center and Harvard Medical School, whose background is as rare as it is relevant: before medicine, he was a regulatory attorney practicing before the Federal Energy Regulatory Commission. That combination of clinical training and legal expertise is exactly what drove him to lead a sweeping 50-state review of how the United States is governing artificial intelligence in mental health — research that produced findings every clinician and practice owner needs to understand.   The conversation covers what that legislative review actually found: 793 state bills reviewed, 143 with direct or indirect implications for AI in mental health, and just 20 enacted into law across 11 states. Dr. Shumate walks through the four major categories of governance that emerged from the research, explains why the near-total absence of clinicians from the policy-making process is one of the study's most striking findings, and makes the case that the rules being written right now will shape the conditions under which mental health care is delivered for years to come. He and Rachel also dig into the practical questions clinicians face today: what disclosure and informed consent look like when AI is part of the care equation, and why eighty percent of high-acuity patients using AI for mental health support have not told their providers about it.   Resources Mentioned:   Articles Referenced: AI Chatbots Systematically Violate Mental Health Ethics Standards — Brown University (October 2025): https://www.brown.edu/news/2025-10-21/ai-mental-health-ethics Pennsylvania Sues Character AI over Chatbot Allegedly Posing as a Doctor — NPR (May 2026): https://www.npr.org/2026/05/05/nx-s1-5812861/characterai-chatbot-medical-advice-pennsylvania-lawsuit Governing AI in Mental Health: 50-State Legislative Review — Dr. Nick Shumate et al., JMIR Mental Health: https://mental.jmir.org/2025/1/e80739   Connect with Dr. Nick Shumate: Division of Digital Psychiatry, Beth Israel Deaconess Medical Center / Harvard Medical School   Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

Rachel Harrison speaks with Cara Cheevers, Vice President of Coverage Policy at Inseparable, a national mental health advocacy organization working to win better mental health care for everyone in this country. Cara brings more than fifteen years of experience in health equity advocacy, including leading Mental Health Parity and Addiction Equity Act enforcement at the Colorado Division of Insurance. In this conversation, Cara and Rachel dig into something that sits at the heart of the mental health access crisis: the workforce shortage is not simply a supply problem — it is a policy problem. From reimbursement rates that push providers out of insurance networks, to administrative burdens that make accepting insurance feel impossible, to a system that asks clinicians to do more with less, the barriers are structural. And that means the solutions are too.   Cara walks through what the data actually shows about workforce shortages, what states like Illinois and Washington are doing right now to move the needle through reimbursement rate mandates and pre-licensure reimbursement requirements, and what both patients and providers can do today to be part of the solution. She also breaks down mental health parity law, explains how patients can file complaints with their state Division of Insurance when they cannot access in-network care, and makes the case that filing those complaints is not just self-advocacy — it is how systemic problems get documented and fixed.   Resources Mentioned:   Articles Referenced: State of the Behavioral Health Workforce, 2025 — HRSA: https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/Behavioral-Health-Workforce-Brief-2025.pdf State Policies Can Help Address the Mental Health Care Workforce Shortages — Pew Charitable Trusts: https://www.pew.org/en/research-and-analysis/articles/2026/04/16/state-policies-can-help-address-the-mental-health-care-workforce-shortages Workforce Report — Inseparable: https://www.inseparable.us/workforce/   Connect with Cara Cheevers: Website: https://www.inseparable.us LinkedIn: https://www.linkedin.com/in/cara-cheevers Instagram: https://www.instagram.com/iaminseparable/   Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

In this episode, Rachel Harrison speaks with Maryland State Delegate Lily Qi, who represents District 15 in Montgomery County and has served in the Maryland General Assembly since 2019. Delegate Qi sits on the Economic Matters Committee, where her work focuses on consumer protection, business regulation, and positioning Maryland for the industries of the future. This conversation centers on Maryland House Bill 883, legislation she championed to require basic disclosure when consumers interact with AI systems in behavioral health contexts, and what it means that the bill passed the House with overwhelming bipartisan support before stalling in the Senate. Delegate Qi brings both urgency and pragmatism to the conversation, grounding the policy debate in a stark reality: there is currently nothing in Maryland law preventing a chatbot from manipulating a vulnerable person toward self-harm.   The second half of the conversation widens the lens to explore how states are increasingly stepping into the AI regulation space in the absence of consistent federal standards, and what mental health professionals and advocates can do right now to move this work forward. Delegate Qi offers a clear-eyed roadmap for effective advocacy, from building coalitions across consumer groups, tech communities, and behavioral health professionals, to reaching legislators early and consistently rather than showing up only at hearings. She closes with a direct call to action for mental health professionals: reach out to your legislators, share your expertise, and show up in Annapolis when the next session begins.   RESOURCES MENTIONED   Articles Referenced:   Maryland House Bill 883 - AI in Behavioral Health Contexts: https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/hb0883?ys=2026rs   State Mental Health Investments - National Governors Association: https://www.nga.org/news/commentary/state-mental-health-investments/   Tennessee Bans AI Therapy Bots as Chatbot Safety Laws Surge - AI2: https://ai2.work/blog/tennessee-bans-ai-therapy-bots-as-chatbot-safety-laws-surge   Connect with Delegate Lily Qi:   Website: https://www.lilyqi.com/ Email: [email protected] Instagram: https://www.instagram.com/lilyqimaryland/ LinkedIn: https://www.linkedin.com/in/lily-qi-604a9018/ Facebook: https://www.facebook.com/lilyqimaryland   Connect with The Mental Health Evolution:   Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution   Music Credit: Music by Zach Harrison

Rachel speaks with Dr. Linda Michaels, PsyD, MBA, a psychologist in private practice in Chicago and co-founder of the Psychotherapy Action Network (PsiAN). Founded in 2017, PsiAN was built to provide a unified voice for psychotherapists across all disciplines and theoretical orientations, advocating for access to quality care and pushing back against the forces reshaping the field. Dr. Michaels brings a rare combination of clinical training and a prior career in business, marketing, and organizational consulting, and that background is evident in how she analyzes the systems bearing down on the profession. The conversation opens with the origins of PsiAN, the research they have conducted with both the public and therapists, and why the organization has made it a priority to cut across the silos that limit collective professional power. The second half of the conversation takes a direct look at practice management companies and what therapists need to know before working with them. Dr. Michaels walks through PsiAN's research with nearly 700 therapists, revealing that despite promises of higher earnings, half reported making the same or less. She details the near-total insurance company ownership of these platforms, the data privacy concerns including a class action suit against Headway for sharing patient data with Google, and the growing use of therapy session transcripts to train proprietary AI language models. Dr. Michaels closes with a clear message for therapists: every business decision is ultimately a clinical one, and the profession's greatest asset in the face of corporate consolidation is knowledge, standards, and solidarity. RESOURCES MENTIONED Articles Referenced: They Thought They Were Doing Good, But It Made People Worse: Why Mental Health Apps Are Under Scrutiny — The Guardian: https://www.theguardian.com/society/2024/feb/04/they-thought-they-were-doing-good-but-it-made-people-worse-why-mental-health-apps-are-under-scrutiny Chatbots and AI Therapy Are Filling Gaps in Mental Health Care, but Regulation is Lagging — Washington Post: https://www.washingtonpost.com/health/2026/04/19/chatbot-therapy-mental-health-regulations/ Practice Management Companies: What Therapists Need to Know — PsiAN: https://www.psian.org/practice-management-companies Connect with Dr. Linda Michaels and PsiAN: Website: https://www.psian.org/ Instagram: https://www.instagram.com/psianofficial/ LinkedIn: https://www.linkedin.com/company/psian/ Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

In this episode, Rachel Harrison speaks with Naveen Raman, a PhD student at Carnegie Mellon University whose research focuses on sequential decision making and the integration of human feedback into AI systems. Naveen is a developer behind PeerCoPilot, an AI powered assistant being tested in real behavioral health settings to support peer support workers in their day to day sessions. The conversation explores how PeerCoPilot works, from its curated database of vetted local resources to its built in tools for benefits navigation, web search, and structured wellness planning, and why the decision to avoid drawing from the open internet was central to its design.   The second half of the conversation digs into the safeguards built into PeerCoPilot, including what Naveen describes as a Swiss cheese model of defense where no single layer of protection carries the full responsibility for catching errors. Rachel and Naveen explore the question of whether tools like this could eventually be used directly by service users, the practical and ethical complexities that come with that, and the broader vision for expanding PeerCoPilot to other peer organizations, county level resource hubs, and systems like 211. Naveen closes with a clear message for anyone thinking about AI in the mental health space: powerful tools still need to be carefully tailored to their specific context to truly serve the people within them.   RESOURCES MENTIONED   Articles Referenced:   AI Use in Mental Health Help Seeking and Support — PubMed Central: https://pmc.ncbi.nlm.nih.gov/articles/PMC12595529/   Human in the Loop, AI in Healthcare Systems — Frontiers in Psychiatry: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1505024/full   PeerCoPilot: AI Assistant for Behavioral Health Navigation — Carnegie Mellon University: https://www.cs.cmu.edu/news/2026/peer-copilot   Connect with Naveen Raman:   Website: http://naveenraman.com   Connect with The Mental Health Evolution:   Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution   Music Credit: Music by Zach Harrison

EPISODE SUMMARY In this solo episode, Rachel Harrison explores the reality of mental health parity enforcement through the lens of a recent case involving Aetna. She breaks down what mental health parity is intended to achieve under the Mental Health Parity and Addiction Equity Act and why, despite being in place for nearly two decades, the gap between policy and practice remains significant. Using the Pennsylvania fine against Aetna as a case study, Rachel walks through the specific violations uncovered, including claim delays, improper denials, and lack of transparency, and explains how these issues directly impact patients, providers, and access to care. The episode then broadens to examine the larger enforcement landscape, highlighting similar actions across states and the growing importance of state-level oversight as federal enforcement becomes less certain. Rachel also reflects on broader policy conversations happening at the state level, including efforts in places like Maryland to improve transparency and accountability in insurance reimbursement practices. The conversation raises important questions about accountability, the effectiveness of financial penalties, and what meaningful enforcement should look like moving forward. It ultimately offers a grounded, forward-looking perspective for clinicians, practice owners, and mental health leaders navigating insurance systems today. RESOURCES MENTIONED Articles Referenced: Shapiro Administration Protects Consumers, Fines Aetna for Violations of Mental Health Parity Laws — Pennsylvania Insurance Department: https://www.pa.gov/agencies/insurance/newsroom/shapiro-admin-protects-consumers-fines-aetna-violation-mental-health-parity-laws Pennsylvania Insurance Regulators Fine Aetna for Violations of Mental Health Parity Regulations — Philadelphia Inquirer: https://www.inquirer.com/health/aetna-fine-pennsylania-mental-health-parity-20260303.html Health Insurers Pay Penalty for Mental Health Parity Compliance Failures — HIPAA Journal: https://www.hipaajournal.com/health-insurers-penalty-mental-health-parity-compliance/ Departments Announce Non-Enforcement of 2024 Mental Health Parity Rule — APA Services: https://www.apaservices.org/practice/news/nonenforcement-2024-mental-health-parity-rule Related Episode: Mental Health Parity Advocacy and Policy with Deborah Steinberg https://pod.link/1724750091/episode/OWQ5YmYzMzMtZmQ5ZS00ZjUyLWFkMDEtZmFiZDdlNmVmNzZh CONNECT WITH THE MENTAL HEALTH EVOLUTION Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: https://www.instagram.com/thementalhealthevolution/ LinkedIn: https://www.linkedin.com/company/the-mental-health-evolution Facebook: https://www.facebook.com/TheMentalHealthEvolution Music Credit: Music by Zach Harrison

EPISODE SUMMARY In this episode, Rachel is joined by Adrienne Wilkerson, founder and CEO of Beacon Media and Marketing and author of Digital Marketing for Mental Health. Adrienne brings a deeply informed perspective shaped by her experience growing up in a therapy practice and working closely with behavioral health organizations. Together, they explore how the mental health landscape is rapidly evolving as private equity backed organizations, larger systems, and AI driven tools reshape how practices compete for visibility. Adrienne shares what makes marketing in mental health fundamentally different, emphasizing the importance of empathy, ethical responsibility, and true human connection when reaching individuals in vulnerable moments. As the conversation continues, Rachel and Adrienne dig into the growing influence of AI in marketing and the broader mental health space. They unpack both the opportunities and risks, including the rise of AI generated content, the erosion of trust online, and concerning trends such as individuals turning to AI for support. Adrienne highlights the increasing difficulty of tracking marketing effectiveness, the return to less predictable attribution models, and the pressure this places on small practice owners. The episode closes with a forward looking perspective on how clinicians and organizations can adapt by staying grounded in authenticity, maintaining ethical standards, and prioritizing meaningful connection in an increasingly complex digital environment. RESOURCES MENTIONED Articles Referenced: Inside the Consolidation Renaissance Across Digital Behavioral Health — Behavioral Health Business: https://bhbusiness.com/2026/03/25/inside-the-consolidation-renaissance-across-digital-behavioral-health/ How AI Is Changing Online Marketing for Small Businesses — Forbes: https://www.forbes.com/sites/nishacharya/2025/10/14/how-ai-is-changing-online-marketing-for-small-businlesses/ Ethical Principles of Psychologists and Code of Conduct — American Psychological Association: https://www.apa.org/ethics/code/index Connect with Adrienne Wilkerson: Beacon Media and Marketing: https://www.beaconmm.com/ Digital Marketing for Mental Health (Book): https://digitalmarketingbook.beaconmm.com/ Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

🎧 Show Notes – Episode 34 Mental Health Access, Telehealth Policy & the Future of Behavioral Health Care with Andrea Fox In this episode of Mental Health Evolution, host Rachel Harrison speaks with Andrea Fox, Senior Editor at Healthcare IT News, about the evolving landscape of mental health access in the United States. Andrea brings more than two decades of experience covering healthcare technology, public health, and government policy, offering a grounded perspective on how telehealth expansion, regulatory uncertainty, and system-level barriers are shaping behavioral health care delivery today. Together, they explore what has meaningfully improved in access to mental health services since the rise of telehealth, where gaps still exist—particularly in rural and underserved communities—and why policy uncertainty continues to affect both providers and patients. The conversation also dives into the ongoing challenges surrounding telehealth prescribing regulations for controlled substances, the impact of insurance reimbursement structures on access to care, and how emerging efforts to integrate social determinants of health data could reshape behavioral health systems in the future. Finally, Andrea and Rachel discuss broader structural barriers—including provider shortages, cost, fragmented systems of care, and uneven access—and reflect on what a truly integrated, patient-centered mental health system could look like if policy and technology evolve in alignment. 🧠 Key Topics Covered Major shifts in mental health access driven by telehealth Persistent rural and underserved community access gaps Federal policy uncertainty around telehealth prescribing rules Insurance reimbursement and its impact on care delivery Provider shortages and systemic behavioral health barriers Social determinants of health data and care coordination The future of integrated, patient-centered mental health systems 📰 Resources Mentioned https://www.healthcareitnews.com/news/where-telehealth-stands-shutdown-every-day-goes-its-worse https://www.healthcareitnews.com/news/telehealth-prescribers-urge-feds-act-quickly-virtual-rx https://www.healthcareitnews.com/news/stakeholders-ask-new-dea-administrator-resolve-telehealth-prescribing-rules https://www.healthcareitnews.com/news/addressing-behavioral-health-resources-and-costs-ohio 🎙 About the Guest Andrea Fox is Senior Editor at Healthcare IT News. She has spent more than two decades covering healthcare technology, public health, and government policy, with a focus on telehealth, digital health infrastructure, and behavioral health access. Her reporting highlights how policy decisions and technological systems shape real-world access to care, particularly in rural and underserved communities. Recent work: https://www.healthcareitnews.com/news/telepsychiatry-may-still-be-out-reach-low-access-areas https://www.healthcareitnews.com/news/how-rural-mississippi-plans-put-federal-funds-work-addressing-health-it-needs 🔗 Connect with Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: https://www.instagram.com/thementalhealthevolution/ LinkedIn: https://www.linkedin.com/company/the-mental-health-evolution Facebook: https://www.facebook.com/TheMentalHealthEvolution 🎶 Music Credit Music by Zach Harrison 💬 Closing Reflection This episode highlights a central tension in modern mental health care: while telehealth and digital tools have expanded access, structural challenges—including funding, regulation, and system fragmentation—continue to limit equitable care. The future of behavioral health will depend on how effectively policy, technology, and care delivery systems evolve together.

Episode Summary In this solo episode, Rachel takes an honest look at where the 988 Suicide and Crisis Lifeline stands nearly three years after its July 2022 launch. She grounds listeners in how the system is structured, what changed in the transition from the old ten-digit lifeline number, and why that shift mattered more than it might seem. Drawing on recent data, Rachel walks through what is genuinely working, including dramatic growth in contact volume, faster answer times, and rising public awareness, while being equally clear-eyed about where the system is still falling short. Rachel digs into the gaps that data is making harder to ignore: uneven awareness across racial and language groups, wide variation in in-state answer rates, inconsistent follow-up practices, and a funding patchwork that is not holding equally in every state. She also addresses the recent discontinuation of the specialized LGBTQ+ line and what that loss means for a population already at elevated risk. This episode is intentional groundwork for an upcoming conversation on virtual crisis teams, and Rachel closes with a direct message to clinicians and practice owners about the role they play in what comes after the call. Resources Mentioned About 988 — The official overview of how 988 came to be, what changed in the transition from the National Suicide Prevention Lifeline, and how the current system is structured New Data Expose Critical Care Gaps in 988 Crisis Lifeline — Coverage of a 2025 JAMA Network Open study examining all 988 contacts since launch, including regional disparities and lower-than-expected usage in the South 988 Mental Health Crisis Line Evolves Nationally, States Seek Stable Funding — Covers recent developments including the rollout of georouting, the discontinuation of the LGBTQ+ specialized line, and how states are working toward more sustainable funding structures 988's Evolution: The Next Chapter in Crisis Care — Written by a founding leader of the National Suicide Prevention Lifeline, this piece focuses on the critical gap between the crisis call and what happens after Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

Episode Summary This week, Rachel brings listeners one of her favorite conversations from her previous podcast, The Mental Health Entrepreneur, featuring Dr. Kryn McClain, founder and CEO of CatapalloVR. Dr. McClain is a therapist turned entrepreneur whose work sits at the intersection of clinical expertise and emerging technology. She built CatapalloVR to give mental health providers, autism specialists, and educators a virtual reality platform designed to help clients build real world life skills in a safe, immersive, and measurable environment. In this conversation, Rachel and Dr. McClain explore how VR is being used to teach daily living skills, emotion regulation, and occupational readiness to transition age youth and others who need a structured space to practice before stepping into the real world. Dr. McClain shares how CatapalloVR developed its robust library of hundreds of modules through direct feedback from therapists, parents, and clients, and how therapists can integrate the platform using standard CPT codes. She also speaks candidly about the entrepreneurial journey, the importance of finding a peer community as a clinician turned business owner, and her vision for expanding VR access across hospital systems, schools, and beyond. Connect with Dr. Kryn McClain CatapalloVR Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

Episode Summary This episode brings one of our favorite conversations from Rachel's previous podcast, The Mental Health Entrepreneur, to the Mental Health Evolution audience. Dr. James Cordova is a researcher and clinician who has spent over two decades studying relationship health, and Matt Rubin is the entrepreneur who helped bring that research to life through Arammu, a company built around a checkup and maintenance-based model of care for couples. Together, they join Rachel to make the case for something the mental health field has long overlooked: treating relationships as a health system that deserves proactive, preventative care rather than crisis-only intervention. Dr. Cordova traces the origins of this work back to his time volunteering at a crisis center, where he noticed month after month that relationship issues were the leading reason people called in for help. The conversation explores how Arammu's relationship checkup works in practice, what it looks like across the full spectrum of couples from newly married to severely distressed, how it fits into existing clinical workflows, and why brief, evidence-based tools like this one may be key to addressing the mental health access crisis. Rachel and her guests also discuss insurance billing, the surprising uptake from the military, and the broader vision of shifting mental health care toward a primary care model where early and frequent support becomes the norm rather than the exception. Connect with Dr. James Cordova and Matt Rubin Arammu: The Proactive Relationship Checkup Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: https://www.instagram.com/thementalhealthevolution/ LinkedIn: https://www.linkedin.com/showcase/the-mental-health-evolution Facebook: https://www.facebook.com/TheMentalHealthEvolution Music Credit: Music by Zach Harrison

Episode Summary Jason Youngblood is the Senior Director at Cigna U.S. Markets Behavioral Center of Excellence and Sales Operations and a licensed professional counselor whose path to the insurance industry was anything but planned. After discovering his passion for the therapeutic relationship early in his career, Jason spent years in clinical work before joining Cigna, where he has spent over two decades focused on removing barriers to care and improving behavioral health access at scale. His work sits at the intersection of employer-sponsored benefits, systems design, and a genuine commitment to reaching people who need support before a crisis brings them in. In this conversation, Rachel and Jason explore what it looks like to build a care continuum that reaches beyond the therapy office. Jason shares a striking data point: roughly 55% of people who need behavioral health support will never seek it, and he describes how Cigna is using data, digital tools, and partnerships like Headspace for Cigna Healthcare to engage that population earlier. They discuss what guardrails responsible digital partnerships require, why navigation has become one of the most pressing challenges in a crowded mental health marketplace, and how tools like coaching and self-guided apps might ultimately free up therapists to work with the people who need them most. Resources Mentioned First Therapy Chatbot Trial Yields Mental Health Benefits — Dartmouth research reporting early clinical trial results showing measurable mental health benefits for some users of therapy chatbots, along with a look at where these tools may and may not be appropriate. A Scoping Review of AI-Driven Digital Interventions in Mental Health Care — A peer-reviewed review of how mental health chatbots are currently being studied and deployed, covering benefits such as accessibility and symptom monitoring alongside challenges related to safety and clinical oversight. Headspace for Cigna Healthcare Enhances Everyday Mental Health Support Through Self-Guided, Science-Backed Resources — Announcement describing Cigna's collaboration with Headspace Health to offer self-guided mental health resources as part of employer benefits, positioning digital tools as early support and care navigation. Connect with Jason Youngblood The Rise of the Anxious Worker Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

EPISODE SUMMARY In this episode, Rachel sits down with Shirali Nigam and Arul Nigam, sibling co-founders of Circuit Breaker Labs, a company built around a simple but urgent idea: AI mental health tools should be rigorously tested for safety before they ever reach a real user. Shirali brings a background in AI safety, psychology, and technology, along with an MBA from the Wharton School at the University of Pennsylvania. Arul contributes expertise in AI applications for healthcare and studied operations, analytics, and global business at Georgetown University's McDonough School of Business. Together, they walk Rachel through their framework for agentic red-teaming, a method of sending AI-powered simulated patients into conversations with mental health chatbots to find the vulnerabilities before vulnerable people do. The conversation covers how they got here personally, why the probabilistic nature of large language models makes exhaustive testing so essential, and what they are actually finding in the field, including how something as small as a misspelled word can be enough to bypass a safety guardrail. The second half of the conversation turns to the bigger picture: who is using Circuit Breaker Labs, what clinicians and parents should look for when evaluating AI tools, and what good policy in this space could actually look like. Rachel and the Nigams explore the tension between moving fast in the startup world and the high stakes of getting things wrong in mental health. Shirali and Arul make the case for independent, third-party safety validation before products launch, rather than enforcement after harm has already occurred, drawing a comparison to food and automobile safety standards. They also push back on the idea of banning AI in mental health altogether, arguing that with a 320-to-one patient-to-provider ratio and growing wait times for care, AI used responsibly has real potential to bridge the access gap. The episode closes with a look at what is next for Circuit Breaker Labs and why they see this work as only growing more urgent over time. RESOURCES MENTIONED Articles Referenced New study: AI chatbots systematically violate mental health ethics standards | Brown University New study warns of risks in AI mental health tools | Stanford Report https://www.circuitbreakerlabs.ai/Whitepaper.pdf Connect with Shirali and Arul Nigam Website: https://www.circuitbreakerlabs.ai Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

Got it! Here are the final show notes: Mental Health Evolution Podcast — Show Notes Episode Title: Community Health, Local Solutions with Malcolm Furgol Episode Summary In this episode, Rachel Harrison sits down in person with Malcolm Furgol, Executive Director of the Coalition for a Healthier Frederick County, for a grounded conversation about what it actually takes to improve mental health access at the community level. Malcolm walks us through how local health improvement coalitions collect data, identify root causes, and bring together healthcare providers, government, nonprofits, and businesses to work toward real solutions — including the Coalition's most recent Community Health Needs Assessment, which found that social isolation and mental health challenges are growing since the pandemic, and that stigma remains a significant barrier, particularly for men and immigrant communities. Rachel and Malcolm also dig into one of the most pressing questions facing mental health providers today: how can more clinicians afford to accept Medicaid and Medicare? They explore the realities of low reimbursement rates, insurance clawbacks, and the administrative burden that pushes providers out of insurance networks — and discuss the systems-level solutions that could change the equation, from collective advocacy to state-level insurance regulation levers. Resources Mentioned Articles Referenced Affordable Therapy is Hard to Find, Even with Insurance — New York Times: https://www.nytimes.com/2024/09/15/business/affordable-therapy-costs.html New Policies Affecting Access to Mental Health Care — APA: https://updates.apaservices.org/new-policies-affecting-access-to-mental-health-care Health Equity Framework — Coalition for a Healthier Frederick County: https://static1.squarespace.com/static/6435982bd0e669659a59352f/t/690cd050d51f6413512b56d3/1762447440408/Health+Equity+Framework+Final.pdf Connect with Malcolm Furgol Coalition for a Healthier Frederick County: https://healthierfrederick.org/events-and-meetings/419u6v9q4uunxtu8xv5j37iv0kug3v Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

EPISODE INTRODUCTION: In this solo episode, Rachel  steps back from guest conversations to share her own observations and questions about one of the most pressing topics in the field: where does technology fit in mental health care, and where does it fall short? Drawing from six recent research articles and peer-reviewed publications, Rachel explores an emerging tiered model of care that blends technology, human connection, and escalation across levels of need — and invites listeners to consider what it means for their corner of the mental health ecosystem. KEY TOPICS DISCUSSED: The technology debate in mental health — full replacement vs. full avoidance vs. integration Overview of six key articles framing the episode's discussion The five stages of mental health care where AI and digital tools are being applied: pretreatment and screening, active treatment, post-treatment monitoring, general support and prevention, and clinical education The emerging tiered or stepped care model — from wellness apps to inpatient care Implications for clients, clinicians, and businesses/systems within the mental health ecosystem MAIN TAKEAWAYS: Technology is most useful at the edges of care — pretreatment screening, post-treatment monitoring, and general wellness support — where it can expand access without replacing the clinical relationship. A tiered stepped care model is already emerging in research and practice, where clients might first engage with low-intensity tools (sleep apps, meditation, mood tracking) before escalating to coaching, group therapy, individual therapy, and higher levels of care as needed. Clinician oversight remains non-negotiable. Rachel emphasizes that AI-assisted notes, treatment plans, and clinical decision support tools are only as safe as the licensed clinician who reviews and edits them. Safety access must be built into any technology that touches mental health. Any tool that asks someone about their mental health must have a clear, reliable pathway to a live person in the event of a crisis. This shift raises important identity questions for clinicians — particularly generalists — about where their expertise fits in a system where technology may address lower-level needs. NOTABLE QUOTES: "I'm not predicting the future. I'm not taking a hard stance, but exploring a model that is already emerging. It's right out there in the research." — Rachel Harrison "If we ever lose the part where a clinician reviews the notes, reviews the treatment plan, reviews the diagnoses, reviews the suggestions — I think we're going to see a lot of problems." — Rachel Harrison "Anytime we are asking technology to ask someone questions about their mental health, that safety planning piece, I believe, absolutely needs to be in place. That is one of the biggest gaps that I see currently." — Rachel Harrison RESOURCES MENTIONED: of them are linked in the show notes. ARTICLE 1: The Evolving Field of Digital Mental Health This peer-reviewed review outlines how AI and digital tools are currently being used across multiple stages of mental health care, from prevention to post-treatment monitoring. Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC12110772/ ARTICLE 2: Health Advisory on AI Chatbots and Wellness Apps (American Psychological Association) This article discusses where AI-based tools may be helpful — and where limitations, risks, and ethical concerns remain. Link: https://www.apa.org/topics/artificial-intelligence-machine-learning/health-advisory-chatbots-wellness-apps ARTICLE 3: First Therapy Chatbot Trial Yields Mental Health Benefits (Dartmouth) This study looks at outcomes from one of the first controlled trials of a therapy chatbot and what it suggests about early-stage support. Link: https://home.dartmouth.edu/news/2025/03/first-therapy-chatbot-trial-yields-mental-health-benefits ARTICLE 4: AI Is Providing Emotional Support for Employees — But Is It a Valuable Tool or a Privacy Threat? Explores workplace use of AI support tools and the tension between access, effectiveness, and privacy. Link: https://theconversation.com/ai-is-providing-emotional-support-for-employees-but-is-it-a-valuable-tool-or-privacy-threat-266570 ARTICLE 5: AI Mental Health Tools: Breakthrough or Band-Aid? Examines whether digital tools meaningfully expand access or risk becoming substitutes for care when systems are under strain. Link: https://hrzone.com/ai-mental-health-tools-breakthrough-or-band-aid-for-employee-wellbeing/ ARTICLE 6: From Clinical Judgment to Machine Learning Looks at how AI is beginning to influence clinical decision-making and what that may mean for professional roles. Link: https://societyforpsychotherapy.org/from-clinical-judgment-to-machine-learning-rethinking-psychotherapeutic-decision-making-with-artificial-intelligence/ Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

Episode Description: In this episode, Rachel sits down with Becky Stoll, Vice President for Crisis and Disaster Management at Centerstone, to explore how crisis mental health systems can be intentionally designed to support staff well-being, retention, and long-term sustainability. Becky draws on nearly four decades of experience to challenge the industry's historic approach to workforce wellness, arguing that organizations must fix broken systems before asking staff to simply be resilient. Listeners will come away with a practical framework for building crisis systems that take care of the people delivering care, from recruitment and hiring all the way through career development and leadership training. Key Topics Discussed: What crisis services actually are and the range of roles within the field How the industry has historically failed staff by prioritizing wellness perks over systemic change A continuum-based framework for sustainable hiring, onboarding, and retention Why being a good clinician does not automatically make someone a good manager Career pathing as an underused retention and development strategy What Centerstone's research on the brain in crisis revealed about how we should approach people post-crisis The responsibilities that come with organizational scale through mergers and acquisitions Why crisis services remains an invisible career track for students entering behavioral health Main Takeaways: Organizations must audit and fix their own systems before offering staff wellness resources. A broken system is itself a source of harm. Sustainable staffing starts at recruitment. Transparent job postings, scenario-based interviews, and intentional onboarding reduce attrition and set staff up for success. Career pathing is an organizational responsibility. Whether staff want to grow as clinicians or move into leadership, it is up to leaders to build real pathways and prepare people for what those roles actually require. Scale only matters if it is used well. Larger organizations have a responsibility to share research, tools, and training broadly rather than keeping them internal. The field is losing potential workforce by not educating students about crisis services as a legitimate and diverse career track. Notable Quotes: "The very first thing we have to do is take care of your own house. We shouldn't even be talking about how to make sure staff are well until we make sure they're operating in a system that is the best it can be." "How dare us to have a system that's not set up well, and then wonder why the staff aren't well, and then just say, well, here's the EAP number out there." "I wonder what it does to your brain to be in a mental health crisis. And I went, whoa." Resources Mentioned: Health Care Worker Burnout — A Call for System-Level Solutions The Effectiveness of EMDR Therapy in Treating PTSD Among ICU Healthcare Professionals Organizational and System-Level Approaches to Supporting the Health Workforce Connect with Becky Stoll: Organization: https://www.centerstone.org Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

EPISODE SUMMARY This solo episode features Rachel Harrison, host of Mental Health Evolution, exploring how rising out-of-pocket health care costs are reshaping access to therapy and mental health care in 2026. Rachel examines national data, insights from practitioners, and lived experiences from clients to explain why costs and coverage patterns have shifted so dramatically—and what this means for the future of affordable, sustainable mental health care. KEY TOPICS DISCUSSED 00:00 – Introduction and context 01:00 – Why 2026 is different 02:04 – Key articles and data sources 05:00 – Provider experiences and referral changes 07:40 – Deductibles, premiums, and co-pay increases 09:30 – Medicaid cuts and coverage loss 10:30 – Who gains and who loses 12:00 – APA recommendations and practical responses 13:00 – Creative solutions for access and affordability 14:30 – Closing reflections MAIN TAKEAWAYS p]:inline" data-streamdown="list-item"> Out-of-pocket costs are changing mental health access nationwide. Even insured clients are leaving therapy due to financial constraints. p]:inline" data-streamdown="list-item"> Insurance structures are compounding affordability gaps. Deductible and co-pay increases are eroding real coverage value. p]:inline" data-streamdown="list-item"> Clinicians are navigating new referral and revenue challenges. Practices are adapting to maintain viability amid shrinking access. p]:inline" data-streamdown="list-item"> Documenting financial impact is critical for advocacy. Gathering data about cost-related care terminations supports system-level reform. p]:inline" data-streamdown="list-item"> Creative, local solutions can help bridge care gaps. Partnerships, flexible scheduling, and funding programs can sustain access during economic strain. RESOURCES MENTIONED Articles and Reports: p]:inline" data-streamdown="list-item"> The High Costs of Mental Health Care: A Barrier, a Burden, and a Call to Action — Access Institute https://pmc.ncbi.nlm.nih.gov/articles/PMC11786981/ p]:inline" data-streamdown="list-item"> Insurance Design Can Create Co-Pay Barriers to Mental Health Care — RWJF https://www.rwjf.org/en/insights/our-research/2024/02/marketplace-pulse-differences-in-cost-sharing-create-barriers-to-mental-healthcare-in-medicare-advantage.html p]:inline" data-streamdown="list-item"> New Policies Affecting Access to Mental Health Care — APA Services 2026 Summary https://updates.apaservices.org/new-policies-affecting-access-to-mental-health-care p]:inline" data-streamdown="list-item"> High Out-of-Pocket Cost Burden for Mental Health Care — PMC Report (2024) https://pmc.ncbi.nlm.nih.gov/articles/PMC11786981/ CONNECT WITH THE MENTAL HEALTH EVOLUTION Website: The Mental Health Evolution Podcast Instagram: @mentalhealthevolution LinkedIn: Mental Health Evolution Facebook: Mental Health Evolution MUSICAL CREDIT Music by Zach Harrison

EPISODE OVERVIEW In this solo episode of the Mental Health Evolution, Rachel explores one of the most promising—and complicated—policy shifts in mental health care today: interstate licensure compacts. As telehealth becomes a permanent part of service delivery, clinicians are increasingly navigating challenges related to cross-state licensure, insurance reimbursement, and legal compliance. Rachel breaks down the current status of licensure compacts for counselors, social workers, and psychologists, and discusses what these changes could mean for access to care, clinician mobility, and the broader mental health landscape. KEY TOPICS DISCUSSED (0:36–1:04) Why interstate licensure compacts matter now more than ever (1:04–1:54) The mismatch between where clinicians are licensed and where clients need care (2:11–2:36) What an interstate licensure compact is and how it works (2:44–3:20) The Counseling Compact: current implementation and participating states (3:20–3:35) The Social Work Licensure Compact and where it stands (3:35–3:57) PSYPACT and why psychologists are ahead of the curve (4:00–4:18) How compacts could reduce administrative burden and expand access to care (4:22–5:55) Insurance reimbursement challenges, parity laws, and telehealth payment uncertainty (6:09–7:19) Potential impacts on rural access and workforce distribution (7:22–7:55) Scope-of-practice laws, consent requirements, and privacy considerations (8:05–9:00) How licensure compacts may reshape competition and national mental health markets (9:06–10:27) Why compacts are promising—but not a complete solution MAIN TAKEAWAYS Interstate licensure compacts allow clinicians to practice across participating states without holding multiple licenses, but implementation varies by profession and state. The Counseling Compact is live in a limited number of states, PSYPACT is already operational for psychologists, and the Social Work Compact is still in development. Licensure compacts do not guarantee insurance reimbursement, which remains one of the biggest barriers to cross-state telehealth care. Telehealth parity laws and Medicaid reimbursement policies differ widely by state and payer. While compacts could significantly expand access to care, clinicians must still navigate legal, ethical, and financial complexities. RESOURCES MENTIONED Counseling Compact: http://counselingcompact.gov PSYPACT: https://psypact.gov/ Social Work Compact: https://swcompact.org/ HHS Telehealth Licensure Overview: https://telehealth.hhs.gov/licensure/licensing-across-state-lines Telehealth & Private Insurance Laws: https://www.ncsl.org/health/the-telehealth-explainer-series/telehealth-private-insurance-laws Medicaid Telehealth Reimbursement Guidelines: https://www.medicaid.gov/medicaid/benefits/telehealth/reimbursement-for-telehealth-and-provider-and-facility-guidelines Federal & State Telehealth Policy Tracker (Manatt): https://www.manatt.com/insights/white-papers/2025/manatt-telehealth-policy-tracker-tracking-ongoing-federal-and-state-telehealth-policy-changes CONNECT WITH THE MENTAL HEALTH EVOLUTION Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

EPISODE SUMMARY In this episode of Mental Health Evolution, host Rachel Harrison welcomes Sue Abderholden, a national leader with over 40 years of experience in disability advocacy, mental health policy, and nonprofit leadership. Sue served as Executive Director of NAMI Minnesota (National Alliance on Mental Illness), where she led systems advocacy by engaging grassroots members, shaping legislation, educating policymakers, and shifting public attitudes about mental health. Her work spanned adult and children's mental health, education, criminal justice, housing, employment, healthcare, and insurance reform. Sue joins Rachel to unpack a powerful reframing: the mental health system isn't "broken" — it's still being built. Drawing on her extensive experience, Sue reflects on systemic improvements over the past decades, practical lessons from school-linked care, workforce development, parity enforcement, and crisis response — and offers thoughtful insights about what's still needed to build a more coordinated and functional system. KEY TOPICS DISCUSSED (IN ORDER) Sue's background: 40+ years advocating for people with mental illnesses and disabilities Why the system isn't "broken"—it's evolving and still being built Shifts in funding and coverage: the impact of Medicaid benefit expansion Early intervention and school-linked mental health services Workforce challenges: diversity, supervision, loan forgiveness, and compensation Mental health parity and the importance of enforcing network adequacy Crisis care systems: 988, mobile teams, voluntary engagement, and upstream intervention How coordinated residential and emergency services can improve outcomes One key message for listeners: You can create change MAIN TAKEAWAYS Reframing the system from "broken" to "still being built" can create momentum for solutions. Early screening matters most when paired with clear pathways to follow-up care. Workforce development and diversity require intentional investment and practical policy solutions. True parity includes enforcing non-quantitative treatment limits and adequate reimbursement. Crisis response works best when it intervenes before an emergency and connects to supports. RESOURCES MENTIONED / REFERENCED Sue's Minnesota Reformer article — Here's How to Move Forward on a Stronger, Functioning Mental Health Care System https://minnesotareformer.com/2025/12/01/heres-how-to-move-forward-on-a-stronger-functioning-mental-health-care-system/ KFF — The Landscape of School-Based Mental Health Services https://www.kff.org/mental-health/the-landscape-of-school-based-mental-health-services/ NASHP — Trends in State Strategies to Improve the Behavioral Health Workforce https://nashp.org/trends-in-state-strategies-to-improve-the-behavioral-health-workforce/ Milliman — Mental Health Parity & Medicaid Implementation for State Agencies https://www.milliman.com/en/insight/mental-health-parity-medicaid-implementation-state-agencies SAMHSA — National Guidelines for a Behavioral Health Coordinated Crisis System https://988crisissystemshelp.samhsa.gov/sites/default/files/2025-04/national-guidelines-crisis-care-pep24-01-037.pdf CONNECT WITH THE GUEST Sue Abderholden LinkedIn: https://www.linkedin.com/in/sue-abderholden-474b047/ Music Credit: Music by Zach Harrison

In Episode 22 of Mental Health Evolution, host Rachel Harrison is joined by Ryan Dewey Smith, Founder and President of Inperium, to explore what it takes to scale mental health and human service organizations in a sustainable way—without sacrificing culture, staff well-being, or quality of care. Ryan shares how his career in behavioral health and community-based services led him to develop Inperium's strategic affiliation model, designed to help nonprofit and for-profit organizations retain their mission while gaining back-office efficiencies. Together, Rachel and Ryan discuss workforce pressure, funding uncertainty, rising administrative costs, and why the future of behavioral health may depend on stronger collaboration, shared services, and smarter systems behind the scenes. KEY TOPICS DISCUSSED (CHRONOLOGICAL) Why many behavioral health organizations are turning to mergers, partnerships, and affiliations The workforce crisis: burnout, vacancies, recruitment barriers, and retention pressure Why Inperium was created—and how strategic affiliation differs from a traditional merger What "shared services" looks like (and what it protects on the clinical side) The cost drivers that strain small and mid-sized agencies (insurance, IT, audits, staffing, benefits) The tension between growth and culture—and how leadership can avoid breaking teams Why behavioral health is still highly fragmented (and what consolidation could mean) Using technology and data systems to support operational sustainability "Asking for help" as a leadership strategy, not a weakness MAIN TAKEAWAYS Workforce challenges in behavioral health are often driven by systems-level strain—not individual failure. Strategic affiliations may help organizations scale while preserving local culture and mission. Consolidating back-office operations can reduce costs without interfering with clinical autonomy. Rising operational expenses (insurance, cybersecurity, utilities, staffing) are outpacing reimbursement. Sustainability requires creative operational leadership so organizations can reinvest in people and care quality. NOTABLE QUOTES "Putting your hand up and asking for help…is a strategy, not a weakness." "In an affiliation, all that remains intact—your history, legacy, and relationships in the community." "We're behind the curtain as a supporting organization…providing all those backbone essential services." RESOURCES MENTIONED (ARTICLES & READINGS) Strategic Growth: A Critical Imperative for Community Behavioral Health Providers https://www.behavioralhealthtech.com/insights/strategic-growth-a-critical-imperative-for-community-behavioral-health-providers The Nonprofit Workforce Is in Crisis https://johnsoncenter.org/blog/the-nonprofit-workforce-is-in-crisis/ Navigating Workforce Challenges: 2025 Trends and Solutions for the Social Sector https://www.social-current.org/2025/02/navigating-workforce-challenges-2025-trends-and-solutions-for-the-social-sector/ CONNECT WITH THE GUEST Ryan Dewey Smith Website: https://ryandeweysmith.com/ LinkedIn: https://www.linkedin.com/in/ryan-dewey-smith

Episode Description In this solo episode, host Rachel Harrison explores one of the most pressing and complex issues shaping mental health care today: the mental health provider shortage — and how technology and AI-driven tools are increasingly positioned as solutions to it. Rachel unpacks what the data actually shows about workforce shortages, clinician burnout, insurance barriers, and access gaps, while also examining what counts as mental health treatment in the first place. Drawing on research from the American Psychological Association, Mental Health America, and peer-reviewed literature, she distinguishes between symptom relief, skill-based supports, and deeper relational healing work. The episode closes by exploring hybrid care models, where technology supports — rather than replaces — highly trained clinicians, and why this approach may offer the most ethical and effective path forward. Key Topics Discussed The documented mental health provider shortage and its impact on access to care Clinician burnout, administrative burden, and insurance reimbursement challenges What qualifies as mental health treatment — and what does not Differences between symptom management tools and psychotherapy The rise of AI-driven mental health tools and wellness apps Evidence limitations and safety concerns around AI as standalone therapy Hybrid models that integrate technology to support, not replace, clinicians Privacy, data ownership, and clinical judgment in AI-assisted care Main Takeaways The mental health provider shortage is real, documented, and unevenly distributed. Mental health care exists on a spectrum, from self-help tools to intensive clinical treatment. AI and app-based tools may help with symptom support but are limited without human involvement. Psychotherapy is inherently relational and grounded in empathy, trust, and clinical judgment. Hybrid care models that reduce administrative burden while preserving human connection show the most promise. Resources & Articles Mentioned Foundational Definitions & Workforce Data American Psychological Association — Mental Health (definition & overview) https://www.apa.org/topics/mental-health Commonwealth Fund — Understanding the U.S. Behavioral Health Workforce Shortage (2023) https://www.commonwealthfund.org/publications/explainer/2023/may/understanding-us-behavioral-health-workforce-shortage American Counseling Association — A Closer Look at the Mental Health Provider Shortage A closer look at the mental health provider shortage Digital Mental Health & AI The Evolving Field of Digital Mental Health (peer-reviewed review) https://pmc.ncbi.nlm.nih.gov/articles/PMC12079407/ American Psychological Association — Artificial intelligence, wellness apps alone cannot solve the mental health crisis Artificial intelligence, wellness apps alone cannot solve mental health crisis Society for Psychotherapy — From Clinical Judgment to Machine Learning: Rethinking Psychotherapeutic Decision-Making with Artificial Intelligence https://societyforpsychotherapy.org/from-clinical-judgment-to-machine-learning-rethinking-psychotherapeutic-decision-making-with-artificial-intelligence/ Types of Mental Health Treatment Mental Health America — Mental Health Treatments (treatment spectrum & types) https://mhanational.org/resources/mental-health-treatments Referenced Podcast Episodes (Hybrid & Tech-Assisted Models) Dr. Ajita Robinson https://pod.link/1724750091/episode/ZjljYzJlOTEtZDIxZS00NjRhLTkyNzMtOWJhZGVjMTk4Nzcw Jordan Harris https://pod.link/1724750091/episode/MzJlOTc2YTgtN2UxMS00Y2ExLWEzMGEtMDMzODJjYzFlNTAy Dr. Dylan Ross https://pod.link/1724750091/episode/Y2EwODM3NmItYTExMS00M2Q5LTk4ZTMtNzJmMzdjZDZkMTUx Uriah Guilford https://pod.link/1724750091/episode/YTc5MzU3NDYtNmU5Mi00ZDhhLTg2NzAtYzNkZTlhZjNmNzY4 Jeremy Zug https://pod.link/1724750091/episode/MmM0YjUzNDEtMTZkOS00MzlmLThhZTYtMzgxMDhiYzEyY2I3 Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison

Episode Description In this episode, Rachel speaks with Cathy Gilbert — Founder and Principal Consultant at CEG Health — about what's happening inside today's behavioral health systems from both the payer and provider perspectives. Earlier this year, Rachel and Cathy spoke about the Big Beautiful Bill, and that conversation opened up so many rich threads around contracting, payer relations, and system design that they kept going. They recorded a second conversation to dive deeper into those broader themes — and this episode is Part Two of that discussion. Cathy shares how value-based care is unfolding in behavioral health, the data and measurement challenges that make it harder to implement, the impact of insurer-owned clinics, and practical strategies for patients navigating access barriers in a system already stretched by workforce shortages. Key Topics Discussed The current state of value-based care in behavioral health and why implementation is still slow Challenges of measuring mental health outcomes and reliance on PHQ-9 and GAD-7 How eliminating prior authorization changed payer visibility into outpatient care Small-practice dominance in behavioral health and inherent capacity limits Operational ways technology can genuinely support small practices (online scheduling, integrated EHR tools, measurement automation) Insurer-owned clinics in pharmacies and big-box settings: access benefits vs. workforce limitations Workforce pipeline issues, provider retirements, and psychiatry shortages Cultural expectations in the U.S. around speed, cost, and "the best care" Practical strategies for patients to access care within a constrained system Articles Mentioned Evernorth Study on Behavioral Health Value-Based Care https://www.fiercehealthcare.com/payers/evernorth-study-look-progress-toward-value-based-care-behavioral-health Times Union — Congressman Pat Ryan Releases Optum Health Survey Results https://www.timesunion.com/health/article/optum-survey-results-pat-ryan-20255087.php Connect with the Guest Cathy Gilbert Founder & Principal Consultant — CEG Health Website: https://ceghealth.com/ LinkedIn: https://www.linkedin.com/in/cathy-gilbert-29648421/ Connect with The Mental Health Evolution Connect with The Mental Health Evolution Website: The Mental Health Evolution Podcast Instagram: @mentalhealthevolution LinkedIn: Mental Health Evolution Facebook: Mental Health Evolution Music credit: Music by Zach Harrison

Episode Description In this solo episode, Rachel reviews the major mental health stories and trends she anticipates will shape 2026. Covering topics from the growing behavioral health market to hybrid human-AI care, policy developments, digital platform growth, affordability pressures, point-solution fatigue, and global workforce gaps, this episode provides a comprehensive overview of what to watch in the year ahead. Listeners will gain context on opportunities, risks, and emerging challenges in the mental health field. Key Topics Discussed Expanding behavioral health market: growth, opportunities, and challenges for clinicians and practices Human-AI hybrid models: integrating technology without losing the human touch AI in government and public health: potential improvements and privacy concerns Scaling digital mental health platforms and evolving business models Affordability and insurance pressures impacting patients and practices Point-solution fatigue in AI tools and the need for better integration Global mental health demand, workforce shortages, and gaps in care delivery Main Takeaways Rapid market growth brings both opportunity for innovation and risk for small practices Hybrid care models can improve access and efficiency but must preserve human connection Government adoption of AI requires careful attention to privacy, security, and equity Digital platforms are transforming patient access, but competition and consolidation create challenges Mental health workforce gaps remain global; strategic planning is needed to meet demand Notable Quotes "Even if you choose not to use AI tools in your practice, AI is likely coming for you anyway." "The human-AI blend offers the best of both worlds: accessibility from technology and empathy from humans." "Point-solution fatigue is slowing adoption and creating skepticism about whether AI is truly helping." Resources Mentioned Behavioral Health Market to Reach USD 172.61 Billion by 2034 AI and Mental Health Care Tools: Dangers and Risks HHS Announces AI Strategy for Health and Human Services Operations US employee health insurance premiums to rise 6% next year, Mercer says  Over a Billion People Living with Mental Health Conditions – Services Require Urgent Scale-Up Connect with The Mental Health Evolution Website: mentalhealthevolution.com Instagram: @mentalhealthevolution LinkedIn: Mental Health Evolution Facebook: Mental Health Evolution Music Credit: Music by Zach Harrison

Episode Description In this special end-of-year episode of the Mental Health Evolution Podcast, Rachel looks back on some of her favorite moments from the first few months of the podcast's relaunch. Since September, the show has featured wide-ranging conversations about the evolving mental health landscape—from AI and technology to insurance reform, private equity, and value-based care. This episode brings together powerful clips and reflections from guests across the season, highlighting the ideas, tensions, and questions shaping mental health care today. Whether you've listened to every episode or you're joining us for the first time, this "best of" conversation offers a snapshot of where the field is headed—and what's at stake as we move into 2026. Episode Highlights & Segments AI and the Human Core of Therapy — Real Change Initiative A conversation with Aaron Vander Meer, Melissa Ward, and Allison Bomba explores the risks of losing human connection as AI and app-based care expand, and why preserving trust, safety, and expertise is essential. Why People Turn to AI — Ajita Robinson Ajita Robinson unpacks the systemic barriers—insurance gaps, access issues, and licensing restrictions—that drive people toward AI tools when traditional care feels out of reach. AI's Potential Strengths in Therapy — Dr. Jordan Harris Dr. Harris offers a nuanced view of AI's role, highlighting how consistent validation—when used carefully—can reduce resistance and support therapeutic progress. Policy Shifts and Mental Health Coverage — Cathy Gilbert Insurance expert Cathy Gilbert discusses the potential long-term impacts of the "Big Beautiful Bill," including coverage losses and disproportionate effects on vulnerable populations. Private Equity and the Human Equation — Dan King Dan King of Fireside Strategic shares a perspective on how clinician well-being and humane workplace culture can align with sustainable, long-term profitability. Structural Forces Shaping Care — Dr. Jane Zhu Dr. Jane Zhu emphasizes why clinicians must understand ownership structures, financing, and revenue pressures as private equity and MSOs continue to expand. Measurement-Based & Value-Based Care — Dr. Dylan Ross Dr. Ross explains why actionable, real-time data is essential for understanding whether care is truly helping patients—and why claims data alone falls short. Data, Partnerships, and Reality — Josephine Wilton Josephine Wilton highlights how value-based care efforts stall when organizations lack solid data and early operational alignment, leaving progress stuck in theory. Key Topics Discussed AI in mental health: risks, benefits, and boundaries Access barriers and systemic gaps in care Healthcare policy changes and coverage implications Private equity and investment in behavioral health Measurement-based and value-based care Data, outcomes, and decision-making in practice Main Takeaways AI can reduce burden and increase access, but it cannot replace the human connection at the core of therapy. Many people turn to AI tools not by choice, but because of deep systemic failures in access and affordability. Policy and payment changes will have long-term consequences for the most vulnerable mental health populations. Investment and growth models matter—how care is financed shapes clinician autonomy and patient outcomes. Data is essential to moving value-based care from theory into everyday clinical practice. Notable Quotes "AI isn't just a tech issue—it's a mirror reflecting the gaps in our mental health system." "Profitability and humanity don't have to be at odds in mental health care." "Without actionable data, it's incredibly hard to answer a simple question: did our patients get better?" Connect with Mental Health Evolution Website: Instagram: LinkedIn: Facebook: 🎵 Music by Zach Harrison

Episode Description: In this episode, Rachel sits down with Dr. Scott Feers, Chief Medical Officer at Amae Health and a leading psychiatrist and neuroscientist, to explore the evolving landscape of severe mental illness (SMI) care. They discuss the innovative integration of technology, AI, and wearable devices into clinical practice to improve outcomes and prevent hospitalizations for individuals living with SMI. Dr. Feers shares insights from his decades of research and clinical experience, highlighting how Amae Health combines conventional in-person care with digital tools for monitoring, early intervention, and precision treatment. Listeners will gain a clear understanding of how mental health care is being transformed to focus on both mental and physical health, emphasizing the importance of human connection alongside technology. Key Topics Discussed: Challenges of traditional SMI care and repeated hospitalizations The role of AI in supporting clinicians without replacing human interaction Wearable devices and data-driven insights for sleep, activity, and heart health Early detection of relapse to prevent full decompensation Integration of primary care, nutrition, and movement into mental health treatment Translating neuroscience and genetics research into real-world clinical applications Cost efficiencies through early intervention and improved treatment tracking Main Takeaways: Technology and AI can augment care, but human connection remains central to mental health treatment. Wearables and digital phenotyping provide objective insights that enhance clinical decision-making. Early intervention can prevent hospitalizations, reducing human suffering and healthcare costs. Addressing physical health is essential for improving overall outcomes for people with SMI. Integrating research-based tools into routine care makes treatment more precise and effective. Notable Quotes: "I have a very strong belief that humans and connections to humans is the core of mental health treatment." "If we can catch relapse early, see if we can do low risk, simpler intervention to prevent the more complicated treatment interventions." "We know that folks with serious mental illness often have reduced lifespans… a lot of the causes of mortality are basic things like cardiovascular health." Resources Mentioned: For-profit companies open psychiatric hospitals in areas clamoring for care — CBS News Private Equity Among US Psychiatric Hospitals — JAMA Psychiatry Amae Health Announces $25 Million Series B — Business Wire Connect with Dr. Scott Feers: Website: https://www.amaehealth.com/team/scott-fears Connect with The Mental Health Evolution: Website: https://www.mentalhealthevolution.com Instagram: @mentalhealthevolution LinkedIn: Mental Health Evolution Facebook: Mental Health Evolution Music Credit: Music by Zach Harrison

Episode Description: In this second part of her conversation with Josephine Wilton, Chief Strategy Officer at Hullanta Consulting, Rachel dives deeper into the complexities of value-based care. Josephine draws on decades of experience in managed care strategy, population health, and contract design to explore why these models often feel difficult to implement. This episode examines the operational realities behind value-based care, including the importance of utilization data, the impact of contracts on organizational performance, and the necessity of interdisciplinary collaboration. Listeners will gain actionable insights on how to navigate these challenges, advocate for their teams, and optimize care delivery in a system that is constantly evolving. Key Topics Discussed: Understanding the impact of value-based payment measures on provider organizations Why utilization data is critical for telling your organization's story Contract design and its influence on revenue, operations, and organizational outcomes Engaging specialists and ancillary providers in value-based care The role of social determinants of health in patient outcomes and reimbursement Strategies for data-driven decision-making and negotiating with health plans Main Takeaways: Ownership of your data is essential — know your utilization metrics and communicate your story clearly Value-based care cannot succeed with primary care alone; specialists and ancillary providers must be included Contracts influence all parts of an organization, not just payment; thorough review is critical Collaboration across disciplines and sharing actionable data drives better outcomes Advocating for your organization requires persistence and strategic negotiation with health plans Notable Quotes: "So it's very incumbent upon you to tell your story in your way. Don't let someone else tell your story." — Josephine Wilton "Primary care cannot do it alone. You need cardiology, endocrinology, podiatry, everyone involved, and they typically haven't so they're contributing to the total cost. They're seeing different needs of the patients than the other providers." — Josephine Wilton Resources Mentioned: National Committee for Quality Assurance (NCQA) Centers for Medicare & Medicaid Services (CMS) National Academy for State Health Policy Milliman Connect with the Guest: Josephine Wilton, MHA Chief Strategy Officer, Hullanta Consulting hullantaconsulting.com Connect with The Mental Health Evolution: Website: mentalhealthevolution.com Instagram: @mentalhealthevolution LinkedIn: Mental Health Evolution Podcast Facebook: Mental Health Evolution Podcast Music Credit: Music by Zach Harrison

Episode Description: In this episode, Rachel sits down with Josephine Wilton, Principal Consultant at Hullanta Consulting, to dive deep into the operational realities of implementing value-based care. They discuss the challenges organizations face in aligning data, staff, and financial models, and how smaller practices and solo practitioners navigate these complex systems. Josephine shares actionable strategies for bridging the gap between theoretical value-based models and real-world execution. Rachel and Josephine had so much to cover that they'll be back next week to continue the conversation, exploring even more practical solutions and lessons learned from both providers and payers. Timestamped Highlights: 0:52–4:28 – Introduction of Josephine Wilton and her expertise in operationalizing value-based care. 5:04–7:40 – Early contracting stages and the importance of communication between providers and payers. 10:15–12:27 – Why operational and clinical teams must be involved early in negotiations. 13:30–16:23 – Challenges faced by solo practitioners and smaller organizations in value-based care. 18:32–21:36 – Importance of real-time data and the delays that can impact value-based programs. 26:25–28:24 – Friction points in attribution, performance metrics, and total cost of care. Key Topics Discussed: Value-based care models vs. fee-for-service systems Operational and clinical alignment during contract negotiation The critical role of real-time data in decision-making Challenges for small and solo practices Understanding total cost of care and outcomes measurement Main Takeaways: Early involvement of clinical and operations teams is crucial to success. Real-time data access is necessary to track performance and guide decisions. Smaller organizations may have agility but require support with modeling and analytics. Clear communication between providers and payers prevents misalignment and frustration. Understanding both baseline and value-based payment structures is essential before execution. Resources Mentioned: Implementing Value-Based Care, a Scoping Review Value-Based State-Directed Payments in Medicaid, Feb 2023–May 2024 Why Primary Care Practitioners Aren't Joining Value-Based Care Payment Models Connect with the Guest: Josephine Wilton, Hullanta Consulting Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: @mentalhealthevolution LinkedIn: Mental Health Evolution Facebook: Mental Health Evolution Music by Zach Harrison

In this episode, Matthew Stone, assistant managing editor at Education Week, joins the Mental Health Evolution Podcast to discuss recent shifts in school mental health policy. Matthew shares insights on federal grant changes, the focus on school psychologists, and how districts are adapting to meet the growing mental health needs of students. He explains the evolution of funding programs, challenges schools face when funding priorities shift, and practical strategies districts are using to provide more effective mental health support. Listeners will gain a clear understanding of how policy impacts schools, educators, and students alike. Timestamped Highlights: 00:03 – Introduction to Matthew Stone and overview of episode 06:10 – Discussion on the increase in student mental health needs post-COVID 11:03 – Overview of federal grant shifts and funding uncertainty 14:07 – Impact of grant terminations on hiring and staffing 19:01 – Focus on school psychologists and narrowing of grants 25:38 – Implications for districts trying to fulfill local needs Key Topics Discussed: COVID's impact on student mental health Federal grant programs for school mental health Policy changes and administrative priorities Workforce challenges: counselors, social workers, and psychologists Local district strategies for sustaining services Main Takeaways: Student mental health needs have increased, exacerbated by COVID Policy changes and grant terminations create uncertainty for districts Narrowing grants to school psychologists may limit local flexibility States and districts are developing innovative strategies to meet needs Sustaining mental health services requires planning beyond federal funding Notable Quotes: "I think the focus on school psychologists has stumped a lot of people in the mental health world." "Schools are navigating unprecedented changes while trying to provide consistent support to students." Resources Mentioned: KFF: The Landscape of School-Based Mental Health Services US House Press Release: Fitzpatrick Leads Bipartisan Coalition Education Week: Trump Admin Relaunches School Mental Health Grants Connect with Matthew Stone: Website: Matthew Stone – Education Week Connect with The Mental Health Evolution: Website: Mental Health Evolution Podcast Instagram: @thementalhealthevolution LinkedIn: The Mental Health Evolution Facebook: The Mental Health Evolution   Music by Zach Harrison

Episode Summary For this week's episode, I was excited to welcome Dr. Dylan Ross, PhD, LMFT, LPCC, Head of Clinical at Blueprint AI and a nationally recognized leader in behavioral healthcare, clinical innovation, and measurement-based care. Dr. Ross brings a wealth of experience from his leadership roles at Optum, Rogers Behavioral Health, and Kaiser Permanente, where he shaped clinical strategy, digital innovation, and measurement-informed care frameworks. He currently chairs the American Psychological Association's National Advisory Committee for Measurement-Based Care, guiding national strategy on standardized clinical measurement protocols. In this conversation, Dr. Ross shares insights on measurement-based care (MBC), value-based care, and how AI can support clinicians without replacing clinical judgment. We discuss how integrating patient-reported outcomes into routine practice improves clinical efficiency, therapeutic alliance, and outcomes, while also addressing workforce challenges and administrative burden. He also highlights Blueprint's AI-driven tools that save clinicians time, enhance care delivery, and enable real-time insights to support patient care. Episode Highlights 0:03 – Introduction to Dr. Dylan Ross, his background in behavioral health, and his current role at Blueprint AI 4:08 – Dr. Ross shares his career journey from Kaiser Permanente to Optum, Rogers Behavioral Health, and Blueprint AI 9:27 – Explaining measurement-based care (MBC): definition, benefits, and impact on treatment outcomes 16:02 – Adoption rates and challenges of MBC in behavioral health, including clinician and patient engagement 17:42 – Value-based care: evolution, payer perspectives, and how outcomes drive reimbursement 27:17 – How AI supports clinicians: reducing administrative burden, increasing MBC adoption, and providing real-time session insights 34:25 – Call to action for the behavioral health system: workforce preparedness, aligned incentives, and systemic improvements Articles & Resources Value-Based Care: What It Is, and Why It's Needed — Commonwealth Fund Getting on Board with Measurement: Implementing Measurement-Informed Mental Health Care — Institute for Healthcare Improvement (IHI) AI in Behavioral Health Documentation: Ethical Considerations for Mental Health Clinicians — Blueprint AI Blog Connect with Dr. Dylan Ross Website: Blueprint AI LinkedIn: Dylan Ross Connect with The Mental Health Evolution Website: The Mental Health Evolution Instagram: @thementalhealthevolution LinkedIn: The Mental Health Evolution Facebook: The Mental Health Entrepreneur Music by Zach Harrison

Episode Summary In this episode, Rachel talks to Dr. Jane Zhu, an internal medicine physician, health services researcher, and Associate Professor of Medicine at Oregon Health & Science University. Dr. Zhu's work focuses on how ownership and financial structures shape healthcare delivery and equity — an increasingly important lens as private equity investment grows in behavioral health. Rachel and Dr. Zhu explore her research on the geographic penetration of private equity ownership in outpatient and residential behavioral health, discussing the implications for access, quality, and clinician autonomy. They also dive into the broader trends of consolidation, policy oversight, and the transparency challenges that affect both patients and providers. Episode Highlights 0:34 – Introduction to Dr. Zhu and her research focus 1:22 – Why private equity is expanding into behavioral health 3:08 – Key findings from Dr. Zhu's JAMA Psychiatry study 6:27 – Impacts on care quality, clinician autonomy, and patient access 9:52 – Policy and transparency implications for healthcare ownership 13:10 – Dr. Zhu's takeaway: balancing investment with public accountability Articles & Resources Private Equity's Inroads into Mental Health Bring Concern – Psychiatry Online Geographic Penetration of Private Equity Ownership in Outpatient and Residential Behavioral Health – JAMA Psychiatry Connect with Dr. Jane Zhu Website: OHSU – Jane M. Zhu, MD, MPP, MSHP LinkedIn: linkedin.com/in/janemzhu Connect with The Mental Health Evolution Website: The Mental Health Evolution Instagram: @thementalhealthevolution LinkedIn: The Mental Health Evolution Facebook: The Mental Health Entrepreneur Music by Zach Harrison

What does it take to grow a mental health practice sustainably—without burning out the people who make it work? In this episode, host Rachel Harrison talks with Dan King, Co-Founder of Fireside Strategic, about how to align profitability with purpose in behavioral health. Dan shares lessons from years advising investors and business leaders on building organizations where clinicians thrive, culture drives retention, and long-term success balances both human and financial outcomes. Listeners will hear practical advice on finding the right investment partners, understanding private equity and venture capital dynamics, and leading with values in a changing behavioral health market. Whether you're a clinician, practice owner, or investor, this conversation offers a blueprint for growth without burnout. Guest & Transcript Information Full Transcript: Provided Guest Name: Dan King Title / Role / Credentials: Co-Founder, Fireside Strategic Bio / Expertise: Dan King is the Co-Founder of Fireside Strategic, helping companies scale sustainably by focusing on human-centered growth. With experience in organizational psychology, M&A strategy, and executive coaching, Dan aligns profitability with purpose to build organizations that thrive without burnout. Website: https://www.firesidestrategic.com/ LinkedIn: https://www.linkedin.com/in/danmking/ Episode Highlights 0:32 – Introduction to Dan King and Fireside Strategic 1:08 – Why aligning business growth with human well-being matters 2:12 – Lessons from scaling companies that grew too fast 3:40 – The link between culture, retention, and sustainable success 5:05 – How private equity and venture capital differ in behavioral health 7:14 – Finding the right investment partner for your mission 9:48 – Balancing profitability with clinician satisfaction 12:22 – The future of integrated behavioral health services 14:36 – Measuring both financial and human outcomes 16:18 – Practical advice for practice owners considering investors 18:07 – Key traits of leaders who build without burnout Articles & Resources Mental Health's Investment Resurgence: A Market Ripe for Innovation – Galen Growth Venture Capital's Priorities Are Evolving as Behavioral Health Market Matures – Behavioral Health Business Fireside Strategic – Dan King Connect with Dan King Website: firesidestrategic.com LinkedIn: linkedin.com/in/danmking Connect with Us Website: The Mental Health Evolution Instagram: @thementalhealthevolution LinkedIn: The Mental Health Evolution Facebook: The Mental Health Entrepreneur Music by Zach Harrison

Episode Recap In this episode, Rachel speaks with Becky DeGrossa, founder of CounselingWise, about the evolving landscape of mental health marketing. Becky shares her insights on how private practice therapists can leverage local marketing and AI to thrive, even in a market crowded with venture-backed platforms. She discusses practical strategies for mapping the client search journey, creating visibility online, and building sustainable practices that attract the right clients. Episode Highlights Becky's unique blend of tech, psychology, and marketing experience Local clinicians' advantage over large therapy platforms Combining local marketing with AI as a competitive equalizer Key strategies for Search Everywhere Optimization Common mistakes therapists make in local search ranking Becky's top advice: do the work to create lasting visibility Articles & Resources Is This the End of the Private Practice Therapist? – Mental Health Match The Marketing Formula That's Fueling Small Business Success – Entrepreneur Connect with Becky DeGrossa Website: counselingwise.com | skool.com/private-practice-builders LinkedIn: Becky DeGrossa Connect with Us Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: @thementalhealthevolution LinkedIn: www.linkedin.com/showcase/the-mental-health-evolution/ Facebook: /TheMentalHealthEvolution Music by Zach Harrison

In this episode, Rachel talks with Deborah Steinberg, Senior Health Policy Attorney at the Legal Action Center, about the current state of mental health parity in the U.S. Deborah explains what parity means, why it matters, and how gaps in enforcement continue to affect patients and providers. They also discuss the recent HHS rule reversal and its impact on insurance coverage, including disparities in reimbursement and network adequacy. Listeners will learn about key barriers in mental health and substance use disorder care, as well as practical steps for advocacy and holding plans accountable. Episode Highlights Introduction to Deborah Steinberg and her policy work Overview of mental health parity laws and importance Discussion on HHS rule reversal and its impact Disparities between mental and physical health coverage Enforcement gaps at federal and state levels Role of data collection in identifying parity violations Network adequacy challenges for providers and patients Aligning health plan coverage criteria with standards of care Steps consumers can take to report parity violations Ways to engage in state-based advocacy and reforms Advocacy benefits for patients, providers, and systemic change Articles & Resources Mental Health Care May Be Harder to Obtain After HHS Rule Reversal – STAT News New Tool Brings Mental Health Parity Problems to Light – AMA Commissioner King Fines Insurers Over $20 Million for Parity Violations – Georgia OCI Mental Health Parity Enforcement Updates – Congressman Tonko Connect with Deborah Steinberg Website: https://www.lac.org LinkedIn: https://www.linkedin.com/in/deborah-steinberg-b4822536/ Instagram: @deborahgwen Connect with Us Website: The Mental Health Evolution Instagram: @thementalhealthevolution LinkedIn: The Mental Health Evolution Facebook: The Mental Health Entrepreneur Music by Zach Harrison

Episode Summary This week, we have a solo episode in which Rachel explores the mental health system through a family systems lens. She examines how different players—including clients, providers, insurers, tech companies, and advocacy organizations—interact and influence access to care, reimbursement, and overall system outcomes. Listeners will gain insight into systemic disparities, the role of new disruptors, and how ongoing dialogue and advocacy can help create a healthier mental health ecosystem. Episode Highlights 0:30 – Rachel introduces solo episode exploring the mental health system 1:06 – Discusses therapist income disparities and systemic influences 2:56 – Explains using a family systems lens to view the industry 3:48 – Highlights relevant articles on barriers to mental health care 7:28 – Role of clients/patients and access challenges in the system 9:52 – Income and influence of individual providers in insurance networks 13:14 – Tech companies and managed service organizations as system disruptors 17:08 – Insurance companies' influence on reimbursement, coverage, and policy 19:01 – Advocacy groups shaping regulations, standards, and systemic improvements 20:05 – Importance of dialogue among all system players for better outcomes Articles & Resources Exploring Barriers to Mental Health Care in the U.S. – AAMC Therapist Salaries in 2025 – Twofold Connect with Us Website: The Mental Health Evolution Instagram: @thementalhealthevolution LinkedIn: The Mental Health Evolution Facebook: The Mental Health Entrepreneur Music by Zach Harrison