There’s no doubt we’re in the midst of a mental health startup boom. With hundreds of new mental health companies having been created over the past few decades, we’ve now seen first generations of mental health unicorns that have built the infrastructure to accelerate this industry in years to come.

‍Generation 1: Employer Channels

• Driver: The first generation of mental health unicorns targeted employers, driven by underlying employee demand for mental health services. As of 2022, the APA reported that 81% of individuals said they would be looking for workplaces that support mental health when they seek future job opportunities.  Furthermore, improved mental health programs have become necessary to reduce attrition and drive performance.
• Company Model: This first generation of companies partnered with employers to supplement or replace existing Employee Assistance Program (EAPs), providing a simpler way to access mental health services that are, importantly, covered by that employer. Whether meditations, screening, counseling, or medication management, these innovative, telehealth-first, solutions contributed to a rise in EAP utilization.
• Outcome: According to a report from Lyra Health, 54 percent of employees said their employer offered an Employee Assistance Program (EAP) in 2021, as a result. Mental health benefits have quickly become a top three priority for employers. This was important for laying the groundwork by creating a new channel with demand that payers could not ignore.

‍Generation 2: Network-Based

• Driver: The second generation of mental health unicorns has been driven by employers pushing payors to expand their networks and access to therapists amidst a growing clinician shortage, in addition to new developments in policy such as those improving compliance with The Mental Health Parity and Addiction Equity Act.
• Company Model: These companies have focused on building network-based, fee-for-service channels. By utilizing marketplace models, these companies have helped bring more clinicians in-network by reducing back office costs for clinicians, while making it easier for consumers to find and book them. As technology platforms, these marketplaces have the opportunity to better optimize networks over time through enhanced measurement and matching.
• Outcome: As a result, as of late 2022, in network behavioral health providers had grown 48% in three years. Having achieved a sizable improvement in access, quality is becoming the next priority.

‍Generation 3: Specialist Providers

• Driver: A new set of companies are being built today driven by an increased payor focus on value and outcomes. Payors are now recognizing the ROI potential for targeting specific populations that have historically been high cost-drivers. While not unicorns yet, these companies appear to be on that trajectory.
• Company Model: These companies deliver specialized approaches for specific conditions or population, driven by an increased payor focus on value and outcomes. Companies such as Firsthand and Vanna have focused on SMI/crisis care, whereas companies such as Equip have focused on eating disorders, and NOCD on OCD.
• Outcome: These companies are driving quality by creating entirely new care models, with novel approaches for treating disorders that aren’t being tried elsewhere. Over time, we imagine a bundling and reselling of these specialist solutions, utilizing the foundational channels of the first two generations in order to further accelerate progress in this industry.