A fascinating, wide-ranging conversation with David Guth, CEO of Centerstone, a nonprofit health system specializing in mental health and substance use disorder treatments. We discuss David’s remarkable journey, from his unlikely beginnings as a math major at his beloved Vanderbilt (yes, we spoke about the equally unlikely success of their football program), to his nearly four-decade stewardship of what has become the largest nonprofit behavioral health provider in the US following the recent merger with Brightli. David sings the praises of incoming CEO, Dr. C.J. Davis, discusses what the merger means for the market, and how it will better serve unmet needs. We also discussed what makes his work so deeply rewarding, the challenges ahead, as well as the (mostly positive) impacts of AI and the irreducible importance of the human connection in therapy.