Module 2

Question 1

What are private equity firms doing for mental health?

Answer 1

Private equity firms are funneling unprecedented funds into mental health apps and related interventions.

Question 2

How much have private investors been pouring into mental health ventures by the third quarter of 2021 alone since the pandemic?

Answer 2

Until recently, mental health was a relative blip on the radar of venture capitalists. But over the past few years, and particularly since the onset of the COVID-19 pandemic, private investors have made a dramatic run for this space, pouring $3.1 billion into mental health ventures by the third quarter of 2021 alone, according to Rock Health, a seed fund that supports startups working in digital health.

Question 3

What is Rock Health?

Answer 3

a seed fund that supports startups working in digital health

Question 4

What does the $3.1 billion invested into mental health ventures by venture capitalists represent?

Answer 4

That represents a third of all digital health funding for 2021, more than 7 times the amount of funding placed in such ventures in 2015.

Question 5

Why have capitalists suddenly been investing in mental health?

Answer 5

The pandemic unleashed enormous new mental health needs, with anxiety and depression rates among U.S. adults skyrocketing from 11% in 2019 to 42% in December 2020, according to the U.S. Centers for Disease Control and Prevention. COVID also brought more people to telehealth and other tech options for treatment, and celebrities’ public admissions of their own struggles helped destigmatize mental health in the public eye. Combined, these forces have met head-on with the ongoing shortage of mental health providers, creating a perfect storm of funding opportunity, said Stephen Hays, a venture capitalist whose syndicate, What If Ventures, has provided $33 million to mental health startups since 2020.

Question 6

What does Stephen Hays say?

Answer 6

“The supply of mental health services and treatments and care is way too low for the amount of demand that’s out there,” Hays said. “From an Econ 101 perspective, if demand is far greater than supply and you put an accessible, effective, and affordable supply into the market, you’re going to see growth.”

Question 7

According to psychologists, what else besides profit motivation is a central reason for the increased investment in mental health?

Answer 7

Outside of profit motivation, a central reason for this increased investment is the desire to improve access for the millions who need it, according to psychologists involved in the area.

Question 8

What are the reasons (that even before the COVID-19 pandemic) half of U.S. adults and even children have not been receiving proper mental healthcare?

Answer 8

Even before the COVID-19 pandemic, less than half of U.S. adults and children with mental health conditions were receiving treatment because of stigma, cost, lack of providers, or long waiting times, according to the National Institute of Mental Health.

Question 9

What does Allyson Plosko say?

Answer 9

“We really see technology as a way to scale the capacity of the system in order to get individuals the care that they need,” said Allyson Plosko, director at Telosity, a venture capital entity that funds early-stage companies aimed at improving young people’s mental health and well-being. In that demographic, “getting someone help at age 14 can have an incredible impact on that individual’s life,” she said.

Question 10

Who is Allyson Plosko?

Answer 10

director at Telosity

Question 11

What is Telosity?

Answer 11

a venture capital entity that funds early-stage companies aimed at improving young people’s mental health and well-being

Question 12

What did Trina Histon, PhD say?

Answer 12

More products also mean more consumer choice, said psychologist Trina Histon, PhD, senior principal consultant in prevention, wellness, and digital health at Kaiser Permanente’s Care Management Institute in Oakland, California

Question 13

Who is Trina Histon, PhD?

Answer 13

senior principal consultant in prevention, wellness, and digital health at Kaiser Permanente’s Care Management Institute in Oakland, California

Question 14

What is an example of “More products also mean more consumer choice”?

Answer 14

Kaiser Permanente, for example, uses six well- vetted commercial cognitive behavioral therapy (CBT) and mindfulness apps that tap different member preferences.

Question 15

What did Histon say about Kaiser Permanente?

Answer 15

“We recognize that members have different learning styles and diverse ways they want to consume content,” Histon said

Question 16

What are other mental healthcare companies doing?

Answer 16

Meanwhile, other mental health care companies are developing digital interventions in other languages and for specialized populations, for example.

Question 17

What does Shannon Wiltsey Stilman say?

Answer 17

More venture capital also means that promising products—many developed by or in collaboration with psychologists—stand a better chance at coming to fruition, said psychologist Shannon Wiltsey Stirman, PhD, an associate professor at the Stanford University School of Medicine and co-chair of the Stanford Mental Health and Technology Innovation Hub. “There is a history of people testing web-based interventions or apps and finding that they work but then lacking the funds or ability to sustain them,” Wiltsey Stirman said.

Question 18

Who is Shannon Wiltsey Stirman, PhD?

Answer 18

an associate professor at the Stanford University School of Medicine and co-chair of the Stanford Mental Health and Technology Innovation Hub

Question 19

What does more venture capital mean?

Answer 19

More venture capital also means that promising products—many developed by or in collaboration with psychologists—stand a better chance at coming to fruition

Question 20

What can working at an adequate company do?

Answer 20

Working in a company with adequate funding can provide the extra ingredients—technological expertise, design, marketing, evaluation, and continual product improvement, for example—to make these online interventions and apps a reality.

Question 21

What are the significant questions, issues, and problems that remain despite mental healthcare becoming more accessible through mental health nowadays?

Answer 21

Is the rise in funding a fad that will disappear once the pandemic is better controlled or when people tire of using these products? Given the current lack of regulation, how can people choose interventions that are effective? And what about uptake?

Question 22

What is an issue that dogs the products in general?

Answer 22

In one study of 93 of the most frequently installed unguided mental health apps—apps whose implementation relies solely on the user’s motivation—just 3.9% of initial users continued using them after 14 days (Journal of Medical Internet Research, Vol. 21, No. 9, 2019).

Question 23

What are mental health tech companies still considering?

Answer 23

Mental health tech companies are still considering how to address issues of diversity, equity, and inclusion best and most cost-effectively.

Question 24

Who is the least likely to purchase and use mental health apps?

Answer 24

The people you hope will benefit most from expanded access are often the least likely to purchase and use these technologies.

Question 25

What other reason is there which Schueller noted that could be a problem for mental health apps?

Answer 25

It’s also difficult to predict the extent to which funders will be willing to support customized interventions for specific client groups, for example male teens with eating disorders or Latinx women with substance use problems, Schueller noted.

Question 26

What are all the problems as to why mental health apps are feared to not survive?

Answer 26

1. In one study of 93 of the most frequently installed unguided mental health apps—apps whose implementation relies solely on the user’s motivation—just 3.9% of initial users continued using them after 14 days (Journal of Medical Internet Research, Vol. 21, No. 9, 2019). 2. Mental health tech companies are still considering how to address issues of diversity, equity, and inclusion best and most cost-effectively. 3. It’s also difficult to predict the extent to which funders will be willing to support customized interventions for specific client groups, for example male teens with eating disorders or Latinx women with substance use problems. 4. Last but not least, it’s unclear what effect this new influx of money will have on traditional practice.

Question 27

Will tech health upend face to face practice in the mental health industry?

Answer 27

Though the development is a big concern among some psychology practitioners, it is unlikely to upend face-to-face practice, those involved in the area believe.

Question 28

What does Frances Thorndike, PhD say?

Answer 28

At their best, these products can provide the treatment necessary to support practitioners who are in high demand, to intervene with people who are awaiting care or require between-office support, or to enhance existing care modalities, said psychologist Frances Thorndike, PhD, senior global lead for insomnia at Pear Therapeutics, one of the few companies to receive U.S. Food and Drug Administration (FDA) approval for some of their digital products, including Somryst, a digital CBT intervention for insomnia.

Question 29

What does Thorndike think that digital therapeutics can do?

Answer 29

“I always think clinicians are guiding the journey, but digital therapeutics can extend what we do and provide support, guidance, and feedback between visits,” Thorndike said. “And when they’ve been rigorously reviewed, we can be confident that they work.”

Question 30

What are the reasons for optimism in mental health apps?

Answer 30

1. One is that venture capital companies are maturing in their vision of why they’re funding these entities, said Histon. 2. Notably, psychologists are becoming key players in some of the recently funded companies, bringing the expertise needed to ensure clinical integrity from the beginning of a product to its eventual uptake. 3. Other positive developments include greater venture capital funding in companies run by women and people of color and the incorporation of these newer technologies into standard health care.

Question 31

What does Histon say about the attitude capitalists have towards mental health apps?

Answer 31

“I’ve seen a shift from [the Silicon Valley mantra] ‘Move fast and break things’ to ‘Move fast with intention,’” she said. At a recent panel she attended on venture capital, speakers “still said that making money was fun,” she said, but “they’re now much more plugged into the intention of doing good work and putting good products out there.”

Question 32

What are examples of psychologists becoming key players in well-funded companies?

Answer 32

For example, before joining Pear Therapeutics, Thorndike worked for years on multidisciplinary teams when she was on the faculty at the University of Virginia, creating digital health products designed to improve access to care for high-need conditions like insomnia. Meanwhile, Andreas Michaelides, PhD, chief of psychology at the digital health platform Noom, has used his psychological expertise to help inform the way the company’s products are conceived and developed.

Question 33

What is a good example of good technologies being integrated into mental health apps thanks to women and people of color in the industry?

Answer 33

In a paper in NEJM Catalyst (Vol. 2, No. 1, 2021), for example, Don Mordecai, MD, Histon, and colleagues describe how Kaiser Permanente has developed a “digital ecosystem” that provides thorough training to clinicians in the technology, tailors the modalities to meet patient needs and styles, monitors and evaluates use and success rates, and continuously makes improvements. When patients use tools in a system like this, their rates of engagement jump 4 to 5 times higher than if they didn’t have these aids. “These technologies are really a way to amplify the healing journey that members are on,” Histon said

Question 34

What is APA doing digital health-wise?

Answer 34

APA is keeping abreast of these developments and creating programs and products to help practitioners, technologists, and consumers understand and navigate this rapidly evolving space. The association is also working with stakeholders to address the fact that, at present, FDA-approved products—even those with a psychology basis—need to be prescribed but that most psychologists lack this authority.

Question 35

What did Vaile Wright, PhD say about what the APA is doing to fix problems on digital health?

Answer 35

To help fix this problem, APA and others “are working to develop a more innovative regulatory model that fits these softwares better and doesn’t use the word ‘prescription,’” said Vaile Wright, PhD, APA’s senior director of health care innovation.

Question 36

Who is Vaile Wright?

Answer 36

APA’s senior director of health care innovation

Question 37

What happened on September 2021 for the APA and FDA partnership?

Answer 37

To aid in this effort, in September 2021, the FDA designated APA an “expert partner organization,” which will allow the association to provide expertise on behavioral change technology and methodology.

Question 38

What did Stirman say about venture funding?

Answer 38

Like it or not, venture funding is pushing these technologies to a central spot in the mental health landscape. Instead of shying away, psychologists can seize the opportunity to ensure that these interventions are ethical, inclusive, live up to their claims, and help people get better, Wiltsey Stirman said. “There’s a lot of promise in this area,” she said, “but we’ve got to be really thoughtful and careful in how we go about it.”

Question 39

What are the seven mental health 'unicorns' in telehealth?

Answer 39

The seven mental health ‘unicorns’ 1. Genoa: $2.5 billion 2. Lyra Health: $2.3 billion 3. Calm: $2 billion 4. BetterUp: $1.7 billion 5. Talkspace: $1.4 billion 6. Modern Health: $1.2 billion 7. Ginger: $1.1 billion