Since 1986, spending on mental health has equaled about one percent of the U.S. economy, or about $150 billion in 2009. So much is at stake, both financially and for the one in five Americans who have experienced a psychological issue, that it’s surprising how few tech companies focus on mental health.
A gradually growing roster of startups, however, want to make it easy for people who are struggling through an emotionally difficult time to find help. These include Y Combinator alum 7 Cups of Tea, Breakthrough, and Talktala.
Now ThriveOn is getting ready to join that group. The startup, which will launch at the end of this summer, offers personalized 8- to 12- week programs with professional therapists that users can access on their smartphones. ThriveOn’s founders are working with researchers at Stanford University and Washington University in St. Louis to create its programs.
“Part of our mission is rebranding mental health. I like to call it the black sheep of health care,” says co-founder Alejandro Foung. “Even hospitals don’t want to deal with it and physicians don’t want to deal with it. Part of ThriveOn is to demystify and destigmatize mental health care.”
Affordable, Discreet Help
ThriveOn was co-founded in 2012 by Foung, who studied psychology as an undergraduate at Stanford but ultimately decided not to become a clinical psychologist. Instead, he embarked on a career in tech, working at eBay and Nextag before becoming an early employee of Trulia, where he met co-founder Nicholas Letourneau.
The startup’s advisory board includes psychiatry professors Barr Taylor from Stanford University School of Medicine, who studies the intersection of technology and psychological treatment; Denise Wilfley of Washington University in St. Louis; and Michelle Newman of Pennsylvania State University.
During their first meeting with Taylor, Foung and Letourneau first pitched a startup idea that would reduce the amount of paperwork mental health providers need to deal with. But then Taylor “pitched us the idea of widespread prevention, making it affordable, accessible, and less stigmatized,” says Foung.
ThriveOn starts with an assessment that looks at your levels of stress and anxiety, how you feel about your body, your sleep quality, social life, and attitude toward food. A chart shows you what areas of your life you can potentially improve. If you chose to sign up, ThriveOn then creates a personalized program based on your results.
Of course, privacy is extremely important for a mental health startup. Foung says ThriveOn is HIPAA compliant and uses anonymous, aggregated data from the assessment to figure out what kinds of programs they should offer.
How ThriveOn Works
ThriveOn’s programs are based on cognitive behavioral therapy (CBT) techniques, in which a client and therapist work together to examine patterns of thoughts that can cause negative behaviors, according to a description from the National Association of Mental Illness.
“It’s been studied the most within psychology and those principles are what our clinical team uses to construct [ThriveOn's] programs,” says Foung.
“Our whole model is taking research and programs that have been validated clinically and making them more consumer friendly,” he adds.
The price of ThriveOn’s programs are still being determined, but Foung says that a program will be under $100 a month. ThriveOn’s therapists interact with users by delivering in-app messages and weekly feedback. Each day’s content takes about 5-15 minutes a day to complete and includes writing prompts (a key part of many CBT programs), breathing exercises, and audio recordings.
In many ways, ThriveOn’s concept is similar to Rise, an app that connects you with a professional nutritionist who provides daily feedback about what you eat for a much lower cost than clinic visits.
“That’s how technology can play a role by providing engagement, much like you’d expect from any other service on your smartphone. Many health startups are using technology to change delivery of primary care and that is what we are trying to do, to provide great care in a new, more accessible, cheaper way,” says Foung.
Though it won’t launch for a few months, ThriveOn is currently working with researchers at Stanford and Washington University in St. Louis to develop its Healthy Body Image (HBI) program, which it is using to test its platform at more than 30 universities in the U.S.
According to a study by the American College Counseling Association and the International Association of Counseling Services, the current ratio of college counselors to students is about one to 1,600 and 29% of student health centers place limits on the number of sessions.
Furthermore, many insurance providers do not cover private sessions with a psychologist, which means the average rate for an appointment is about $150 to $200. The expense of therapy, coupled with the stigma attached to it, means that many people don’t reach out for help until they are in the middle of a crisis.
Instead, patients with mental health issues often rely solely on medication to cope with their problems. In a 2012 study, the American Psychological Association (APA) found that the use of psychotropic drugs by Americans increased 22% from 2001 to 2010, which means that one in five adults are now taking at least one medication.
“It’s not because people wouldn’t like to try therapy,” Foung says. “But the barriers are too high and the number of people seeing therapists have been declining every year for the past 15 years.”
ThriveOn claims that HBI, a 10-week-long online program that is meant to help users create better eating habits and improve their body image, has reduced disordered eating among users by 50%. HBI is supported by a $4 million grant from the National Institutes of Health (NIH). The startup is currently researching the scale and efficacy of HBI through partnerships with college counseling centers.
Providing New Options
ThriveOn looks for coaches who are licensed, practicing therapists and can spend at least two hours a week (or twenty minutes per day) working with the startup’s clients.
“We have personalized content, but also connectivity to coaches who give support and answer questions by text message and voice message, giving you the benefit of that one-to-one connection, but allowing you to do it on your own pace in a personalized way that meets your needs,” says Foung.
It’s important to note that ThriveOn is not for everyone. If its assessment shows that someone may suffer from a serious psychological disorder, the company will refer him or her to a counseling center to see a therapist in person. Instead, it targets people who want to improve the quality of their life and deal with stress or bad habits.
“ThriveOn is helpful for those types of situations, where you really want someone who is a trusted, known person who can help you think through negative thoughts and behaviors, and provide you with tools and exercises to reframe your thinking and give you tools to do that,” says Foung. “So we’re not talking about someone with PTSD or schizophrenia or bipolar disorder.”
Foung says that ThriveOn is focusing on building a network of counselors so the company can make good matches for people who need more in-depth, long-term support.
Even if someone is not coping with a mental illness, working with a therapist can still be helpful. Though it’s often viewed as an indulgence, therapy is a form of mental exercise that helps clients correct negative habits and builds psychological resilience.
Foung says that while working on ThriveOn, he was struck by the fact that schools are required by law to teach physical education classes. Furthermore, there are a multitude of companies, including many tech startups, that focus on exercise and nutrition. But although psychological well-being is just as important as physical health, there is still a paucity of companies in the area.
“Right now the big brands in this space are drug companies like Eli Lilly and Pfizer,” says Foung. “It’s one modality and there should be more options.”
Photo from PicJumbo