(2019-04-23) No More Time On The Couch The Rise Of Digital Mental Health Therapeutics

No More Time on the Couch: The Rise of Digital Mental Health Therapeutics. She was referred to a mental health digital therapeutics company called Learn to Live

Wylie was suffering from a mild mental health disorder known as social anxiety—a condition that, for her, was particularly acute around any activity involving eating or food

“The online program took me through my thinking process and showed me how to negate my automatic negative thoughts,” recalled Wylie. “The homework really helped, but it was tough

Learn to Live is one company that that is bringing what is known as Cognitive Behavioral Therapy, or CBT, to the masses via a digital platform

“True cognitive behavioral therapy is, in its essence, evidenced-based; there is lots of science and research behind it. It’s the one that works.”

CBT, of course, is not without its critics

critics of CBT, posits Burkeman, would argue that “psychological pain needs first not to be eliminated, but understood. From this perspective, depression is less like a tumor and more like a stabbing pain in your abdomen: it’s telling you something, and you need to find out what.”

Either way, I expect there to be considerable consolidation in the coming year or two; there just isn’t enough room for dozens of online CBT delivery platforms.”

Health care and technology venture capitalists, flush with capital and always looking for the New New Thing, have been watching the mental health delivery sector open up and have begun pouring in money, backing companies that look to deliver scalable mental health solutions through digital means. But all this cash has created a muddied marketplace

you need a great clinical team, best-in-class technology, an easy-to-navigate user experience, and a knack for storytelling and teaching.”

...employee assistant programs (EAPs)—those corporate 911 numbers offered to employees allowing them to set up phone or in-person therapy sessions—claim engagement rates for mental health services are in the one to five percent range. In contrast, the upper tier of online CBT companies, such as Learn to Live and its closest competitors Big Health and MyStrength, have been able to achieve engagement rates above 30 percent.

Felsenthal suggested that the ultimate heavyweights in the sector will be culled from those who are not necessarily selling directly to the consumer (the so-called ‘B2C’ players) but those who have staked their future as solutions for health plans or self-insured employers—companies like Learn to Live, which was so successful in treating Heidi Wylie’s social anxiety about food and eating.

data does no good without equally impressive engagement metrics

Learn to Live—which sells primarily into large health carriers, such as the statewide Blue Cross Blue Shield plans, as well as top-tier employers, colleges and universities—has rolled out four major products to date addressing generalized anxiety, social anxiety, sleep disorders and depression.

Learn to Live uses techniques like videos, animations and interactive engagements powered by a combination of artificial intelligence and live human coaching that bring to life the teachings of CBT in ways that not even traditional in-person therapy sessions can achieve

Another firm that is making waves in the digital delivery of cognitive behavioral therapeutics is UK-import Big Health, which has taken the view that sleep is the best vector—the tip of the spear of sorts—for piercing into a whole constellation of sub-clinical mental health conditions

Hames contacted the book’s author, Colin Espie, a professor of sleep medicine at Oxford University. The two hit it off and formed a company that would couple Espie’s expertise in sleep disorders with Hames’ background in technology to create Sleepio, the UK’s first ever digital sleep disorder product

with the high degree of comorbidity between sleep and other mental disorders like depression, the Big Health team is betting that its Sleepio product will lead to a host of further applications that focus on an array of other mental health conditions. Their first spin-off, a product called Daylight, is focused on addressing worry and anxiety.

Now part of digital health platform Livongo, Denver-based MyStrength is widely regarded as another platform that has enjoyed success effectively delivering CBT tools for addressing a broad range of conditions in the corporate marketplace, albeit with a starkly different interface from that of Learn to Live or Big Health.

The company was the brainchild of CEO Scott Cousino, a former executive at the now shuttered for-profit and online university company Alta Colleges

after nearly a decade in the space, the company has amassed a dauntingly vast library of videos, tutorials and resources aimed at guiding sufferers through countless numbers of exercises and coursework

One company in the space that has been on the receiving end of the industry’s firing squad is Silicon Valley-based BetterHelp. The online counseling site was accused, in a stinging exposé by Taylor Lorenz in The Atlantic, of paying off internet influencers for endorsing the company’s mental health counseling chops—essentially a payola scheme for mental health therapy.

The degree of clinical severity of the cases companies are prepared to address is one axis of differentiation; Chicago-based Regroup Health, which provides a telepsychiatry platform to support mental health clinicians and health care facilities sits at one extreme of that continuum. Firms like Learn to Live, Big Health and MyStrength would be positioned adjacent to telepsychiatry

Popular apps like Calm—which has raised over $100 million in venture financing—as well as other solutions for low-acuity issues like self-esteem, stress and worry, such as Headspace, Pacifica and Talkspace, occupy the other extreme end of the spectrum.

Where the sector gets really muddled is in the middle

Companies like Boston-based MeQuilibrium and New York City-based Happify fall into this middle ground. While both make some claims about evidence-based scientific research, much of the programming seems more Tony Robbins than Dr. Jennifer Melfi.

MeQuilibrium CEO Jan Bruce came out of a career in holistic health,

lifestyle and fitness behemoth Life Time Fitness, which operates 141 clubs across North America

tapped Jen Elmquist, a longtime company veteran and licensed marriage and family therapist, to shepherd the creation and roll-out of Life Time Mind, an internal coaching platform to get people “from good to great.”

Life Time is initially rolling out Life Time Mind only to its estimated 38,000 employees, but future plans could call for offering the product to the company’s 1.7 million (and growing) club members—a move that could potentially put Life Time on a collision course with a number of venture-backed digital CBT platforms looking to occupy the same space.