What if the smartest response to addiction, relapse, and repeat court involvement is not harsher punishment, but a highly structured path back to stability? The Honorable Shannon R. Dougherty, a Circuit Judge for Division 6 of the 23rd Judicial Circuit in Jefferson County, Missouri, and  Lori Epley, the Director of Project Access at Chestnut Health Systems, break down how problem-solving courts are helping people stay in recovery, keep families together, and rebuild their lives while protecting public safety.

Judge Dougherty explains how treatment courts work in practice: close monitoring, regular drug testing, team staffing, and individualized responses that mix accountability with support. Lori Epley, Director of Project Access at Chestnut Health Systems, shares how Chestnut's clinician and peer support specialists work alongside the court team to provide therapy, transportation help, resume support, and practical services that participants need to succeed. You'll discover:

Our guests make the case for better education, stronger interagency collaboration, and a future treatment court center where participants can access multiple services in one place. If you care about criminal justice, substance use recovery, family stability, or practical solutions that actually change outcomes, this episode is essential listening.

Michael Castanon is the founder and CEO of Alter Behavioral Health and Care Predictor, and founder of the Behavioral Health Outcomes Consortium. 

After 30 years in banking and predictive analytics, Michael brings an outsider’s eye to behavioral health and makes a case the field can’t ignore: if you can measure the inputs, you can improve the outcomes. He explains how a deeply personal trauma journey led him from private equity and finance into mental health care, and why that intersection of lived experience and data science became the foundation for Care Predictor.

Michael discusses two important concepts  - “relational velocity and relational intelligence” - and how these traits can be measured, scored, and developed. He describes how Care Predictor uses psychometrics and AI to help deliver better care.

We also get into what some are calling the loneliness epidemic, driven by AI “companionship,” remote work, and algorithmic echo chambers. Michael makes the case that when we lost human connection, people lose the friction, challenge, and healthy conflict that build resilience, judgment, and real relationships.

Finally, Michael discusses the upcoming BHOC 26 gathering, where policymakers, health plans, providers, technologists, and researchers will come together to create a more unified outcomes framework for behavioral health (more information is provided below). 

The Behavioral Health Outcomes Consortium (BHOC26) is an outcomes-focused event designed for behavioral health leaders, operators, providers, payers, and partners committed to advancing measurable outcomes across the continuum of care. 

Mental health and substance use disorders are behind a shocking share of pregnancy-related deaths across Missouri – indeed, nationwide - and many of those deaths were preventable. 

Joining us to discuss this are Charisse Montgomery, Family Services Coordinator with Chestnut Health Systems, and Lindsey VonDras, Perinatal Care Coordination Manager for the Missouri Hospital Association. Charisse and Lindsey break down what the data really says about pregnancy, postpartum risk, foster care disruption, and why so many families never get connected to the support they need.

You’ll discover why nearly 40% of pregnancy-related deaths happen after delivery, how stigma and access barriers keep people from asking for help, and why Missouri’s maternity care deserts make the problem even harder to solve. We also get into what actually works: family-centered care, individualized recovery pathways, peer support, doulas, and coordinated wraparound services that keep mom, baby, and family in the picture. 

Charisse shares how Chestnut Health Systems supports parents through pregnancy and postpartum, and Lindsey explains Project STORK, a new Missouri framework promoting real connection, recovery support, and ongoing care.

If you care about maternal health, behavioral health, child welfare, or better systems for families in crisis, this conversation is essential listening. 

Starting January 1, 2027, changes to Medicaid eligibility requirements will leave millions without coverage. Dr. Timothy McBride, the Bernard Becker Professor of Public Health at Washington University in St. Louis and a leading health economist, breaks down these provisions and explains how they threaten to strip coverage from people who are already working.We discuss the new twice-a-year eligibility checks, the end of self-attestation, and the extra documentation now required of caregivers, pregnant women, and medically frail patients. What sounds simple on paper quickly becomes a maze of mailed forms, state-by-state implementation differences, missing paperwork, and delayed doctor sign-offs.

Key points include:

Dr. McBride also outlines the broader stakes: rising uncompensated care, higher medical debt, added pressure on rural hospitals and safety-net providers, and a likely increase in uninsured Americans as coverage rolls back month by month. For a clear-eyed look at what these changes mean for patients, providers, and the healthcare system, this is essential listening.

Grant Wood’s American Gothic (1930), depicting a middle-aged rural couple, is what “seniors” look like in the popular imagination, but recent data tell a very different story. Opioid overdoses and prescription misuse are rising fast among the elderly.  Returning to the pod for his second appearance to discuss this little-known issue and the bill proposed to address it is Al Guida, veteran healthcare lobbyist and policy strategist with over 30 years of experience navigating Washington’s complex legislative landscape. We discuss: 

With the upcoming legislative hurdles and regulatory headwinds, understanding how this bill could reshape care for millions has never been more urgent. This podcast is for healthcare professionals, advocates, policymakers, or anyone with a personal stake in getting seniors battling substance use disorder the attention and treatment they need and deserve. 

The ASAM Criteria Fourth Edition (released in 2023) is the most widely used, evidence-based set of standards for assessing, placing, and treating individuals with substance use disorders (SUDs), addiction, and co-occurring conditions. Developed by the American Society of Addiction Medicine (ASAM), the fourth edition champions holistic, person-centered care that’s more inclusive, equitable, and effective than ever before. 

We are joined by Diana Kelly, a Licensed Clinical Social Worker (LCSW), clinician, educator, and Clinical Director for the Consulting and Training Team at the Hazelden Betty Ford Foundation, where she leads the development and implementation of national training and consultation initiatives for the ASAM Criteria Fourth Edition. Diana is an Army veteran with 12 years of service, during which she served as both a Combat Medical Sergeant and a Sexual Assault Response Coordinator. Diana joins us to discuss how this new blueprint is revolutionizing the way we approach substance use and co-occurring disorders. 

We discuss how the 2023 revision incorporates harm reduction, medication-assisted treatment, and trauma-informed strategies into standard practice. Diana breaks down the key differences between adolescent and adult treatment standards, emphasizing the power of early intervention to alter lives. She shares the groundbreaking focus on family inclusion, peer support, and tailored approaches for marginalized populations, including women veterans and justice-involved individuals. 

We also explore the critical challenges—and opportunities—related to access and how this blueprint acts as a north star for future policy, funding, and community efforts. 

Dr. Mark Godley was there at the creation, 40 years ago, when he was the first director of Chestnut Health Systems’ Lighthouse Institute for Research and Training. Dr. Godley pulls back the curtain on a remarkable four-decade journey,  from the Lighthouse Institute’s early struggles to keep the lights on to its emergence as the world-class research powerhouse it is today. 

He shares behind-the-scenes stories of their bootstrapping early days and major milestones along the way: winning their first major NIH grants in 1997, developing client follow-up protocols that led to a 19-year study, the institute's evolution from program evaluation to investigator-initiated research, among other notable achievements.

We break down: how research shifted from confrontational models to supportive, adolescent-centered care; the secret to building lasting community partnerships; and the surprising ways resilience and vision transformed a fledgling organization into a national leader. 

In a recent article on our Catalyst Substack, titled. “A Growing Trend in Modern Policing: First-Responders in Mental Health Emergencies,” we examined how police officers have increasingly become the default first responders to behavioral health crises, and how law enforcement is partnering with mental health providers to more effectively respond. That article focused primarily on the law enforcement perspective and was informed by a podcast we did with Edwardsville, Illinois, Police Chief Michael Fillback, and how his department is transforming responses to behavioral health emergencies via its partnership with Chestnut Health Systems. 

This podcast shifts the lens to the mental health provider’s viewpoint, thanks to our guests, Julie Brugger,  Director of Access & Crisis Services at Chestnut Health Systems, and Kara Wardein, a Recovery Specialist also with Chestnut. We discuss: 

Embracing these models creates a future where mental health crises are managed with compassion, expertise, and collaboration. It’s a conversation – and topic – that ought to start a broader conversation among policymakers, law enforcement officials, mental health advocates, and community leaders eager to pave the way for a more empathetic, efficient, and effective crisis response system. 

The extraordinary Dr. Leslie Korn is a pioneering integrative medicine expert with over 40 years of experience living among and studying indigenous cultures. She joins us to discuss how targeted, culturally-informed dietary strategies can heal the brain, reduce chronic stress, and restore well-being. 
 

We discuss the importance of bioindividuality and personalized dietary strategies over one-size-fits-all diets. You'll discover how trauma impacts biochemistry, and how specific nutrients can reliably fuel recovery. Dr. Korn’s insights are backed by research on trauma survivor populations, including Holocaust offspring, revealing how biochemistry reflects behavioral shifts and how targeted nutrition can reset these responses.
 

Other key topics include the global shift toward food as medicine, the influence of refined, processed diets on chronic disease, and practical tips for integrating nutrient-rich foods into everyday life. 

Leslie is the author of 10 books; we discussed the recent re-issue of Nutrition Essentials for Mental Health: A Complete Guide to the Food-Mood Connection, which updates the original published in 2016. We also discussed her parallel career as a documentary filmmaker, which is informed by her work on indigenous cultures and the connection between nutrition and whole health. This is a timely and important conversation, raising awareness of the importance of nutrition and its connection to mental health disorders, chronic illnesses, and trauma. Be prepared to rethink everything you thought you knew about diet, trauma, and healing.

Dr. Korn's filmography includes:  

Alex Dopp is an implementation scientist and child clinical psychologist who studies the use of research evidence and related policy implications for improving youth mental health services. Alex shares how his unique dual expertise in mental health and economic evaluation helps unlock the real-world value of evidence-based interventions for adolescents. We break down:

If you’re an advocate, policymaker, or leader seeking to transform youth mental health services, this episode is your insider’s guide to making smarter investments that truly reach the kids who need it most.

Links to the studies Alex mentioned in the podcast: