Episodes

  • Ep 31: The Relationship Checkup with Dr. James Cordova and Matt Rubin of Arammu

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

    Episode Summary

    This episode brings one of our favorite conversations from Rachel's previous podcast, The Mental Health Entrepreneur, to the Mental Health Evolution audience. Dr. James Cordova is a researcher and clinician who has spent over two decades studying relationship health, and Matt Rubin is the entrepreneur who helped bring that research to life through Arammu, a company built around a checkup and maintenance-based model of care for couples. Together, they join Rachel to make the case for something the mental health field has long overlooked: treating relationships as a health system that deserves proactive, preventative care rather than crisis-only intervention. Dr. Cordova traces the origins of this work back to his time volunteering at a crisis center, where he noticed month after month that relationship issues were the leading reason people called in for help.

    The conversation explores how Arammu's relationship checkup works in practice, what it looks like across the full spectrum of couples from newly married to severely distressed, how it fits into existing clinical workflows, and why brief, evidence-based tools like this one may be key to addressing the mental health access crisis. Rachel and her guests also discuss insurance billing, the surprising uptake from the military, and the broader vision of shifting mental health care toward a primary care model where early and frequent support becomes the norm rather than the exception.

    Connect with Dr. James Cordova and Matt Rubin

    Arammu: The Proactive Relationship Checkup

    Connect with The Mental Health Evolution

    • Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast
    • Instagram: https://www.instagram.com/thementalhealthevolution/
    • LinkedIn: https://www.linkedin.com/showcase/the-mental-health-evolution
    • Facebook: https://www.facebook.com/TheMentalHealthEvolution

    Music Credit: Music by Zach Harrison
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    30 mins
  • Ep 30: Rethinking Behavioral Health Access with Jason Youngblood

    Ep 30: Rethinking Behavioral Health Access with Jason Youngblood
    Mar 19 2026
    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 First Therapy Chatbot Trial Yields Mental Health Benefits — 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 Scoping Review of AI-Driven Digital Interventions in Mental Health Care — 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. Headspace for Cigna Healthcare Enhances Everyday Mental Health Support Through Self-Guided, Science-Backed Resources — 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 The Rise of the Anxious Worker Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcastInstagram: /thementalhealthevolution/LinkedIn: /the-mental-health-evolutionFacebook: /TheMentalHealthEvolutionMusic Credit: Music by Zach Harrison
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    29 mins
  • Ep 29: Crash-Testing AI for Mental Health with Shirali and Arul Nigam

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

    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

    New study: AI chatbots systematically violate mental health ethics standards | Brown University

    New study warns of risks in AI mental health tools | Stanford Report

    https://www.circuitbreakerlabs.ai/Whitepaper.pdf

    Connect with Shirali and Arul Nigam

    Website: https://www.circuitbreakerlabs.ai

    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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    29 mins
  • Ep 28: Community Health, Local Solutions with Malcolm Furgol

    Ep 28: Community Health, Local Solutions with Malcolm Furgol
    Mar 5 2026
    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: https://www.nytimes.com/2024/09/15/business/affordable-therapy-costs.htmlNew Policies Affecting Access to Mental Health Care — APA: https://updates.apaservices.org/new-policies-affecting-access-to-mental-health-careHealth Equity Framework — Coalition for a Healthier Frederick County: https://static1.squarespace.com/static/6435982bd0e669659a59352f/t/690cd050d51f6413512b56d3/1762447440408/Health+Equity+Framework+Final.pdf Connect with Malcolm Furgol Coalition for a Healthier Frederick County: https://healthierfrederick.org/events-and-meetings/419u6v9q4uunxtu8xv5j37iv0kug3v 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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    30 mins
  • Ep 27: Tiered Care, Technology, and the Future of Mental Health

    Ep 27: Tiered Care, Technology, and the Future of Mental Health
    Feb 26 2026
    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. integrationOverview of six key articles framing the episode's discussionThe 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 educationThe emerging tiered or stepped care model — from wellness apps to inpatient careImplications 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: https://pmc.ncbi.nlm.nih.gov/articles/PMC12110772/ 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: https://www.apa.org/topics/artificial-intelligence-machine-learning/health-advisory-chatbots-wellness-apps 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: https://home.dartmouth.edu/news/2025/03/first-therapy-chatbot-trial-yields-mental-health-benefits 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: https://theconversation.com/ai-is-providing-emotional-support-for-employees-but-is-it-a-valuable-tool-or-privacy-threat-266570 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: https://hrzone.com/ai-mental-health-tools-breakthrough-or-band-aid-for-employee-wellbeing/ 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: https://societyforpsychotherapy.org/from-clinical-judgment-to-machine-learning-rethinking-psychotherapeutic-decision-making-with-artificial-intelligence/ Connect with The Mental Health Evolution Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast Instagram: /...
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    22 mins
  • Ep 26: Who Supports the Crisis Workers with Becky Stoll

    Ep 26: Who Supports the Crisis Workers with Becky Stoll
    Feb 18 2026
    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 fieldHow the industry has historically failed staff by prioritizing wellness perks over systemic changeA continuum-based framework for sustainable hiring, onboarding, and retentionWhy being a good clinician does not automatically make someone a good managerCareer pathing as an underused retention and development strategyWhat Centerstone's research on the brain in crisis revealed about how we should approach people post-crisisThe responsibilities that come with organizational scale through mergers and acquisitionsWhy 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 ProfessionalsOrganizational 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
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    28 mins
  • Ep 25: Out‑of‑Pocket and Out of Reach

    Ep 25: Out‑of‑Pocket and Out of Reach
    Feb 11 2026
    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
    1. Out-of-pocket costs are changing mental health access nationwide. Even insured clients are leaving therapy due to financial constraints.
    2. Insurance structures are compounding affordability gaps. Deductible and co-pay increases are eroding real coverage value.
    3. Clinicians are navigating new referral and revenue challenges. Practices are adapting to maintain viability amid shrinking access.
    4. Documenting financial impact is critical for advocacy. Gathering data about cost-related care terminations supports system-level reform.
    5. 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
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    15 mins
  • Ep 24: Interstate Licensure Compacts

    Ep 24: Interstate Licensure Compacts
    Feb 4 2026
    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
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    11 mins