- Good evening, everyone.
My name is Michael Martin,
and I am excited that we are kicking off the
Johnny Martin Mental Healthcare Challenge.
I’d be remiss if I didn’t go and give a shout-out
to the student chairs and team in this room before
we get things kicked off.
So, can I ask you guys to stand up for a brief second,
and get your applause?
We have a fantastic evening plan for you,
and it gives me great pleasure to introduce someone
who’s very, very important to this school, Dean Harrison.
Dean Harrison is renowned as an economist
who’s dedicated her career to creating inclusive
and sustainable policies in development,
economics, international trade,
global labor markets, and now, in higher education.
She’s also been very supportive of our efforts
to create awareness of mental health care related issues,
and is helping us to go and strive to improve the quality of
and access to mental health care for all.
So, without one more second being wasted, Ann Harrison.
- Thank you so much, Michael.
It’s such an honor to be here
for this really important event.
And Michael, thank you so much for all the work
that you have done to make this happen.
We couldn’t have had this and tomorrow without Michael,
so we should give him round of applause.
So now, it’s my privilege to introduce today’s speaker,
and (indistinct) BS/05 Karan Singh.
Karan co-founded Ginger,
the world’s first mental health technology platform in 2011.
By combining high quality human care
with data science and augmented intelligence,
the team at Ginger created an entirely new platform
for the delivery of mental healthcare on demand.
As COO, Karan has led Ginger’s reach
to over 25 million people in more than 50 countries
in the world.
In 2021, Headspace dedicated to science-backed meditation
and mindfulness tools,
joined forces with Ginger to form Headspace Health,
forming the world’s most comprehensive
and accessible mental healthcare platform.
Karan currently serves as COO of Headspace Health,
which touches nearly 100 million people worldwide.
Karan is a leader in the digital health community,
serving as a scholar at the Aspen Institute,
and delivering keynotes at the Public Health Institute
and the National Institute of Mental Health.
Ginger has received numerous recognitions,
including by the World Economic Forum
as a technology pioneer, and by Fast Company
as one of the most innovative companies in healthcare.
Karan, thank you so much for taking the time
to speak with us today.
We are really grateful to have you back here on the campus,
and we look forward to a lively and informative discussion
on a really, really important topic.
So, I’m now going to turn it over
to our fabulous MBA students,
Matheus Loesche and Madhu Gupta.
And they will moderate today’s discussion.
Take it away.
- Well, is it working?
Okay, Karan, thank you so much for coming today.
It’s a pleasure to have you here with us tonight.
I also like to thank our audience
for taking some time to hear more about Karan’s career
and also the mental healthcare industry,
I think, it’s really important.
My name is Matheus, as Dean Harrison said.
I’m a second year MBA class of 2023,
and I’ll be moderating this panel along with–
- Madhu Gupta.
I’m a first year MBA class of 2024,
and I’m very excited to talk
about all things mental health with you tonight.
- Okay, let’s jump in for the first question.
So Karan, I’d love to start this conversation
with learning more about you.
We have tell more about yourself here
that you must be having training a lot as well.
So, who is Karan?
Can you please tell me a little bit more
about your journey, education, family,
your inspirations, and also,
like we can’t leave this aside,
what prompts you to take the leap
and risk of founding Ginger?
- Sure, happy too.
And Dean Harrison and Michael,
thank you again for this opportunity.
This is a full circle moment.
I was sharing with my wife who is also an undergrad from Cal
and came back for her PhD in the School of Public Health,
that this is pretty special,
I mean, to have a entire event dedicated
to mental healthcare and mental health innovation.
I mean, it really takes this room
and countless others like this
to really solve this challenge.
So, you know, while the accolades are wonderful,
they’re really still a drop in the bucket when it comes
to just how much access and how much need there is
in the world.
So, happy to start at the very beginning
and be as real as we can through this.
I was very, very beginning born in Malaysia.
My parents moved to Cleveland, Ohio,
when I was about two.
I came out to the Bay Area when I was about 10,
and I came to Cal,
and I didn’t know what I wanted to be when I grow up.
I knew I wanted to do something with purpose,
and I had this vague notion of what that meant.
And I never realized actually
that I think business could be a vehicle for that.
And so, I think, like most people
who don’t know what they wanna do when they grow up,
I got into consulting ‘cause I wanted to keep learning
and I wanted to keep solving
what I thought was tough problems.
And so, you know, I spent a few years,
close to five years actually doing that.
And now, about 13 years ago,
had a personal brush with mental health,
like I’m sure many people in this room.
I was on the other end of a phone call after a loved one
who had tried to take their own life.
And you know, I’ve always thought of myself
as a good read on people and a good judge of character,
and you know, I had no idea at all.
And you know, I realized in a lot of communities of color,
especially, my family’s originally from India,
mental health is just the no-go zone.
It’s the topic that just no one talks about.
And I realize when I look back at that time that, you know,
it’s actually something we didn’t talk about.
So, that was the spark for me,
that kind of eventually set me on the path
to founding Ginger.
- Makes sense, makes sense.
And also speaking a little bit
about your consulting career a little bit.
You’ve been like five years, if I’m not mistaken,
in consulting, working for ZS Associates Consulting.
And like, what make you,
there are many folks here that stop their career
to take their MBAs, and what make you,
like, what prompt you to pivot from a career
into an MBA?
And following up on that,
when you embark into the NBA journey,
what’s becoming a founder already a dream goal of yours?
Was being a founder a dream goal?
Yeah, I wanna say that it was,
but no, no. (audience laughing)
I think, maybe I’ll go backwards.
I’ll start with that and we can talk about consulting.
You know, I had this blush with mental health, right?
And then the deeper I dug,
the more I realized that teammates
at work were experiencing stress and burnout,
that people in my family directly that I was at times,
you know, going through
what I thought were just these ups and downs,
but was real meaningful stress or anxiety at times.
And so, I went back to school with the idea
that I wanted to create the space to try to think about
and do something here.
And I didn’t really know what it was gonna look like.
I actually didn’t have an intention of starting a company.
I had wanted to actually try to tackle this problem,
you know, having grown up in the Bay Area,
having seen the rise of technology
and kinda the impact it could have,
thinking about how technology could play a role
in mental health.
And you know, at the time,
there was really just a couple of use cases for technology.
There was biotechnology, there was EMRs and medical records,
and then there was everything else, right?
There wasn’t really a digital health ecosystem.
There wasn’t care delivery innovation
or thinking about new ways
of actually scaling access to care.
And so, I went back to school
in a dual degree program between Harvard and MIT,
really focused on this intersection
of health science and technology.
And I just kept bugging everybody I could find
and asking them what they knew about mental health,
and the different applications for technology
and mental health.
And I kind of stumbled
into sort of the original kind of founding of Ginger.
And when I look back and I give advice to entrepreneurs
who are thinking about starting a company,
I usually say, “Don’t do it.”
Really, really, don’t do it,
unless you just can’t shake it.
You know, like this idea of founder market fit
or the idea that like,
you really can’t not solve this problem was I think,
probably, most prominent for me.
And that’s ultimately why I decided that
because I didn’t see anything else out there,
that I needed to solve it.
I think the world has changed quite a bit,
the fact that, again,
we have this room with these many people
that there might actually be things out there
that don’t necessarily require you to start a company
that you could actually still have impact with.
- Thanks for sharing, Karan,
that was really insightful.
Speaking of school, we know that your team
at the MIT media lab was pivotal in the founding of Ginger.
We have many aspiring entrepreneurs here today,
and similar to MIT, has a variety
of different entrepreneurship focus programs and resources.
You touched upon this a little bit,
but just going a step further,
what are the types of resources that you would recommend
that folks here in the room take advantage
of during their MBA program?
- Yeah, there’s a lot in that question.
I think, there’s a lot of great opportunities
at a place like Cal.
You know, I think one of the things I learned was just
how important innovation happens
at these intersection of these disciplines
of people who wouldn’t have historically gotten together
that start to have a conversation around a problem
and look at it from different angles.
And so, you know, just as a starting point,
being engaged in these sorts of activities,
but just as importantly,
also getting out of Haas
and getting into the rest of the community
or bringing others into Haas and thinking about,
how can other people solve this problem, right?
Like, one of my favorite examples was,
you know, I would go to a course,
actually, we didn’t have a course on sales,
like, sales training and negotiations,
and they actually implemented one my second year
in business school.
And I loved going to those courses and then taking that
and trying to apply it to an explicit problem.
So, at the time,
we had just founded Ginger.
And so, I was finding myself in class learning about
how to influence people,
learning about how to build a balance sheet,
learning about these sort of business fundamentals
and then applying that to the startup.
The thing that I didn’t learn
that I wish I had learned was the importance
of founder mental health,
the importance of actually taking care of yourself,
while you’re going through that journey,
I think, at the time, and even still now to some degree,
most people and many founders actually burn out
in their first few years
because they actually don’t take care
of their own mental health through that.
And so that was a huge lesson for me.
- Yeah, and that’s definitely, I think, we’re all,
I think I speak for everyone in this room when I say
we’re all navigating similar experiences,
and hearing sort of your experience going
through all of that is very helpful.
And that’s a great segue actually to my next question,
which is around, you know,
in the spirit of getting to know you a little bit more,
and we are here to talk about mental health, I can go first.
Personally, for me,
I was just telling Karan a little bit ago,
but my prior employer was contracted with Ginger.
And so, Ginger and their mental health resources,
has been my best friend for the past four years.
And especially, during the pandemic,
when the mental health challenges became a lot more real
for a lot of people, such as burnout,
which you just talked about.
And so, I’m curious, Karan,
what are the types of things and practices
that you engage in to prioritize your own mental health,
and especially, in a very turbulent time like this,
and let alone for founder,
what are the types of things that keep you going?
- Yeah, I’ve developed a routine now.
I didn’t have that while I was in school.
And so, you know, I actually,
if we can rewind back to the question,
and then we can kind of get to what I do now,
because I think, in business school,
I’ve found that not enough people
or maybe not even business school, but in graduate school,
not enough people were real, were just authentic,
were honest and open and knew what they wanted.
They knew what other people thought,
they were supposed to do.
And as a result, they pursued things
that actually didn’t give them happiness.
And I think I was in that camp too,
like, I don’t think I fully understood
and it’s taken me this journey over the last decade now
to really understand that.
And, you know, so tangibly what that means now
in terms of self-care, it’s, I meditate.
I’ve been a long time Headspace user actually,
prior to the merger.
And so, that was nice, again, full circle moment.
So, I meditate regularly,
and for me, that my practice is,
it’s a five minute walk,
and I’ll just walk around the house or walk around the block
or walk in nature in some way and meditate.
And that just reset
in the morning has been incredibly helpful for me.
The second is, I have a group that I get together with
about once a month.
And it started in some ways like a founder support group,
a group of about eight other founders
who had started a company around the same time.
And we were just sharing, you know,
we thought was gonna be just work best practices, right?
And it very quickly turned
into just life best practices or life situations.
And people have gone through life tragedies,
divorces, family suicides,
companies that have closed down,
you know, just the whole gamut of situations
that are really incredibly stressful,
but ultimately, impact your ability to be really effective
on the job.
And I think that learning for me has been a willingness
to actually have those conversations,
and be real with others,
so that you can be really with yourself,
and you can actually hold yourself
to the things you care most about.
And so, you know, I wish that I had learned that earlier
in my career, that so much my success actually is a function
of developing these habits.
- That’s amazing.
Thank you so much for sharing that.
And let’s switch gears here a little bit,
talk about more danger that you are
in the mental healthcare industry and its strengths.
And back in 2011 when you founded Ginger,
to put it simple, it was a time,
and that was that mental healthcare was not
so much like a thing in 2011.
The pandemic has changed the narrative
and mental health is now considered a critical part
of the core healthcare today.
And thinking about that in your product,
can you give us insight as
what’s been like to work at a company
that has experienced such tremendous growth,
over the past few years?
- It’s hard, it’s really hard.
You know, I think there’s the pre-COVID story,
there’s the COVID story.
I wanna say that mental health has made it
into the forefront.
I think, we’re on that journey now.
We’re having these conversations,
we’re having these conversations in these kinds of rooms
in government, in boardrooms, and in other settings
that have historically would never have been
in the dialogue.
So, we’ve come a long way,
and still just a whole lot more we’ve gotta do.
But yet, you know, 10 years ago,
there was no digital health industry.
There was no digital mental health industry.
And when we first started there was a lot of no,
a lot of not now, a lot of this is impossible,
and like, it’s true for so many things.
You know, it takes resilience,
it takes being good at getting back up again.
And I think that’s true.
Again, I mean, that’s still true today, right?
I’m sure many of you in the audience here are pursuing this.
When we talk about mental health,
I mean, it’s like talking about physical health, right?
It’s an incredibly massive, huge need.
And so, no one company,
no one person is gonna solve this challenge, right?
And that was true 10 years ago,
and it’s especially true now
where a billion people worldwide are in need of care.
COVID has just happened or is happening,
and the collective trauma
that we’ve all experienced is real.
And so, that has only gotten worse,
unfortunately, not better.
And so I think the opportunity
that all of us have to really make an impact,
is even more pronounced.
So, we started the journey originally,
coming out of research,
we were doing at MIT at the time,
leveraging data we could collect passively
to really basically predict when someone, a patient,
a member was having a symptom flare.
And you know,
I’ve gone through a couple pivots over the years.
The first pivot was this business model pivot,
which was in effect, we used to sell to provider groups,
basically, sell to other hospitals and clinics,
that is the technology platform we had built.
And eventually, we realized that we had to become one,
that the only way to solve a broken system was
to really rewire the whole machine from soup to nuts,
was to recruit a provider group
that was actually reflective of the populations
we were trying to serve.
It was building a business model
that allowed for product innovation,
versus just fee for service medicine.
It was changing a few of these variables
that allowed us to then create an experience
that ultimately, you know,
members or individuals really needed,
which just in the existing system wasn’t gonna get created.
- And just following up on that,
like talking about the difficulties
that you had along the way,
we are seeing this,
today, like Facebook laid off 11,000 employees,
and this seems to be like a trend right now
with the current situation of the economy.
Companies are being forced to lay off employees
in cut costs.
Do you have any particular top of mind relevant examples
of challenges that you can share with us besides those ones,
but as an entrepreneur and along the way
that you were managing Ginger,
and how did you eventually overcome those situations?
- Yeah, it’s gonna be a challenging year,
there’s no doubt.
And there’s challenging 18 to 24 months,
and certainly, these are kinda the first signs
or maybe ongoing signs of that.
I think, for me,
the saving grace to some degree is,
like incredible companies, incredible products
and experiences get built in these situations.
We felt that coming out of getting into,
at the time I was in business school in 2009,
and saw just a meaningful and real downturn.
And when people go through those environments,
they start to question what they’re working on,
what they care about.
And so I think there’s a huge reshifting of workforce
and labor into problems that matter.
And I think that’s in some way a benefit
to what might be going on right now as painful
and as challenging as it is.
And it has been given COVID, given inflation,
given all these macro scenarios,
I think, there’s also an incredible amount of innovation
that’s happening right now, right?
And there’s an incredible amount of people
who are willing to take a risk.
And so, you know, we’ve had to see
that over the course of Ginger.
When we first made that business model pivot,
we actually had to go through a round of layoffs and change
and really retool the leadership team and our whole team,
which was hard.
It’s hard to get, right?
And doing that in a way that’s compassionate,
in a way that actually cares for people,
but allows you to still stay true to your mission,
those are tough decisions to make.
But I think, looking back,
you know, it was the right decision that we made to change
that business model and actually retool the team
to really tackle this problem in the way
that we’ve now fashion it.
And so, you know,
I think, it’s gonna be challenging over the last 18
to 24 months.
But I guess the flip side of it is also,
we’ve had an internal mantra right now,
around mindful entrepreneurship and mindful spending.
And the idea that in times like this,
you actually do question where you’re making investments,
and you really start to double down and investigate
and figure out like, well,
okay, what’s the kernel, what’s the nugget?
Like, what is gonna be most valuable to invest in?
And you really adopt a model of essentialism, right?
Less but better, and I think that’s what this is about.
It’s subtraction, so you can focus on the things
that really do matter most,
and are ultimately gonna give you the impact,
you’re looking to achieve.
- Thanks for sharing, Karan,
that’s definitely insightful.
I know that there’s obviously risk and reward
that comes with being a founder,
some of which you already spoke to right now.
But I think there’s particularly something interesting
about being a leader of a mental health care company,
because there is a challenge that comes
with an accountability of the fact
that the company actually practices what it preaches.
As Dean Harrison mentioned,
you are the COO currently of Headspace Health.
As the COO, how do you ensure that your employees wellbeing
and mental wellbeing is maintained?
- Yeah, when we first started,
I used to always talk about how I almost felt inconsistent
with our mission to be a mental health startup,
because as a startup, you’re going through the grind
or what feels like the grind, right?
And you know, I didn’t realize just how true
that that was, right?
And managing a virtual first largely company now,
during COVID, has been hard.
I mean, it’s been hard on so many people,
but I think there’s a few things
that we’ve been able to do that have helped a lot.
One is just there’s no replacement for space, time.
Again, going back to that less
but better sort of philosophy,
we have something we have called mind days,
where once every other week, we have Fridays in effect off,
allow people to just create the space they need
to invest in the things, oftentimes outside of work.
We start many meetings with a mindful moment
or even a mindful meditation,
which has been an incredible reset just
to get people centered before they start,
if there’s back to back Zooms, one session after the other.
That’s been a really helpful way
to maintain some level, again, space.
We focus on making sure we invest in mental health benefits,
and so making sure that our teams have access
to high quality mental healthcare
as well as physical healthcare.
And you know, that’s a really critical part of the equation.
And then I think, you know,
community and connection is also a huge part
of creating a safe environment
and really focusing on diversity, equity,
inclusion and belonging more than anything else.
The (indistinct) I think is something
that I think I’ve learned over the years,
just how critical that can be
and how critical that is actually to your mental health.
And so, we spend a lot of time and energy thinking
about how do we support different populations
because their needs are gonna be different, right?
And so, you know,
whether it’s through employee resource groups
or whether it’s by finding other mentors
that can support our communities of color
and other teammates,
it’s really continuing to invest in that.
And I’ll say, we haven’t gotten it all right,
but the thing that we do often is just collecting feedback
and listening to, and adapting,
because we’re not by any means in a post-COVID world,
but we are in kind of a new phase of that.
And so we’re now learning to adapt
and create kind of benefits and experiences for our teams
that can make them most effective.
I think the last piece of this
that’s actually been really helpful
from an operational standpoint is actually,
very tight goal setting,
like being really explicit about not more, but less,
not harder, but easier, right?
Not adding resources,
but figuring out ways to subtract them.
And like, I know my mental model in the early days was like,
it was the opposite of all those things,
which just made this all that much harder.
And you realize when you look back, like,
you know, it’s, what’s the shorter version of that email
that the person receiving it might be able
to actually respond to in a faster way,
and allows them to get back to their family, right?
Is this actually an hour long meeting
or is it a minute long–
[Madhu] Email. - Email, right?
So, like modes of communication.
There’s like all of these ways where you can start
to create just a more sustainable work environment, right?
And like, you know,
I think back to my days in consulting or otherwise,
like, I was programmed,
I can’t speak for all of us,
but I know I felt like I had been programmed
that you had to do more and you had to run through the grind
and that was success, and it’s just not.
And I realized, like looking back,
if I actually constrained the problem, gave it some time,
but gave myself time outside of that work
to be more effective,
I was gonna be far better
at the time I was spending at the job.
- That’s great.
I think, it’s definitely refreshing to hear
that Headspace helped promotes a culture
that really serves the diverse populations.
I can say for a fact that that’s not what we see
in most companies.
So, it’s really refreshing to hear that.
Thank you for sharing.
So here at Haas, we really care about diversity,
and in this case,
you know, the intersection of healthcare and diversity,
and we’re always looking to learn
how to design products and services
with an equity-focused lens.
As a fellow South Asian and person of color,
I assume you are aware of the cultural challenges
that come with maybe serving populations
that are not as willing to accept
or acknowledge mental health solutions.
And so to that end, I’m just wondering,
have you in your career so far encountered those challenges?
Sure, you have.
And if that’s the case,
how have you overcome those challenges
to be really able to serve diverse populations,
especially, when we think about some
of those cultural barriers,
and serving different geographies?
- I think, there’s kind of a few dimensions
to that question.
So, what’s really fascinating,
actually, the first thought
that’s coming to mind is when COVID started to hit
in February, or when we started to see it show up
in the conversations people were having with their coaches
and their clinicians,
they used different language to describe it, right?
They might have used their native tongue,
they might have described kind of different scenarios,
but there was a commonality across all of them,
which is to say, workplace stress,
relationship issues, sleep, anxiety,
there’s like, those are the top four or five,
no matter geography, no matter the day of the week,
month of the year, that if like persisted
that were true in Italy, in Japan, in Brazil,
in the United States.
And obviously, we don’t have representative data,
across the globe,
but what we found was
that there was actually a lot of consistency
and you actually have to tailor the experience
to meet those specific needs, right?
And so, the core fundamental issues
that people were experiencing were universal,
around mental health challenges,
but you couldn’t create a one-size-fits-all solution.
And what that meant was you had to recruit a provider group
that reflected the populations you served.
So, making sure we had coaches and clinicians
that came from the communities
that we were trying to support.
It meant recruiting a product, design,
engineering operations team
that can represent and understand those populations
that meant especially recruiting a marketing
and communications group that could speak
to the different variations
in each of those different regions.
And so, I think that’s something
that’s one way we’ve done it is both
from a recruitment standpoint,
thinking about ways where we can actually recruit
from the populations we’re looking to serve,
so we can serve them more effectively.
I think there’s another aspect of the question,
which is there are just certain populations
for whom it’s much harder to get care.
And you know, I shared the example certainly in India,
and a lot of South Asian communities where again,
it’s just the no-go zone.
You just don’t talk about it, people shut down.
And I didn’t realize that that wasn’t even a thing
that was happening at the time.
And I look back and now I see it’s exactly
what was happening.
And as a result, you don’t seek access to care
and things get far more pronounced than they should
for more chronic than they should.
And so, prevention is a huge part of, I think,
the solution and something that we’ve really focused on
through meditation and coaching and content services,
which are easier for a lot of communities.
But again, especially,
places where there’s a high stigma
that it’s much easier to talk about something like sleep,
than it is to talk about something like depression
or bipolar disorder, right?
And so those are more approachable on ramps
for those populations to really start to engage.
But then once they engage, if they need clinical care,
getting them outta care as fast as they can.
And so figuring out ways to reduce the stigma
in those populations, I think, is a big part.
And then I’d say the last piece of our strategy,
and it’s something that I’d say in full transparency,
we’re evolving and trying to get better at is,
getting better data about what works for whom,
when, and how.
Because we know there are gonna be some differences
in the way that we treat or support different populations.
And so, we need to be able to measure that
and understand it,
have that feedback into the product development cycle,
and then tweak the product then,
and by product, I mean the combination of the technology
and the care providers to really be able to then deliver
on that experience.
And we may discover that there are certain populations
for whom we’re actually not a great fit,
like we don’t do a good job.
And if that’s true,
it’s our duty to really find other groups
who may be building very specific targeted solutions
for those populations
that can get them the support they need.
They can figure out how to remove the friction
that they need.
So, I’m hopeful because I think technology in particular,
and a lot of these solutions are increasingly focused
on ways to remove friction.
And from so many of these communities,
there’s just a lot of friction.
Let’s continue talking about challenges,
but now, let’s talk about challenges that come with a merge.
With a merger, you say?
Yeah. - Yeah.
Ginger and Headspace merger is one
of the most exciting ones that happened,
and creates new opportunities for the two companies
to deliver, add it to value to the existing users
and for the future ones as well.
What do you think are the challenges that you
and your leadership are facing with this merger?
And what do you think are the victories
that have occurred because of this merger?
- Victories, I like that.
I wouldn’t go that far yet.
I would say as is often the case,
it’s almost always about the people.
And so, I think the hard thing is merging two teams means,
you know, merging two groups of people.
And I think that the fortunate part
about the Ginger and Headspace merger had been,
you know, there were sort of two cultures
or two sets of values
that were very similar, very consistent.
So, that has made kind of overarching this far easier,
but you know, it’s landing different teams,
combining different groups, that’s hard,
you know, that you gotta work through the specifics.
There’s a lot of details to work out.
And so, we were in the messy middle
for some time as we’ve been working
to try to bring those two teams together,
and realize the promise of the vision.
But I’d say we’re getting out on the other side here.
And first step in that has actually,
really just been creating a unified experience
from prevention in the form of meditation,
mindfulness content and behavioral health coaching,
all the way into clinical care
in the form of therapy and psychiatry services.
So, having a full spectrum
that people can actually move between or move amongst
in a seamless or frictionless way as possible is a big part
of the solution.
You know, I think the industrial logic
of the merger was really,
you know, when we first made the pivot for Ginger,
from selling the providers to becoming one,
we talked about the three Cs,
coaching, clinical and content.
Picked two outta three,
meaning you can’t do all the things.
And we largely picked coaching and clinical services,
kind of the people aspect of mental healthcare.
And when we looked around the ecosystem,
the Headspace team had built this incredible content,
this incredible stigma-free brand and experience
that was accessible by hundreds of millions
of people around the world.
And so, bringing the two together actually allowed us
to create this fully comprehensive experience
that went from prevention, that lower lift,
stigma-free experience, all the way to clinical care.
And so, I’d say that’s as close
to the victory categories I’ve put,
which is to say we’ve built that member experience,
and we’ve learned a lot.
We had a number of shared customers.
We’ve rolled out to a number of large employers.
We’ve rolled out to a number of large health plans,
you know, Kaiser Permanente here in our backyard.
Incredibly exciting, we got a chance to roll out nationwide
to all 12 million members across Kaiser,
which has been a huge opportunity to unlock access to care
to many people and really realize this vision
of Headspace Health,
which is this comprehensive mental health solution.
So you know, I think we’re on the first,
I guess, now it’s second year of multi-year journey
to realize that.
And I think we’re starting to discover just
how much opportunity and how much need there is,
because there’s as I’m sure many of you
in the audience know, right?
Over the course of the last two years in particular,
the need is almost doubled.
I mean, it’s more than doubled in certain groups,
and especially, in kind of teens and adolescent populations.
It’s gone even higher than that.
So, we’re on that journey.
I think we’ve been learning a lot,
and we’ve got both some lessons learned
as well as I think some early momentum around that.
- And one last question,
like in the role that you wired right now,
what excites you more for the future?
What do you think is the future for this industry
for the next 10 years, 15 years?
- I’d say looking at all of you, seriously.
I mean, this is a pretty lonely stage.
There was no stage back in the day,
and you couldn’t talk about mental health, right?
You didn’t talk, you didn’t pitch mental health
at the venture firms, you didn’t talk about it in school.
You certainly didn’t talk about it at your job.
And I think that’s starting to change.
So, I’d say I’m hopeful for the level of investment
that has come in recent years.
I think, there’s a catch-up factor.
There was so much disinvestment or underinvestment
for so many years,
that now people are actually recognizing just
how impactful mental health can be and physical health,
can be on economic productivity.
It can be on so many of these fundamental foundational goals
that we have as a society.
So, I think there’s a lot of investment,
like pure dollars that are coming in.
I think, there’s a lot of new talent
that’s coming into this space that gives me a lot of hope.
I think, we’re starting to see some meaningful innovations.
I think, we’ve seen a lot of noise over the last few years
that’s sometimes made it hard to figure out,
well, what’s real and what’s not.
How do people, I think,
it’s a space where you can’t be fast and loose, right?
You’re taking care of a really challenging situations
for people and privacy and security
and high quality care are just so critical, right?
And so, I think you’re seeing peep signs
that people are making investments
in that core infrastructure
to really create great products and experiences.
So, I’m excited,
I mean, this feels like one of the defining challenges
of our generation.
And I think that we’re actually starting to make investments
that represent that.
And I think we’re gonna start to see what works for whom,
when and how, right?
You know, like we have a version and a vision
for what that could look like at Headspace Health,
but I think there’s gonna be a whole host of solutions
that are gonna start to get created that hopefully,
we can partner with, that we can refer out to,
that we can point people to that are gonna start
to meet that need.
And I think, that’s super exciting.
‘Cause when we talk about mental health,
it’s more than just sitting
on a couch seeing a therapist, right?
And that’s sort of been the defacto,
like what people think of,
when really it’s this huge spectrum of solutions in need
that we’re just scratching the surface around,
and we’re gonna start to actually have,
you know, I think a dramatic impact across society, so.
- That’s amazing.
I think we can jump to Q&A.
- Thank you.
Thank you so much for this.
So, we now have the opportunity
to hear from you the audience.
If you want to go to the back of the room,
there’s a microphone there.
And if you could just identify yourself
and then ask your question, that would be really wonderful.
- Hi, thank you so much for coming to speak with us today.
My name is Vanessa,
and I’m an undergrad student at Berkeley.
So, I’m wondering,
do you believe that in the future of mental health,
will it be solely solved through digital solutions,
which is kind of what we’re seeing right now,
or do you think that we’ll eventually have to marry the bits
and atoms and really involve in person human connection?
- That is a great question.
How many other undergrads are in the audience?
Oh wow, okay, all right.
Starting early. (audience laughing)
Yeah, no, I know that was the leading question,
and I’m with you.
This technology is not the panacea here, right?
Like, it’s not in and of itself the solution,
and it can’t be.
But what technology can do is,
start to solve just a fundamental supply
and demand imbalance.
‘Cause the real reality is,
there’s just not enough providers out there.
And if you look at the training programs,
you look at the universities, you look at the schools,
they’re not creating enough therapists,
and or certainly not enough psychiatrists
to meet the need, right?
And so, I think that the solution here is not an either
or it’s an and,
and it’s virtual solutions or virtual first solutions
for a certain portion of the population
for whom virtual is appropriate.
But there’s a subset of the population
that actually needs to be able to meet in person.
They might even need inpatient hospitalizations
or any sort of more chronic and intensive care,
in which case you absolutely need it.
So, I think we’ve often gotten lost
in the wrong conversation, which is like, is it which one?
And I think what you’re highlighting is,
it’s a both, right?
And there’s no replacement for the human connection.
And there’s not enough people,
so we gotta figure out ways for them
to have the scale they need,
and for us to think about other kinds of care.
Like, seven years ago when
we started behavioral health coaching,
that was a foreign concept, right?
People said, “That’s illegal, not okay, not allowed.”
But it turned out in physical health,
you had nurse practitioners, you had physician assistants,
you had all these clinician extenders
that were actually doing an incredible job
that allowed the clinician or the physician
to do what they did best,
practice at the top of their license, right?
And it’s the same,
that’s when you think about solutions in this space,
it’s thinking about it from a systems lens
and thinking about, well, what’s the combination of things
that need to come together?
What part can I play and what parts should others play
to help solve this?
So, I’m really hopeful,
and I think that there’s some really incredible innovation
that’s also happening in in-person treatment
to make those experiences actually,
far more member first, member friendly.
Awesome, thank you so much.
[Karan] Yeah, thanks Vanessa.
Hi, I’m also an undergrad.
My name’s Carissa Pham.
That was a fantastic question, Vanessa,
‘cause that was also mine.
But along the same lines,
I think that mental health often isn’t addressed
because it’s not seen, like a broken leg,
you can see. - [Karan] Yep.
- So, how are ways that you’re drawing insights
from the data that you’re gathering
to show that mental health is actually prevalent
and needs to be addressed in all the different geographies
as you mentioned earlier?
- Yeah, you know, it doesn’t start,
so the challenge in this space is that
we’ve used survey tools, right?
Like the PHQ-9 and the GAD-7
that were originally developed by pharmaceutical companies,
Pfizer in this case,
really to justify the endpoints
for their pharmaceutical agents, right?
Their drugs simply, right?
They weren’t intended as a screening tool.
And so, you can identify the need actually
in lots of really interesting ways.
I mean, we see it in the ways
in which people might engage with the app,
the frequency, the duration,
the content of conversations they might be having
with a coach that actually triggers
for them potentially needing more acute care.
And so, I think,
it’s thinking about all the different sources
of “Demand,” right,
of where mental health can present,
and not in traditional ways.
It might be in a physician’s office where according now
to the US Preventative Services Task Force,
you’re required to or you will be required
to screen for anxiety and depression
as part of general primary care treatment.
So, that’s gonna be a really powerful way.
But the challenges is,
you’re gonna discover all this need, and then what?
Where do you send them?
You’re gonna wait in line for months, not even weeks,
months, as I’m sure many of you know,
to seek access to care.
And so, you know, I think,
there are unique data sources you can start to tap into
that can identify need,
but I think so much of this comes down
to just reducing the stigma and allowing people
who may not even know they have mental health issues
to get some sort of help, whatever that might look like.
Thank you. - [Karan] Thank you.
Hi, I’m from B School MBA.
Basically, my question is related
to the concept of profit maximization
that we are all thought of that is something
that we are all very fond of by fall, by now.
But mental health being basic human right in the world,
like how do you see these companies coming, you know,
basically using tech as a source and then data
and then building tools on top of it so that we all get?
But the idea is,
only privileged people are getting the access,
but there are so many people
who are not getting the access of this.
Is there any way where because you have been living
in this industry for 10 years,
what do you think, what are the other ways
where you can build tools for people
who doesn’t have access to these kind of things,
especially, developing nations?
What was your name? - [Tarun] This is Tarun.
Tarun, nice to meet you. - [Tarun] Thank you.
So, I think there was a couple parts to your question.
So one is, you know, for companies
or for let’s say businesses who are profit maximizing,
their most important asset as their people, right?
And for far too long, they’ve underinvested
in mental health resources for their employees.
And so, one powerful force in this are employers,
particularly, self-insured employers
who pay for health insurance for their teams
to really buy solutions that allow their teams
to get access to high quality care,
because traditional health plans, if not,
have limited access, right?
And so, I think that’s a really powerful kind of mechanism
to start to generate the kind of change that we need.
The second I think you’re describing is,
how can governments and or other bodies actually play a role
in drive unlocking access,
especially, for communities
who can’t afford it otherwise, right?
Medicaid in this country and or other populations abroad.
And I think the challenge there is,
right now, cost of care is going up not down.
Which means, for those of you who,
as you know, in your profit maximizing course,
will know that the number of people you can serve,
is gonna drop as a result.
So, the focus has to be on supply site innovation,
has to be on figuring out ways
to pull costs outta the system,
unlock access and reserve the expensive resources
to those that actually need that level of care.
And so, I think it’s solutions and technology,
can certainly play a really critical role
in dropping that cost per covered life really, right,
or cost per engaged member.
If you can catch them early,
if you can catch them in a preventative context,
you may not need eight to 12 courses of treatment.
Maybe you need a five-minute meditation,
maybe you need any number of conversation
for a half hour with a behavioral health coach, right?
And there’s, obviously, I give the Headspace examples,
but there’s lots of other examples of solutions
that actually allow us to solve this at a systems level.
- Thank you.
Is there anything Headspace is trying to do
in this road to make sure that the access
to mental health will be served to people
who doesn’t have even privilege?
- Yeah, no, I think it’s foundational
to how we think of the world.
I mean, our mission and our vision is a world
where everyone can be kind to their mind,
and everyone means everyone.
And so that’s taken the form of giving away access
to healthcare providers, to teachers,
to specific communities we know were particularly need.
It’s including increasingly working with government payers
to actually cover the cost of some of the care
that we’re delivering,
and we’re gonna continue to go down that path.
So, something that we know we can’t do alone, to be clear,
we’re gonna help support from our specific lens,
but again, we’re looking to partner,
and I’m hopeful that more and more people are gonna start
to support and target those populations,
because there’s such a massive need.
Thank you so much, yeah.
Thank you so much for being with us today.
I’m Alina, second year MBA exchange student.
Can you please share your view on experiential medicine,
and do you think it will take bigger pace
in their treatment over the drug medicine
that we currently used to have?
And do you believe that such technology as gaming, VR, AI,
will actually develop this and will change the way
how we approach the healthcare,
both mental healthcare and just the regular healthcare?
- Yeah, great question.
I’m very bullish on it long term.
I think there’s no doubt
that these sorts of solutions are gonna be a part of
what changes the equation here, right?
And you know, virtual reality therapy
or exposure therapy, for instance,
for specific targeted use cases,
are already showing an incredible amount
of clinically validated data, right?
And so, there’s no doubt that I think that’s gonna be true.
I think the challenge is gonna be figuring out
what’s the right economic models
or what’s the right payment models
to actually support those sorts of innovations?
Because traditionally, most of medicine is still fee
for service, and you’re paying per transaction or per visit,
and those visits aren’t considered a visit.
And so, I think it’s gonna be increasingly, you know,
companies like us and others that are focused
on ultimately value and value-based care
that actually are really interested
in potentially offering those kinds of solutions to members.
If it gets them better and we know
and we can prove that it gets them better,
and we can do it in a cost-effective way, that’s fantastic.
I think, the challenge right now is that most plans,
health plans in particular,
where most of mental health is paid for,
don’t operate in a value-based care environment.
So, they’re not incentive
to really roll those kinds of tools out there.
But as we start to develop more evidence of the success
of not only the clinical efficacy but the economic efficacy
or ultimately, the cost savings that could result from that,
we’ll start to see some significant adoption.
- Great, thank you.
What timeline do you think we are talking here,
like it’s a three year, five year,
10 year, 20 year? - Don’t ask me that.
Clearly, I’m not good with time.
I know it will happen.
- [Alina] Okay. - It’s just sequester way.
No, I think it’s gonna take longer than all
of us would like. - [Alina] Oh no.
And so, I actually think just as a PSA for everyone
in this audience,
it’s gonna take you longer than you’d like to do the thing
that you wanna do in healthcare, that’s been true.
And especially, in mental healthcare,
even if you can’t take the last two years and extrapolate
that out, right?
Like, you’ve gotta extend the timeline,
so you play the long game.
But if you play the long game and you’re willing to do that,
and you’re willing to go deep and invest
and invest in relationships and find incredible people
and actually really understand and study the space,
it’s gonna happen.
And it’s just a question
of can you figure out the right sequence
in the right order to be able to do that?
So, I’m hopeful,
you just have to have enough in the tank to survive,
until you can thrive. - [Alina] Thank you.
- Hey, thank you, Karan.
My name is Kai, I’m an MBA student here.
So, a lot of digital health companies have been struggling
in the past year,
especially, after good day go public like Tyler (indistinct)
and his and hers, mental health American,
well, they had a bad first half of 2022.
And so, I’m just wondering
what’s your post-pandemic playbook
to navigate those challenges?
And another thing I like to ask is,
how do you influence the government
to decrease the restrictions on regulatory
for digital health?
I know Biden administration has been trying to do something,
but it’s still far from desirable,
so like to hear your strategy, thank you.
- Yeah, two big questions.
I’ll go backwards.
So, I’d say we’re moving in the right direction
for mental health to be a part of a number
of now pretty large presidential speeches is meaningful
and it’s insufficient.
I think, there’s far more that we need to do here.
And I think a lot of it has to do with payment model reform,
payment model innovation,
and the more we can start to pay
for alternative forms of treatment, right?
Not just a visit, but continuous outside of clinic care
and these other tools are these other solutions,
the more we’re gonna create product innovation,
like that product innovation,
follows business model innovation.
And so, that’s something that I think,
we’re really excited about and continuing to advocate for.
And as part of a variety of other groups
that are thinking about ways to do that.
I think, the other big one in particularly,
in mental health care is,
just the challenging state by state licensing regulations,
which in effect trap supply or clinical supply in states
that may have excess and not in states that don’t.
And so we’ve gotta find a way to fix that problem.
So, I’m hopeful that’s gonna take longer, I think,
than all of us would like.
But I think again, we’re moving in the right direction.
We’re starting to see some signs
that some of these payment model innovations
in particular, that health plans are starting to compensate
for these sorts of solutions can actually bear real fruit
and can show, and that you can actually bend the cost curve.
And as soon as you start to do that,
things start to get adopted much faster.
And I think that almost ties to the first question
or first topic, which is, yeah, it’s hard.
I think, expectations were inflated,
and you’ve gotta really be able to set realistic targets.
You’ve gotta have sound business fundamentals.
There’s no replacement for strong unit economics, right?
If your unit economics don’t work,
don’t pour a lot of cash on the system, right?
‘Cause you’re not gonna actually,
produce a lot of ultimately profit,
you can plow back into the model.
So, I think some of
that is sort of people peeling back the layers
and starting to look and see,
okay, well, what were the unit economics in this business
where they largely really just driven
by a whole lot of top of funnel marketing?
Or is it really fundamentally,
some sort of product innovation that’s actually driving,
a sustainable competitive advantage?
And I will say, like the flip side of this is,
it’s incredible that we have a number
of digital health public companies, right?
Again, most companies in the past were largely biotechnology
or other firms, there wasn’t care or service delivery
or tech-enabled service deliveries,
companies that have actually gone public.
So, I think they’re blazing the trail,
and I’m hopeful they’re gonna continue
to attract more and more capital into the space.
[Kai] Thank you.
We have time for one last question.
Oh my God, stress. (audience laughing)
Hi Karan, my name is Molesha.
I’m an undergrad student at Haas.
Thank you so much for your time, first of all.
I actually have a two-part question,
surrounding making intentional choices.
What I’ve kind of noticed
as an undergrad is society has a set rhetoric
of what success looks like,
and we’re kind of conditioned to believe
that’s what we want.
So, the first part of my question is,
how did you differentiate what you wanted versus
what was expected of you?
I mean, having gone through the five years of consulting,
and then realizing, looking back now,
are there any frameworks that you would kind of impart on us
to be able to better navigate that decision?
And then the second question that I had was,
how did you navigate the ambiguity
and the risks involved with entering a space
that at that time hadn’t been disrupted yet,
and kind of weigh the stability that you had in your life
with this motivation and desire
to wanna do something different?
Because yes, impulse is important,
but then with these things you have to be very calculated
about whether something’s gonna be feasible,
‘cause it is like your life that is gonna change, so.
- No big deal.
Those are two incredible questions.
We could probably spend a whole hour talking about that.
There are two books that were really influential in my life
that came to mind as you were talking
about the first and the second.
The first is “Measure of a Man,”
measure of a person, it’s by Sidney Poitier,
who’s the first African American to win an Academy Award.
And the whole book was really about
how we’re conditioned to measure ourselves against
what others think of us.
And the key to happiness in his words,
was “To measure yourself against yourself.”
Just do you, focus on you first.
And I just did not understand that.
And for so long, and especially,
for I’m sure, I mean if you’re in this room,
you probably have some elements of this achiever mentality.
Like, you’re constantly measuring yourself,
against other people’s rubric,
and you’re always gonna lose that game.
There’s always gonna be someone who’s done it faster,
better in a more impactful way.
And I just realized that I was just not,
if I kept doing that, I was never gonna be happy.
And so, I spent time,
I did this exercise,
it’s called In My Perfect World,
and it was basically from a personal family and work.
Like, what did I want?
What did it look like?
What did it feel like?
What did it tangibly, like when I woke up in the day,
what did my day look like or my week or my month look like?
And then I could fashion my work to reflect that.
The second part of your question was,
there’s a book called “The Power of Regret” by Daniel Pink.
He wrote a book called “Drive,”
about mastery, autonomy, and purpose.
And one of the main kind of themes in this book was,
I forgot what he calls it,
like the boldness regret, the idea that most people’s,
one of two biggest regrets are connection,
like to other people and boldness.
You didn’t take the leap you thought you could.
And I think so many people,
especially, in business school and graduate school,
but to some degree in undergrad,
I kind of felt like I had to do the same thing.
I had to hop into consulting ‘cause that’s what people did.
And I didn’t really think about,
well, what do I really want?
Like, what gives me purpose?
What gives me a sense of understanding?
And focus on that and then craft a world around that,
and that’s not easy.
Didn’t have a nest egg.
There’s real risk around that.
Starting a company without a nest egg,
it didn’t have a fallback plant.
And so that’s really hard, and it takes a toll,
but I couldn’t shake it.
I knew even if I didn’t do this, I’d be doing this.
And so, I ultimately realized like this was a path for me.
And it’s not for everyone,
but two good books that might give some frameworks
that could be helpful.
[Molesha] Thank you so much.
Yeah, my pleasure.
- So, that concludes our evening.
We really wanna thank you, Karan,
and our student moderators for a really insightful
and powerful evening.
We also wanna thank you, Michael Martin,
for making this evening possible.
Thank you so much everyone.