🧠 Know Your Options

The latest on the business of mental health and wellness

Welcome to On The Mind, a collection of stories, news, and analyses on the startups, investors, and thought leaders in mental health and wellness.

Here’s what’s included in issue No. 10:

  • Using data to accelerate finding the right treatment option

  • Studying the relationship between mental health and greenspace

  • Finding “awe” in your daily routines

🎙️ Interview with Morgan Hewett and Kyle Pierce, CEO and COO of Options MD

Conversations with founders, investors, and thought leaders in mental health and wellness.

When you speak with Morgan Hewett (Co-Founder/CEO) and Kyle Pierce (Co-Founder/COO) of Options MD, the first thing that comes across is their enthusiasm for and commitment to the work they’re doing. Options MD, which participated in the 2020 cohort of the UnitedHealthcare Accelerator Powered by Techstars, is a platform using patient and clinical data to better help people with severe illnesses access the right treatment, faster. The company is focusing first on patients with treatment-resistant depression (meaning they’ve tried 3 different types of treatments to no avail) - a population of over five and a half million Americans, according to the team.

Can you start us off with why you decided to build Options MD?

We’ve been best friends for nearly a decade. In that time, we’ve been through all of the ups and downs life has thrown at us.

The biggest was a few years back, when Morgan’s older brother was diagnosed with depression and suicidal ideation. He tried over 10 drugs, landed in a hospital over 4 times, and still couldn’t shake his suicidal thoughts. Luckily, he eventually found a treatment plan that worked for him.

Kyle also had a close friend who, after being connected with the wrong treatment, took her own life.

For us, we knew there had to a better way, and thought about how we could use data analytics to shorten the time frame to finding the right care. We know that there’s people out there who have tried and failed to treat their depression, many of which will eventually turn to a suicide attempt if they can’t find relief. We want to show those people that they have options, that they have hope, and we’re building the Options MD platform to make that happen. When we’re working really late at night, that’s who we’re thinking of.

You’re both clearly close to the cause. How do you two split the work of running your company?

When we got started it was all hands on deck. We’re lucky that we benefit from a close relationship and communicate extremely well. It allowed us to avoid needing strict lines of where our responsibilities split from the start.

As we got more sophisticated and needed to dig deeper into certain parts of the business, we found places where we had interests and skillsets.

Morgan launched Facebook’s healthcare marketing division, working with pharma and healthtech companies to recruit and engage patients, so she was a natural fit for patient engagement. She’s since built up what’s now the largest community of treatment-resistant patients on Facebook.

Kyle started off as a lawyer involved with acquisitions, and has been leading our fundraising and investor relations. He’s behind our partnerships with companies like Field Trip Health.

And beyond us two, we’re supported by an all-star team of people with the clinical knowledge, data expertise, and personal passion for building something we all full-heartedly believe in.

Can you walk me through the product building journey? What has it looked like?

We’ve learned a lot since first getting started, and once we got into the flow of getting out of our own way, centering on constant improvement, our product really took shape.

The problem we’re most interested in solving is the patient experience. You’ve been diagnosed, tried a bunch of treatements, none worked, and now you’re ready to give up. It’s been a guiding force for us to remain a patient facing tool. We want to educate patients and make sure they know they still have so many treatment options out there, and that there’s at least one that will work for them.

Our MVP was a quiz patients could take; the output was a list of treatments they’re eligible for, with details on each, including the risks involved. We received great feedback, but we really left patients hanging - they liked the options, but wondered what to do next and who they could speak to to learn more.

Most of the identified treatments aren’t just readily available at your local PCP, or even psychiatrist. We found it wasn’t just about treatment matching, but also provider matching. That led us to begin developing a network of top specialists so that we could match patients with the right care plan and the right provider to deliver that care plan.

What we’re really proud of building is a community for those with treatment-resistant depression. Everybody told us that people who are depressed are difficult to engage, that they wouldn’t talk to us. We found that was completely wrong - while these people may not want to engage with their health insurer, or might not want to talk to their old doctor, they’re desperate for a solution and they do want to talk to someone. In addition to continuing to develop our matching algorithms, we’ve created a waitlist and accompanying Facebook community, where we engage daily with free resources.

“Options” is in your company name, and you mention over 500 available treatments. What do these consist of?

The vast majority of patients are only getting access to a subset of SSRIs, such as Lexapro. This is what psychiatrists primarily prescribe.

The majority of patients we work with are far beyond that, but there are so many other options - neurogeneration medications, SNRIs, atypical antidepressants, and a variety of more cutting edge treatments like transcranial magnetic stimulation, electroconvulsive therapy, and psychedelics. Then there are combinations of multiple treatments, and a variety of options that are still being researched in clinical trials.

Our view is that the main problem is a lack of education, where patients aren’t aware that they have other options available to them. They’ve spent so much time and money on treatments that have failed them, don’t have much money left, and are desperate to get their life back on track.

How do you determine the right option for each patient? What does being an Options MD member entail?

In addition to considering basic medical protocols, we bring in data that we’ve generated from looking at clinical trials and academic journals to determine a range of treatment options.

From there, we apply machine learning, taking into account individual patient medical history, direct feedback from physicians we partner with, and a variety of non-traditional data points, including a patients’ ability to pay, motivations, and lifestyle. This culminates in a prioritized list of options personalized for each patient.

Our members go through four steps. First, they receive their list of personalized treatment options. Second, we refer them to the right providers in their price range. Third, we pair each user with a peer mentor who has also been through depression. And finally, we enable them to track their progress daily through a mobile app, flagging any changes and side effects through their treatment.

How do you make money?

Our initial business model focuses on two groups.

First, we charge a small monthly access fee of $25/month, which gives members access to the full Options MD platform. Secondly, the majority of our revenue is generated through partnerships with clinics. We provide patient referrals and help our partners with overall patient engagement.

Longer term, we also see a clear opportunity in working with payers - UnitedHealthcare is one of our largest investors. They see our value in reaching a difficult patient population and helping them re-engage with the healthcare system.

What’s been the hardest part of working on Options MD?

We’ve built a pretty robust waitlist of patients who are eager to use our platform, which has been both a blessing and a curse. We’re grateful for the interest, but it’s not like we’re waiting to drop the next trendy clothing line. It’s people who are in desperate need of a treatment that works. There’s an emotional struggle attached to our effort of getting this up and running as soon as possible, and in a safe way.

We’re playing the start up game for a topic that matters. Sometimes we feel we’re moving like snails, but then we look back and see the progress we’ve made. Our launch can’t come soon enough, but it’s that struggle of how fast we can get to market vs. figuring out everything we can do to derisk our company, which inherently slows us down.

The part that makes it difficult is the same part that motivates us to continue the work each day.

🩺 Clinical Coverage

Discussion of clinical concepts, studies, or perspectives on mental health and wellbeing.

It’s been intuitively known for a long time that being in nature has a positive effect on mental health, but it’s now being researched to see just how positive that effect is for people living with mental illnesses.

Dr. John Torous, director of the digital psychiatry division at Beth Israel, used a platform his lab has developed to investigate the correlation between schizophrenia symptoms and time spent in green spaces.

The platform pulls participants’ GPS data from their phone and tracks that against a map of NDVI (normalized difference vegetation index), which is a measure of green space in a given area. With that, the researchers can assign a green space “score” and correlate that score with participants’ symptoms. In the initial (small scale) study, it was found that participants who had schizophrenia who spent more time in green space environments had lower symptoms of anxiety, depression, and psychosis.

The results are correlational, not causational, but are informing the design of future research. Dr. Torous is continuing to investigate the relationship between mental health and greenspaces, as well as the impact pollution has on mental health.

💰 Recent Investments and IPOs

Rundown of recent investment news in mental health and wellness companies.

Investments have been pouring into the space the past few weeks. It’s an early sign of continued interest despite our transition to post-pandemic life - a signal that mental health is less of a passing trend and more of a sustained component of our health and wellbeing that we’ll prioritize moving forward.

📖 Interesting Reads

Sometimes mental health-related. Sometimes just things I find interesting.

  • A deep dive into North Korea’s hacking army. New Yorker

  • Are outdoor mask mandates still necessary? The Atlantic

  • Seth Rogen’s secret to happiness. The New York Times Magazine

  • The importance of carving out downtime between meetings. Microsoft

  • How Big Tech became Big (spoiler: mad acquisitions). The Washington Post

  • The fungus is among us. NYTimes

  • You’re at higher risk for dementia if you sleep less than 6 hours. WSJ

  • I’m late on this one - but Patrick Collison is a legend. Noahpinion

  • Over 200,000 people live with a neural implant of some kind. New Yorker

  • So inspiring. Battle of the Daniels is coming soon. WSJ

  • The saga of Signal vs. Cellebrite. Signal

  • A guide to better online arguments. The Guardian

  • Headspace releases another feature on Netflix, focused on better sleep. Esquire

  • CVS is now offering mental healthcare in stores. NPR

  • Fine dining goes vegan. NYTimes

  • The history of NYC offices - is the office as we know it dead? Curbed

  • How much energy does Bitcoin actually consume? HBR

  • A look at Bill and Melinda Gates’ real estate portfolio. Robb Report

  • Can we live to 200? NYTimes

🧠 Mindfulness Tip of the Week

Tips to improve your mental health and wellbeing.

Now that we’re deep into Spring, approaching Summer, and slowly but surely returning to a sense of normalcy, it’s the perfect time to make “awe walks” a part of your practice.

It’s easy to get caught up in a routine, focus on getting from point A to point B, or even just let your mind remain preoccupied with random thoughts. I try to spend at least 15 minutes outside each day (ideally longer), whether it’s just sitting in my backyard, walking around the block, or going for a run or bike ride. The outdoor time is in and of itself helpful for my mental health, but incorporating “awe” really forces me to be present.

Incorporating “awe” simply means that you’re actively looking for and consciously noting when things in your environment spark a sense of wonder. In a study of older adults published last September in the journal Emotion, half of the participants went on weekly 15-minute walks and were told to snap “selfies,” while the other half did the same but were instructed specifically to take note of things that inspired awe (e.g., colors, sounds, smells). The “awe walk” group not only reported less distress and increasing awe, joy, compassion, and gratitude, but also smiled more in their selfies and captured more of the surrounding nature, rather than themselves.

Try it out for yourself this week, and see how it feels to tune in.

On Your Mind

I’d love your feedback - feel free to email me at tarockoff@berkeley.edu.

If you’re working on something in mental health and wellness, let’s talk. You can book some time with me here.

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Written by Daniel Tarockoff, an MBA student at UC Berkeley and former healthcare strategy consultant exploring the future of mental health. Born in Michigan. Based in Berkeley, CA.