The Mental Health Evolution

The Mental Health Entrepreneur podcast is back—with a slightly new name and an expanded focus. We’re excited to introduce The Mental Health Evolution, where we’ll continue the journey of exploring what’s changing in the mental health field, and we’re so glad to have you with us as a listener. Explore the rapidly changing world of mental health with The Mental Health Evolution, hosted by Rachel Harrison. Each episode brings honest conversations with clinicians, tech founders, investors, insurance companies, and other key voices shaping the industry. We dive into what’s working, what’s not, and what’s next—from innovative startups and ethical considerations in tech-driven therapy to policy changes, access to care, and the human connections that remain at the heart of mental health services. Whether you’re a professional in the field, someone seeking care, or simply curious about the evolution of mental health, this podcast provides insights, perspectives, and practical information to help you navigate a complex and fast-moving landscape. Join us to stay informed, challenge assumptions, and be part of the conversation shaping the future of mental health.

Ep 51: 10 Years of Trauma Specialists - a Live Episode 08/13/2026

Ep 51: 10 Years of Trauma Specialists - a Live Episode 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: More information: Connect with Trauma Specialists of Maryland: Website: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/42302440

Ep 50: When Child Care Can't Wait for Nine to Five with Sara Bradley 08/06/2026

Ep 50: When Child Care Can't Wait for Nine to Five with Sara Bradley 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: How Inaccessible Child Care Affects Families and Early Childhood Educators — University of Michigan School of Public Health: U.S. Children Living with a Parent with Substance Use Disorder — JAMA Pediatrics (2025): Connect with Sara Bradley: York Day Early Learning: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/42060355

Ep 49: What Happens When You Replace the Fax Machine with Shana Palmieri 07/30/2026

Ep 49: What Happens When You Replace the Fax Machine with Shana Palmieri 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): AI in the Mental Health Care Workforce Is Met with Fear, Pushback, and Enthusiasm — NPR (April 2026): XFERALL Expands Real-Time Patient Transfer Platform in Southern California — PR Newswire (February 2026): Connect with Shana Palmieri: XFERALL: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/42152925

Ep 48: Everybody's Talking About Mental Health But Nobody's Funding It with Stephanie Slowly Little 07/23/2026

Ep 48: Everybody's Talking About Mental Health But Nobody's Funding It with Stephanie Slowly Little 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: The Workforce Report: Bridging the Mental Health Care Gap — Maryland State Snapshot — Inseparable (March 2026): Barriers to Health Care for Rural Americans — Rural Minds: Community Resources and Hazards Across the Rural-Urban Continuum — JAMA Network Open (April 2026): Additional Resource: OMB Proposed Changes to the Uniform Guidance (Federal Grant Rules) — National Council of Nonprofits: Connect with Stephanie Slowly Little: NAMI Maryland: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/42014915

EP 47: What the Research Actually Shows About AI Therapy with Dr. Nick Jacobson 07/16/2026

EP 47: What the Research Actually Shows About AI Therapy with Dr. Nick Jacobson 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): Bill Doesn't Protect NH from AI Harm, It Assures It — Union Leader (January 2026): First Therapy Chatbot Trial Yields Mental Health Benefits — Dartmouth News (March 2025): Connect with Dr. Nick Jacobson / Additional Resources: This Therapist Helped Clients Feel Better. It Was A.I. — New York Times (syndicated): How to Build a Therapeutic Chatbot — Psychiatric News: AI, Neuroscience, and Data Are Fueling Personalized Mental Health Care — APA Monitor on Psychology: Can 'AI Therapists' Help Save LGBTQ+ People? — Out Magazine: AIM High Laboratory at Dartmouth: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41893270

Ep 46: The Crisis Text Line with Dr. Shairi Turner 07/09/2026

Ep 46: The Crisis Text Line with Dr. Shairi Turner 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): Why Depression Goes Undetected in Teen Boys — NBC News (June 2024): Annual Trends 2025 — Crisis Text Line: Additional resource - Crisis Text line Terms and Conditions: Connect with Dr. Shairi Turner: Crisis Text Line: Text HOME to 741741 Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41939720

Ep 45: Stop Doing What Worked Ten Years Ago with Dr. Elizabeth Carr 07/02/2026

Ep 45: Stop Doing What Worked Ten Years Ago with Dr. Elizabeth Carr 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): Telehealth and Hybrid Practice Are Here to Stay — APA Monitor on Psychology (2024): Strategic Positioning During Industry Upheaval — Dr. Elizabeth Carr, Kentlands Psychotherapy (January 2026): Connect with Dr. Elizabeth Carr: Kentlands Psychotherapy: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41919395

Ep 44: They Knew and They Profited Anyway with Matthew Bergman 06/25/2026

Ep 44: They Knew and They Profited Anyway with Matthew Bergman 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): Jury Finds Meta and YouTube Negligent in Landmark Lawsuit on Social Media Safety — NBC News (March 2026): Social Media Addiction Lawsuit Update — Social Media Victims Law Center: Connect with Matthew Bergman: Social Media Victims Law Center: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41575670

Ep 43: When Payers Own the Data: What the CAQH Rebrand Means for Providers 06/18/2026

Ep 43: When Payers Own the Data: What the CAQH Rebrand Means for Providers 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: Leading Health Plans Become CAQH Owners to Shape the Future of Healthcare Data — Becker's Payer Issues: Insurer-Owned CAQH Rebrands to DataSpring — Becker's Payer Issues: 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): Connect with The Mental Health Evolution Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41648010

Ep 42: What Clinicians Need to Know About AI Law with Dr. Nick Shumate 06/11/2026

Ep 42: What Clinicians Need to Know About AI Law with Dr. Nick Shumate 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): Pennsylvania Sues Character AI over Chatbot Allegedly Posing as a Doctor — NPR (May 2026): Governing AI in Mental Health: 50-State Legislative Review — Dr. Nick Shumate et al., JMIR Mental Health: Connect with Dr. Nick Shumate: Division of Digital Psychiatry, Beth Israel Deaconess Medical Center / Harvard Medical School Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41527020

Ep 41: The Coverage Gap Is a Policy Problem with Cara Cheevers 06/04/2026

Ep 41: The Coverage Gap Is a Policy Problem with Cara Cheevers 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: State Policies Can Help Address the Mental Health Care Workforce Shortages — Pew Charitable Trusts: Workforce Report — Inseparable: Connect with Cara Cheevers: Website: LinkedIn: Instagram: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41537250

Ep 40: When States Step Up for Safety with Delegate Lily Qi 05/28/2026

Ep 40: When States Step Up for Safety with Delegate Lily Qi 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: State Mental Health Investments - National Governors Association: Tennessee Bans AI Therapy Bots as Chatbot Safety Laws Surge - AI2: Connect with Delegate Lily Qi: Website: Email: Instagram: LinkedIn: Facebook: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41451200

Ep 39: Brain Science for Better Leadership with Dr. Lisa Riegel 05/21/2026

Ep 39: Brain Science for Better Leadership with Dr. Lisa Riegel In this episode, Rachel Harrison speaks with Dr. Lisa Riegel, leadership strategist and creator of the NeuroWell Framework, about why most organizational change efforts fail and what brain science reveals about how to fix that. Dr. Riegel opens with a foundational idea that runs through all of her work: behavior is always the intersection of biology and context, and when leaders understand that, they stop seeing resistant employees and start seeing brains that feel unsafe. From there, the conversation moves into the gap between aspirational leadership and operational leadership, why people do not hate meetings but do hate bad ones, and how the systems leaders build either support or quietly undermine the people inside them. The second half of the conversation gets into the structure of the 8C Framework, walking through how each element from culture and clarity to coaching, communication, and celebration plays a role in either fueling or draining the people inside an organization. Dr. Riegel breaks down the four types of talking that leaders need to master, directive, dialogue, data analysis, and discussion, and explains how conflating them is one of the most common drivers of disengagement and burnout. She closes with a practical mind-body reset routine any leader can start tomorrow, and a reframe that is both simple and profound: when we see someone out of control, we are not talking to that person. We are talking to an unconscious part of their brain that believes it is in danger. RESOURCES MENTIONED Articles Referenced: Stanford Researchers Investigate How the Brain Changes with Different Learning Experiences - Stanford Graduate School of Education: Seven Workplace Challenges for 2025 - Gallup: Book: Aspirations to Operations: A Leader's Guide to Making Transformative Change Stick - Dr. Lisa Riegel: Connect with Dr. Lisa Riegel: Website: LinkedIn: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41338580

Ep 38: Advocacy, Autonomy and the Future of Psychotherapy with Linda Michaels of PsiAN 05/14/2026

Ep 38: Advocacy, Autonomy and the Future of Psychotherapy with Linda Michaels of PsiAN 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: Chatbots and AI Therapy Are Filling Gaps in Mental Health Care, but Regulation is Lagging — Washington Post: Practice Management Companies: What Therapists Need to Know — PsiAN: Connect with Dr. Linda Michaels and PsiAN: Website: Instagram: LinkedIn: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41283755

Ep 37: Trusted Tools for Peer Workers with Naveen Raman 05/07/2026

Ep 37: Trusted Tools for Peer Workers with Naveen Raman 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: Human in the Loop, AI in Healthcare Systems — Frontiers in Psychiatry: PeerCoPilot: AI Assistant for Behavioral Health Navigation — Carnegie Mellon University: Connect with Naveen Raman: Website: Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41166820

Ep 36: The Reality of Parity Enforcement 04/30/2026

Ep 36: The Reality of Parity Enforcement 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: Pennsylvania Insurance Regulators Fine Aetna for Violations of Mental Health Parity Regulations — Philadelphia Inquirer: Health Insurers Pay Penalty for Mental Health Parity Compliance Failures — HIPAA Journal: Departments Announce Non-Enforcement of 2024 Mental Health Parity Rule — APA Services: Related Episode: Mental Health Parity Advocacy and Policy with Deborah Steinberg CONNECT WITH THE MENTAL HEALTH EVOLUTION Website: Instagram: LinkedIn: Facebook: Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/41052190

Ep 35: Ethical Marketing Strategies for Mental Health Practices with Adrienne Wilkerson 04/23/2026

Ep 35: Ethical Marketing Strategies for Mental Health Practices with Adrienne Wilkerson 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: How AI Is Changing Online Marketing for Small Businesses — Forbes: Ethical Principles of Psychologists and Code of Conduct — American Psychological Association: Connect with Adrienne Wilkerson: Beacon Media and Marketing: Digital Marketing for Mental Health (Book): Connect with The Mental Health Evolution: Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/40974295

Ep 34: Mental Health Access, Telehealth Policy and the Future of Behavioral Health Care with Andrea Fox 04/15/2026

Ep 34: Mental Health Access, Telehealth Policy and the Future of Behavioral Health Care with Andrea Fox 🎧 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 🎙 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: 🔗 Connect with Mental Health Evolution Website: Instagram: LinkedIn: Facebook: 🎶 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/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/40887870

Ep 33: The 988 Hotline: Three Years In 04/07/2026

Ep 33: The 988 Hotline: Three Years In 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 — 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 — 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 — 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 — 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: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/40763965

Ep 32: Virtual Worlds, Real Skills with Dr. Kryn McClain 04/02/2026

Ep 31: The Relationship Checkup with Dr. James Cordova and Matt Rubin of Arammu 03/25/2026

Ep 30: Rethinking Behavioral Health Access with Jason Youngblood 03/19/2026

Ep 30: Rethinking Behavioral Health Access with Jason Youngblood 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 — 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 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. — 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 Connect with The Mental Health Evolution Website: Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/40527310

Ep 29: Crash-Testing AI for Mental Health with Shirali and Arul Nigam 03/12/2026

Ep 29: Crash-Testing AI for Mental Health with Shirali and Arul Nigam 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 Connect with Shirali and Arul Nigam Website: Connect with The Mental Health Evolution Website: Instagram: LinkedIn: Facebook: Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/40414625

Ep 28: Community Health, Local Solutions with Malcolm Furgol 03/05/2026

Ep 28: Community Health, Local Solutions with Malcolm Furgol 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: New Policies Affecting Access to Mental Health Care — APA: Health Equity Framework — Coalition for a Healthier Frederick County: Connect with Malcolm Furgol Coalition for a Healthier Frederick County: Connect with The Mental Health Evolution Website: Instagram: LinkedIn: Facebook: Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/40329780

Ep 27: Tiered Care, Technology, and the Future of Mental Health 02/26/2026

Ep 27: Tiered Care, Technology, and the Future of Mental Health 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: 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: 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: 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: 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: 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: Connect with The Mental Health Evolution Website: Instagram: LinkedIn: Facebook: Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/40245145

Ep 26: Who Supports the Crisis Workers with Becky Stoll 02/18/2026

Ep 26: Who Supports the Crisis Workers with Becky Stoll 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: Connect with Becky Stoll: Organization: Connect with The Mental Health Evolution Website: Instagram: LinkedIn: Facebook: Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/40153860

Ep 25: Out‑of‑Pocket and Out of Reach 02/11/2026

Ep 25: Out‑of‑Pocket and Out of Reach 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 Out-of-pocket costs are changing mental health access nationwide. Even insured clients are leaving therapy due to financial constraints. Insurance structures are compounding affordability gaps. Deductible and co-pay increases are eroding real coverage value. Clinicians are navigating new referral and revenue challenges. Practices are adapting to maintain viability amid shrinking access. Documenting financial impact is critical for advocacy. Gathering data about cost-related care terminations supports system-level reform. 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: 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/ 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 New Policies Affecting Access to Mental Health Care — APA Services 2026 Summary https://updates.apaservices.org/new-policies-affecting-access-to-mental-health-care 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/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/40076600

Ep 24: Interstate Licensure Compacts 02/04/2026

Ep 24: Interstate Licensure Compacts 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: PSYPACT: Social Work Compact: HHS Telehealth Licensure Overview: Telehealth & Private Insurance Laws: Medicaid Telehealth Reimbursement Guidelines: Federal & State Telehealth Policy Tracker (Manatt): CONNECT WITH THE MENTAL HEALTH EVOLUTION Website: Instagram: LinkedIn: Facebook: Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/39995005

Ep 23: Building a Mental Health System That Works with Sue Abderholden 01/29/2026

Ep 23: Building a Mental Health System That Works with Sue Abderholden 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 KFF — The Landscape of School-Based Mental Health Services NASHP — Trends in State Strategies to Improve the Behavioral Health Workforce Milliman — Mental Health Parity & Medicaid Implementation for State Agencies SAMHSA — National Guidelines for a Behavioral Health Coordinated Crisis System CONNECT WITH THE GUEST Sue Abderholden LinkedIn: Music Credit: Music by Zach Harrison /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/39922715

Ep 22: Scaling Mental Health Organizations with Ryan Dewey Smith 01/22/2026

Ep 22: Scaling Mental Health Organizations with Ryan Dewey Smith 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 The Nonprofit Workforce Is in Crisis Navigating Workforce Challenges: 2025 Trends and Solutions for the Social Sector CONNECT WITH THE GUEST Ryan Dewey Smith Website: LinkedIn: /episode/index/show/638bd6a9-a8aa-40fb-89c8-5ece4dacb562/id/39816605