The Mental Health Evolution

Hosted by Rachel Harrison

Entrepreneurship Health FitnessInterviews guests

Website RSS feed

Episodes

109

Latest episode

Sep 2026

Language

EN-US

About the show

The Mental Health Entrepreneur podcast is back—with a slightly new name and an expanded focus. We're excited to introduce The Mental Health Evolution, where we'll continue the journey of exploring what's changing in the mental health field, and we're so glad to have you with us as a listener. Explore the rapidly changing world of mental health with The Mental Health Evolution, hosted by Rachel Harrison. Each episode brings honest conversations with clinicians, tech founders, investors, insurance companies, and other key voices shaping the industry. We dive into what's working, what's not, and what's next—from innovative startups and ethical considerations in tech-driven therapy to policy changes, access to care, and the human connections that remain at the heart of mental health services. Whether you're a professional in the field, someone seeking care, or simply curious about the evolution of mental health, this podcast provides insights, perspectives, and practical information to help you navigate a complex and fast-moving landscape. Join us to stay informed, challenge assumptions, and be part of the conversation shaping the future of mental health.

Listen to episodes

60 recent

October 1, 2026Episode 5814 min

Ep 58: Two States, Two Directions: What's Happening to the Future of Our Workforce

This week Rachel goes solo to talk about something she has been watching unfold in real time — two states making completely opposite decisions about who gets reimbursed in behavioral health, at the exact same moment, with major implications for the mental health workforce pipeline. Rachel owns a multi-state group practice and runs a training institute. She employs clinicians at every stage of licensure — interns, provisionally licensed, and fully licensed — and she has skin in this game. What she is watching happen right now affects every practice that trains the next generation of therapists. The episode starts by defining the three levels of licensure in behavioral health and how insurance has historically treated each one. Then it gets into the two stories happening simultaneously. Blue Cross Blue Shield of Michigan, which holds nearly 70 percent of the state's commercial market, announced that starting March 1, 2027, it will no longer reimburse for services provided by limited licensed clinicians in private practice settings — framing it as a quality of care decision that practice owners across Michigan are pushing back on hard. At the exact same time, Maryland passed HB 1094 and SB 910, signed into law in April 2026, mandating that insurance companies operating in Maryland reimburse for services provided by supervised graduate-level interns starting January 1, 2027. One state is expanding the pipeline. One state's largest insurer is choking it. There is no federal standard. And the question of whether the Michigan decision spreads to other states or other insurers is one nobody can answer yet. Rachel closes with a direct call to action: if you are a practice owner, look at your payer contracts. If you are a pre-licensed clinician, ask whether the practices you are considering have examined this issue. If you supervise, understand that the financial infrastructure supporting that work is not guaranteed. This story is not finished. Resources Mentioned Articles Referenced: New Insurance Policy on Limited Licensed Therapists — Dr. Joel L. Young, Psychology Today (June 2026): https://www.psychologytoday.com/us/blog/when-your-adult-child-breaks-your-heart/202606/new-insurance-policy-on-limited-licensed Maryland Insurance Administration Bulletin 26-14 — HB 1094 and SB 910 (June 2026): https://insurance.maryland.gov/Pages/Bulletins/Bulletin-26-14.aspx Michigan Blue Cross to Limit Mental Health Benefit. Will Thousands Lose Care? — Robin Erb, Bridge Michigan (June 11, 2026): https://bridgemi.com/michigan-health-watch/michigan-blue-cross-to-limit-mental-health-benefit-will-thousands-lose-care/ 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 by Zach Harrison

September 17, 2026Episode 5620 min

Ep 56: Making Psychedelic Therapy Accessible with Myriam Barthes

Rachel speaks with Myriam Barthes, co-founder and CEO of Journey Clinical, the largest network of ketamine-assisted psychotherapy trained therapists in the United States. Journey Clinical operates as a collaborative care platform — connecting licensed psychotherapists with a dedicated medical team so that therapists can offer ketamine-assisted psychotherapy to their clients without having to navigate the medical side alone. Myriam came to this work through her own personal experience with ketamine-assisted psychotherapy, which she describes as transformative. Before co-founding Journey Clinical, she worked as an AI strategist and consultant — and she has brought that systems-thinking lens to one of the most complex problems in mental health: how do you take a treatment that is clinically promising, legally available, and genuinely hard to access, and make it actually reachable for patients and the therapists who want to offer it? The conversation focuses on the business and systems side of psychedelic-assisted therapy — how Journey Clinical works, what it actually takes for a licensed therapist to start offering KAP, and what the regulatory landscape looks like right now. Myriam walks Rachel through the collaborative care model, what happens when a client goes through a ketamine session, and why the therapeutic relationship before and after the medicine is as important as the medicine itself. She also shares her perspective on where the field is heading as psilocybin moves closer to FDA approval — and why she believes the infrastructure being built now for ketamine will matter enormously for what comes next. This episode pairs well with our conversation with Will Ratliff of Transcend Health Solutions, which goes deeper into the clinical and medical side of ketamine-assisted psychotherapy. Resources Mentioned Articles Referenced: FDA Moves to Fast-Track Review of Psilocybin and Methylone for Mental Health — CNN (April 2026): https://www.cnn.com/2026/04/24/health/fda-psychedelic-drugs-priority-vouchers What Psychedelics Reveal About the Human Capacity for Healing — Myriam Barthes, Journey Clinical (May 2026) Note: written by guest, published on guest's organization website : https://www.journeyclinical.com/resources/what-psychedelics-reveal-about-the-human-capacity-for-healing Considerations for Potential Future Therapeutic Use of Psychedelic Drugs — FDA/Federal Register (July 2026): https://www.federalregister.gov/documents/2026/07/14/2026-14155/considerations-for-potential-future-therapeutic-use-of-psychedelic-drugs-public-hearing-request-for Psychedelic Drugs and Mental Health — CNBC (July 2026): https://www.cnbc.com/2026/07/19/psychedelic-drugs-mental-health.html Connect with Myriam Barthes: Journey Clinical: https://www.journeyclinical.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 by Zach Harrison

September 14, 2026Episode 5727 min

Ep 57: IV Ketamine-Assisted Psychotherapy with Will Ratliff

This week we are revisiting a conversation Rachel recorded on the original Mental Health Entrepreneur podcast with Will Ratliff, co-founder of Transcend Health Solutions, one of the world's leading IV ketamine-assisted psychotherapy practices. If last week's conversation with Myriam Barthes focused on the business and access side of psychedelic-assisted therapy, this one goes deeper into the clinical and medical side — what the treatment actually looks like, how it works, and why Will built his practice the way he did. Will's path to ketamine therapy is unlike most. He started as an EMT at 18, became a paramedic by 21, and spent his twenties in ambulances, emergency rooms, critical care units, and eventually helicopters as a flight nurse and paramedic. His early expertise in ketamine was entirely medical — pain management, intubation facilitation, emergency care. The mental health application came later, driven by his own experience developing significant PTSD symptoms early in his career and finding himself in a treatment-resistant position after years of trying traditional approaches. When Will started looking at ketamine clinics as a place to do clinical work, what he found troubled him. The way the industry was operating — the lack of psychotherapeutic support, the purely medical model, the absence of ethical grounding — wasn't how he would do it. So he built his own practice from scratch on an extremely small budget, starting with auction furniture and a scrappy commitment to doing it right. The conversation covers how IV ketamine works differently from other delivery methods, why the psychotherapeutic support around the medicine matters as much as the medicine itself, the challenges of getting the medical community to take ketamine therapy seriously, and the business realities of building in a novel market. Will also shares his perspective on what it takes to pursue something that hasn't been done before — and why getting punched in the chin repeatedly is just part of the deal. Note: This episode was originally recorded for The Mental Health Entrepreneur podcast and is being shared here because of its relevance to our ongoing conversations about psychedelic-assisted therapy. We think it pairs well with our recent conversation with Myriam Barthes of Journey Clinical. Connect with Will Ratliff: Transcend Health Solutions: https://www.transcendketamine.com Transcend Ketamine Podcast LinkedIn: https://www.linkedin.com/in/will-ratliff Instagram: @transcendkap Email: info@transcendketamine.com Phone: 833-313-2512 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 by Zach Harrison

September 9, 2026Episode 5524 min

Ep 55: Be the One Who Does It

This week Rachel steps away from the interview format to do something she has been wanting to do for a while — take stock of everything the podcast has surfaced over the last year and pull it into a single, honest conversation about what is actually happening in mental health right now, and what clinicians and practice owners can do about it. The landscape has shifted dramatically. Federal funding for mental health programs is being cut. SAMHSA has faced consolidation proposals. The 988 crisis line has seen reduced funding. School mental health grants have been halted. Insurance companies are finding loopholes in parity law, and federal agencies have signaled they will not enforce the rules designed to close them. AI is moving faster than regulation. And in the middle of all of it, clinicians who went to school to do therapy are trying to keep their practices afloat while the rules of the game change around them. Rachel draws on conversations from across the podcast's history — with health policy attorneys, state delegates, insurance experts, advocacy leaders, and community organizers — to map out what is driving these changes and what the real levers for change actually are. The episode closes with five concrete action steps that any clinician can take this week, whether they have an hour or five minutes, to be part of shaping what the mental health system becomes next. As Sue Abderholden, retired Executive Director of NAMI Minnesota, put it in Episode 23: the mental health system isn't broken. It's still being built. This episode is about showing up to build it. Episodes Referenced: Ep 2 — Real Change: https://pod.link/1724750091/episode/YjMzODkxYmEtYWZkMi00MWJiLTkxMzgtMWMxYTlmZjJkY2Ri Ep 4 — When AI Meets Therapy: Risks, Ethics, and Advocacy with Dr. Ajita Robinson: https://pod.link/1724750091/episode/ZjljYzJlOTEtZDIxZS00NjRhLTkyNzMtOWJhZGVjMTk4Nzcw Ep 7 — Policy Shifts Reshaping Mental Health Care with Cathy Gilbert: https://pod.link/1724750091/episode/ODYxOTRhMjYtNTg4NS00YjNiLTk3ZTQtYWJlZjZhMDY1Zjcy Ep 9 — Understanding Mental Health Parity with Deborah Steinberg: https://pod.link/1724750091/episode/OWQ5YmYzMzMtZmQ5ZS00ZjUyLWFkMDEtZmFiZDdlNmVmNzZh Ep 23 — Building a Mental Health System That Works with Sue Abderholden: https://pod.link/1724750091/episode/OGE2YWJmM2ItY2JkZS00ZTE3LTliZTUtMWI1NDBiMTg0ZjZl Ep 28 — Community Health, Local Solutions with Malcolm Furgol: https://pod.link/1724750091/episode/NzM4ZWNkN2UtZjI1Zi00ZWQ0LTliYTQtZDI0Nzc0ODc2MmZj Ep 40 — When States Step Up for Safety with Delegate Lily Qi: https://pod.link/1724750091/episode/ZGNiYjdiM2MtODY5Yy00YTQzLTlhOTUtNGMzYjE4ZTM1ZmZj Ep 41 — The Coverage Gap Is a Policy Problem with Cara Cheevers: https://pod.link/1724750091/episode/ZDk5N2RmZmYtNDYyYi00ZmVlLTkwYzYtNmIwOWYyZGZkNTc5 Resources Mentioned: Inseparable Workforce Report: https://www.inseparable.us Kennedy Forum Mental Health Parity Index: https://www.thekennedyforum.org Mental Health Insurance Reform Task Force: https://insurancereformtaskforce.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 by Zach Harrison

September 3, 202624 min

Ep 54: Building Collective Power with Nicole Sartini

Rachel speaks with Nicole Sartini, a licensed clinician, group practice owner, and founder of Build Better Health — a nonprofit think tank that is building the kind of collective provider power that this field has been missing. Nicole came to advocacy the way most providers do: through her own practice. In 2024, after ten years of building Bridge Counseling and Wellness into a 60-provider group practice in Louisville, Kentucky, she watched insurance carve-outs and contract repairing cut her practice's income by 30 percent for the same number of sessions. She started organizing locally — monthly meetings, surveys, conversations with the Kentucky Department of Insurance — and discovered something that stopped her in her tracks: the laws protecting providers from exactly this kind of harm already existed. They just had no teeth to enforce them. What started as a small Kentucky organizing effort has grown into a 50-state coalition with 4,000 providers directly participating. The Mental Health Insurance Reform Task Force is now structured around state-specific pages, state leads, and three national committees — Education, Innovation, and Legal and Legislative — with a team of attorneys tracking litigation opportunities and model legislation based on successful wins in states like Illinois, where HB1085 connected the reimbursement floor to the Medicare rate and raised commercial insurance rates for providers by approximately 30 percent. The conversation covers the two pillars of the Task Force's work: enforcing parity law, and protecting provider independence as insurers and behavioral health platforms consolidate. Nicole walks Rachel through what vertical consolidation actually looks like on the ground — providers being required to credential through third-party platforms to access major insurers, charts being pulled when providers leave, and data concerns that have no adequate legal framework yet. She also shares the Progressive Advocacy Ladder, a step-by-step framework that tells providers and state leads exactly where their state stands and what the next achievable step looks like. And she closes with an invitation: the Task Force meets the second Wednesday of every month at 11am Eastern — and everyone is welcome. Resources Mentioned Articles Referenced: Trump Administration Puts Its Stamp on Mental Health Parity — Mercer (2026): https://www.mercer.com/en-us/insights/us-health-news/trump-administration-puts-its-stamp-on-mental-health-parity/ What Plan Sponsors Need to Know: 2025 Mental Health Parity Report to Congress — Sequoia (May 2026): https://www.sequoia.com/2026/05/mental-health-parity-2025-report/ Behavioral Healthcare Services Market Update — Capstone Partners (March 2026): https://www.capstonepartners.com/insights/article-behavioral-healthcare-services-market-update/ Progressive Advocacy Ladder and National Strategy — Mental Health Insurance Reform Task Force: https://insurancereformtaskforce.org Connect with Nicole Sartini: Mental Health Insurance Reform Task Force: https://insurancereformtaskforce.org Build Better Health: https://buildbetterhealth.org Monthly meetings: Second Wednesday of every month, 11am EDT / 8am PDT 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 by Zach Harrison

August 27, 2026Episode 5230 min

Ep 52: Follow the Money, Follow the Power with Joanne Frederick

Rachel speaks with Joanne Frederick, founder and CEO of Government Market Strategies, about something most clinicians never see but feel every single day — the procurement decisions, ownership structures, and administrative design choices that determine who gets credentialed, who gets paid, and who gets left out. Joanne has spent more than 30 years on the inside of the largest government healthcare programs in the country — Medicare, Medicaid, TRICARE, and Veterans Health — helping clients win contracts in excess of 25 billion dollars and watching the same patterns play out across every system she has worked in. Her perspective on the CAQH rebrand to DataSpring is not that of a worried clinician. It is that of someone who has seen this move before and knows exactly what it means when the entity governing a shared infrastructure becomes owned by the people who benefit most from controlling it. The conversation covers the structural conflict of interest created by insurer ownership of the credentialing backbone, why credentialing delays are a revenue problem and a patient access problem as much as an administrative one, and what it would actually take to fix a system that Joanne argues was never designed to serve everyone equitably. She walks Rachel through the TRICARE reforms happening in 2026 and what they reveal about how large government healthcare programs modernize — and don't. And she ends with a call to action that is both practical and urgent: find the people with the courage to say this doesn't make sense anymore, and support them, because they are going to need all the help they can get. This episode also includes a brief ad read for the Foundations of Trauma Therapy course at the Trauma Specialist Training Institute — an eight-week live remote training starting October 20th. Early bird pricing is available through October 6th. Group rates for teams of five or more are available by emailing info@traumaspecialiststraining.com and mentioning the podcast. Featured Training Foundations of Trauma Therapy — Trauma Specialist Training Institute https://www.traumaspecialiststraining.com/trainings/foundations-trauma-therapy Resources Mentioned Articles Referenced: CAQH Rebrands as DataSpring: Under Payer Ownership — Acuity News: https://acuity.news/regulation/caqh-rebrands-dataspring-payer-ownership-credentialing-2026/ 5 Trends Shaping Payer Enrollment and Medical Credentialing in 2026 — Medallion: https://medallion.co/resources/blog/5-trends-shaping-payer-enrollment-and-medical-credentialing-in-2026 These Changes to TRICARE Plans Are Taking Place in 2026 — Military.com: https://www.military.com/benefits/tricare/these-changes-tricare-plans-are-taking-place-2026.html 5 Things We Need To Do To Improve The US Healthcare System — Joanne Frederick, Authority Magazine: https://medium.com/authority-magazine/joanne-frederick-of-government-market-strategies-5-things-we-need-to-do-to-improve-the-us-0dc5ca52aa7a Connect with Joanne Frederick: Government Market Strategies: https://marketstrategiesonline.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 by Zach Harrison

August 20, 2026Episode 5225 min

Ep 52: Pessimism Is Not a Strategy with Marcus Schmit

Rachel speaks with Marcus Schmit, Executive Director of NAMI Minnesota, about what is actually happening on the ground as federal Medicaid funding cuts ripple through the mental health system — and why, despite everything, pessimism is not a strategy. NAMI Minnesota has been a statewide leader in mental health advocacy, education, and peer support for decades. Marcus stepped into the Executive Director role as his state was navigating an extraordinary convergence of collective trauma — the pandemic, the murder of George Floyd, a school shooting, the assassination of a state legislator, and the sweeping immigration enforcement of Operation Metro Surge. The result was a 4,000 percent increase in NAMI Minnesota's social media engagement and helpline calls through the roof. What that moment revealed about the need for mental health information and community connection is now reshaping how NAMI Minnesota thinks about its work. The conversation also digs into the policy crisis facing community mental health providers. The federal Medicaid funding freeze that stopped payments in their tracks is not a future threat — it is already affecting providers across Minnesota and the country. Marcus walks Rachel through what that means for the clinicians, crisis services, and peer support programs that depend on Medicaid reimbursement, and why peer support in particular — one of the most cost-effective tools in mental health care — is often the first thing cut when budgets tighten. He also shares what he believes the path forward looks like: a community-wide response to collective need, with employers, funders, sports teams, and neighbors stepping up together. Resources Mentioned Articles Referenced: Mental Health Providers Say Federal Medicaid Halt Will Lead to More Crisis — MPR News (February 2026): https://www.mprnews.org/episode/2026/02/26/mental-health-provider-federal-medicaid-halt-will-lead-to-more-crisis Medicaid Cuts Threaten Hundreds of Hospitals, New Report Finds — NBC News: https://www.nbcnews.com/health/health-news/medicaid-cuts-threaten-hundreds-hospitals-new-report-finds-rcna265789 State Budget Fallout: Trump Health Funding Cuts — KFF Health News: https://kffhealthnews.org/news/article/state-budget-fallout-trump-health-funding-cuts-obbba/ Medicaid and Social Services Under Pressure — KFF Health News: https://kffhealthnews.org/medicaid/medicaid-social-services-gavin-newsom-california-republican-criticism/ Connect with Marcus Schmit: NAMI Minnesota: https://namimn.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 by Zach Harrison

August 13, 2026Episode 5126 min

Ep 51: 10 Years of Trauma Specialists - a Live Episode

This week's episode is something a little different. Recorded live at the 10-year anniversary celebration of Trauma Specialists of Maryland, this episode turns the tables on Rachel — instead of hosting, she is interviewed by two of her longtime friends and supporters from the Frederick community, Tom Lynch and Karlys Kline. Tom Lynch spent more than 45 years practicing law in Maryland, most recently with Miles and Stockbridge in Frederick, and has served as chair of the Community Foundation, Frederick Community College, and the Frederick Chamber of Commerce. By his own account, his most important role is supporting the work of his wife, Karlys. Karlys Kline is a community leader and philanthropist who founded the Women's Giving Circle and has served on the boards of more than 42 local nonprofits and businesses. Together they bring a community perspective to a conversation about what it means to build something meaningful in mental health care over ten years. The conversation covers how Trauma Specialists of Maryland grew from a single practice to seven locations, what Rachel has learned about building a team of clinicians who are genuinely committed to trauma work, and what the next chapter looks like. Tom also shares something personal about his own experience as a patient at Trauma Specialists — a candid and moving reflection on what seeking help looked like for him and what it made possible. It is one of the most powerful moments we have recorded on the podcast. Foundations of Trauma Therapy — Trauma Specialist Training Institute: Course starts: October 20, 2026 Format: Eight-week live remote training on Zoom Early bird pricing through: October 6, 2026 Group rates for teams of five or more: info@traumaspecialiststraining.com More information: https://www.traumaspecialiststraining.com/trainings/foundations-trauma-therapy Connect with Trauma Specialists of Maryland: Website: https://www.traumaspecialiststraining.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 by Zach Harrison

August 6, 2026Episode 5021 min

Ep 50: When Child Care Can't Wait for Nine to Five with Sara Bradley

Rachel speaks with Sara Bradley, Executive Director of York Day Early Learning in York, Pennsylvania, about a problem most people in the mental health field have never thought about — and that affects millions of the patients they see every day. The American child care system was built around a standard workday. For the nearly 20 percent of workers who work nonstandard hours — overnight shift workers, first responders, healthcare workers, contract workers, and others — that system simply does not work. York Day is one of the very few organizations in the country trying to change that. Founded more than 90 years ago, York Day has spent the last six months piloting a 24-hour early learning program that meets families where they actually are rather than where the system assumed they would be. Sara walks Rachel through what building that program has actually looked like — the surveys, the pivots, the assumptions that turned out to be wrong, and the ones that turned out to be right. What started as an attempt to run a clean second shift became a fully fluid 24-hour model because the community did not need a program with a clean start and stop — it needed one that could absorb the reality of shift work schedules. York Day is now 18 months into a pilot designed to produce a replicable blueprint that other organizations across the country can use. The conversation also covers the behavioral health dimensions of child care access — the chronic stress, anxiety, and depression that parents experience when reliable care is unavailable, the six million children in the United States living with a parent with co-occurring substance use disorder and mental illness, and why for families in recovery, child care is not a peripheral issue but often a direct factor in whether a parent can sustain sobriety. For clinicians, the message is direct: the parents sitting across from you in your office are being shaped by forces that start well before they walk through your door. Resources Mentioned Articles Referenced: When Work Isn't 9-to-5, Child Care Can't Be Either — The 74 Million: https://www.the74million.org/zero2eight/when-work-isnt-9-to-5-child-care-cant-be-either/ How Inaccessible Child Care Affects Families and Early Childhood Educators — University of Michigan School of Public Health: https://sph.umich.edu/pursuit/2025posts/how-inaccessible-childcare-affects-families-and-early-childhood-educators.html U.S. Children Living with a Parent with Substance Use Disorder — JAMA Pediatrics (2025): https://jamanetwork.com/journals/jamapediatrics/fullarticle/2833575 Connect with Sara Bradley: York Day Early Learning: https://www.yorkday.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 by Zach Harrison

July 30, 2026Episode 4933 min

Ep 49: What Happens When You Replace the Fax Machine with Shana Palmieri

Rachel speaks with Shana Palmieri, Chief Clinical Officer and co-founder of XFERALL (pronounced Transfer-all) , a real-time patient transfer and care coordination platform that is replacing one of the most broken processes in behavioral health — the psychiatric placement referral. Shana spent years as the Director of Behavioral Health Services at George Washington University Hospital in Washington, D.C., where she watched something that would change the direction of her career. Patients in psychiatric crisis sitting in overwhelmed emergency departments for hours, sometimes days, while her team of highly trained clinical social workers spent the majority of their time making phone calls and sending faxes trying to find them a placement. She co-founded XFERALL to solve that problem directly. The platform works by replacing the fragmented, paper-based referral process with a real-time digital system. A clinician enters basic patient information, the platform geolocates available, clinically matched facilities across the continuum of care, and within seconds the clinician knows which facilities have a bed and can accept the patient. XFERALL's median response time across the platform is 15 seconds. One county in California cut its average psychiatric wait time from more than two hours to 17 minutes. The national average for psychiatric placement is seven to eight hours or more. The conversation also goes deep on AI — specifically where Shana believes it belongs in behavioral health and where it does not. She draws a clear line between using AI as an operational tool to reduce administrative burden, surface critical clinical information, and connect a fragmented system, versus using it to make clinical decisions or predict risk in ways that could strip patients of their rights. Her framework is one of the clearest articulations of responsible AI use in behavioral health we have heard on this show. Resources Mentioned: Articles Referenced: Children in a Mental Health Crisis Can Spend Days in the ER Waiting for Treatment — NPR (August 2025): https://www.npr.org/sections/shots-health-news/2025/08/15/nx-s1-5502689/pediatric-mental-health-er-boarding-jama-health-forum AI in the Mental Health Care Workforce Is Met with Fear, Pushback, and Enthusiasm — NPR (April 2026): https://www.npr.org/2026/04/07/nx-s1-5771707/mental-health-care-workforce-artificial-intelligence-ai XFERALL Expands Real-Time Patient Transfer Platform in Southern California — PR Newswire (February 2026): https://www.prnewswire.com/news-releases/xferall-officially-expands-real-time-patient-transfer-platform-in-southern-california-after-already-seeing-success-in-the-state-302689675.html Connect with Shana Palmieri: XFERALL: https://www.xferall.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 by Zach Harrison