Meeting with mental health experts face-to-face is no longer the only option for individuals looking to improve their mental well-being. The Australian mental health care industry is increasingly adopting web-based technologies to deliver mental health services – for example, real-time communication between patients and professionals can be facilitated through videoconferencing, telephony and online chat programmes. There are two core benefits to delivering mental health services via the web – there are no geographical, attitudinal and financial barriers to access to care and the overall cost of delivery is significantly reduced.
But one local startup Uprise wants to take e-mental health care further, offering companies of all sizes a digital suite of evidence-based therapies, starting with cognitive behavioural therapy (CBT), one of the most powerful treatments in psychology. The startup has essentially stripped down CBT so that it can be delivered online at a fraction of the time and cost – essentially, people can learn skills from the privacy of their smartphone or laptop, and be self-directed in their journey towards good mental health, while still having access to a psychologist.
Uprise, a recent graduate of the University of Sydney’s INCUBATE accelerator programme, was founded by clinical psychologist Dr Jay Spence, who has 10 years of clinical experience treating patients with a range of anxiety and depressive disorders.
Although the current version of Uprise was launched earlier this year, its genesis can be traced back to 2009 when Dr Spence was working in a hospital. He was introduced to a research team that was working on early versions of internet-based mental health treatments in Australia and he ended up collaborating with that team to complete his PhD thesis, which centred on the treatment of post-traumatic stress disorder online.
This research evolved into a technology business.
About 18 months ago, Uprise had a different value proposition and target audience; it delivered courses to help acculturate international university students to Australia. After realising there wasn’t a big-enough demand for such a service among students who were coping quite well with assistance from university-based support services, the startup pivoted. The pivot was also prompted by people repeatedly suggesting that a service like Uprise would deliver greater value to employees, and ultimately, companies.
The startup then restructured itself to target the workplace.
Though there is greater social awareness around mental health, it’s rarely openly discussed in the workplace. However, a culture of silence on mental health has been known to worsen suffering and impact workplace performance – a lose-lose for everybody.
“One in five Australian workers suffers from a mental health condition each year but only one in 20 access the employee counselling programme offered by their workplace and that means thousands of people are suffering from painful symptoms when they don’t need to be,” said Dr Spence.
What Uprise does is it makes accessing specialist mental health advice as easy as logging into an application, watching videos, followed by a 10-minute phone call from a psychologist once a week for three weeks. It’s essentially a stripped-down and straight-to-the-point online course with the added value of having access to a mental health expert.
Dr Spence said, for years, clinical psychologists have operated under the assumption that it’s the therapeutic relationship that helps heals patients. However, 10 years of data shows the same result can be achieved without having a face-to-face relationship with a psychologist.
“If you see a clinical psychologist, they’ll give you research-recommended treatments. As a patient, what you’re getting for the most part, is a suite of tools that come from cognitive behavioural therapy, which is a standard treatment for most mental health conditions. What we’ve done is we’ve really stripped it down so CBT is delivered as simply as possible,” said Dr Spence.
“The videos are about eight minutes long; and what we found is that people usually watch it two or three times to [maximise their] understanding. Add the phone call and it’s enough to put the ideas into action and experience real change.”
Dr Spence doesn’t deny the benefits of having face-to-face meetings with clinical psychologists – for example, such sessions are usually tailored to the patient’s unique circumstances and needs, whereas Uprise, like most online courses, employs a ‘one size fits all’ approach. However, Uprise doesn’t intend to replace traditional practices. It’s been designed specifically for individuals who are time-poor and cannot conveniently attend appointments. People with severe, ongoing symptoms will be referred to a clinical psychiatrist or psychologist.
The combination of instructional videos that teach CBT skills and short phone calls has been proven to be the most effective, according to Dr Spence. It allows people to watch videos at the time of their choosing – most users are watching videos at night – take the ideas presented to them and put them into practice, while also having access to a psychologist to address further questions and concerns.
“The calls are pretty short, not like long telephone counselling calls. Most people in the course say that the phone check-ins are the best part. They’re involved in lots of different online learning programmes – for example, they might be watching a whole series of videos on YouTube – but the additional phone call means they’re able to talk about what they need to do in the next week,” said Dr Spence.
“Uprise is a great way to get an understanding of what happens when you see a psychologist without making it into something big and scary.”
Earlier this year, Uprise conducted a pilot trial of 25 employees working in high stress jobs and found that, on average, three weeks of using Uprise resulted in symptom levels shifting from the moderate range back to normal. Added to that, absenteeism was reduced by 48 percent.
Therefore, Uprise’s online treatment programme has the same outcomes as face-to-face sessions with a psychologist, but is delivered in less than half the time and a quarter of the cost.
However, identifying and executing the right monetisation strategy will be a challenge for Uprise. Currently, it operates on a B2B model, charging companies $50 per employee, with higher charges for people that want other versions or types of support. The problem with the B2B model is that it requires companies to be on board with the cause of promoting mental well-being in the workplace. A lot of companies dismiss the issue, let alone proactively invest in the mental well-being of their employees.
A B2C multi-tiered subscription model is another option for the startup, and may prove to be more effective especially as more treatment programmes and resources are added to the platform.
If Uprise continues to embrace the latest technology – for example, virtual reality, which is being explored as a treatment option for individuals living with post-traumatic stress disorder – it could diversify its offering and expand its value proposition. Dr Spence is fully aware of the startup’s potential to become the platform of choice for tech-savvy individuals – in fact, the near-future plan is to use machine learning to improve Uprise’s user experience. He said he envisions a smart platform that understands what a user might be looking for and then delivers skills based on their preferences.
Within the next couple of years, Uprise will be offering a suite of evidence-based treatments and approaches including CBT, dialectical behavioural therapy, and mindfulness, among many others.
“These are the skills that anybody can use to feel better in moments that count,” said Dr Spence.
“We have to make sure that the way we market [Uprise] is not stigmatising. We talk about [Uprise] as a psychological toolkit that anybody can use to [maximise] their performance. It’s available to everybody; it doesn’t just people who have mental health conditions. We want users to feel like they’re learning a skill rather than feel like they’ve got a serious problem that needs to be fixed by a professional,” said Dr Spence.
To fine-tune its growth strategy, Uprise will be doing paid and unpaid trials with very large companies (with more than 5,000 employees worldwide), medium-sized enterprises and small businesses. After the startup establishes a product-market fit, it will be looking to roll out its offering more vigorously.
Image: Dr Jay Spence, Founder, Uprise. Source: Provided.