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During the 2022 Going Digital: Behavioral Health Tech Conference, the venture capital panel featured healthcare investors such as Chrissy Farr, a Principal and Healthtech Lead at OMERS Ventures. Farr remarked that startups focusing on anxiety and depression “will continue to be a tricky funding environment in the next couple of years. But more investors I'm talking to are thinking about severe mental illness…I think those companies will do quite well in the coming years because it's a space that has not been invested in in the same way.”
As investors and innovators in the mental health space start focusing their attention on serious mental illness (SMI) focused startups, they need to keep some critical concepts in mind if they hope to successfully engage and serve patients managing severe mental illness. Hear from leading SMI startups on their unique approaches to engagement and partnership in this week’s blog.
The National Institute of Mental Health (NIMH) defines SMI as “a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.” SMI can include conditions such as major depressive disorder, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD), and borderline personality disorder.
As of 2017, there were 11.2 million adults in the United States with an SMI. Because SMIs involve serious functional impairment, these impairments can lead to difficulty maintaining employment, poor social support, multiple psychiatric hospitalizations, homelessness, incarceration, and co-existing substance use disorders. In fact, about 1 in 4 adults with an SMI also have a substance use disorder. The SMI population also has a life expectancy that is 20-25 years lower than those without SMI. People with SMI also have worse medical outcomes, higher rates of suicide, and greater levels of stigma than those without SMI. Even further, there is a shortage of providers who treat SMI.
We spoke with Dr. Holly DuBois, the Chief Clinical Officer at Mindstrong, during our Going Digital: Behavioral Health Tech Conference and she emphasized, “We know that those social determinants [of health], for folks, especially with a serious mental illness, they're profound, and they have a huge impact on their ability to engage and then sustain any outcomes.” Watch her session here.
There are a growing number of startups focused on SMI care, such as Amae Health, aptihealth, firsthand, Mindstrong, and NOCD.
Amae Health utilizes psychiatry-led, integrated care providers for outpatient physical and behavioral health services delivered within in-person clinics. Amae Health focuses on caring for the highest need individuals who are experiencing unmanaged acute episodes or chronically unstable severe mental illness. Often these individuals are seeking care through Inpatient Psychiatry and ERs and unfortunately are met with months long waitlists to get any kind of specialty-related SMI care. For this population, piecemeal solutions or relying on the existing fragmented network has proven to be insufficient.
Amae Health’s solution is designed based on real world evidence and research from their CMO’s integrated care model at the VA, which demonstrated industry leading clinical and financial outcomes. Their tech-enabled integrated outpatient psychiatry-led behavioral and primary care services are delivered via our in-person clinics and community centers. Each patient has a dedicated care team who in addition to providing clinical care, focuses on basic needs, healthy living, social, and community components impacting the patient, helping them stabilize their lives, have community support, and rebuild purpose.
aptihealth matches members ages 12 and older with a collaborative care team including a licensed therapist and psychiatric prescriber, if needed, and focuses on those with mild symptoms to those with SMI.
aptihealth’s mission is to improve behavioral healthcare for underserved populations—one member at a time. To accomplish this, they operate fully within the healthcare system, partnering directly with health plans, health systems, physician practices and community-based organizations to intelligently integrate care. With domain expertise in patient engagement, behavioral and medical care, virtual-first care delivery and unprecedented data and insights; their care model reliably impacts the most important behavioral health drivers of outcomes and cost. Their technology guides care using workflow best practices and data insights to enable right care, right modality, right time. Their modern design creates an intuitive experience for members and robust capabilities for providers to optimize engagement. Insights from their treatment data drives breakthroughs in mental health understanding, treatments, and outcomes. All of this results in informed, organized, coordinated, collaborative and successful care, evidenced by unprecedented member experience, clinical outcomes and return on investment.
Mindstrong offers telehealth and virtual care using therapists and psychiatrists. Mindstrong also users AI-powered digital biomarkers, collected passively as members use the Mindstrong app, to monitor patients' mental health status.
Mindstrong's blend of proven science, state-of-the-art technology, and dedicated care teams are the secret sauce behind our ability to help members feel better, do better, and stay better. They believe in mental health care for all and specialize in serious or complex challenges. It may take more work, and they’re committed to better outcomes for everyone. The Mindstrong App & Care Platform includes measurement-based clinical care, customized interventions, case management and resources for SDoH needs; 24/7 support for all acuity levels, with a specialization in SMI gives our members the safety net they need to build confidence in their care. Their integrated care team includes Care Partners, Therapists, Psychiatric NPs, and MDs. Each Care team is a tailored blend of provider(s) based on members’ specific needs and preferences. Mindstrong is mental health care with the strength to tackle anything.
NOCD is a telehealth provider for the treatment of OCD, utilizing therapists who are trained in Exposure and Response Prevention (ERP) therapy, the gold standard for OCD treatment.
There are 179 million* people with Obsessive compulsive disorder (OCD) around the world. Never before has there been a dedicated platform to identify people who are suffering from OCD, bringing them to care, helping them navigate the healthcare industry, and providing in-between care support in order to make sure they maintain their care journey. This member-focused approach that was built from the consumer backward is truly groundbreaking in the behavioral healthcare space, arguably in the healthcare industry in general. People suffering from OCD no longer have to feel alone as they continue to reduce the social stigma surrounding OCD. Reducing this stigma & identifying people in need allows us to enroll patients into the largest telehealth network of OCD-specialized therapists.
NOCD has reinvented the front door to healthcare and revolutionized OCD treatment & patient experience. They have developed a discreet way of identifying a serious mental illness community through innovations such as finding those suffering where they are in their journey by engaging with consumers and helping them navigate the healthcare system in order to receive the right care.
As well as utilizing technology to create an experience from treatment seeking to receiving treatment through our telehealth platform and offering in-between session care & support through peer communities, direct access to experts and self-help tools.
NOCD’s telehealth platform enables patients to schedule live face-to-face therapy sessions with licensed clinical therapists specializing in ERP therapy. In between visits NOCD’s member tools empower them to better manage their OCD and practice therapeutic techniques. The combination of therapy, and care management support between sessions is an innovation in the behavioral healthcare industry. They have created an integrated platform between consumer engagement, healthcare treatment, and in between care, an integration that is unique in the behavioral healthcare space. NOCD has designed this entire experience from the consumer backward in order to meet a suffering and underserved demographic where they are in their care journey, bringing them to affordable, accessible and insurance-covered care, and working with them to maintain their journey in order to regain their lives.
*Based on a global population of 7.8 billion people and a recognized OCD lifetime prevalence of 2.3%
What do SMI startups steeped in care delivery want payers and providers to know? Here are some of their thoughts:
Amae Health: “[Payers and providers] know that consistent high quality SMI+SUD, medical, and social integrated care are deeply necessary to effectively help this population. However, being able to bring these pieces together in an equitable, measurement, evidence based and incentive-aligned manner has been the primary challenge. Amae Health seeks to do just that in order to provide integrated care.”
aptihealth: “When care is clinically integrated with health plans and systems across all points-of-care; patients can be engaged whenever and wherever they touch the system, with insights that create the opportunity to navigate the patient to the optimal course of care, reducing ED visits and admissions. That’s the challenge, and it’s our job to make sure payers and providers know that there’s a solution.”
firsthand: “Real support can only be financed if we truly integrate the medical and behavioral risk dollar. Without that integration, there is not enough savings to substantiate investment in appropriate whole-person clinical models at scale.”
Mindstrong: “These populations need more than an episodic fix; they need support that balances mental health care with whole person care, with a goal of building resilience and empowerment. With the right blend of data, technology, and care, SMI members can experience sustained outcomes and Payers can reduce [total cost of care].”
NOCD: Obsessive-compulsive disorder (OCD) is a severe psychiatric condition. It is imperative that those suffering from OCD require specialized treatment: Exposure & Response Prevention (ERP). Lifetime prevalence of OCD is approximately 2.3%, affecting nearly 1 in 40 people (~8M Americans). OCD is debilitating; those suffering are 10X more likely to commit suicide, it is ranked by the WHO as 10th leading casue of disablity, and approximatly 1 in 4 people with OCD develop substance abuse. Despite the prevalence, OCD is widely misunderstood & misdiagnosed. This, combined with a lack of mental health resources, causes a 14-17 year patient journey to find appropriate care. Limited access to proper care at the appropriate time creates a burden on the healthcare system. Per 1M commercially insured, OCD generates $104M+ annually in behavioral health costs; of which, 96% is associated with inappropriate care.
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