On this episode of the Catalyst Podcast we speak with Chestnut Health Systems' CEO Dr. Dave Sharar. We discussed:

• Dave’s 35-year career at Chestnut Health Systems, including his current role as CEO and his previous leadership of Chestnut Global Partners, where he managed behavioral health services for over 600 employers and 1 million employees worldwide.
• The significant shift in public and political attitudes toward mental health and substance use disorders over the past decade, with increased recognition and bipartisan support for expanding treatment resources.
• Medicaid’s role as the largest funder of mental health and substance use services in the United States, providing essential healthcare access for millions of Americans, including the working poor.
• Chestnut’s evolution into an integrated healthcare organization, now a federally qualified health center, combining behavioral health with primary care.
• The benefits of an integrated care model, where multidisciplinary teams coordinate to reduce inefficiencies and improve outcomes for patients with complex needs.
• The potential negative impact of Medicaid funding cuts, particularly on rural areas and small towns, where access to substance use disorder treatment is already limited.
• The success of Chestnut’s walk-in medication-assisted treatment program for opioid use.
• Challenges associated with proposed Medicaid work requirements, including the failure of previous attempts and the likely overestimation of able-bodied, non-working Medicaid recipients.
• Dave's cautious optimism that policymakers will appreciate Medicaid’s importance and approach any reforms thoughtfully.

We’re joined by Melissa Sienna, Executive Director of MDFT International (Multidimensional Family Therapy), and by Sandra Arguelles, National Trainer, also with MDFT International. MDFT transforms lives through family-centered treatment for youth struggling with mental health and other challenges, including

• Substance Misuse
• Mental Health
• Crime & Delinquency
• Antisocial & Aggressive Behaviors
• School & Family Problems
• Emotional Difficulties

MDFT has more than 30 years of rigorous research that proves its efficacy, and the widespread adoption of MDFT demonstrates its feasibility. Today, clinicians implement and sustain MDFT programs in over 150 public and private settings throughout the U.S. and Europe. We discussed:

• The MDFT for OUD program: the gaps in care that it was created to address, how the program’s enhanced training, overdose protocols, and medication access differ from standard MDFT approaches.
• The Connecticut Demonstration Project, a pilot study/program evaluation involving participants aged 15 to 19 diagnosed with OUD. They tell us about the methodology and their findings.
• Plans to expand the program beyond the 6 sites statewide it is currently in.
• MDFT’s history of partnering with LI in working with the GAIN (Global Appraisal of Individual Needs) and the most significant outcomes achieved through their collaboration.

Dateline: Washington, DC. This week’s guest is Chuck Ingoglia, President and CEO of the National Council for Mental Wellbeing, the. unifying voice of America’s community mental health and addiction treatment organizations. Together with more than 3,300 member organizations, they serve more than 10 million adults and children living with mental illnesses and addictions. For fifty-five years, the organization has been a voice on Capitol Hill, driving policy and social change. We discussed:

1. The organization’s mission and Chuck’s role (on the morning we spoke, he was just back from a meeting at the White House ).
2. With Medicaid funding under threat, the messages are likely to resonate with lawmakers.
3. The Mental Health First Aid (MHFA) program, which has been used to train more than 3 million people in the U.S. to identify, understand and respond to signs and symptoms of mental health and substance use challenges.
4. The importance of storytelling to showcase the value of services promoting mental wellbeing.
5. The intersection of AI and mental health - AI’s potential to help clinicians cut the time spent on note-taking and administrative processes, improve decision-making and client access, etc. Chuck also raised concerns, such as whether AI can be entrusted to generate duty-to-warn notifications when necessary.
6. The importance of keeping engaged with elected officials to help them understand the crucial role Medicaid plays in healthcare delivery.