Consumer Bottlenecks in Mental Health

The world is recovering from Covid-19, but a parallel health crisis has only intensified. Nearly a quarter of US adults faced a mental health issue in the past year, a 35% increase from just six years ago. The epidemic is particularly severe among young people, with 19% of American adults under 25 experiencing a depressive episode and 22% an anxiety disorder in the past year, compared to 8% and 19% for the overall population, respectively.

Consumer health platforms have made significant strides in addressing this mental health crisis. Telehealth platforms like BetterHelp have improved consumer access to clinicians. Mobile-first apps like Headspace, Calm, and Tangerine have distributed self-care resources and exercises. Automation software across clinical decision support, note-taking, information retrieval, and medical coding have enabled mental health clinicians to spend more time with patients and improve outcomes.

However, the rate of innovation does not meet the magnitude of the crisis. We surveyed consumers aged 18-30, the most acutely affected age group, who reported incidence of anxiety or depression, to identify bottlenecks across three critical pillars in consumer mental health.

Supportive Social Networks

Last spring, the U.S. Surgeon General likened the mortality impact of loneliness to smoking 15 cigarettes daily. The scale of the loneliness epidemic, he said, is on par with addiction, obesity, and tobacco use. Our survey found that just as many consumers struggle to maintain supportive social networks as they struggle to find adequate care.

However, the largest bottleneck is not forming relationships, but engaging in meaningful discussions within them.

The data reflects the need for the next evolution of social platforms. While Facebook, Instagram, Snapchat, and other social apps facilitated connection, those connections were not necessarily in a manner conducive to mental well-being (that impact is now so well documented, that it needs no repeating here). We see clear opportunities behind:

• Digital apps that facilitate IRL connections – online platforms that get consumers offline – that harness the communication and network effects of consumer internet to cultivate real-world connections

• Platforms for everyday advice and coaching. Financial and logistical constraints often limit therapy to addressing only the most critical patient issues. New entrants, particularly leveraging AI, can bypass those constraints by scaling clinically-trained on-demand mental health advice platforms with minimal costs of service (at least relative to human professionals) that deliver support for a broader, and frankly less acute, range of concerns and consumers

Affordability as a barrier to mental health access

Insurance qualification arguably remains the largest challenge for consumers; as a result, consumers forgo seeking help altogether or resort to treatment only in the most critical situations, leaving a wide range of mental health concerns unaddressed.

We see a few areas where startups can improve affordability, specifically:

• Reducing administrative cost structures through automating backend processes that clinicians can pass back to consumers in care pricing

• Facilitating eligibility for tax-advantaged accounts like HSAs and FSAs. Eligibility is a huge source of friction for the supply side who endure all kinds of gymnastics in qualifying products and services, from referencing the dynamic IRS Publication 502 list to determining Letter of Medical Necessity requirements to engaging TPAs and benefits coordinators who manage accounts

Mental Health Accessibility

The shortage of mental health professionals is well-documented, with 37% of Americans (122 million people) living in "mental health shortage areas" as of March 2021, and 60% of professionals not accepting new patients. Surprisingly, the primary accessibility bottleneck is not finding a professional, but finding the right professional – someone who understands the patient's specific situation.

This is a natural challenge for technology to solve. Platforms can leverage vast databases of patient data across diverse populations and conditions to provide personalized treatment plans and experiences based on patient characteristics and response patterns – either directly to the user or through a human clinician.

The AI Angle

Respondents who regularly see a mental health professional expressed openness to AI product features within their patient journey. In fact, a majority of the panel is open to every feature polled from AI-guided meditation to diagnostics to care coordination. The highest demand is for everyday advice and support to supplement professional treatment, remarkably higher than demand for AI-led core therapy, suggesting consumers seek solutions that complement, rather than replace, existing care infrastructure in an overburdened and under-resourced system.

Unsurprisingly, when we asked our panel what excites them most about the idea of an AI therapist, convenience and accessibility ranked first.

The generational challenge is an opportunity for generational companies. From tackling loneliness to the provider shortage to insurance coverage gaps, here are a few early-stage businesses leading the charge:

• Meeno is an AI-powered, privacy-focused app that offers personalized insights and expert-informed advice to help users navigate interpersonal issues – supporting a broader range of use cases and consumers than the under-resourced clinician infrastructure can meet

• Kai is an AI-powered wellness coach that integrates evidence-based tools and techniques to help users manage anxiety, depression, sleep disorders, and other mental health challenges through personalized guidance and habit formation

• Slingshot AI, an AI mental health research lab, is building a foundation model for psychology by partnering with mental health providers across the globe

• Bend Health, a virtual pediatric behavioral care provider, addresses both financial and accessibility bottlenecks with in-network and low wait time care

• The mental health crisis is not limited to adults. The CDC found before the pandemic one in five children face mental health issues, but only 20% received care. The situation has only deteriorated as 71% of parents said the pandemic had taken a toll on their child’s mental health. Cartwheel partners directly with schools to implement multi-tiered systems of support for early intervention and prevention

• Mental, founded by operators from Calm, is addressing the specific challenges the male patient population faces – a group significantly less likely to seek mental health treatment

Reach out to abordetsky@nea.com and hworland@nea.com to continue the conversation.