A Few of Rachel's Favorite 2025 Podcast Moments

welcome to Mental Health Evolution, a podcast about what's changing in mental health and why it matters. I'm your host, Rachel Harrison, inviting you into honest conversations with people from all perspectives in the field. Clinicians, tech founders, investors, insurance companies, and all the folks in between. Let's explore what's working, what's not, and what's next.

Welcome back everyone to the Mental Health Evolution Podcast. This episode is a little different. It's going to be a solo show where I'm going to share some of my favorite moments from episodes so far this year. It's hard to believe that the new version of our podcast has only been running since September and yet we have had so many incredible conversations. We've explored topics like AI, a lot of AI in mental health. We've talked about billing challenges, the Big and beautiful Bill for healthcare, parity, marketing, private equity in behavioral health, as well as measurement based and value based care. Today I wanna share a few clips that really stood out for me. So kind of highlighting some of the moments is what we have planned for in this episode. Hopefully that will give you a little refresher if you've been listening in, some highlights from the year. If you haven't been listening in, it kind of gives you a little synopsis of some of the big moments that I have pulled out from the conversation so far and I'm hoping that it helps you as you're thinking about what's to come in the new year. Whether you have a business in mental health, whether you are someone who receives clinical services in some way, or whether you're a clinician yourself, I think these pieces are all relevant to what the landscape of mental health is looking for. Whether you've been following us since the mental health evolution or you're brand new to this podcast and our work, this is a great way to see a range of conversations we've had this year. We would love to hear from you about these topics and what you want us to explore going forward. You can email us at the mhepod so m h e p o d mail.com or find us on social media. We would love to have a conversation with you. So let's dive in to 2025 and some of our clips. This first one I want to talk about was a conversation with some of my colleagues locally and a real change initiative that we have been working on. Erin Vandermeer, Melissa Ward, Allison Bomba and I were talking about one of the big topics that has really shaped so many discussions this year and it's likely to continue. And was AI in mental health. One of the reasons we started talking about this is because while AI can reduce workload and paperwork, there's also a real concern about losing the human element in mental health care. And my colleagues spoke very eloquently about this concern and why it's so important to preserve the human connection in therapy.

I think when I started seeing how fast mental health care was shifting towards apps and tech driven solutions, I felt that we were losing something really important in the industry, that human connection and trained expertise that make real therapy so powerful.

And coming into contact in my practice with folks that have sought mental health guidance or care from these apps or

platforms and had just what I would

consider to be nearly catastrophic outcomes, it

became really important that we educate people

about the limitations of these kind of ways of going about therapy.

I've also been really uncomfortable with the way that care is being delivered by these big tech companies and AI. And I just care so deeply about protecting and preserving what real mental health therapy is, which involves that real connection, that human connection, safety and trust relationship.

I love that insight. It was practical and thought provoking. One thing to consider when we talk about AI and its use in mental health is that it can mean a lot of different things. It can mean replacement of a human therapist with a chatbot, which is what Erin was speaking to above. It can also mean helping with back office tasks like insurance billing or AI, acting more like an assistant to a human therapist, helping with things like recording notes and making treatment plans. And then someone that spoke more to that angle of the use of AI is Dr. Jordan Harris. And in the clip with Dr. Jordan Harris, he is someone who tends to be a little more on the positive side of the debate about the use of AI therapy. And I thought it was really interesting when he spoke to the ways that AI can sometimes do a better job than humans in consistently validating what people are feeling and thinking, simply because AI is a robot and it doesn't get distracted or fatigued.

When we're talking about AI and therapy, one of the big things that I see online is people saying things like, man, this AI, it's sort of too nice to other people. And on the one hand, if someone's like in a real sort of delusion, right? If they're really in a place where they're really at risk for themselves and for other people, like that's not good. And I have friends who are working on this problem now of how do we actually make these systems safe? And a lot of systems, not all large language models are safe, but some of them are actually pretty safe already. But the other side of this is that this thing that AI does where it is consistently validating, is actually the antidote to a lot of resistance. Now you have to be careful that you don't validate poor behavior, but validating positive intent, validating underlying emotions, and being relentless in it. I mean, from the research that I've done and the coaching that I've gotten, we don't do enough of that. And I think that's one of the key reasons why this, these large language models are so persuasive.

Hmm.

Because they are consistently validating.

I love this perspective and it really expanded my thinking and reminded me that while AI brings challenges, it can also have some unique strengths that humans can't always offer consistently. So I want to also talk about some of the other opportunities with AI, and this leads me to Dr. Ejeta Robinson. And early on I had a chance to speak with her about why people are drawn to engage with AI tools in mental health care. And this clip stuck out to me because it helps frame some of the broader systemic issues at play, why people are seeking support outside of traditional care and what gaps technology might be stepping in to fill. Here's what Ajeta shared.

That people are willing to engage with an artificial tool, right? To seek community, to seek, seek support. Because our health care system is so fragmented in ways that has nothing to do with clinicians ability to run their businesses, right? It's fragmented. Even when you have health insurance, can you afford to access the insurance? Right. Are there enough clinicians available in your area? Whether they're available nationally, we're still restricted by being able, only being able to practice in the states where we're licensed. And so how are the systemic barriers creating the additional pain and angst that might lead the most vulnerable people to seek AI out as a resource?

I love this perspective because it reminds us that AI isn't just a techie curiosity. It's interacting with very real gaps in the mental health system. Ageta highlights the limitations of access, insurance hurdles and licensing restrictions that leave many people struggling to find care. AI can't fix these problems, but by itself. But understanding why people turn to it is crucial for clinicians, policymakers, and anyone invested in mental health care. With that, I want to move on to something else. In the health care world, or really the mental health world where we saw a lot of news this year, we Spoke with Kathy Gilbert, an insurance expert, about the changes coming from what's been nicknamed the biggest beautiful bill, which was passed this summer. How are you looking at these various policies? What do you see as the big things that we need to be looking at and addressing in the mental health industry?

One of it is, part of it is more general. I see it as just the number, sheer numbers of people losing health care coverage over the next 10 years based on the bill. That's huge. A lot of those that lose coverage I think will be individuals with mental health challenges. So because of the work requirement and when you think about this in perspective, something else that's happening in the administration is the dismantling of the Department of Education, which funds training programs for persons with disabilities who now have a work requirement, but the training programs may not be there any longer. So I think it's, it's even broader than what people are realizing right now. So that cover, that's part of what we have to think about. Plus there's in the mental health world for people under ACA coverage or Medicare or Medicaid, all, all three of those are significantly impacted by this bill. Those are, those are usually our most vulnerable populations. The people that could use the addition supports.

Again, the long term effects of this legislation are still unfolding. There are going to be more and more details probably coming in the new year and this might be something that we're able to revisit and give a little more update on. But I love how Cassie introduced some ways to think about this and how it might impact all of us so in a different side of our industry. I'd like to talk about my episode with Dan King. He's the founder and CEO of Fireside Strategic and it's a company, an investment company that acquires and supports outpatient mental health practices with a core focus on clinician satisfaction, workplace culture and sustainable human centered growth. Drawing on his background in law, private investing and executive coaching, Dan positions Fireside not just as a business investor, but as a partner aiming to build practices that balance profitability with high quality care and humane workplace values.

In my opinion, in mental health, if we leave the venture world behind, if we get more into the PE world, what I would argue is that profitability and human fuel each other. We will actually obtain in the long term the most profitable returns for our investors if we really, really care about the human side of the equation.

Dan highlights the potential for responsible investment that supports both clinicians and, and clients. However, not all investors approach mental health care with the same priorities. One who has raised concerns about how the industry as a whole may be investing in mental health is Dr. Jane Zhu of Oregon Health and Science university. Here is Dr. Zhu.

Yeah, I mean, I think the other thing that a lot of business owners may consider are not necessarily selling their practice wholesale, but partnering with a management services organization that does all the back office billing and administrative tasks, scheduling, things like that. And many of those management services organizations are also increasingly being acquired and owned by private equity firms. So I think clinicians often are putting their heads down and they're really mission oriented to do the work. And they may not be entirely engaging with the larger structural forces that shape how they practice. And so I often tell younger trainees that are coming into the field now, clinical fields now, you know, you really need to understand how organizations are structured and financed, you know, how clinical priorities are set, who's setting the revenue pressures, who makes the decisions. That's becoming increasingly essential because clinicians are having less and less say in some of those larger structural forces. And so PE is one of those structural forces.

Another major focus this year has been the role of measurement based and value based care in mental health. A shift that changes not only how practices operate, but how they make decisions, track outcomes and ensure quality care. I spoke with Dr. Dylan Ross from Blueprint AI about one of the biggest challenges practices face in implementing value based care, which is getting the right data and using it effectively day to day. Here's what he had to say.

The challenge the payers face is really a lack of actionable data. Claims based data is highly blunt. You may have, you know, a location code in terms of where the care is happening, a diagnosis. You'll have CPT codes and other types of codes that map back to reimbursement and billing. But it's really hard for a payer to ultimately identify and answer a seemingly simple question. Did our member get better? And if so, by how much? So that's a member client level view at the provider level, whether it's an independent clinician in private practice or a very large behavioral health organization, that same question is equally as difficult to answer.

This really underscores how crucial it is to have actionable real time data in mental health care. Without it, both payers and providers struggle to see the impact of their work, making it challenging to move from the concept of value based care to consistent everyday practice improvements. And I've got just one more segment I'd like to talk about today. And that is one of the biggest hurdles in moving toward value based care isn't just the contracts or the payment models, it's how organizations manage the data and bring the right people to the table. That brings me to Josephine Wilton, who has seen firsthand how these gaps can create challenges for provider groups trying to make value based care work in practice.

But again, when you don't have the data and you have the right parties, then you still have a major fundamental gap, right? So I've seen that happen as well, where you have your coo, maybe other operations leaders, you may have a strategic business advisor, your cfo, but then there's missing data, poor data, data gaps. And so they're listening, they're at the table, they're offering up their input and feedback. But it's. It's somewhat theoretical, right? It's conceptual. It's based off of our subjective view of what's been happening and what may happen once we join this partnership.

This really underscores the importance of having both accurate data and the right operational and clinical teams involved early on. Without that, even the best intentions can stay just that, theoretical ideas rather than actionable outcomes. So with those clips, those highlights we've heard from the AI side of things, from clinicians as well as tech companies, from an investor as well as someone helping to implement value based care as well as someone on the insurance side. It kind of wraps up some of the moments of the conversations and the things that are happening on the Mental Health Evolution Podcast. I really appreciate your listening, your support this year as we have shifted from the Mental Health Entrepreneur Podcast into the Mental Health Evolution podcast. Largely because of all the changes happening right now. Our hope is to continue to raise the conversation. I think there are so many reasons for us to be talking, to be learning, to be understanding things because the changes happening in real time are happening so quickly and we hope you'll tune in to continue learning with us next week. We are going to talk about some of the episodes coming in the new year. Some of the topics will be familiar and some may be new. We're going to give an overview of what we're seeing, what we're looking at, and I'd love to hear from you. So if you would like to hear something on a particular topic, we're going to be putting things together on socials, on Instagram, on LinkedIn, we're going to do some polls and we'd love to hear from you. So please reach out to us on social media or email. The mhepod it's m h e p o d mail.com we'd love to hear from you. We'd love to talk about what you want to hear about and we hope you all have a wonderful end of the year. Thanks for listening. We'll see you soon.