The Mental Health Evolution

Rachel Harrison
  • 4.9 (12)
  • MENTAL HEALTH
  • UPDATED WEEKLY

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.

  1. 3D AGO

    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: 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

    28 min

  2. FEB 11

    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 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

    15 min

  3. FEB 4

    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: 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

    11 min

  4. JAN 29

    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 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

    31 min

  5. JAN 22

    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 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

    26 min

  6. JAN 15

    Ep 21: Technology, Therapy, and the Future of Care

    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

    26 min

  7. JAN 8

    Ep 20: Inside Behavioral Health Systems with Cathy Gilbert

    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

    26 min

  8. JAN 1

    Ep 19: Big Mental Health Stories & Trends to Watch in 2026

    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

    17 min
See All (78)

4.9
out of 5
12 Ratings

About

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.

Information