Digital coaches for mental health: research & start-up
Hello and welcome to Careviser by Marie Loubiere, the weekly newsletter that cuts through the healthcare noise with a single focus: productization of the latest research and tech breakthroughs.
This week, we do a deep-dive on digitizing mental health care through mobile apps.
THE RESEARCH
Digital coaches for mental health in a hot topic in research. Several clinical trials have proven that digital coaches can be as efficient as more traditional 1-to-1 therapy sessions:
Coached Mobile App Platform for the Treatment of Depression and Anxiety Among Primary Care Patients by Andrea K. Graham, PhD; Carolyn J. Greene, PhD; Mary J. Kwasny, ScD; et al showed that a suite of self-help apps was effective in reducing depression and anxiety over a period of two months vs. usual primary care treatment.
Effectiveness of a Digital Cognitive Behavior Therapy–Guided Self-Help Intervention for Eating Disorders in College Women by Ellen E. Fitzsimmons-Craft, PhD; C. Barr Taylor, MD2; Andrea K. Graham, PhD; et al found that a digital coach was more efficient in reducing eating disorders psychopathology than usual care and at par with usual care for eating disorders behaviors with one caveat: low retention rate through the overall engagement (31%).
A Solution-Focused Research Approach to Achieve an Implementable Revolution in Digital Mental Health by David C. Mohr, PhD; Heleen Riper, PhD; Stephen M. Schueller, PhD discussed how mental health apps have been proven efficient in clinical research studies but fail to be adopted in real world settings because of 1., the user experience that is oftentimes designed by clinicians that aim to replicate the offline therapy experience instead of creating new experiences based on the possibilities offered by digital technologies, 2. How they are prescribed (lack of adoption by providers and patients). 3. Lack of product development agility in research studies meaning that design, features and UX-UI fail to iterate to meet patient needs and retain them.
THE EARLY-STAGE START-UP OF THE WEEK
The problem: A growing number of people experience mental health issues, and 1-to-1 therapy is expensive and not scalable.
The solution: A Cognitive Behavioral Therapy (CBT)-based app that takes you on a journey to build emotional skills day after day. They target users that experience “common human hurdles like chronic procrastination, low confidence & self-esteem” said Theodoric Chew, Co-founder and CEO of Intellect. Founded in 2019 and released in 2020, Intellect is an app that mimics the experience you would have with a cognitive behavioral therapist. First, you select which areas you want to work on, and then Intellect puts you on a training journey with micro-learning touch points every day.
Why now: Headspace and Calm have led the way with meditation and shown that 1/ consumers are ready to pay monthly subscriptions for mental wellbeing apps, 2/ several studies show that digital coaches can be as efficient as therapy 3/ Covid-19 has made the need for virtual mental health care even more acute.
User experience: Intellect is a super clean app with vibrant illustrations. They keep away from the hippie-dippy/muted aesthetic you find in most apps in that space. It is even joyful. Interactions are intuitive, similar to swiping between stories on Instagram.
Content: Journeys are based on what I call the 101 of CTB: Self-esteem, Assertiveness, Anxiety, Emotion Regulation... They last three weeks which is about enough time to learn a new habit. They include short readings/ audio sessions and simple frameworks that can be easily applied in real life. After each session, a quiz puts you in a concrete situation and enables you to apply the skills you have just learned. The examples they give are very good. You can also journal in the app.
Mechanisms to hook the user: the sessions are short enough that you can do it during a commute, users love rescue sessions (one-off sessions) and personality tests.
Virality: there doesn’t seem to be any kind of built-in virality mechanisms in-app, users cannot invite friends, or share test results with them.
Growth:
1/ B2C: they seem to be growing organically on the app stores, and have reached over several 100k downloads on each store. When searching for CBT and self-improvement keywords, they are pretty well ranked. Google selected them as one of their top mental health apps of the year. Otherwise, their presence on social media is extremely limited. I could not identify any paid marketing channels.
2/ B2B seems to be their core focus: they have an offer dedicated to employers as a perk for employees to develop social skills (e.g., communication). They have started implementing an inbound marketing strategy with regular blog posts related to employee well-being and productivity. The partnerships team seems to be already well staffed with several people onboard.
Later, they could also go down the long B2B health route by conducting research studies to back the efficacy of Intellect for specific mental health issues and get reimbursed by payers.
Monetization: Their enterprise offer is still in a pilot mode, and there are no in-app purchases/premium plans in the current app during covid-19 (otherwise it will be around $50 a year).
Funding: as I was writing this post, they just closed their seed round.
Team: They are based in Singapore: South-East Asia is a major market for self-improvement apps where therapy is still pretty stigmatized. Their core track-record does not seem to be in consumer mobile apps but they do have growth expertise, as the CEO is a former head of affiliate growth and content marketing at a marketplace, and the COO is a former HR. Credibility-wise, they have several psychologists on board.
Exciting challenges ahead: As their current acquisition strategy seems to be focused on B2B, to what extent can a top-down strategy with HR work for a mental health product? How will they make employees use an app pushed by the HR team as opposed to selecting one they like and later asking for reimbursement as a perk? Is the pain point of building emotional skills strong enough that employers are willing to pay for it, especially in markets where mental health is still stigmatized?
And last but not least, they seem to have a really organic traction on the B2C side, how will they build a growth machine that scales?
Have you seen any exciting mental health apps recently? Send them my way!
Have a great week,