Self Disclosed

Patrick Gilligan
  • 5.0 (3)
  • Mental Health
  • Updated Weekly

Self Disclosed is a weekly podcast for Medicaid executives, clinical leaders, and anyone else tasked with the nearly impossible job of delivering better mental health outcomes for underserved youth — under budget, under pressure, and under public scrutiny.

  1. Sep 22

    Why "Just Get Them Into Therapy" Stopped Working with Carmine DiMaro @ One Mind

    Carmine Di Maro reads hundreds of mental health startup pitches a year. He has watched 51 companies go through the One Mind Accelerator, raise $1.45 billion between them, and in some cases shut down. He also spent his first job out of college mired in addiction, reading every self-help book he could find, convinced that needing help was a personal failing. Both of those things are load-bearing in this conversation. Patrick and Carmine met in 2023, when Somethings was one of eleven companies in the accelerator's first cohort. Three years later they sit down as two people with lived experience of the thing they're both trying to fix, and the conversation moves fast between the systems level and the personal one. They get into why a decade of paid-for therapy hasn't moved outcomes, why a free 100-year-old program with no leadership still runs 2,000 meetings a week in Los Angeles, what a survey found about the one workplace benefit that actually improves mental wellness, and why neither of them thinks the health care system should be responsible for making sure you have friends. In this episode: • The survey question about confidants where the average answer came back zero • Why Carmine argues screen use meets the clinical criteria for addiction • What peer support does that therapy structurally cannot • The workplace benefit that outperformed every wellness perk in the study • How Covid lowered the barrier to a first 12-step meeting • Why adding psychiatric beds makes the bed problem worse • What Carmine would change about mental health if he had one wish Applications for the fifth One Mind Accelerator cohort are open through mid-October. Subscribe to Self Disclosed on YouTube, Spotify, and Apple Podcasts. Chapters: 00:00 Ten years of paying for therapy, no change 01:58 The average answer was zero 06:22 It meets the definition of addiction 09:25 The iPad at the dinner table 12:36 2,000 meetings a week, nobody in charge 15:01 Why the ER became a food bank 23:49 What it took to ask for help 34:12 A brain textbook with no psychiatry in it 37:35 The only perk that worked 55:41 Cohort five, and the EpiPen for addiction

  2. Sep 15

    It's Hard to Be a Human, So Help Someone | Laura Nolan, PhD, Director at Manatt

    Laura Nolan joined the Peace Corps out of college because she'd found community health at the very end of school, fallen for it, and wanted to go somewhere far from where she grew up. She landed in the Fiji Islands, assigned to a women's group, and spent the first stretch of her service talking to them about health and how to cook healthy food. Nobody was interested. Nobody wanted to hang out with her. So she stopped talking and started watching. What she saw was that health wasn't anywhere near the top of the list. These women didn't have resources and they didn't have agency, and everything else followed from that. She switched from being a health volunteer to a business volunteer and started helping them build businesses. A lot of beekeeping. Set up the hives, extract the honey, sell it to the resorts and the farmers market. Solve the root problem and a mother is more likely to have bus fare to get to the hospital when her kid has an infected cut. That instinct traveled. A PhD in demography and social policy at Princeton, a master's at Harvard Chan, seven and a half years at Mathematica analyzing data from the Medicaid and CHIP programs, and now director at Manatt. If you've ever cited a national number about who is enrolled in Medicaid or what services they got, there's a decent chance she had a hand in helping to calculate it. Patrick Gilligan sits with Laura on what the new federal legislation is doing to state Medicaid budgets, why every state's program is a snowflake, and the thing that keeps coming up in Somethings' own teen surveys: the single most cited barrier to a teenager getting mental health care is a parent. For a lot of those kids, the pain of asking for consent is worse than what they were already carrying, so they don't ask. Then it turns personal. Laura has two kids under seven and writes a Substack called The Family Stack about technology and products for parents and families, and her answer to how it all holds together is uncomfortably simple. Name the one thing you will not trade. Hers is picking up her kids. She does that as often as she can, does the bedtime routine, and goes back to her computer almost every night. Highlights: - The Peace Corps in Fiji, and the moment she realized she should stop talking - Beekeeping as public health, and what solving the root problem actually looks like - A nighttime tour of Harvard Chan that turned into a career - Two projects at once, adoring one and struggling through the other, and what that told her - What the new federal legislation is doing to Medicaid financing and work requirements - The silver lining for health plans: help people stay enrolled - Why Medicaid is a snowflake in all fifty states, and why that's hard to build for - Aligning an intervention with what payers actually pay for - How peer support gets billed, and why teens asked for an older sibling instead of a clinician - Parents as the number one cited barrier to teen mental health access - The shape of ambition after having kids - Be clear about your priorities and what works for yourself and your family - What she's afraid of for her kids: uncertainty and speed, together - Her mission, in seven words Subscribe to Self Disclosed for more honest conversations about what it actually takes to fix mental health care. New episodes on YouTube, Spotify, and Apple Podcasts. Timestamps: 00:00 Intro 01:00 The Peace Corps, and landing in the Fiji Islands 02:46 When she stopped talking about health and started listening 11:46 Two projects at once, and what her own reaction told her 13:55 What the new federal legislation is doing to Medicaid 17:47 Why Medicaid is a snowflake in all fifty states 26:31 How peer support actually gets billed 30:40 Parents are the number one barrier to teen mental health care 37:22 Name the one thing you will not trade 48:16 Her mission: I want my kids to be proud of me

  3. Sep 8

    Stop Asking What’s Wrong With People | Dr. Jean Wright, NYC DOHMH

    In this episode of Self Disclosed, we sit down with Dr. H. Jean Wright II, founder and CEO of Mental Health Success Boost and former Executive Deputy Commissioner of Mental Hygiene at NYC DOHMH, on why the question you ask about a person decides the answer you get. We cover: ✅ Why “what happened to you” opens a conversation and “what’s wrong with you” shuts one down ✅ The interviews Jean refused to run until the guards took the leg irons and chains off ✅ How a Philadelphia division that started with two people, a peer specialist and an administrator, grew to 60 ✅ Why men serving life sentences pooled eight-dollar-a-week wages to pay for other families’ dinners ✅ What New York gets right about behavioral health, and the zip codes still getting left out Whether you run a system, fund one, or work inside one, this is a conversation about the difference between serving people and deciding for them. 🎧 Subscribe for more conversations like these #BehavioralHealth #MentalHealth #ServantLeadership #TraumaInformedCare #PublicHealth 00:00 Intro 02:11 The rent you pay for being on this earth 03:38 Twelve years old, and choosing the kids nobody picked 05:26 What his parents showed him about servant leadership 06:27 “Your career chooses you” 09:24 Crime shows, and the mentor who pushed him toward forensics 13:16 What happened to you, not what’s wrong with you 15:32 Fundamental attribution error 16:29 No formula, no fear: building rapport behind the walls 18:52 Why he refused to interview anyone in leg irons 20:42 The Montgomery decision and the men coming home 22:07 Fathers and Children Together 25:27 Philadelphia: from one person at a time to a whole city 29:59 Two people to sixty, and a division still running today 33:48 Peer specialists, years ahead of reimbursement 35:46 Influencing people who don’t answer to you 38:50 New York, times ten 44:13 What NYC gets right, and what he’d fix tomorrow 51:06 Changing mindsets and giving hope

  4. Aug 25

    How to Fix Youth Mental Health Without Training More Therapists | Dr. Amber Childs @ Somethings

    Dr. Amber Childs has spent nearly 15 years working on one question: how do we actually get young people the mental health care they need? Early in her training she was writing discharge plans for teenagers, telling families the soonest available clinician was 12 weeks out, and bridging the gap with emergency services. The math never worked, and it still doesn't. Amber is a licensed clinical psychologist, associate professor of psychiatry at Yale School of Medicine, and now Chief Clinical Officer at Somethings. She sits in a rare seat, holding academic rigor and real-world deployment at the same time. In this conversation with Patrick Gilligan, she makes the case that the answer isn't waiting on a technological breakthrough. It's the oldest thing we have: relationships, connection, and being witnessed by someone who has been where you are. She and Patrick get into what the research says about therapeutic alliance, why an adult intervention can't just be pointed at a 16-year-old, and the moment in a group therapy room that changed how she thinks about who is qualified to help. In this episode: • Why Amber didn't know psychology existed until college, and the whiteboard quote that changed her direction • What the research says about therapeutic alliance, and why that finding widens who can deliver care • The teenager whose one sentence reframed her entire approach to scale • Why pace and prioritization are bigger problems than clinician shortage • What she learned watching a teen accept from a peer what she couldn't deliver herself • How to build technology that props up human connection instead of replacing it • The one thing she'd change with a magic wand Subscribe for new conversations on youth mental health, care delivery, and what actually works. Listen on YouTube, Spotify, and Apple Podcasts. Learn more about Somethings at somethings.com

  5. 12/10/2025

    If Teens Won’t Engage, Nothing Else Matters. Marc Fagan on Youth Voice, Peer Support, and Systems That Actually Work

    What really moves the needle for transition-age youth (16–24)? It’s not another program list—it’s engagement. In this episode, Patrick sits down with Marc Fagan, President of YouthCare Illinois, to unpack a new playbook: put youth voice on the mic, design for discovery (not lectures), make peer support core infrastructure, and measure uptake instead of offerings. Who this is for: Medicaid leaders, child-welfare teams, providers, school partners, policymakers, and anyone building youth programs that need to work in the real world. You’ll learn: Why “listening” (for real) is the biggest shift since 2015 How to win the first yes from the least-likely-to-engage population Where peer support and community fit alongside therapy How to design discovery-oriented care—healthy risk with real safety nets The role of virtual touchpoints, SDOH (jobs/school), and what to measure next Chapters 00:00 Cold open — quick banter & setup 00:27 Who is Marc Fagan & what YouthCare does 01:08 Why Marc chose clinical psychology 01:57 Therapeutic schools: the power of relational work 03:10 From 1:1 therapy to systems design 04:13 Story: a student turns classroom chaos into graduation 06:26 Scaling impact beyond one campus 09:06 Thresholds highlights: youth homelessness program 10:27 Launching First Episode Psychosis care in Illinois 12:14 Why early intervention changes the arc 13:24 Then vs now: outcomes and accountability 14:39 What “transition-age youth” actually need (and don’t get) 16:06 2025’s biggest shift: youth voice leads 17:47 What teens keep telling us (and how adults should respond) 18:15 Discovery-oriented care: learning by doing, with guardrails 20:20 Design for exploration, not lectures 21:21 YouthCare’s population: youth with child-welfare histories 22:51 Virtual touchpoints & continuity across placements 24:00 Beyond therapy: groups, play/animal therapy, peer support 25:07 The pivot: from mostly clinical to mostly social 26:10 Multidisciplinary models that actually stick 27:02 The engagement problem—and how to solve it 28:04 Training staff to earn the first yes 29:10 Measuring what matters: uptake, not inventory 29:37 SDOH in practice: jobs, school, first opportunities 31:25 Early jobs and lessons (including a data-entry horror story) 33:01 Leadership: excitement, ownership, youth focus groups 34:40 Preventing burnout: celebrate small wins 38:05 The next 10–15 years: risk, policy, connection 40:07 Hopes for the future: faster access, shorter time in care 42:02 Biggest levers: tech plumbing + nontraditional care 44:11 Why relationships still beat everything 44:52 Showing up authentically (yes, there was a dance-off) 46:13 What keeps Marc optimistic 48:25 Where to learn more about YouthCare 49:14 One snap: immediate access + one committed adult 50:01 Closing If this was useful, please like, subscribe, and share with someone building for youth. If you or someone you know is in crisis, call or text 988 (U.S.).

  6. 11/18/2025

    Mental Health Isn’t “Cool.” Here’s How We Designed Around That

    What makes a teen mental health product worth opening every day? In this episode of Self Disclosed, Somethings’ design team walks through the choices behind our new brand and product: why we center connection before anything else, how we keep teens in the driver’s seat, and why our visual system embraces graffiti over clinical calm. We also share how we use AI as a quiet assist for mentors rather than a chatbot on the front line, and the naming story behind Somethings. You will learn The core problem we see behind the stats: loneliness How to design for trust, agency, and real conversation Why a teen-facing brand should feel expressive, not pastel and clinical Where AI helps humans show up better, and where it does not The origin of our name and why words matter to teens Chapters 00:00 Cold open and why design matters in youth mental health 01:58 Meet the team and backgrounds 03:56 First designer’s path from pro sports to product 05:46 Our design philosophy: build with teens, not for them 07:06 What we hear every day: loneliness is the through-line 08:32 Teens can say more than adults think, if you listen 10:37 How adult minimization harms trust 11:54 Designing for genuine connection and rapport 15:50 Our AI stance: support mentors, do not replace them 19:43 Features that help mentors remember, follow up, and be present 20:50 A different approach to product and brand in mental health 21:27 What most teen mental health brands miss 23:37 Can mental health feel “cool” and authentic 25:16 Launching the new brand 27:44 Why graffiti, not fog and pastels 29:21 Empowering teen self-expression on purpose 31:32 Keeping the brand a mirror to teen life 33:23 Bringing brand principles into product decisions 35:59 What excites us about the next chapter 38:33 Why we are called Somethings 45:27 Final thoughts and how to get involved If this was useful, like and subscribe, and share it with someone building for teens.

  7. 11/12/2025

    Does Digital Peer Support Work for Teens? Inside North Carolina’s Real-World Results

    In this episode of Self Disclosed, we open up Somethings’ first clinical outcomes report from our statewide rollout in North Carolina and talk plainly about what changed for teens, how we measured it, and what it means for families, schools, payers, and states. What this episode covers - What Somethings is: a youth mental health app that pairs teens (13–26) with certified peer mentors for on-demand support and continuity of relationship- Why North Carolina partnered to offer the program free to ~1.2M teens across all 100 counties- How we evaluated impact (pre–post design; PHQ-8, GAD-7, WHO-5, ASQ-3)- Engagement at scale, rural access, and why human connection beats chatbots for this age group- What the data says about depression, anxiety, well-being, and suicidal ideation- Where this fits in the care ecosystem (ED diversion, continuity, cost, and appropriate utilization) Key findings (real-world, not a lab)- Average time from sign-up to first connection: ~6 hours- In about 2 months: 77% of teens improved in at least one domain; 52% showed clinically meaningful improvement; nearly 1 in 4 reached remission in at least one area- Teens who started with suicidal thoughts: prevalence dropped from ~40% at intake to ~27% at follow-up; median time to resolution = 16 days- Who we served: a high-need, diverse population with common moderate-to-severe symptoms, including many youth who struggle to access traditional care Who should watch Parents and educators, Medicaid and health-plan leaders, state and county health officials, school mental-health teams, clinicians, and builders who need evidence on what actually engages teens and moves outcomes. Chapters 00:00 Intro and why we recorded this 00:50 Meet the team 05:06 What Somethings does and why peers matter 06:50 North Carolina partnership overview 08:19 Study design and measures (PHQ-8, GAD-7, WHO-5, ASQ-3) 11:01 Who we served and why access matters 12:16 Engagement metrics and 6-hour time to first connection 13:11 Baseline risk: depression, anxiety, suicidal ideation 15:32 Outcomes at ~2 months: improvement, clinical change, remission 16:45 Why rapport is the intervention 19:51 Depression results, then anxiety and well-being 22:58 Suicidal ideation: resolution timeline and impact 26:38 “Teens are not little adults” and system navigation 29:42 Why many teens drop out of treatment and how peers help 33:31 ER boarding, cost, and appropriate utilization 36:34 Rural access and continuity in the real world 38:19 Case study from the field 41:13 Making support more accessible for different learners 41:58 What health plans and states can do right now 42:55 Rapid-fire: one change we’d make for youth mental health 45:59 Closing thoughts This is a real-world, pre–post outcomes evaluation, not medical advice. If you or someone you know is in crisis, call or text 988 in the U.S.

  8. 10/14/2025

    The System Is Failing Our Kids: How to Rebuild Child Welfare from the Inside Out, with Nicole Six, VP of Product Development at Centene

    What if the system built to protect children is also the one traumatizing them? Nicole Six — VP of Product Development at Sentara Health and a licensed clinical social worker — has spent her career inside the child welfare and behavioral health systems. From her early days as a social worker in New York City to leading large-scale Medicaid and child welfare initiatives in North Carolina, Nicole has seen how policy, poverty, and broken systems collide to shape the lives of vulnerable kids. In this powerful conversation, she and Patrick Gilligan dive into what’s working, what’s failing, and what needs to change — now. You’ll hear: - Why children in foster care lose connection to their families and communities the longer they’re in care - The painful truth that “we created the trauma” for many of the kids our systems claim to protect - Why the best clinicians are leaving behavioral health — and how that’s quietly deepening the access crisis - The case for upstream prevention and family-centered care - What a transformed child welfare system could look like by 2030 - And the one thing Nicole says every child needs most: someone who loves them. This episode is raw, eye-opening, and deeply human. If you care about child welfare, mental health, or Medicaid reform — you need to hear this one. Timestamps 00:00 – Introduction 02:00 – Nicole’s path from social work to leadership 07:00 – Lessons from child welfare in NYC vs. North Carolina 13:00 – Why prevention is everything — and why it’s underfunded 17:00 – The myth of “bad families” and what kids really need 24:00 – The mental health access crisis and why clinicians are leaving 30:00 – How to design systems that actually help families 36:00 – What a trauma-informed future could look like 40:00 – Why kids in care lose their connection to “their people” 43:00 – The hard truth: we created the trauma we’re trying to fix 48:00 – The one thing Nicole wishes every child could have

See All (19)

Ratings & Reviews

5
out of 5
3 Ratings

About

Self Disclosed is a weekly podcast for Medicaid executives, clinical leaders, and anyone else tasked with the nearly impossible job of delivering better mental health outcomes for underserved youth — under budget, under pressure, and under public scrutiny.

Information

  • Creator
    Patrick Gilligan
  • Years Active
    2025 - 2026
  • Episodes
    19
  • Rating
    Clean
  • Copyright
    © Patrick Gilligan
  • Show Website
    Self Disclosed