Stephen Hays
May 22, 2020
The lack of evidence-based measurement and testing tools available within the behavioral health industry is the root of the behavioral health crisis we face today.
We have been observing, testing, and measuring our physical health since the beginning of time. We have always been able to look at each other and tell who is fat or skinny, tall or short, fast or slow. Then we developed tools. The oldest evidence for the existence of weighing scales is about 2,400 B.C., and the earliest evidence of manufactured mirrors dates back to 6,000 B.C. Since then, we have developed myriad healthcare diagnostic tools from basic heart rate monitors to sophisticated MRI machines.
To date, we rely mostly on clinically-validated evidence-based surveys that seem to work when both administered correctly and interpreted correctly. The problem is, most antidepressants are prescribed by general practitioners who aren’t getting reimbursed for administering these surveys nor are they always qualified to administer them in the first place. Even if they do hand out a PHQ-9 or a GAD-7, they certainly are not going to follow up with one of the other nearly 200 similar surveys to get to the bottom of the real issue. They are also not in a position to do any type of extensive counseling.
These surveys do seem to be effective to some degree. But I’d rather see some sort of empirical testing used, just as we do in physical health. When was the last time your doctor asked you for your opinion on whether or not you had a broken leg? That’s what I thought — never. They get an x-ray to find out for sure, and then they apply the right treatment once they’ve first measured and assessed.
I want to be clear that at the same time, there are some aspects of mental health that only a survey can measure. Questions about suicidal ideation, for example, require a user’s opinion. So, I’m not trying to say the surveys aren’t useful; they are. They would be most useful as a supplement to an empirical measurement, though.
I believe strongly that investing in measurement and testing capabilities for the purpose of evaluating outcomes, identifying those in need, and facilitating the delivery of care at the right time in the right way is a huge opportunity within the mental health space. Doing so will improve outcomes, reduce costs, and increase access to care. We’ve already seen it in the data from companies that are doing this.
I can’t share information with you from private companies, but I can point you to the results a public company, Catasys, reports on their outcomes, which show reducing costs by 50% or more in populations where mental health differences are present with co-morbidities such as chronic illness. Check out my analysis on what Catasys reported on this topic in their Q1 2020 earnings.
Mindstrong has developed a platform that leverages measurement data gathered passively from your smart phone about your mental and emotional states. That data is used to project how your emotional state is trending, and when that trend is bad, it alerts a clinician to proactively reach out to you and provide care.
This measurement technology is referred to as “digital phenotyping.” How you handle your phone, how you type, and other behaviors can be analyzed as a biomarker to predict behavioral health trends. You can learn more about how this works in this video of co-founder Dr. Thomas Insel explaining the technology back in 2018.
This model of providing care exactly when and how it is needed — instead of waiting six weeks for an appointment to see a psychiatrist — is truly revolutionary. In the traditional care model, we schedule appointments with clinicians, sometimes months in advance. We show up, give our opinion about how we’re doing, then we spend an hour talking to the provider whether we need to or not at that moment. Mindstrong is the opposite of this.
Mindstrong knows when you need help and delivers it, even if it’s only a few minutes of texting, or a quick call, or a video chat. This care is delivered by a fully employed clinical team at Mindstrong — opposed to their services being delivered through a marketplace-like solution. This is far more efficient and effective than the traditional care model. The proof is in the outcomes and the reduction in overall healthcare costs for payers in populations using the platform.
If you think about it, it’s really not that earth shattering. Everything happening with our bodies starts with our minds. It stands to reason that if we treat the mind, the body will follow. So, it’s logical that we would see these cost reductions in mentally ill patients with chronic illness co-morbidities.
In addition to the technology, Mindstrong has put together a world class team led by Daniel Graf to commercialize their cutting-edge technology. This technology was developed by the brightest neuroscientists and technologists on the planet, and is now being commercialized by some of the best product development talent around — people who have developed or contributed to products like Uber, Twitter, Google Maps, and others.
Mindstrong is revolutionizing how we administer mental health care. Today, they are focused on treating those with serious mental illnesses (SMIs like bipolar, schizophrenia, etc.). In the future, that population will expand. Further into the future, the applications of their measurement and testing capabilities are limitless. At full-scale deployment, I believe firmly that this technology can lead Mindstrong Health to be a once-in-a-generation company that radically transforms an industry that is in crisis today.
If you’re reading this, and you are hoping to work in the mental health tech space, there are numerous opportunities at Mindstrong Health today. All of their job openings are listed on their website.
We are truly fortunate to have been included in this round. I wanted to say a special thank you to Tom Insel, Paul Dagum, Daniel Graf, Reva Nohria and to our investors for making this possible. It’s an honor and a privilege to be apart of what you are all doing.
We dig into the deal, and more thoughts on the business, and how it can transform mental health care in the 5/22/2020 Mental Health Market Update on the Stigma Podcast which you can find here (Direct Stream, Apple, Spotify, Google Play, Read More)
About the Author: Stephen Hays — After decades of addiction and struggling with bipolar disorder, Stephen was fortunate to receive help and has focused his attention on funding solutions to the problems he lived with. You can read more about his story here.
About What If Ventures — What If Ventures exists to invest in mental health and addiction focused startups. The fund was launched in 2019 by Stephen Hays. You can follow our syndicate on AngelList here. Join our deal distribution email list here.
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