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.

• 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

• 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.

• "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."

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/

Ryan Dewey Smith
Website: https://ryandeweysmith.com/
LinkedIn: https://www.linkedin.com/in/ryan-dewey-smith