The Mental Health Evolution

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

Ep 41: The Coverage Gap Is a Policy Problem with Cara Cheevers

Rachel Harrison speaks with Cara Cheevers, Vice President of Coverage Policy at Inseparable, a national mental health advocacy organization working to win better mental health care for everyone in this country. Cara brings more than fifteen years of experience in health equity advocacy, including leading Mental Health Parity and Addiction Equity Act enforcement at the Colorado Division of Insurance. In this conversation, Cara and Rachel dig into something that sits at the heart of the mental health access crisis: the workforce shortage is not simply a supply problem — it is a policy problem. From reimbursement rates that push providers out of insurance networks, to administrative burdens that make accepting insurance feel impossible, to a system that asks clinicians to do more with less, the barriers are structural. And that means the solutions are too. Cara walks through what the data actually shows about workforce shortages, what states like Illinois and Washington are doing right now to move the needle through reimbursement rate mandates and pre-licensure reimbursement requirements, and what both patients and providers can do today to be part of the solution. She also breaks down mental health parity law, explains how patients can file complaints with their state Division of Insurance when they cannot access in-network care, and makes the case that filing those complaints is not just self-advocacy — it is how systemic problems get documented and fixed. Resources Mentioned: Articles Referenced: State of the Behavioral Health Workforce, 2025 — HRSA: https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/Behavioral-Health-Workforce-Brief-2025.pdf [https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/Behavioral-Health-Workforce-Brief-2025.pdf] State Policies Can Help Address the Mental Health Care Workforce Shortages — Pew Charitable Trusts: https://www.pew.org/en/research-and-analysis/articles/2026/04/16/state-policies-can-help-address-the-mental-health-care-workforce-shortages [https://www.pew.org/en/research-and-analysis/articles/2026/04/16/state-policies-can-help-address-the-mental-health-care-workforce-shortages] Workforce Report — Inseparable: https://www.inseparable.us/workforce/ [https://www.inseparable.us/workforce/] Connect with Cara Cheevers: Website: https://www.inseparable.us [https://www.inseparable.us/] LinkedIn: https://www.linkedin.com/in/cara-cheevers [https://www.linkedin.com/in/cara-cheevers] Instagram: https://www.instagram.com/iaminseparable/ [https://www.instagram.com/iaminseparable/] 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

Ep 40: When States Step Up for Safety with Delegate Lily Qi

In this episode, Rachel Harrison speaks with Maryland State Delegate Lily Qi, who represents District 15 in Montgomery County and has served in the Maryland General Assembly since 2019. Delegate Qi sits on the Economic Matters Committee, where her work focuses on consumer protection, business regulation, and positioning Maryland for the industries of the future. This conversation centers on Maryland House Bill 883, legislation she championed to require basic disclosure when consumers interact with AI systems in behavioral health contexts, and what it means that the bill passed the House with overwhelming bipartisan support before stalling in the Senate. Delegate Qi brings both urgency and pragmatism to the conversation, grounding the policy debate in a stark reality: there is currently nothing in Maryland law preventing a chatbot from manipulating a vulnerable person toward self-harm. The second half of the conversation widens the lens to explore how states are increasingly stepping into the AI regulation space in the absence of consistent federal standards, and what mental health professionals and advocates can do right now to move this work forward. Delegate Qi offers a clear-eyed roadmap for effective advocacy, from building coalitions across consumer groups, tech communities, and behavioral health professionals, to reaching legislators early and consistently rather than showing up only at hearings. She closes with a direct call to action for mental health professionals: reach out to your legislators, share your expertise, and show up in Annapolis when the next session begins. RESOURCES MENTIONED Articles Referenced: Maryland House Bill 883 - AI in Behavioral Health Contexts: https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/hb0883?ys=2026rs [https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/hb0883?ys=2026rs] State Mental Health Investments - National Governors Association: https://www.nga.org/news/commentary/state-mental-health-investments/ [https://www.nga.org/news/commentary/state-mental-health-investments/] Tennessee Bans AI Therapy Bots as Chatbot Safety Laws Surge - AI2: https://ai2.work/blog/tennessee-bans-ai-therapy-bots-as-chatbot-safety-laws-surge [https://ai2.work/blog/tennessee-bans-ai-therapy-bots-as-chatbot-safety-laws-surge] Connect with Delegate Lily Qi: Website: https://www.lilyqi.com/ [https://www.lilyqi.com/] Email: lily.qi@house.maryland.gov [lily.qi@house.maryland.gov] Instagram: https://www.instagram.com/lilyqimaryland/ [https://www.instagram.com/lilyqimaryland/] LinkedIn: https://www.linkedin.com/in/lily-qi-604a9018/ [https://www.linkedin.com/in/lily-qi-604a9018/] Facebook: https://www.facebook.com/lilyqimaryland [https://www.facebook.com/lilyqimaryland] 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

Ep 38: Advocacy, Autonomy and the Future of Psychotherapy with Linda Michaels of PsiAN

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 [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/ [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 [https://www.psian.org/practice-management-companies] Connect with Dr. Linda Michaels and PsiAN: Website: https://www.psian.org/ [https://www.psian.org/] Instagram: https://www.instagram.com/psianofficial/ [https://www.instagram.com/psianofficial/] LinkedIn: https://www.linkedin.com/company/psian/ [https://www.linkedin.com/company/psian/] 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

Ep 37: Trusted Tools for Peer Workers with Naveen Raman

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/ [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 [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 [https://www.cs.cmu.edu/news/2026/peer-copilot] Connect with Naveen Raman: Website: http://naveenraman.com [http://naveenraman.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 Credit: Music by Zach Harrison