Latest / The Mental Health Evolution / Ep 30: Rethinking Behavioral Health Access with Jason Youngblood

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Ep 30: Rethinking Behavioral Health Access with Jason Youngblood · The Mental Health Evolution

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(Transcribed by TurboScribe. Go Unlimited to remove this message.) This podcast is part of the Frederick Podcast Network.
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Learn more at listenfrederick.com.
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Welcome to Mental Health Evolution, a podcast about what's changing in mental
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health and why it matters.
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I'm your host, Rachel Harrison, inviting you into honest conversations with
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people from all perspectives in the field, clinicians, tech founders,
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investors, insurance companies, and all the folks in between.
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Let's explore what's working, what's not, and what's next.
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Welcome back, everyone, to the Mental Health Evolution podcast, where we talk
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about how the landscape is quickly evolving in the mental health industry
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and why those changes matter.
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Today, I am excited to talk to Jason Youngblood.
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He is the Senior Director at Cigna U.S. Markets Behavioral Center
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of Excellence and Sales Operations.
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Jason brings a unique perspective at the intersection of behavioral health,
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employer-sponsored care, and large-scale systems design.
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His work focuses on how mental health supports are structured, delivered, and
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accessed, particularly for people who may not need traditional therapy but
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still need meaningful support.
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This conversation is going to build on themes we've explored recently around
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things like provider shortages, technology-enabled care, and growing interest
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in tools that can support people earlier, faster, and at a lower
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level of intensity without replacing clinician-led treatment.
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So with that, as always, before we talk to our guest, I'd
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like to bring up some relevant articles related to today's topic.
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These may be helpful for listeners who want to dive a little
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bit deeper.
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I have a few more articles than usual this time, and there's
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a little bit of kind of two groups about integrating tech into
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treatment models.
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As you all are aware, or if you're listening for the first
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time, we really like to provide all the viewpoints that we can
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on this podcast.
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We try to explore all sides of things to let you evaluate
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things for yourself and make decisions for yourself.
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So with that in mind, we kind of included those two different
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segments of articles and focused largely around introducing chatbots into the
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therapeutic process.
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Now I want to be clear that, and you'll see there's an
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article with what Cigna is integrating into some of their pieces, and
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it's not all about chatbots.
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So I just want to be clear about that.
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Headspace that you will see an article about that they use is
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often a meditation app, offers sleep support, some other things like that
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that are not related to a chatbot.
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And these articles are all largely kind of chatbot focused.
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So I just wanted to give an acknowledgement to that before we
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kind of briefly talk through the articles.
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The first one, though, I think is interesting is it is a
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research study and called The First Therapy Chatbot Trial Yields Mental Health
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Benefits.
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And this was from Dartmouth in 2025.
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And it really reports on early results from a clinical trial of
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a therapy chatbot showing measurable mental health benefits for some users.
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It raises questions about where chatbot tools may be useful, and particularly
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in low intensity support, early intervention, or symptom management, but also
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highlighting the limits of these tools.
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The next article, also in support of chatbots for mental health, is
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a review on mental health chatbots.
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And this peer reviewed article reviews how mental health chatbots are currently
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being studied and deployed.
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It highlights benefits such as accessibility, self-guided skill practice, and
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symptom monitoring while also noting challenges related to engagement, safety,
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and clinical oversight.
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And the third article references what our guest and his organization are
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doing, which is called Headspace for Cigna Healthcare Enhances Everyday Mental
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Health Support.
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And this announcement describes Cigna's collaboration with Headspace Health to
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offer self-guided, science-backed mental health resources as part of employer
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benefits.
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The partnership highlights how large payers are positioning digital tools as
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early support and navigation, helping people manage stress, build skills, and
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potentially determine where they need a higher level of care.
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So that is all the positive research and information out around chatbots.
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But next, I kind of included a couple articles around a different
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vein of thinking.
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There are a couple articles here.
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The first one is called How Insurance Woes Are Impacting Mental Health
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Care.
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And this article looks at reasons that psychologists specifically, 34%, do not
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take any insurance.
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It identifies pain points such as administrative burden, complex billing
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requirements, and payment disputes or clawbacks as primary reasons.
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And then this next article, APA, which is the American Psychological
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Association, actually put out a health advisory about chatbots and wellness
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apps.
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And their advisory is included in our show notes.
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You can go and read those.
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But essentially, they outline both the promise, so it's a fair evaluation,
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and the limitations of AI-driven chatbots and wellness apps.
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The advisory emphasizes that while these tools may offer accessible support for
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some users, they lack sufficient evidence and safeguards to function as
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standalone therapy, especially for individuals with complex and severe needs.
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So with those two lines of the conversation, what's out there in
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the media, what's being talked about, that kind of gives you a
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good launching point for the conversation with our guest.
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And I want to go ahead and introduce Jason again.
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And we're just going to dive in and have a conversation.
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And I can't wait to hear some of the different perspectives.
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So with that said, Jason, welcome.
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Rachel, it's really great to be here with you today.
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Thanks for welcoming me.
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Absolutely.
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So I would like to start a bit about you.
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You represent the human side.
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You're not just an insurance company or a human who's trying to
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work to the betterment of mental health.
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And I'd like to talk about your professional journey.
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So what kind of led you into the insurance industry and specifically
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looking at behavioral health markets?
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Yeah.
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Well, I am a human all day, every day.
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So thank you for calling that out.
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I'll start early on in my career because I never intended, I'm
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a licensed professional counselor, never intended to be a therapist.
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And I remember the moment in my life when I realized that
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that was my path.
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And it actually started in college.
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I was going to be a physical therapist.
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And I had gone three years of pre-PT and did an
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internship at my local hospital.
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And I will never forget that day going to my hospital and
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the doors of the physical therapy unit opened and all of the
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sights and the sounds and the noises and the smells of a
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hospital unit physical therapy like washed over me.
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And I knew that I made a terrible mistake, that I was
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not cut out to be a physical therapist.
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But I stuck through that internship throughout the course of the summer
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and ended up working with one individual, a man I would say
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probably in his 40s who had had an accident and became paralyzed
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from the waist down.
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And he was there, not that he was going to regain functioning,
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but he wasn't really taking great care of himself.
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He had a lot of loss, his business, relationships, financial had to
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move back, loss of his health and independence.
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So I worked with him throughout the course of the summer.
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At the end of that experience, I knowing that I was going
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to go back and not understanding what I was going to do.
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I don't know how I was going to talk to my parents
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about changing my major so late.
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The physical therapist in my interview, as my closure interview said, you
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know what, we've noticed this individual that you've worked with, he started
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coming twice a week.
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And he told you the story of his life and all of
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his losses.
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And he's showing up differently at home.
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He's caring for himself.
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He's washing his clothes.
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And your relationship has made an impact.
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And I will never forget that moment, walking out to my car
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and it hit me.
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I knew that my path was not to help people from the
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physical side, but just amazed that a relationship can have such a
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profound impact.
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So long story short, I changed my major.
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I took every psychology class I could, graduated with a minor and
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then went on to get my master's degree and work as an
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addictions counselor in a dual diagnosis.
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I found my way to the insurance industry by accident.
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I had heard of a position here at this company.
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It was close by where I had been working.
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My wife was expecting our first child.
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And I heard, gosh, this is a job that is work Monday
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through Friday, 830 to 5.
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And you have to be a clinician.
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And I thought, well, I can give that a try.
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I will do that for two years.
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And then I'm going to leave.
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I'm going to learn everything I can about this industry in two
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years.
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And then I'm going to go back out.
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And here I am, like 23 years later and time for younger
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clinicians or younger folks are listening.
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Time goes by really fast.
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But I was really surprised when I came here that starting work
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doing utilization management, case management, answering the phone and talking
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to people in crisis.
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We as clinicians here could do amazing work in removing barriers and
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supporting providers who are out there in the community with treatment.
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And I will tell you, I had envisioned coming into a role
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like this that it would be a lot of struggle and conflict.
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And what I found that it was just the opposite.
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It was good partnerships.
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It was focused on evidence-based care.
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It was collaboration and improving people's lives at a time when they
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needed it.
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And I began to tell that story to anybody that would listen.
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And so ended up kind of moving my way to supporting employers
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today as part of my role here at Sigma Healthcare.
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I like that.
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That is a different perspective.
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I think, you know, to just kind of dive into things that
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we can hear on the outside of where you're working is not
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so much specific to your insurance company, but the insurance industry can
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certainly be kind of painted as the bad guy, if you will,
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in like patients trying to get services or providers struggling.
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And they are certainly part of the ecosystem, but just a part
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of the ecosystem.
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I'm curious what you say to people who have that perspective.
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And, you know, I think the perspective is understandable.
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I think people's memories are very long.
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I remember in the 80s and the HMO days where care was
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gated versus how we view things today.
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We're not gating care.
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We're a gateway to care because we understand, at least in my
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organization, that the best way to improve somebody's health and well-being
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and lower their overall medical cost is by making sure that they
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get the care that they need with providers that are best fit
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providing higher quality of care.
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And so usually, as people get to know us and get to
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know our passion for that work, I think we surprise a lot
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of people.
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But it is a big industry, and there's many different kinds of
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players from traditional insurance companies to third-party administrators.
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Maybe they're 24-7, 365, not always accessible, complex to navigate.
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And so I think the frustration is well-deserved in many instances,
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but we've worked really hard in my time here, especially going 24
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-7, being available for people to change that and make ourselves more
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accessible.
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Yeah.
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So how would you say your organization is thinking about the mental
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health needs of your consumers at this point?
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Yes.
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Well, foundationally, one out of four people will have a behavioral health
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condition in a given year, so about 25%.
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And the research shows that the sad truth is that 55%
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of them will never get access to care or support in their
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lifetime.
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And that's really staggering because the consequences of that are really
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significant.
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Those individuals who have both medical needs and behavioral needs are up
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to six times more costly from a total medical spend.
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And I think the longitudinal research shows if you have a chronic
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medical condition and an untreated behavioral health condition, you're likely
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to die earlier.
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By 15 years, I think is the latest research that I saw.
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So not only do you use more medical services overall and your
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lifespan isn't as long, your quality of life is greatly impacted.
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And how you show up at work, how you show up as
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a parent, as a caregiver, it is all impacted.
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So our focus on mental health and behavioral health in general is
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to be here to support the, I call them the lucky 45
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% of people who will step forward and seek out care.
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And so we do that by being here 24-7, 365, you
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know, able to do pre-certifications for higher levels of care.
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So there is no barrier, there's no waiting.
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But also to take a look at the 55% who will
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never call us for care or support.
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But because we've got a lot of data, we understand who they
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might be.
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Perhaps they've gone to their doctor and they've gotten a prescription for
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an SSRI and filled it but stopped taking it.
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And so we know that they're likely out there languishing.
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Maybe they were on our website searching for providers but never scheduled
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an appointment or made a call.
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Maybe an out-of-network substance use disorder treatment facility is calling
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and checking their benefits.
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Like we have clues by looking at behavioral medical pharmacy data, even
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EAP data, to who the 55% of people are.
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And so I want to reach out and engage them and support
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them and provide tools and resources for them to get the care
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that they need.
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Okay.
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And is that part of what brought this Headspace collaboration into play
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for Cigna?
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I think in our journey, and I will say when I started
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over two decades ago, there was a really big emphasis on the
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highest cost treatment.
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And so there was a lot of focus on acute care, residential
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treatment.
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However, I think we've come a long way in our society and
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as an industry at recognizing that most people are walking around being
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untreated for illness.
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And the quality of life is significantly impaired.
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So we've looked at developing out the other end of the spectrum
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and making sure that people have access to resources and tools to
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support them.
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When I was seeing people, and it's been a few years since
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I've seen people face-to-face, but I like to refer to
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them as the worried well.
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So they're going to work every day.
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They're taking care of their families, right?
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But they're managing a lot of stress and a lot of anxiety
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and lower levels of depression.
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It really gives them tools and resources that they can have in
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their pocket to utilize.
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And if by chance, through engagement with those tools, that it is
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evident that they need a higher level of care or support, like
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such as seeing a therapist face-to-face, let's make it really
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easy for them to find someone and get them connected to someone
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who would be a best match for them.
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So absolutely, this is part of our journey to focus on what
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we sometimes refer to as subclinical.
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You mentioned sleep, things like that.
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And how long has this been going on, this partnership?
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How long have people had access to these tools?
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So we announced the partnership in the fall.
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And gosh, these days and months all seem to go together.
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So we added Headspace for Cigna Healthcare effective on January 1st of
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this year.
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And the amazing thing to me, when we added this, the benefits
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on 1.1 for about 7 million members, is that we didn't
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do any kind of promotional campaign.
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As we were implementing and getting things up and running, those campaigns
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started weeks later.
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But what we saw were thousands of people based on, I guess,
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seeing press releases or being on our Cigna app ecosystem discovered the
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benefits.
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And a lot of people were drawn to having that level of
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care or support offered.
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So as we're getting a few more weeks of exposure or, you
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know, the announcements and letting people know that they have access at
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no cost, we're seeing a really big uptick in interest from our
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customers.
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I was curious about that.
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Are people able to bypass that part?
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Is it structured kind of like an EAP where they have to
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try Headspace first, and then if their acuity is too high, they
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go to the next level?
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Or can they bypass it altogether if they're like, hey, I just
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know I need to sit down with a face-to-face therapist?
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Yeah.
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So again, like our core philosophy is being a gateway to care
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and understanding that people will enter care where they want.
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So I think from my perspective, I want to make sure people
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know of all of the resources that are available to them and
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keep it really simple and easy to access.
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So we don't require that people use Headspace for Cigna Healthcare or
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EAP.
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People can start where they want.
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And so they can bypass that and go straight to seeing a
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provider if that's what they elect to do.
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Okay.
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I'm curious, a lot of the articles I read and the technology
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in healthcare and especially mental health care, what type of guardrails do
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you have in place for these tools that help maybe protect privacy
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if crisis escalates, if there's suicidal ideation, clinical oversight, any of
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those pieces?
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Yeah.
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So before we partner with any organization, there is a really heavy
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vetting process around data and privacy.
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I think that is a primary concern to make sure we are
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connecting or sharing data and referring people out to a resource that
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their protected health information remains protected.
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And so I think that is like the first gate and that
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has to be rock solid.
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And then again, I think you mentioned it to make sure that
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there is an escalation pathway.
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The tools are great, but if somebody is out there and needs
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additional care, additional support, how do they get routed back into our
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ecosystem to get connected to one of our network providers easily and
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seamlessly?
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And then also as we're looking at partners in the behavioral space,
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we have very few partners.
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And so Headspace for Cigna Healthcare really represents, I think, a level
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of trust between these organizations and the mission of improving the health
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and well-being of others that is nicely aligned.
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But really making sure that the programs that they bring to the
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table are backed by evidence-based research studies.
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Okay.
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I like that.
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So you're clearly like at the newer phases of rolling this out
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and kind of seeing how this helps.
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So maybe the data is too new, but I'm curious for your
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organization.
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I like that you talked about focusing on the longer term, more
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residential care initially, and now looking to that other side.
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Where are you seeing barriers at any level of care in general
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for your consumers?
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Like where is the place where you're aware of issues that need
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to be solved, even if they're difficult to solve?
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Yeah, I love that question.
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I think back to when I started and I worked in community
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mental health, you could find me in the yellow pages.
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I bet there are some of your listeners who were like, what's
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a yellow page?
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Totally.
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And then Google came to be and like searching online.
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But I think back to when I started in the industry, there's
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like a single point of entry for outpatient professional care.
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And thank goodness, as we've evolved and matured as an industry, there's
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a lot of different ways that people can care for their behavioral
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health and well-being, including peer coaching, which has become very popular
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in the last few years, up to relaxation and stress activities, things
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like that.
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The use of coaching in the industry, I think, has become a
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little bit more prevalent than it had been in the past.
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And I think just I've had a recent experience with my own
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wife and we were talking about types of providers and she mentioned
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wanting to recommend a psychiatrist for one of her friends because they
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needed to talk.
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And I was like, well, psychiatrists sometimes do that, but that's not
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typically why they do.
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And I realized after being married for over 20 years that my
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own wife didn't necessarily understand the difference between types of
21:49
providers.
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So all of that being said, I think we have a much
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more complex ecosystem where we had limited resources or a single pathway
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before.
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There's so many options in the app stores of our cell phones,
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so many options.
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It's overwhelming.
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And I think the growth has been great, but it is really
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confusing for consumers.
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And so the call from employer groups, big and small, has been
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great.
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We have so many more options for people to take care of
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themselves, but nobody could figure out how to start.
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And so providing navigation, I think to answer your question, providing
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navigation and support, whether somebody is calling us, spending time with a
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clinician, doing a quick evaluation and helping them understand the resources
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or whether that's happening digitally, but then getting them connected,
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pointing them to their options for resources that may benefit them, that
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guided navigation has really become forefront.
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That's interesting.
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I do think that even in, you mentioned coaching and the difference
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between coaching and therapy, and that could be a whole separate podcast
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conversation, Jason, but it's not always clear even to providers, even to
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coaches.
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I've had those conversations.
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At what point does a coach say, whoa, that's a therapy thing?
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Or does the therapist say you could benefit from a coach?
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Those lines are not clearly drawn in our industry even.
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So of course, consumers have some confusion around that.
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Yeah, absolutely.
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And I am an executive coach and went through coach training.
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And funny, I thought it would be so easy to become a
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coach because I'm a therapist by training.
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It's totally different.
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The skill sets are really quite different.
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I think I struggled in my class the most.
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I will say in doing coaching, it is so different from therapy.
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It's a little bit of a relief to be so direct and
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to hold people accountable.
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But that is very different than therapy.
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But I think you call out a very good point.
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Still a lot of gray in that space.
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Yeah.
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So I do have a question.
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I've talked to a lot of different guests.
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Do you think that some of these digital support tools can actually
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reduce demand on the therapy workforce?
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Or do you think they increase demand by kind of identifying some
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of that unmet need and the people that might need to go
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further?
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Yeah, I think I would like to cheat and say I think
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potentially both.
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I think rather than reduce or increase, I would say I hope
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at the end of the day, access to these tools and resources
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optimizes what happens when somebody gets connected in a therapist office.
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First and foremost, I think we've made huge leaps and bounds around
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individual preference and getting people connected to like a best match,
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whether it's ethnicity or a language or clinical specialty and characteristics
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of a provider that will hopefully help them feel in the first
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and second session that they're with the right provider.
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So we'll see less one and kind of done dropout.
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So really looking, how do we help clinicians out in the field
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increase their therapeutic alliance, getting someone up to three visits and
25:09
beyond because our data suggests when somebody spends three visits with a
25:13
professional that they tend to have overall better health outcomes.
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So I think that in providing some access to coaching and support
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that perhaps will take that out of the therapist office and that
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opens up access for people who do need mental health or substance
25:30
use disorder care and support.
25:32
So I guess at the end of the day, I really hope
25:34
it helps to balance and optimize and that when people are in
25:38
the therapy chair, they're there, they're a good fit with the provider
25:42
and they're ready to work.
25:45
And defining the different pieces, I think to your point of navigational
25:49
tools, that's really probably the next thing.
25:52
So we are just about out of time, but I would love
25:56
to give you an opportunity to just leave our listeners with the
26:00
last thought.
26:01
So kind of, and you can adjust your answers to the different
26:04
groups, but we have listeners who are mental health consumers.
26:07
We have listeners who are mental health providers.
26:09
And then we have a lot of listeners that are more on
26:12
the, in the industry somehow in the business places maybe.
26:16
So what do you think is most important for people to take
26:21
away from this conversation or from your perspective where you sit?
26:25
I know it's a big question.
26:27
It's a huge question.
26:29
I think you called it out.
26:31
The world is evolving rapidly.
26:33
And so happy to spend time with you to talk about how
26:37
it is evolving.
26:38
I think having an open mind and being opening to learning.
26:42
And I'm talking on my end of the spectrum here at Cigna
26:46
Healthcare to consumers, to providers and being open to understand the dynamic
26:52
changes and how we can work together.
26:55
And I think assuming positive intent, something we talk a lot about
26:59
here, assuming positive intent goes a really long way and holding accountable
27:04
when things don't go the way that they should and being accountable.
27:07
That's all a little boring.
27:08
So I think I would say there's one message that I want
27:11
to leave people.
27:12
It doesn't matter whether you're a consumer or caregiver, you know, the
27:16
question that employers ask me, what's the best way for us to
27:19
improve the health and well-being of our employees?
27:22
And my message to them is by taking care of yourself, take
27:26
really good care of yourself, prioritize yourself, manage your own stress, make
27:31
sure you're getting sleep because that way you will be in the
27:35
best place to take care of others.
27:36
I like that.
27:37
I heard collaboration and taking care of yourself in order to help
27:42
others.
27:42
That's, that's good advice, Jason.
27:45
Well, thank you so much for taking the time today out of
27:49
your busy schedule and having this conversation about systems and how we
27:53
can meet people where they need it the most.
27:56
So for all of you listening, information will be in the show
28:00
notes about how to connect with Jason if you have any questions
28:04
or ongoing things you want to explore.
28:07
And we will be back next week to continue talking about the
28:11
forces shaping the mental health industry today.
28:14
Thanks for listening.
28:15
And don't forget to check the show notes for the links to
28:18
the articles that we discussed today.
28:20
Bye bye, everybody.
28:21
Thanks for listening to the Mental Health Evolution podcast.
28:25
Join the conversation.
28:27
Find us on social, send us your thoughts and tell us what
28:30
you're seeing in your corner of the mental health world.
28:33
Until next time, stay curious and keep evolving.