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The Mental Health Evolution

The Mental Health Evolution

By: Rachel Harrison
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 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.2024 Economics Hygiene & Healthy Living Leadership Management & Leadership Psychology Psychology & Mental Health
Episodes
  • Ep 22: Scaling Mental Health Organizations with Ryan Dewey Smith

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

    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
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    26 mins
  • Ep 21: Technology, Therapy, and the Future of Care

    Ep 21: Technology, Therapy, and the Future of Care
    Jan 15 2026
    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
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    26 mins
  • Ep 20: Inside Behavioral Health Systems with Cathy Gilbert

    Ep 20: Inside Behavioral Health Systems with Cathy Gilbert
    Jan 8 2026
    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: mentalhealthevolution.com

    • Instagram: @mentalhealthevolution

    • LinkedIn: Mental Health Evolution

    • Facebook: Mental Health Evolution

    Music credit: Music by Zach Harrison
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    26 mins
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