Episode Description
The Science Advanced. The Patients Did Not Get Better.
What Tom Insel, the man who ran America's mental health agency for 13 years and spent $20 billion, learned when none of it moved the needle.
Tom Insel is one of the most consequential figures in modern mental health. He directed the National Institute of Mental Health for 13 years, oversaw more than $20 billion in research funding, and helped reshape how America understands the brain. He was there for the human genome sequencing. For the MRI revolution. For a generation of breakthroughs that were supposed to change everything.
They didn't.
In this episode, Mark Jacobstein sits down with Tom for a conversation that is rare in this field: a true insider who is willing to say exactly what went wrong, why, and what he is doing about it.
They get into why world-class science can fail patients completely. How the mental health system's three-way misalignment between patients, providers, and payers kills good ideas before they reach anyone. Why AI won't save us through chatbots, but might finally give psychiatry something it has never had: real diagnostics. And what it actually takes to build something in this space that sticks.
This episode covers:
- Why $20 billion in research barely moved outcomes
- The structural trap that kills every good mental health innovation
- What his latest company is doing that is actually working
- Why AI's biggest gift to mental health won't be therapy, it will be measurement
- What it costs to be honest about failure, and why it matters
About the Speakers
Mark Jacobstein, Host
is the co-founder and president of Jimini Health. A longtime entrepreneur at the intersection of AI and health tech, he now leads Jimini’s mission to transform mental and behavioral health through clinically grounded, AI-powered care.
Tom Insel, Guest
is a psychiatrist, neuroscientist, and entrepreneur who served as director of the National Institute of Mental Health from 2002 to 2015. Over 13 years, he oversaw more than $20 billion in research funding and helped position psychiatric neuroscience at the center of American mental health policy. Since leaving NIMH, he has founded multiple health technology companies and is currently the co-founder of Benchmark Health. He is the author of Healing: Our Path from Mental Illness to Mental Health.
For healthcare executives, researchers, investors, and anyone who thinks the mental health crisis deserves serious answers — this is the show.