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San Francisco mental health startup Big Health expands into anxiety

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Anxiety is the most common mental health issue in the United States, with around 40 million adults experience anxiety-related disorders every year.

This population is much more likely to require healthcare services like hospitalization or emergency room visits, adding millions in additional costs to the healthcare system.

San Francisco, California-based mental health startup Big Health is trying to tackle that issue with a new digital therapeutic called Daylight meant to deliver personalized CBT techniques to help relieve anxiety-related issues.

The startup previously developed the Sleepio application, which is targeted at insomnia, and is offered to around 12 million users through partnerships with payers and employers like Boston Medical Center, Comcast and the NHS.

Daylight combines evidence-based therapies like worry scheduling – which helps to compartmentalize anxiety-driving issues – with animations and audiovisual components.

Big Health Medical Director Jenna Carl said that the application was developed in partnership with clinical advisers with expertise in anxiety like UCLA psychologist Michelle Craske and Boston University’s Dr. Michael Otto.

Besides clinical experts though, the company also brought in digital and multimedia professionals from organizations like Pixar and Radiolab to help

“It’s been a challenge for digital therapeutics companies to create products that are effective and engaging,” Carl said. “One of our other big differentiators is we really view the importance of bringing in people who are experts in engaging people through digital media to create digital applications that people will actually use.”

As part of the effort to prove out the technology, the startup has also embarked on two research studies to evaluate the tool’s clinical effectiveness against traditional in-person CBT.

“This is not meant to be a replacement for in-person care, but we still think it’s important that we’re achieving the highest treatment standard possible,” Carl said.

Still, Carl said the company has shied away from validation in the form of FDA approval citing the nascent nature of the digital therapeutics regulatory space as well as their own internal guidelines for keeping in line with “clinical veracity, scientific rigor and ethical considerations.”

That decision contrast Big Health with some of its competitors in the space like Pear Therapeutics and Akili Interactive, which are attempting to create prescription-based digital therapeutics for substance abuse and attention deficit hyperactivity disorder, respectively.

Another recent example is Cognoa, a Palo Alto-based startup which received FDA Breakthrough Designation for its digital diagnostic and digital therapeutic devices for autism.

A few structural factors have led to the adoption and development of tech-enabled behavioral health tools.

One is the simple lack of available mental health providers in the country. A 2016 report from the Health Resources and Services Administration estimated a shortage of 250,000 workers in the field by 2025. Another is the stigma associated with mental health conditions, leading the estimated one in five people suffering from mental health issues, to forgo treatment.

The mismatch between supply and demand has created a potential market opportunity for digital health providers, of which there are many. Some of the other venture-backed companies targeting using technology to offer CBT therapies to patients through payers and employers include London-based Unmind and San Francisco-based Modern Health.

However it looks as if the industry is tipping toward a larger move towards consolidation. San Francisco-based Lantern shut down operations last year after failing to find a viable business model and had its assets picked up on the cheap by chronic care management company Omada HealthLivongo also entered the behavioral health field by acquiring Denver-based myStrength earlier this month.

Behavioral health has also been one of the rare digital health segments where direct-to-consumer business models have thrived.

Case in point, Meditation app company Calm just raised an $88 million Series B financing round led by private equity firm TPG Capital that valued the company at $1 billion.

Photo: phototechno, Getty Images

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