Confronting Persistent Gaps in the Mental Healthcare System
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The mental healthcare system has been broken for decades. Each of us has felt its shortcomings: Holly, a new mother who has now experienced two traumatic births; Elena, the daughter of a psychologist who fought hard to deliver mental health at scale through grants and school-based mental health programs; and Candace who has seen the devastating impacts of untreated substance use disorder and mental illness affect her community.
Lack of access inspired us to work toward change. As healthcare investors at General Catalyst, we are determined to invest in better mental healthcare. This mission feels particularly important as already thin hospital and outpatient budgets have been stretched further by the need to divert resources to the pandemic.
Over the past few years, a proliferation of new mental health companies has emerged and is already making an impact. There is clearly a growing awareness that the mind and physical body do not operate as separate entities. That said, the mental health market is inundated with point solutions that don’t work with each other. We not only need to connect these solutions but integrate them with whole health. No one company will address everything, but a connected ecosystem can drive differentiated outcomes.
To do this, the industry needs to embrace a new mindset. Instead of solving individual problems, we need to think at a systems level when designing solutions. This means fostering radical collaboration across companies and partnering with the healthcare system to define the future of mental health. As a community, here are three key areas we need to focus on in order to drive tangible change.
Improving access and personalized care through robust diagnostics
Right now, we have a one-size-fits-all system. The lack of availability makes finding a relevant in-network provider extremely difficult, especially one who can deliver personalized care tailored to a patient’s specific needs. We need a system that identifies an individual’s needs and allows them to access an appropriate care provider whether they are looking for cultural appropriateness, specialties in specific disorders, or care via accessible modalities like video calls.
One reason for this is that we lack sufficient diagnostics to predict mental illness before it happens and to measure the success of treatments along the way. By developing better diagnostics and biomarkers, we can intervene earlier and more effectively. With better metrics for monitoring and measuring quality of mental health outcomes, we can move away from a largely one-size-fits treatment landscape to one that is data-driven, highly personalized and that delivers better outcomes.
Tackling mental health challenges in the context of people’s whole lives
The mind and body are connected but our system divides the two. Even the vocabulary that clinicians use needs to be changed. We need the way we deliver and pay for care to support treatment of a person as a whole. We need to be able to measure the value of this to prove that addressing mental health creates better physical health and ultimately lowers health expenditures. This will help ensure that mental health is prioritized in a value-based system.
Zooming out, this shift to treating the whole person must also include a rise in community-based care. Right now, mental illnesses are largely treated in highly medicalized settings. We see the care setting expanding and expect this shift to continue toward bringing care to people where they are whether it be the home, schools, workplaces, over video—all options need to exist. Tackling mental health challenges in the context of a person’s life will also lead to better clinical outcomes. For example, providing a virtual family-based treatment (FBT) for eating disorders avoids the stigma and life-disruption of an inpatient experience. By engaging their families and teaching healthy eating skills in their regular environment, it sets patients up for long-term successful recovery.
Expanding and augmenting the workforce
The gap between mental health treatment capacity and need is vast and growing. According to McKinsey, 56% of counties in the United States are without a psychiatrist, 64% of counties have a shortage of mental health providers, and 70% of counties lack a child psychiatrist. What’s more, it’s lower-income, rural Black, Indigenous, and people of color and LGBTQ+ communities that disproportionately suffer from lack of access to quality mental health care due to stigma, lack of insurance coverage, and prohibitive costs coupled with shortages of therapists in their communities.
We need to expand the pool of therapists through access to education and attract more people to the industry by offering livable wages, fulfilling work environments, and exciting career progression opportunities. We also need to tap into new, highly underutilized pools, such as peer support, group therapy, and asynchronous models. Leveraging more scalable workforces and technologies will help us better meet the mental health needs of our society.
Looking ahead, reducing gaps in mental healthcare will require meaningful industry consolidation between mental and physical health providers as well as continued research and technological advancement. By coming together to build a community set around intention, inclusivity, and innovation, we are poised to deliver impactful outcomes and better meet the dire need for sufficient mental healthcare.
The mental healthcare system has been broken for decades. Each of us has felt its shortcomings: Holly, a new mother who has now experienced two traumatic births; Elena, the daughter of a psychologist who fought hard to deliver mental health at scale through grants and school-based mental health programs; and Candace who has seen the devastating impacts of untreated substance use disorder and mental illness affect her community.
Lack of access inspired us to work toward change. As healthcare investors at General Catalyst, we are determined to invest in better mental healthcare. This mission feels particularly important as already thin hospital and outpatient budgets have been stretched further by the need to divert resources to the pandemic.
Over the past few years, a proliferation of new mental health companies has emerged and is already making an impact. There is clearly a growing awareness that the mind and physical body do not operate as separate entities. That said, the mental health market is inundated with point solutions that don’t work with each other. We not only need to connect these solutions but integrate them with whole health. No one company will address everything, but a connected ecosystem can drive differentiated outcomes.
To do this, the industry needs to embrace a new mindset. Instead of solving individual problems, we need to think at a systems level when designing solutions. This means fostering radical collaboration across companies and partnering with the healthcare system to define the future of mental health. As a community, here are three key areas we need to focus on in order to drive tangible change.
Improving access and personalized care through robust diagnostics
Right now, we have a one-size-fits-all system. The lack of availability makes finding a relevant in-network provider extremely difficult, especially one who can deliver personalized care tailored to a patient’s specific needs. We need a system that identifies an individual’s needs and allows them to access an appropriate care provider whether they are looking for cultural appropriateness, specialties in specific disorders, or care via accessible modalities like video calls.
One reason for this is that we lack sufficient diagnostics to predict mental illness before it happens and to measure the success of treatments along the way. By developing better diagnostics and biomarkers, we can intervene earlier and more effectively. With better metrics for monitoring and measuring quality of mental health outcomes, we can move away from a largely one-size-fits treatment landscape to one that is data-driven, highly personalized and that delivers better outcomes.
Tackling mental health challenges in the context of people’s whole lives
The mind and body are connected but our system divides the two. Even the vocabulary that clinicians use needs to be changed. We need the way we deliver and pay for care to support treatment of a person as a whole. We need to be able to measure the value of this to prove that addressing mental health creates better physical health and ultimately lowers health expenditures. This will help ensure that mental health is prioritized in a value-based system.
Zooming out, this shift to treating the whole person must also include a rise in community-based care. Right now, mental illnesses are largely treated in highly medicalized settings. We see the care setting expanding and expect this shift to continue toward bringing care to people where they are whether it be the home, schools, workplaces, over video—all options need to exist. Tackling mental health challenges in the context of a person’s life will also lead to better clinical outcomes. For example, providing a virtual family-based treatment (FBT) for eating disorders avoids the stigma and life-disruption of an inpatient experience. By engaging their families and teaching healthy eating skills in their regular environment, it sets patients up for long-term successful recovery.
Expanding and augmenting the workforce
The gap between mental health treatment capacity and need is vast and growing. According to McKinsey, 56% of counties in the United States are without a psychiatrist, 64% of counties have a shortage of mental health providers, and 70% of counties lack a child psychiatrist. What’s more, it’s lower-income, rural Black, Indigenous, and people of color and LGBTQ+ communities that disproportionately suffer from lack of access to quality mental health care due to stigma, lack of insurance coverage, and prohibitive costs coupled with shortages of therapists in their communities.
We need to expand the pool of therapists through access to education and attract more people to the industry by offering livable wages, fulfilling work environments, and exciting career progression opportunities. We also need to tap into new, highly underutilized pools, such as peer support, group therapy, and asynchronous models. Leveraging more scalable workforces and technologies will help us better meet the mental health needs of our society.
Looking ahead, reducing gaps in mental healthcare will require meaningful industry consolidation between mental and physical health providers as well as continued research and technological advancement. By coming together to build a community set around intention, inclusivity, and innovation, we are poised to deliver impactful outcomes and better meet the dire need for sufficient mental healthcare.
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