Rachel talks with Val Strunk, a licensed social worker, child therapist, and co-owner of Wired to Bloom Therapy in the Cincinnati area. Val is an immigrant and an EMDR-trained therapist. She uses child-centered, trauma-informed play and creative approaches with children and families, including immigrant families. Rachel found her work in Cincinnati Magazine. They discuss how immigration enforcement and changes to health coverage are adding stress for immigrant and mixed-status families. Georgetown's Center for Children and Families has called this a "perfect storm" for children's mental health.

Val describes the fear, confusion, and grief she sees in children, and how kids absorb everything around them. She explains what shows up in play therapy, including children's confusion about whether to trust or fear uniformed officers. She also covers the industry side: a provider shortage, practices dropping Medicaid and insurance because of reimbursement cuts, and families too afraid to leave home or share information, even for telehealth. For clinicians and practice owners, she suggests offering accessibility and low-cost spaces when there is capacity, advocating, and building trusted referral relationships through community outreach. She also encourages listeners to get to know their immigrant neighbors.

Resources Mentioned

Articles Referenced:

• The Cost of Living Afraid. Cincinnati Magazine (July 2026): https://www.cincinnatimagazine.com/article/cost-of-living-afraid/
• Fear as Policy: The Growing Mental Health Toll of Mass Deportation Policies. American Immigration Council (August 2026): https://www.americanimmigrationcouncil.org/blog/mental-health-mass-deportation-immigration-policies/
• The Perfect Storm: How Immigration and Medicaid Policy Changes Are Exacerbating a Student Mental Health Crisis. Georgetown Center for Children and Families (January 2026): https://ccf.georgetown.edu/2026/01/06/the-perfect-storm-how-immigration-and-medicaid-policy-changes-are-exacerbating-a-student-mental-health-crisis/
• Navigating Uncertainty: Facilitating Parent-Child Conversations About Immigration Enforcement-Related Family Separation. Journal of the American Academy of Child and Adolescent Psychiatry (July 2026): https://pubmed.ncbi.nlm.nih.gov/42398894/

Connect with Val Strunk:
Wired to Bloom Therapy: https://wiredtobloomtherapy.com/
LinkedIn: https://www.linkedin.com/in/val-s-719992a8/

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

Rachel welcomes back Dr. Libby Stuyt, a guest many listeners may remember from our previous podcast, The Mental Health Entrepreneur. Dr. Stuyt is a board-certified psychiatrist and volunteer clinical faculty at the University of Colorado Health Science Center. She is also a trainer for the People's Organization for Community Acupuncture. When she joined us before, the conversation was about the use of acupuncture in addiction treatment. That episode is linked below.

Dr. Stuyt has spent over three decades working in Colorado with people who have co-occurring mental illness and substance use disorder. She has been watching the mental health consequences of today's high-potency cannabis on young people unfold in real time. Colorado was one of the first states to legalize recreational marijuana, so she has had a longer window than most to see what happens when cannabis becomes normalized, commercialized, and increasingly potent. In this conversation, she and Rachel cover how much the product has changed. THC in the plant has gone from about 2–3 percent in the 1960s through the 1980s to an average of up to 20 percent today, and some concentrates are 99.9 percent pure. They also cover intoxicating hemp products like delta 8 and delta 10, why the developing brain is most at risk, why the research doesn't support cannabis as a treatment for PTSD, what regulation could look like, and what clinicians and practice owners can do now.

Resources Mentioned

Articles Referenced:

• Cannabis Legalization and Adolescent Behavioral Health: Are Current Policies Sufficiently Protecting Adolescents? — Behavioral Health News (September 2026): https://behavioralhealthnews.org/cannabis-legalization-and-adolescent-behavioral-health-are-current-policies-sufficiently-protecting-adolescents/
• Cannabis and Teens — CDC: https://www.cdc.gov/cannabis/health-effects/cannabis-and-teens.html
• A Huge Study Finds a Link Between Cannabis Use in Teens and Psychosis Later — NPR (February 2026): https://www.npr.org/2026/02/23/nx-s1-5719338-e1/a-huge-study-finds-a-link-between-cannabis-use-in-teens-and-psychosis-later

Dr. Stuyt's original appearance (ear acupuncture and addiction treatment): https://www.traumaspecialiststraining.com/resources/podcast-episodes/15-2024

Connect with Dr. Libby Stuyt:
LinkedIn: https://www.linkedin.com/in/libby-stuyt-4a45461b/
People's Organization for Community Acupuncture: https://pocacoop.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

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

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

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

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

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

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