Rachel speaks with Dr. Linda Michaels, PsyD, MBA, a psychologist in private practice in Chicago and co-founder of the Psychotherapy Action Network (PsiAN). Founded in 2017, PsiAN was built to provide a unified voice for psychotherapists across all disciplines and theoretical orientations, advocating for access to quality care and pushing back against the forces reshaping the field. Dr. Michaels brings a rare combination of clinical training and a prior career in business, marketing, and organizational consulting, and that background is evident in how she analyzes the systems bearing down on the profession. The conversation opens with the origins of PsiAN, the research they have conducted with both the public and therapists, and why the organization has made it a priority to cut across the silos that limit collective professional power.

The second half of the conversation takes a direct look at practice management companies and what therapists need to know before working with them. Dr. Michaels walks through PsiAN's research with nearly 700 therapists, revealing that despite promises of higher earnings, half reported making the same or less. She details the near-total insurance company ownership of these platforms, the data privacy concerns including a class action suit against Headway for sharing patient data with Google, and the growing use of therapy session transcripts to train proprietary AI language models. Dr. Michaels closes with a clear message for therapists: every business decision is ultimately a clinical one, and the profession's greatest asset in the face of corporate consolidation is knowledge, standards, and solidarity.

RESOURCES MENTIONED

Articles Referenced:

They Thought They Were Doing Good, But It Made People Worse: Why Mental Health Apps Are Under Scrutiny — The Guardian: https://www.theguardian.com/society/2024/feb/04/they-thought-they-were-doing-good-but-it-made-people-worse-why-mental-health-apps-are-under-scrutiny

Chatbots and AI Therapy Are Filling Gaps in Mental Health Care, but Regulation is Lagging — Washington Post: https://www.washingtonpost.com/health/2026/04/19/chatbot-therapy-mental-health-regulations/

Practice Management Companies: What Therapists Need to Know — PsiAN: https://www.psian.org/practice-management-companies

Connect with Dr. Linda Michaels and PsiAN:

Website: https://www.psian.org/ Instagram: https://www.instagram.com/psianofficial/ LinkedIn: https://www.linkedin.com/company/psian/

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

In this episode, Rachel Harrison speaks with Naveen Raman, a PhD student at Carnegie Mellon University whose research focuses on sequential decision making and the integration of human feedback into AI systems. Naveen is a developer behind PeerCoPilot, an AI powered assistant being tested in real behavioral health settings to support peer support workers in their day to day sessions. The conversation explores how PeerCoPilot works, from its curated database of vetted local resources to its built in tools for benefits navigation, web search, and structured wellness planning, and why the decision to avoid drawing from the open internet was central to its design. The second half of the conversation digs into the safeguards built into PeerCoPilot, including what Naveen describes as a Swiss cheese model of defense where no single layer of protection carries the full responsibility for catching errors. Rachel and Naveen explore the question of whether tools like this could eventually be used directly by service users, the practical and ethical complexities that come with that, and the broader vision for expanding PeerCoPilot to other peer organizations, county level resource hubs, and systems like 211. Naveen closes with a clear message for anyone thinking about AI in the mental health space: powerful tools still need to be carefully tailored to their specific context to truly serve the people within them. RESOURCES MENTIONED Articles Referenced: AI Use in Mental Health Help Seeking and Support — PubMed Central: https://pmc.ncbi.nlm.nih.gov/articles/PMC12595529/ Human in the Loop, AI in Healthcare Systems — Frontiers in Psychiatry: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1505024/full PeerCoPilot: AI Assistant for Behavioral Health Navigation — Carnegie Mellon University: https://www.cs.cmu.edu/news/2026/peer-copilot Connect with Naveen Raman: Website: http://naveenraman.com 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

EPISODE SUMMARY

In this solo episode, Rachel Harrison explores the reality of mental health parity enforcement through the lens of a recent case involving Aetna. She breaks down what mental health parity is intended to achieve under the Mental Health Parity and Addiction Equity Act and why, despite being in place for nearly two decades, the gap between policy and practice remains significant. Using the Pennsylvania fine against Aetna as a case study, Rachel walks through the specific violations uncovered, including claim delays, improper denials, and lack of transparency, and explains how these issues directly impact patients, providers, and access to care.

The episode then broadens to examine the larger enforcement landscape, highlighting similar actions across states and the growing importance of state-level oversight as federal enforcement becomes less certain. Rachel also reflects on broader policy conversations happening at the state level, including efforts in places like Maryland to improve transparency and accountability in insurance reimbursement practices. The conversation raises important questions about accountability, the effectiveness of financial penalties, and what meaningful enforcement should look like moving forward. It ultimately offers a grounded, forward-looking perspective for clinicians, practice owners, and mental health leaders navigating insurance systems today.

RESOURCES MENTIONED Articles Referenced:

Shapiro Administration Protects Consumers, Fines Aetna for Violations of Mental Health Parity Laws — Pennsylvania Insurance Department: https://www.pa.gov/agencies/insurance/newsroom/shapiro-admin-protects-consumers-fines-aetna-violation-mental-health-parity-laws

Pennsylvania Insurance Regulators Fine Aetna for Violations of Mental Health Parity Regulations — Philadelphia Inquirer: https://www.inquirer.com/health/aetna-fine-pennsylania-mental-health-parity-20260303.html

Health Insurers Pay Penalty for Mental Health Parity Compliance Failures — HIPAA Journal: https://www.hipaajournal.com/health-insurers-penalty-mental-health-parity-compliance/

Departments Announce Non-Enforcement of 2024 Mental Health Parity Rule — APA Services: https://www.apaservices.org/practice/news/nonenforcement-2024-mental-health-parity-rule

Related Episode:

Mental Health Parity Advocacy and Policy with Deborah Steinberg https://pod.link/1724750091/episode/OWQ5YmYzMzMtZmQ5ZS00ZjUyLWFkMDEtZmFiZDdlNmVmNzZh

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/company/the-mental-health-evolution Facebook: https://www.facebook.com/TheMentalHealthEvolution

Music Credit: Music by Zach Harrison

EPISODE SUMMARY

In this episode, Rachel is joined by Adrienne Wilkerson, founder and CEO of Beacon Media and Marketing and author of Digital Marketing for Mental Health. Adrienne brings a deeply informed perspective shaped by her experience growing up in a therapy practice and working closely with behavioral health organizations. Together, they explore how the mental health landscape is rapidly evolving as private equity backed organizations, larger systems, and AI driven tools reshape how practices compete for visibility. Adrienne shares what makes marketing in mental health fundamentally different, emphasizing the importance of empathy, ethical responsibility, and true human connection when reaching individuals in vulnerable moments.

As the conversation continues, Rachel and Adrienne dig into the growing influence of AI in marketing and the broader mental health space. They unpack both the opportunities and risks, including the rise of AI generated content, the erosion of trust online, and concerning trends such as individuals turning to AI for support. Adrienne highlights the increasing difficulty of tracking marketing effectiveness, the return to less predictable attribution models, and the pressure this places on small practice owners. The episode closes with a forward looking perspective on how clinicians and organizations can adapt by staying grounded in authenticity, maintaining ethical standards, and prioritizing meaningful connection in an increasingly complex digital environment.

RESOURCES MENTIONED Articles Referenced:

Inside the Consolidation Renaissance Across Digital Behavioral Health — Behavioral Health Business: https://bhbusiness.com/2026/03/25/inside-the-consolidation-renaissance-across-digital-behavioral-health/

How AI Is Changing Online Marketing for Small Businesses — Forbes: https://www.forbes.com/sites/nishacharya/2025/10/14/how-ai-is-changing-online-marketing-for-small-businlesses/

Ethical Principles of Psychologists and Code of Conduct — American Psychological Association: https://www.apa.org/ethics/code/index

Connect with Adrienne Wilkerson:

Beacon Media and Marketing: https://www.beaconmm.com/ Digital Marketing for Mental Health (Book): https://digitalmarketingbook.beaconmm.com/

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

🎧 Show Notes – Episode 34

Mental Health Access, Telehealth Policy & the Future of Behavioral Health Care with Andrea Fox

In this episode of Mental Health Evolution, host Rachel Harrison speaks with Andrea Fox, Senior Editor at Healthcare IT News, about the evolving landscape of mental health access in the United States.

Andrea brings more than two decades of experience covering healthcare technology, public health, and government policy, offering a grounded perspective on how telehealth expansion, regulatory uncertainty, and system-level barriers are shaping behavioral health care delivery today.

Together, they explore what has meaningfully improved in access to mental health services since the rise of telehealth, where gaps still exist—particularly in rural and underserved communities—and why policy uncertainty continues to affect both providers and patients.

The conversation also dives into the ongoing challenges surrounding telehealth prescribing regulations for controlled substances, the impact of insurance reimbursement structures on access to care, and how emerging efforts to integrate social determinants of health data could reshape behavioral health systems in the future.

Finally, Andrea and Rachel discuss broader structural barriers—including provider shortages, cost, fragmented systems of care, and uneven access—and reflect on what a truly integrated, patient-centered mental health system could look like if policy and technology evolve in alignment.

🧠 Key Topics Covered

• Major shifts in mental health access driven by telehealth
• Persistent rural and underserved community access gaps
• Federal policy uncertainty around telehealth prescribing rules
• Insurance reimbursement and its impact on care delivery
• Provider shortages and systemic behavioral health barriers
• Social determinants of health data and care coordination
• The future of integrated, patient-centered mental health systems

📰 Resources Mentioned

• https://www.healthcareitnews.com/news/where-telehealth-stands-shutdown-every-day-goes-its-worse
• https://www.healthcareitnews.com/news/telehealth-prescribers-urge-feds-act-quickly-virtual-rx
• https://www.healthcareitnews.com/news/stakeholders-ask-new-dea-administrator-resolve-telehealth-prescribing-rules
• https://www.healthcareitnews.com/news/addressing-behavioral-health-resources-and-costs-ohio

🎙 About the Guest

Andrea Fox is Senior Editor at Healthcare IT News. She has spent more than two decades covering healthcare technology, public health, and government policy, with a focus on telehealth, digital health infrastructure, and behavioral health access.

Her reporting highlights how policy decisions and technological systems shape real-world access to care, particularly in rural and underserved communities.

Recent work:

• https://www.healthcareitnews.com/news/telepsychiatry-may-still-be-out-reach-low-access-areas
• https://www.healthcareitnews.com/news/how-rural-mississippi-plans-put-federal-funds-work-addressing-health-it-needs

🔗 Connect with Mental Health Evolution

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

🎶 Music Credit

Music by Zach Harrison

💬 Closing Reflection

This episode highlights a central tension in modern mental health care: while telehealth and digital tools have expanded access, structural challenges—including funding, regulation, and system fragmentation—continue to limit equitable care. The future of behavioral health will depend on how effectively policy, technology, and care delivery systems evolve together.

Episode Summary

In this solo episode, Rachel takes an honest look at where the 988 Suicide and Crisis Lifeline stands nearly three years after its July 2022 launch. She grounds listeners in how the system is structured, what changed in the transition from the old ten-digit lifeline number, and why that shift mattered more than it might seem. Drawing on recent data, Rachel walks through what is genuinely working, including dramatic growth in contact volume, faster answer times, and rising public awareness, while being equally clear-eyed about where the system is still falling short.

Rachel digs into the gaps that data is making harder to ignore: uneven awareness across racial and language groups, wide variation in in-state answer rates, inconsistent follow-up practices, and a funding patchwork that is not holding equally in every state. She also addresses the recent discontinuation of the specialized LGBTQ+ line and what that loss means for a population already at elevated risk. This episode is intentional groundwork for an upcoming conversation on virtual crisis teams, and Rachel closes with a direct message to clinicians and practice owners about the role they play in what comes after the call.

Resources Mentioned

• About 988 — The official overview of how 988 came to be, what changed in the transition from the National Suicide Prevention Lifeline, and how the current system is structured
• New Data Expose Critical Care Gaps in 988 Crisis Lifeline — Coverage of a 2025 JAMA Network Open study examining all 988 contacts since launch, including regional disparities and lower-than-expected usage in the South
• 988 Mental Health Crisis Line Evolves Nationally, States Seek Stable Funding — Covers recent developments including the rollout of georouting, the discontinuation of the LGBTQ+ specialized line, and how states are working toward more sustainable funding structures
• 988's Evolution: The Next Chapter in Crisis Care — Written by a founding leader of the National Suicide Prevention Lifeline, this piece focuses on the critical gap between the crisis call and what happens after

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

Episode Summary

This week, Rachel brings listeners one of her favorite conversations from her previous podcast, The Mental Health Entrepreneur, featuring Dr. Kryn McClain, founder and CEO of CatapalloVR. Dr. McClain is a therapist turned entrepreneur whose work sits at the intersection of clinical expertise and emerging technology. She built CatapalloVR to give mental health providers, autism specialists, and educators a virtual reality platform designed to help clients build real world life skills in a safe, immersive, and measurable environment.

In this conversation, Rachel and Dr. McClain explore how VR is being used to teach daily living skills, emotion regulation, and occupational readiness to transition age youth and others who need a structured space to practice before stepping into the real world. Dr. McClain shares how CatapalloVR developed its robust library of hundreds of modules through direct feedback from therapists, parents, and clients, and how therapists can integrate the platform using standard CPT codes. She also speaks candidly about the entrepreneurial journey, the importance of finding a peer community as a clinician turned business owner, and her vision for expanding VR access across hospital systems, schools, and beyond.

Connect with Dr. Kryn McClain

• CatapalloVR

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

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

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-podcast
• Instagram: /thementalhealthevolution/
• LinkedIn: /the-mental-health-evolution
• Facebook: /TheMentalHealthEvolution

Music Credit: Music by Zach Harrison

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