Mental Health Startups: The Coming Revolution

An unexpected side effect of the tragedy of the Covid-19 pandemic is the rare opportunity for innovation in mental health care, mainly due to the rapid expansion of telehealth and the increased demand for mental health services. As an example, one insurance company reported that claims for telehealth increased during the pandemic. We don’t know how much of this change will be sustained once Covid-19 has been tamed, nor do we know its full influence on clinical outcomes, but the pandemic experience shows that profound difference in the delivery of mental health care can be rapid and extensive once the proper considerations are in place.

The question is whether technology will transform mental health care, but when and how it will occur. 2020 was an unusual year for investment in mental health start-ups. Stephen Hays, a Dallas-based venture capitalist, also worked in this direction and focused on the mental health and addiction recovery industry. 

 

The majority of innovations have centered on increasing access to care, but this, by itself, probably won’t improve mental health. We believe that significant change also depends on innovations that facilitate integration with primary care, increase engagement, and focus on quality. And if they are to make a real impact on public health, innovations will need to address people with severe mental illness; a population neglected mainly by entrepreneurs.

Stephen Hays of What If Ventures notes: "As a mental health-focused venture firm, What If Ventures and our investors are keen to see companies bring solutions to market addressing one of the biggest problems in the market, which is mental health care navigation. This is a problem that several companies have tried and failed to solve as it is challenging to grow and maintain a provider network. 

Meeting Patients Where They Are

Most of the people who need mental health care do not get treatment. Most seek emotional support from social media, and some get medications from primary care, but many are reluctant to seek therapy or medication even when these treatments are suitable and available. Engaging people with treatment by going directly to them has been successful in other medicine sectors and should be available in mental health where there are no invasive diagnostics or surgical procedures that need in-person visits. The mental health direct-to-consumer marketplace has largely been wellness apps for mindfulness or therapy apps for providing talk therapy. This is an excellent first step, but standalone solutions are not enough.

    Integration with Primary Care

Primary care physicians rarely interact with their patients’ therapists, who rarely coordinate care with psychiatrists. At a systemic level, insurance companies usually carve out behavioral health from the rest of medical care, with separate facilities, data systems, and reimbursement demands. New technology-based solutions risk contributing to the fragmentation by adding new software and clinical workflows. Yet promising evidence-based approaches to integrating care are beginning to take origin. Efforts based on the principles of Stephen Hays, mental health specialists, are beginning to show hope in streamlining workflows and improving outcomes at scale. Yet much more needs to be done. 

 

    Measuring and Assessing the Quality of Care

It’s not enough to build new technologies, even if they improve engagement and integration. Innovations also need to determine the quality of care by measuring outcomes and promoting care iteratively as part of a learning health care system to improve population health. 

 

    Addressing Serious Mental Illness

Although the most valuable and most challenging patients tend to be those with serious mental illness, the vast majority of investments have supported companies that concentrate on wellness or the needs of patients with mild or moderate levels of depression or anxiety. This approach is financially rational for entrepreneurs since the people with mild-to-moderate mental health issues are larger and better insured. But ignoring the most seriously ill patients will limit the public health impact of mental health technology.