Rethinking Behavioral Health Access with Jason Youngblood

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. Foreign. Welcome back everyone to the Mental Health Evolution Podcast where we talk about how the landscape is quickly evolving in the mental health industry and why those changes matter. Today I am excited to talk to Jason Youngblood. He is the Senior Director at Cigna US Markets Behavioral center of Excellence and Sales Operations. He is Jason brings a unique perspective at the intersection of behavioral health, employer sponsored care and large scale systems design. His work focuses on how mental health supports are structured, delivered and accessed, particularly for people who may not need traditional therapy but still need meaningful support. This conversation is going to build on themes we've explored recently around things like provider shortages, technology enabled care and and growing interest in tools that can support people earlier, faster and at a lower level of intensity without replacing clinician led treatment. So with that as always before we talk to our guest, I'd like to bring up some relevant articles related to today's topic. These may be helpful for listeners who want to dive a little bit deeper. I have a few more articles than usual this time and there's a little bit of kind of two groups about integrating tech into treatment models. As you all are aware or if you're listening for the first time, we really like to provide all the viewpoints that we can on this podcast. We try to explore all sides of things to let you evaluate things for yourself and make decisions for yourself. So with that in mind, we kind of included those two different segments of articles and focused largely around introducing chatbots into the therapeutic process. Now I want to be clear that and you'll see there's an article with what CIGNA is integrating into some of their pieces and it's not all about chatbots. So I just want to be clear about that headspace that you will see. An article about that they use is often a meditation app, offer sleep support, some other things like that that are not related to a chatbot. And these articles are all largely kind of chatbot focused. So I just wanted to give an acknowledgement to that before we kind of briefly talk through the articles. The first one though I think is interesting is it is a research study and called the first therapy chatbot trial yields mental health benefits and this was from Dartmouth in 2025 and it really reports on early results from a clinical trial of a therapy chatbot showing measurable mental health benefits for some users. It raises questions about where chatbot tools may be useful and particularly in low intensity support, early intervention or symptom, but also highlighting the limits of these tools. The next article, also in support of Chatbots for Mental Health, is a review on mental health chatbots and this peer reviewed article reviews how mental health chatbots are currently being studied and deployed. It highlights benefits such as accessibility, self guided skill practice and symptom monitoring, while also noting challenges related to engagement, safety and clinical oversight. And the third article references what our guest and his organization are doing, which is called Headspace for Cigna Healthcare enhances everyday mental health support and this announcement describes Cigna's collaboration with Headspace Health to offer self guided science backed mental health resources as part of employer benefits. The partnership highlights how large payers are positioning digital tools as early support and navigation, helping people manage stress, build skills and potentially determine where they need a higher level of care. So that is all the positive research and information out around Chatbots. But next I kind of included a couple articles around a different vein of thinking. There are a couple articles here. The first one is called How Insurance Woes are Impacting Mental Health Care and this article looks at reasons that psychologists specifically 34% do not take any insurance. It identifies pain points such as administrative burden, complex billing requirements and payment disputes or clawbacks as primary reasons. And then this next article, apa, which is the American Psychological association, actually put out a health advisory about chatbots and wellness apps and their advisory is included in our show notes. You can go and read those. Um, but essentially they outline both the promise, so it's a fair evaluation and the limitations of AI driven chatbots and wellness apps. The advisory emphasizes that while these tools may offer accessible support for some users, they lack sufficient evidence and safeguards to function as standalone therapy, especially for individuals with complex and severe needs. So with those two lines of the conversation, what's out there in the media, what's being talked about, that kind of gives you a good launching point for the conversation with our guest. And I want to go ahead and introduce Jason again and we're just going to dive in and have a conversation and I can't wait to hear some of the different perspectives. So with that said, Jason, welcome Rachel.

It's really great to be here with you today. Thanks for welcoming me.

Absolutely. So I would like to start a bit about you. You represent the human side. You're not just an insurance company. You're a human who' trying to work to the betterment of mental health. And I'd like to talk about your professional journey. So what kind of led you into the insurance industry and specifically looking at behavioral health markets?

Yeah, well, I am a human all day, every day. So thank you for calling that out. I. I'll start early on in my career because I never intended. I'm a licensed professional counselor, never intended to be a therapist. And I remember the moment in my life when I realized that that was my path. And it actually started in college. I was going to be a physical therapist and I had gone three years of pre PT and did an internship at my local hospital. And I will never forget that day, going to my hospital and the doors of the physical therapy unit opened and all of the sights and the sounds and the noises and the smells of the hospital unit, physical therapy, like, washed over me. And I knew that I made a terrible mistake, that I was not cut out to be a physical therapist. But I stuck through that internship throughout the course of the summer and ended up working with one individual, a man, I would say probably in his 40s, who had had an accident and became paralyzed from the waist down. And he was there. Not that he was going to regain functioning, but he wasn't really taking great care of himself. He had a lot of loss. His business relationships, financial, had to move back of loss of his health and independence. So I worked with him throughout the course of the summer. At the end of that experience, I. Knowing that I was going to go back and not understanding what I was going to do. I don't know how I was going to talk to my parents about changing my major so late. The physical therapist and my, and my interview, as my, my closure interview said, you know what we've noticed this individual that you've worked with, he started coming twice a week and he told you the story of his life and all of his losses. And he's showing up differently at home. He's caring for himself, he's washing his clothes. And your relationship has made an impact. And I will never forget that moment. Walking out to my car and it hit me. I knew that my path was not to help people from the physical side, but just amazed that a relationship can have such a profound impact. So, long story short, I changed my major. I took every psychology class I could, graduated with a minor, and then went on to get my master's degree and Work as an addictions counselor in a dual diagnosis. I found my way to the insurance industry by accident. I had heard of a position here at this company. It was close by where I had been working. My wife was expecting our first child and I heard, gosh, this is a job that is work Monday through Friday, 8:30 to 5 and you have to be a clinician. And I thought, well, I can give that a try. I will do that for two years and then I'm going to leave. I'm going to learn everything I can about this industry in two years and then I'm going to go back out here. I am like 23 years later and time for younger clinicians or young, younger folks are listening. Time goes by really fast. But I was really surprised when I came here that starting work, doing utilization management, case management, answering the phone and talking to people in crisis, we as clinicians here could do amazing work and removing barriers and supporting providers who are out there in the community with treatment. And I will tell you, I had envisioned coming into a role like this that it would be a lot of struggle and conflict. And what I found that it was just the opposite. It was good partnerships, it was focused on evidence based care. It was collaboration and improving people's lives at a time when they needed it. And I began to tell that story to anybody that would listen. And so ended up kind of moving my way to supporting employers today as part of my role here at Sigma Healthcare.

I like that that is a different perspective. I think, you know, to just kind of dive into things that we can hear on the outside of where you're working is not so much specific to your insurance company. But the insurance industry can certainly be kind of painted as the bad guy, if you will, in like patients trying to get services or providers struggling. And they are certainly part of the ecosystem, but just a part of the ecosystem. I'm curious what you say to people who have that perspective.

Yeah, and you know, I think the perspective is understandable. I think people's memories are very long. I remember in the 80s in the HMO days where there was gated versus how we view things. Today we're not gating care, we're a gateway to care. Because we understand, at least in my organization that the best way to improve somebody's health and well being and lower their overall medical cost is by making sure that they get the care that they need with providers that are best fit providing higher quality of care. And so usually as people get to know us and get to know our passion for that work, I think we surprised a lot of people. But it is, you call it is a big industry and there's many different kind of players from traditional insurance companies to third party administrators. Maybe they're 24 7, 365, not always accessible, complex to navigate. And so I think the frustration is well deserved in many instances. But we've worked really hard in my time here, especially going 24 7, being available for people to change that and make ourselves more accessible.

Yeah. So how would you say your organization is thinking about the mental health needs of your consumers at this point?

Yes. Well, foundationally, one out of four people will have a behavioral health condition in a given year. So about 25%. And the research shows that the sad truth is that 55% of them them will never get access to care or support in their lifetime. And that's really staggering because the consequences of that are really significant. Those individuals who have both medical needs and behavioral needs are up to six times more costly from a total medical spend. And I think the longitudinal research shows if you have a chronic medical condition and an untreated behavioral health condition, you're likely to die earlier by 15 years, I think is the latest research that I saw. Not only do you use more medical services overall and your lifespan isn't as long, your quality of life is greatly impacted and how you show up at work, how you show up as a parent, as a caregiver, it is all impacted. Our focus on mental health and behavioral health in general is to be here to support. But I call them the lucky 45% of people who will step forward and seek out care. And so we do that by being here 24 7, 365, you know, able to do pre certifications for higher levels of care. So there is no barrier, there's no waiting. But also to take a look at the 55% who will never call us for care or support. But because we've got a lot of data, we understand who they might be. Perhaps they've gone to their doctor and they've gotten a prescription for an SSRI and filled it, but stopped taking it. And so we know that they're likely out there languishing. Maybe they were on our website searching for providers, but never scheduled an appointment or made a call. Maybe an out of network substance use disorder treatment facility is calling and checking their benefits. Like we have clues by looking at behavioral medical pharmacy data, even EAP data to WHO the 55% of people are and so want to reach out and engage them and support them to Provide tools and resources for them to get the care that they need.

Okay. And is that part of what brought this headspace collaboration into play for Cigna?

I think in our journey, and you know, when, I will say when I started over two decades ago, there was a really big emphasis on the highest cost treatments. And so there was a lot of focus on acute care, residential treatment. However, I think we've come a long way in our society and as an industry at recognizing that most people are walking around being untreated for illness and the quality of life is significantly impaired. So we've looked at developing out the other end of the spectrum and making sure that people have access to resources and tools to support them. When I was seeing people, and it's been a few years since I've seen people face to face, but I like to refer to them as the worried. Well, so they're going to work every day, they're taking care of their families, right. But they're managing a lot of stress and a lot of anxiety and lower levels of depression. It really gives them tools and resources that they can have in their pocket to utilize. And if by chance, through engagement with those tools, that is evident that they need a higher level of care or support like, such as seeing a therapist face to face, let's make it really easy for them to find someone and get them connected to someone who would be a best match for them. So absolutely, that this is part of our journey to focus on, you know, what we sometimes refer as to subclinical. You mentioned sleep, things like that.

And how long has this been going on, this partnership? How long have people had access to these tools?

So we announced the partnership in the fall and gosh, these days and months all seem to go together. So we added Headspace for Cigna healthcare effective on January 1st of this year. And the amazing thing to me when we added this, the benefits on 1:1 for about 7 million members is that we didn't do any kind of promotional campaign as we were implementing and getting things up and running. Those campaigns started weeks later. But what we saw were thousands of people based on, I guess seeing press releases or being on our, like my Cigna app ecosystem, discovered the benefits and a lot of people were drawn to having that level of care support offered. So as we're getting a few more weeks of exposure or, you know, the announcements and letting people know that they have access at no cost, we're seeing a really big uptick in interest from our customers.

Okay, I was curious about that. Are people able to Bypass that part. Is it structured kind of like an EAP where they have to try headspace first and then if their acuity is too high, they go to the next level? Or can they bypass it altogether if they're like, hey, I just know I need to sit down with a face to face therapist?

Yep. So again, like our core philosophy is being a gateway to care and understanding that people will enter care where they want. So I think from my perspective, I want to make sure people know of all of the resources that are available to them and keep it really simple and easy to access. So we don't require that people use headspace for Cigna Healthcare or eap. People can start where they want and so they can bypass that and go straight to seeing a provider if that's what they elect to do.

Okay, okay, I'm curious. A lot of the articles I read and the technology in healthcare and especially mental healthcare, what type of guardrails do you have in place for these tools that help maybe protect privacy if crisis escalates, if there's a swee, suicidal ideation, clinical oversight, any of those pieces?

Yeah. So before we partner with any organization, there is a really heavy vetting process around data and privacy. I think that is primary concern to make sure we are connecting or sharing data and referring people out to a resource that their protected health information remains protected. And so I think that is like the first gate and that has to be to be rock solid. And then again, I think you mentioned it to make sure that there is an escalation pathway. The tools are great, but if somebody is out there and needs additional care, additional support, how do they get routed back into our ecosystem to get connected to one of our network providers easily and seamlessly. And then also as we're looking at partners in the behavioral space, we have very few partners. And so headspace for Cigna Healthcare really represents, I think, a level of trust between these organizations and mission to improving the health and well being of others that is nicely aligned, but really making sure that the programs that they bring to the table are backed by evidence based research studies.

Okay, I like that. So you're clearly like at the newer phases of rolling this out and kind of seeing how this helps. So maybe the data is too new. But I'm curious, for your organization, I like that you talked about focusing on the longer term, more residential care initially and now looking to that other side, where are you seeing barriers at any level of care in general for your consumers? Like where is the place where you're aware of Issues that need to be solved, even if they're difficult to solve.

Yeah, I love that question. I think back to when I started and I worked in community mental health. You could find me in the yellow pages. I bet there are some of your listeners who are like, what's a yellow page? Right. And then, and then, yeah, and then Google came to be and like searching online. But I think back to when I started in the industry, there's like a single point of entry for outpatient professional care. And you know, and thank goodness, as we've evolved and matured as an industry, there's a lot of different ways that people can care for their behavioral health and well being, including peer coaching, which has become very popular in the last few years, up to, you know, relaxation and stress activities, things like that. The use of coaching in the industry, I think is become a little bit more prevalent than it had been in the past. And I think just I've had a recent experience with my own wife and we were talking about types of providers and she mentioned wanting to recommend a psychiatrist for one of her friends because they needed to talk. And I was like, well, psychiatrists sometimes do that, but that's not typically why they do. And I realized after being married for over 20 years that my own wife didn't necessarily understand the difference between types of providers. So that all of that being said, I think we have a much more complex ecosystem where we had limited resources or a single pathway before. There's so many options in the app stores of our cell phone, so many options, it's overwhelming. And I think the growth has been great, but it is really confusing for consumers. And so the call from employer groups big and small has been great. We have so many more options for people to take care of themselves, but nobody could figure out how to start. And so providing navigation, I think to answer your question, providing navigation and support, whether somebody is calling us, spending time with a clinician, doing a quick evaluation and helping them understand their resources, or whether that's happening digitally, but then getting them connected, pointing them to their options for resources that may benefit them, that guided navigation has really become forefront.

That's interesting. I do think that even in you mentioned coaching and the difference between coaching and therapy, and that could be a whole separate podcast conversation, Jason. But it's not always clear, even to providers, even to coaches. I've had those conversations. At what point does a coach say, whoa, that's a therapy thing, or does a therapist say, you could benefit from a coach? Like those lines are not clearly drawn in Our industry even. So, of course, consumers have some confusion around that.

Yeah, absolutely. And I am an executive coach and went through coach training and funny. Like, I thought it would be so easy to become a coach because I'm a. I'm a therapist by training.

It's totally different.

Skill sets are really quite different. I think I struggled in my class the most, I will say in doing coaching, it is so different from therapy. It's a little bit of a relief to be so direct and to hold people accountable. But that is very different in therapy. But I think you call out a very good point. Still a lot of gray in that space.

Yeah. So I do have a question. I've talked to a lot of different guests. Do you think that some of these digital support tools can actually reduce demand on the therapy workforce, or do you think they increase demand by kind of identifying some of that unmet need and the people that might need to go further?

Yeah, I think I would like to cheat and say, I think potentially both. I think rather than reduce or increase, I would say I hope at the end of the day, access to these tools and resources optimizes what happens when somebody gets connected in a therapist's office. First and foremost, you know, I think we've made huge leaps and bounds around individual preference and getting people connected to like a best match, whether it's ethnicity or language or clinical specialty and characteristics of a provider that will hopefully help them feel in the first and second session that they're with the right provider. So we'll see less one and kind of done dropout. So really looking how do we help clinicians out in the field increase their therapeutic alliance, you know, getting someone up to three visits and beyond, because their data suggests when somebody spends three visits with a professional that they tend to have overall better health outcomes. So I think that in providing some access to coaching and support, that perhaps we'll take that out of the therapist office and that opens up access for people who do need mental health or substance use disorder care and support. So I guess at the end of the day, I really hope it helps to balance and optimize and that when people are in the therapy chair, they're there, they're a good fit with the provider and they're ready to work

and defining the different pieces. I think to your point of navigational tools, that's really probably the next thing. So we are just about out of time, but I would love to give you an opportunity to just leave our listeners with the last thought. So kind of. And you can adjust Your answers to the different groups. But we have listeners who are mental health consumers, we have listeners who are mental health providers. And then we have a lot of listeners that are more on the, in the industry somehow in the business places maybe. So what do you think is most important for people to take away from this conversation or from your perspective where you sit? I know it's a big question.

That's a huge question. I think you called it out. The world is evolving rapidly and so happy to spend time with you to talk about how it is evolving. I think having an open mind and being, opening to learning and I'm talking on my end of that spectrum here at Cigna Healthcare to consumers, to providers and being open to understand the dynamic changes and how we can work together. And I think assuming positive intent, something we talk a lot about here, assuming positive intent goes a really long way. And holding accountable when things don't go the way that they should and being accountable, that's all a little boring. So I think I would say if there's one message that I want to leave people, it doesn't matter whether you're consumer or caregiver. You know the question that employers ask me, what's the best way for us to improve, you know, the health and well being of our employees? And my message to them is by taking care of yourself. Take really good care of yourself. Prioritize yourself, manage your own stress, make sure you're getting sleep because that way you will be in the best place to take care of others.

I like that. I heard collaboration and taking care of yourself in order to help others. That's good advice, Jason. Well, thank you so much for taking the time today out of your busy schedule and having this conversation about systems and how we can meet people where they need it the most. So for all of you, listening information will be in the show notes about how to connect with Jason if you have any questions or ongoing things you want to explore. And we will be back next week to continue talking about the forces shaping the mental health industry today. Thanks for listening and don't forget to check the show notes for the links to the articles that we discussed today. Bye bye everybody.