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Filtered field notes — system critique.

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All system critique posts.

Sorted newest first. Each post links primary sources and methodology.

The FDA Has Approved 1,400+ AI Medical Devices — Zero Are for Mental Health

More than 1,400 AI-enabled medical devices have received FDA authorization. Radiology has over 1,100. Mental health has zero. The gap is not an oversight. It reveals a regulatory system that still treats behavioral health as a lower-order priority.

Jul 10, 2026 Matthew Sexton, LCSW

Employers Are Betting on AI for Mental Health Benefits. Their Workers Don't Trust It.

83% of employers want AI to run mental health benefits navigation — but only 24% of employees actually use it, and workers are twice as likely as employers to say they simply don't trust AI.

Jul 10, 2026 Matthew Sexton, LCSW

The Workforce Drain: Why Burned-Out Therapists Are Thinking About Quitting, and Why 137 Million Americans Live in a Mental Health Shortage Area

The claim that 40% of therapists want to quit doesn't check out. The verified numbers are heavy enough: 48% of behavioral health workers have considered leaving, 137 million Americans live in a federal mental health shortage area, and only 27% of the need for providers there is met. The drain is real, and it was built.

Jul 06, 2026 Matthew Sexton, LCSW

Private Equity Bought the Couch: 56 Behavioral Health Deals in 2025, and What New Ownership Means for Your Care

Private equity firms closed 56 behavioral health deals in 2025, inside a record-value year for health care buyouts. The research on what happens next is blunt about staffing and careful about outcomes. Here is the plain version.

Jul 06, 2026 Matthew Sexton, LCSW

The Insurance Reimbursement Gap: Therapists Are Paid About 30% Less by Insurance Than Private Pay, and That Shapes Who Can Access Care

Insurance pays therapists about $111 per session. Private pay averages $159 for the same hour. That gap, roughly 30%, is the most-cited barrier pushing therapists off insurance panels, and it quietly decides whether your insurance card gets you an actual appointment.

Jul 06, 2026 Matthew Sexton, LCSW

137 Million Americans Live in a Mental Health Desert — and the Number Just Grew by 15 Million in One Year

As of December 2025, 137 million Americans — 40% of the country — live in a federally designated Mental Health Professional Shortage Area. That is 15 million more people than the year before. The shortage didn't grow because the crisis got worse. It grew because the system designed to fix it kept failing.

Jun 30, 2026 Matthew Sexton, LCSW

The ERISA Loophole: How Large Employers Used a Federal Lawsuit to Kill Your Mental Health Coverage Upgrade

A lobbying group for Fortune 500 companies sued the federal government in January 2025 to block the most significant mental health parity upgrade in a decade. By May 2025, enforcement was paused indefinitely — and the workers those companies cover are the ones who pay for it.

Jun 30, 2026 Matthew Sexton, LCSW

PE-Owned Behavioral Health Is Starting to Crack: What Summit BHC's Debt Crisis Tells Us

Summit BHC, backed by Patient Square Capital, completed a distressed debt exchange in 2025 and now carries a negative credit outlook — and it is not alone.

Jun 29, 2026 Matthew Sexton, LCSW

Private Equity Has Now Acquired 574 Autism Therapy Centers — Here Is What That Means for the Kids Inside Them

Researchers counted 574 autism therapy centers now owned by private equity across 42 states. Here's what the research shows happens next.

Jun 29, 2026 Matthew Sexton, LCSW

The Parity Rollback Is Here: What Happens When the Federal Government Stops Enforcing Mental Health Coverage Rules

The Trump administration suspended enforcement of the 2024 MHPAEA rule and gutted EBSA's staff. Here's what that means for the 136 million people it covered.

Jun 29, 2026 Matthew Sexton, LCSW

The Psychiatrist Cliff: New Study Projects a 43% Demand Surge While the Workforce Shrinks

A federal workforce simulation published June 2026 in Psychiatric Services projects psychiatric demand rising 43.7% by 2037 while the supply of adult psychiatrists drops 12.3% — not a hiring problem, a structural failure the market cannot self-correct.

Jun 28, 2026 Matthew Sexton, LCSW

Your Insurer Is Becoming Your Therapist — and That Should Worry You

UnitedHealth's Optum and Cigna's Evernorth are building their own behavioral health care groups while simultaneously controlling which care their members can access — a structural conflict of interest that independent clinicians and patients are already absorbing.

Jun 28, 2026 Matthew Sexton, LCSW

$700 Million for Mental Health — and None of It Fixes the Access Problem

On June 17, 2026, HHS announced $700M for 988, CCBHCs, and SUD programs. That same week, the DOL confirmed it will no longer defend the parity rules that would force commercial insurers to actually cover the mental health care people already pay for.

Jun 28, 2026 Matthew Sexton, LCSW

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