Ep 46: The Crisis Text Line with Dr. Shairi Turner

Ep 46: The Crisis Text Line with Dr. Shairi Turner

Rachel speaks with Dr. Shairi Turner, Chief Health Officer at Crisis Text Line, a nonprofit that provides free, 24/7 text-based mental health support and crisis intervention through a community of trained volunteer counselors. In 2025, Crisis Text Line had more conversations than any year since its founding — over 1.5 million — and the data from those conversations tells a story that every clinician and practice owner needs to hear. Dr. Turner walks Rachel through how Crisis Text Line actually works: what happens from the moment someone texts HOME to 741741, how volunteer counselors are trained and supervised, and how the organization handles the rare cases — just one percent — where a conversation cannot be de-escalated. She also shares the founding story of Crisis Text Line, born from a moment when a young person reached out for help through a volunteer platform with nowhere else to turn. The conversation covers what the 2025 data reveals about who is reaching out — rural communities, young people, and boys under 14 reporting suicidal thoughts at striking rates — and ends with a direct call to action for clinicians: ask young men and boys how they are doing, and ask clearly. If you or someone you know needs support, text HOME to 741741 to connect with a live volunteer Crisis Counselor. Resources Mentioned: Articles Referenced: 988 Mental Health Help Lifeline Helps Five Million in First Year — NPR (July 2023): https://www.npr.org/sections/health-shots/2023/07/15/1187862144/988-mental-health-crisis-line-gets-5-million-calls-texts-and-chats-in-first-year [https://www.npr.org/sections/health-shots/2023/07/15/1187862144/988-mental-health-crisis-line-gets-5-million-calls-texts-and-chats-in-first-year] Why Depression Goes Undetected in Teen Boys — NBC News (June 2024): https://www.nbcnews.com/health/health-news/depression-anxiety-teen-boys-diagnosis-undetected-rcna141649 [https://www.nbcnews.com/health/health-news/depression-anxiety-teen-boys-diagnosis-undetected-rcna141649] Annual Trends 2025 — Crisis Text Line: https://www.crisistextline.org/annual-trends/ [https://www.crisistextline.org/annual-trends/] Additional resource - Crisis Text line Terms and Conditions: https://www.crisistextline.org/terms-of-service/ [https://www.crisistextline.org/terms-of-service/] Connect with Dr. Shairi Turner: Crisis Text Line: https://www.crisistextline.org [https://www.crisistextline.org/] Text HOME to 741741 Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast [https://www.traumaspecialiststraining.com/mental-health-evolution-podcast] Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Ep 45: Stop Doing What Worked Ten Years Ago with Dr. Elizabeth Carr

Rachel speaks with Dr. Elizabeth Carr, a clinical psychologist and the founder and CEO of Kentlands Psychotherapy in Gaithersburg, Maryland. Elizabeth leads a team of 20 doctoral and master's-level clinicians and has spent over two decades building a community-focused, financially sustainable practice through some of the most disruptive periods in the history of mental health care. A former Navy psychologist and sought-after speaker on practice management, she recently published a piece on strategic positioning during industry upheaval that is the centerpiece of this conversation. The mental health practice landscape is shifting in ways that are affecting practices at every size — but not all in the same direction. Elizabeth describes what she calls the barbell effect: solo practitioners, particularly those operating fully virtual, are being squeezed out by venture capital-backed platforms with enormous marketing budgets and SEO dominance, while large practices that over-expanded during the COVID telehealth boom are now sitting on overhead they cannot fill. Mid-sized, community-rooted practices that stayed nimble are finding themselves in a stronger position — but only if their leaders are paying attention to what's actually happening in the market and willing to respond. Elizabeth and Rachel dig into what that looks like in practice: how to read referral data, when to pivot your service offerings, what AI can and cannot replace in clinical work, and why hyperlocal, in-person, relationship-based care may be the most durable competitive advantage a practice owner has right now. Resources Mentioned Articles Referenced: * A Workforce Under Pressure: Preparing the Behavioral Health Workforce for Today and Tomorrow — National Council for Mental Wellbeing (2025): https://www.thenationalcouncil.org/behavioral-health-workforce-under-pressure-preparing-today-tomorrow/ [https://www.thenationalcouncil.org/behavioral-health-workforce-under-pressure-preparing-today-tomorrow/] * Telehealth and Hybrid Practice Are Here to Stay — APA Monitor on Psychology (2024): https://www.apa.org/monitor/2024/09/telehealth-hybrid-practice [https://www.apa.org/monitor/2024/09/telehealth-hybrid-practice] * Strategic Positioning During Industry Upheaval — Dr. Elizabeth Carr, Kentlands Psychotherapy (January 2026): https://www.kentlandspsychotherapy.com/mental-health-professional/strategic-positioning-during-industry-upheaval/ [https://www.kentlandspsychotherapy.com/mental-health-professional/strategic-positioning-during-industry-upheaval/] Connect with Dr. Elizabeth Carr: * Kentlands Psychotherapy: https://www.kentlandspsychotherapy.com [https://www.kentlandspsychotherapy.com] Connect with The Mental Health Evolution: * Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast [https://www.traumaspecialiststraining.com/mental-health-evolution-podcast] * Instagram: /thementalhealthevolution/ * LinkedIn: /the-mental-health-evolution * Facebook: /TheMentalHealthEvolution * Music by Zach Harrison

Ep 44: They Knew and They Profited Anyway with Matthew Bergman

Rachel speaks with Matthew Bergman, founding attorney of the Social Media Victims Law Center, about the landmark KGM verdict — the first social media addiction case in the United States to reach a jury. In March 2026, a Los Angeles jury found Meta and YouTube negligent in the design of their platforms and awarded $6 million in damages to a young woman whose mental health was seriously harmed by her use of Instagram and YouTube beginning at age six. Matthew has spent four years building the legal case that made this moment possible, and the theory at its center is straightforward: this was never about content. It was about a product engineered to be addictive — one that shows kids not what they want to see, but what they cannot look away from. The conversation covers Section 230 and how the product liability approach found a path around it, the eggshell plaintiff doctrine and why blaming the victim failed in court, and what the verdict actually changes for the thousands of similar cases still working through the courts. Matthew also speaks directly to clinicians: ask about social media. When you see anxiety, depression, eating disorders, or suicidality in young patients, social media needs to be part of the assessment. The youth mental health crisis started in 2012 — when content began being fed to kids algorithmically — and the research establishing a causal relationship has only grown stronger since. Resources Mentioned: Articles Referenced: Research Points to How Companies Could Make Social Media Less Addictive for Teens — NPR (March 2026): https://www.npr.org/2026/03/27/nx-s1-5763017/social-media-teens-addictive-design [https://www.npr.org/2026/03/27/nx-s1-5763017/social-media-teens-addictive-design] Jury Finds Meta and YouTube Negligent in Landmark Lawsuit on Social Media Safety — NBC News (March 2026): https://www.nbcnews.com/tech/tech-news/verdict-reached-landmark-social-media-addiction-trial-rcna263421 [https://www.nbcnews.com/tech/tech-news/verdict-reached-landmark-social-media-addiction-trial-rcna263421] Social Media Addiction Lawsuit Update — Social Media Victims Law Center: https://socialmediavictims.org/social-media-lawsuits/ [https://socialmediavictims.org/social-media-lawsuits/] Connect with Matthew Bergman: Social Media Victims Law Center: https://socialmediavictims.org [https://socialmediavictims.org/] Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast [https://www.traumaspecialiststraining.com/mental-health-evolution-podcast] Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Ep 43: When Payers Own the Data: What the CAQH Rebrand Means for Providers

In this solo episode, Rachel Harrison takes a break from her usual guest conversations to address something that has been generating a lot of discussion in the mental health community this week: the rebranding of CAQH as DataSpring. If you have been in mental health practice for any amount of time, you know CAQH. It is the credentialing portal most clinicians and practice owners have relied on for years to maintain licensing, training history, liability insurance, and practice information for insurance credentialing — a system designed so that providers enter their data once and it flows out to multiple payers rather than filling out the same paperwork over and over again for each insurance company. But CAQH is no longer the nonprofit utility it once was. In January 2026, the organization converted from a nonprofit and became owned by a consortium of 12 of the nation's largest health plans, including UnitedHealth Group, Cigna, Aetna, Humana, Centene, Elevance Health, and several Blue Cross Blue Shield plans. And this past week, the organization rebranded as DataSpring, powered by CAQH — a change timed to coincide with the AHIP 2026 conference, a major gathering for health insurance executives. Rachel walks through what the rebrand actually means, why the ownership shift matters, and what questions every clinician and practice owner should be asking right now. She covers the concerns being raised in the field — including whether payers will use this platform in ways that benefit their own administrative processes at the expense of providers, whether incomplete data could be used to slow credentialing or delay directory listings, and what oversight exists when the governing board is made up of representatives from the very insurers pulling the data. She is also clear about what we do not yet know: this is a developing situation, independent reporting has not fully caught up, and there is no confirmed evidence yet that providers are being harmed. But the structural shift is significant, and Rachel makes the case that awareness matters even when we do not have all the answers. Resources Mentioned * CAQH Rebrands as DataSpring to Power the Next Era of Healthcare Data — Globe Newswire: https://finance.yahoo.com/sectors/healthcare/articles/caqh-rebrands-dataspring-power-next-110700451.html [https://finance.yahoo.com/sectors/healthcare/articles/caqh-rebrands-dataspring-power-next-110700451.html] * Leading Health Plans Become CAQH Owners to Shape the Future of Healthcare Data — Becker's Payer Issues: https://www.beckerspayer.com/m-and-a/major-insurers-take-ownership-of-former-nonprofit-healthcare-data-organization/ [https://www.beckerspayer.com/m-and-a/major-insurers-take-ownership-of-former-nonprofit-healthcare-data-organization/] * Insurer-Owned CAQH Rebrands to DataSpring — Becker's Payer Issues: https://www.beckerspayer.com/leadership/insurer-owned-caqh-rebrands-to-dataspring/ [https://www.beckerspayer.com/leadership/insurer-owned-caqh-rebrands-to-dataspring/] * When Payers Own the Data: What CAQH's New Structure Means for Provider Revenue and Credentialing — Ventra Health (private company blog; read with that context in mind): https://ventrahealth.com/blog/when-payers-own-the-data-what-caqhs-new-structure-means-for-provider-revenue-credentialing/ [https://ventrahealth.com/blog/when-payers-own-the-data-what-caqhs-new-structure-means-for-provider-revenue-credentialing/] Connect with The Mental Health Evolution * Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast [https://www.traumaspecialiststraining.com/mental-health-evolution-podcast] * Instagram: /thementalhealthevolution/ * LinkedIn: /the-mental-health-evolution * Facebook: /TheMentalHealthEvolution Music by Zach Harrison

Ep 42: What Clinicians Need to Know About AI Law with Dr. Nick Shumate

Rachel Harrison speaks with Dr. Nick Shumate, a psychiatrist at the Division of Digital Psychiatry at Beth Israel Deaconess Medical Center and Harvard Medical School, whose background is as rare as it is relevant: before medicine, he was a regulatory attorney practicing before the Federal Energy Regulatory Commission. That combination of clinical training and legal expertise is exactly what drove him to lead a sweeping 50-state review of how the United States is governing artificial intelligence in mental health — research that produced findings every clinician and practice owner needs to understand. The conversation covers what that legislative review actually found: 793 state bills reviewed, 143 with direct or indirect implications for AI in mental health, and just 20 enacted into law across 11 states. Dr. Shumate walks through the four major categories of governance that emerged from the research, explains why the near-total absence of clinicians from the policy-making process is one of the study's most striking findings, and makes the case that the rules being written right now will shape the conditions under which mental health care is delivered for years to come. He and Rachel also dig into the practical questions clinicians face today: what disclosure and informed consent look like when AI is part of the care equation, and why eighty percent of high-acuity patients using AI for mental health support have not told their providers about it. Resources Mentioned: Articles Referenced: AI Chatbots Systematically Violate Mental Health Ethics Standards — Brown University (October 2025): https://www.brown.edu/news/2025-10-21/ai-mental-health-ethics [https://www.brown.edu/news/2025-10-21/ai-mental-health-ethics] Pennsylvania Sues Character AI over Chatbot Allegedly Posing as a Doctor — NPR (May 2026): https://www.npr.org/2026/05/05/nx-s1-5812861/characterai-chatbot-medical-advice-pennsylvania-lawsuit [https://www.npr.org/2026/05/05/nx-s1-5812861/characterai-chatbot-medical-advice-pennsylvania-lawsuit] Governing AI in Mental Health: 50-State Legislative Review — Dr. Nick Shumate et al., JMIR Mental Health: https://mental.jmir.org/2025/1/e80739 [https://mental.jmir.org/2025/1/e80739] Connect with Dr. Nick Shumate: Division of Digital Psychiatry, Beth Israel Deaconess Medical Center / Harvard Medical School Connect with The Mental Health Evolution: Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast [https://www.traumaspecialiststraining.com/mental-health-evolution-podcast] Instagram: /thementalhealthevolution/ LinkedIn: /the-mental-health-evolution Facebook: /TheMentalHealthEvolution Music Credit: Music by Zach Harrison