Massage-booking platform Urban responds to reports of alleged sexual assaults by some therapists

Urban, a popular UK-based startup that allows customers to find self-employed massage therapists who can be booked to attend customers’ homes, has been named in an investigation into alleged abuse by unlicensed freelance therapists.

The startup has raised $35.7M from investors that include the likes of Felix Capital, Passion Capital, the London Co-Investment Fund, angels from a network of Harvard Business School alumni, and others. Originally launched in 2014 “Urban Massage,” the startup has ridden the wave of Uber-like, gig-economy services where a service provider could be booked via an app and they would magically arrive.

But last week, the startup was cited in a BBC story that described the practice of alleged sexual assaults by home-visit massage therapists. Specifically, the news report does not suggest that Urban is complicit in the assault, but it cited two different cases — one that has resulted in a conviction in court — where the therapists in question advertised and were booked through Urban.

In one of those cases, the BBC report details how the platform was slow to respond to the complaint: three years after the customer filed a report with the police and reported the therapist in question to Urban, the BBC could still find his profile on the site. (It has since been removed.)

These do not appear to have been isolated incidents. Separately, TechCrunch has also spoken to another woman who alleges she was assaulted by an Urban massage therapist. She too said she could still see the therapist on the platform, despite her reporting the incident to Urban. (She chose not to detail her experience for this story.)

Urban is by no means the only way that consumers can find and book massage therapists. The BBC said it “heard from dozens of women who have been sexually assaulted by massage therapists in their own homes.” But with two of the cases cited in the story originating from sessions booked on the Urban platform, it highlights a problem that persists across a number of gig-economy marketplaces: too often the platform operators are getting caught out with bad actors using the platform, raising questions about how effective its screening processes are.

It also highlights problems specific to the wellness industry in the UK, and specifically around masseurs and how they are regulated. Under current UK regulations, massage therapists do not need a licence, nor any formal training, to start practicing massage. There is one accredited register of practitioners, but the listings are voluntary, meaning many therapists do not appear on it.

Additionally, only some local councils require premises offering massage therapy to have a business license, which can be revoked in cases where there might be complaints lodged against its practices. In any case, this would not cover gig-economy massage therapists who might visit a home. In simple terms, in the UK at least, anyone can claim to be a trained massage therapist.

The BBC report outlines how a woman called Taylor — not her real name — alleged she booked an at-home massage on the Urban app in October 2019. Unable to find a female therapist who was available, she booked a male therapist with hundreds of positive reviews.

Taylor told the BBC the massage therapist committed a serious sexual assault on her during the session, which was subsequently reported to both Urban and the police – who later dropped their investigation due to a lack of evidence.

Urban said it would remove the therapist from the platform, but the woman claimed the therapist’s profile was still accessible two weeks later.

BBC News then found his profile was still visible three years on from the incident. It was only removed after Urban was contacted by the BBC.

Urban says customers are not able to book a therapist against whom a complaint has been made, despite their profile being visible.

A spokesperson for Urban told TechCrunch: “The [BBC] article refers to a long delay before a deactivated therapist’s profile was removed from the app. While the practitioner’s access to the platform was revoked immediately upon receiving the complaint and delivered no further appointments, their profile was still visible if you had their name or unique link. This was our mistake and falls below the high standards we set for ourselves at Urban. On 21 June we revised the app and website so the entire online presence of a practitioner on Urban is removed on deactivation.”

Urban told us therapists are required to undergo rigorous vetting – including a DBS check which was introduced in 2019 – and insist only a tiny fraction of their bookings have resulted in a complaint. The firm said all complaints are taken seriously and investigated.

So why did it take so long to introduce this DBS check, since Urban was started in 2014?

The Urban spokesperson said in response: “We continuously advance our trust and safety protocols in the absence of regulation. This has improved the trust and safety protocols of the industry and we’ve seen other platforms following our advancements.”

TechCrunch asked Urban about what safeguarding is put in place in a scenario where a male therapist’s profile may have hundreds of positive reviews simply because the women are too afraid to come forward.

A spokesperson for Urban told TechCrunch: “Users are not required to leave a rating, and should anyone wish to make a report in confidence, our team is here to support them.”

Although in theory one does not need any license to practice massage therapy in the UK, Urban said they go through other kinds of vetting:

“All professionals who join our platform go through a rigorous vetting process including a DBS check, assessment, qualification checks to the min standard of level 3 UK recognized qualification (BTEC, ITEC and the like – we do not accept anyone with short courses), insurance check, ID & right to work check and COVID compliance,” said a spokesperson. Users can request qualifications for any therapist booked on the platform.

In addition to that, it also provides support services, the spokesperson added. “We have a robust support system in place. This includes both internal and external trust and safety committees that inform our processes and complaints procedures as well as a quality assurance team. We work closely with the police and our partnership with The Survivor’s Trust provides us with education and guidance on prevention policies.”

Urban said the number of complaints relating to any inappropriate behavior is a at 0.02% of all of bookings historically, giving it a notional ‘safety rating’ of 99.98%.

On Google Ads, Urban claims to have taken over one million bookings. Simple maths show that 0.02% of a million is 200, although there is no suggestion that this is an accurate number of serious complaints and does not reflect the nature of a complaint.

On the the 0.02% complaints rate, Urban’s spokesperson commented:”We categorise “complaints” as any reported event, and this includes reports by the client or the practitioner of suggestive behaviour or assault. Some of the incidents will be unfounded. The majority of these incidents arise from suggestive behaviour from clients rather than complaints made against practitioners.”

Urban said it does not allow therapists to message clients off-app. “This is against our policy. We encourage all users to communicate via the app only,” said the spokesperson.

The company also noted that it has also put in place internal training process for customer service team members around what is and isn’t a sexual assault.

“We have a zero-tolerance policy towards any behavior that makes anyone feel distressed, uncomfortable or intimidated, even in subtle or ‘small’ ways,” said the spokesperson. “We are a silver-accredited Trauma Informed Employer, which recognises the training we have in place to make sure incidents are handled sensitively and employees are supported.”

Urban says it would “welcome” more regulation of the massage industry, but it begs the question of what that would look like.

“With physiotherapy and osteopathy, there are central governing bodies such as HCPC and GosC whereby complaints are registered industry-wide which can lead to disqualification of a practitioner. We support such measures for the massage industry,” said a spokesperson. Urban added it is “continuing our dialogue with government and minister on the topic of introducing regulation for the industry. Urban is the only commercial organisation pushing for this.”

Controversy

This is not the first time Urban has attracted controversy.

In 2018, TechCrunch reported that it had leaked its entire customer database, by leaving its Google-hosted ElasticSearch database online without a password.

This allowed anyone to read hundreds of thousands of customer and staff records. Anyone who knew where to look could access, edit or delete the database. Urban pulled the database offline after TechCrunch reached out.

The leak exposed more than 309,000 user records, including names, email addresses and phone numbers. One user, who did not want to be named, said the data exposure was a “huge violation” of her privacy. Among the records included thousands of complaints from workers about their clients, relating to sexual misconduct.

At the time, chief executive Jack Tang said in a statement: “Urban is looking into this as a matter of utmost urgency. We have informed the ICO and will take all other appropriate action, including in relation to data and communications.”

Urban’s investors

TechCrunch contacted the investors in Urban to ask for their comments on this story.

Passion Capital sent us this statement:

“It’s terrible when anyone is assaulted and even one victim is one too many. As investors in Urban since 2014, we’ve always been proud to back the company in its mission to deliver wellness to more people at their place of work or home — but especially because of the company’s industry-leading trust and safety protocols for customers. Any professional on the urban platform has to undergo a DBS check, assessment and minimum standard of level 3 UK recognized qualification, among other criteria. While there’s still more work to be done (particularly across the sector at large) and we’re always looking for further improvements, the company’s incident rate of 0.02% is a testament to its commitment to customer safety.”

A spokesperson for Firestartr sent TechCrunch the following statement: “As early seed investors in Urban with Passion Capital, we always encouraged the company to implement best practices to ensure the safety and wellness of both therapists and clients at home. However, we cannot comment further because Firestartr did not hold a directorship in the company and was not involved in any board-level efforts to address this topic.”

A spokesperson on behalf of ADV said: “Sexual offences are horrendous crimes and we are saddened to hear about these allegations. As a business we take any allegations of this nature incredibly seriously. We also expect our investee companies to take these matters with the same seriousness.”

We also asked for comment from other Lead Investors in funding rounds for Urban. Felix Capital is referring media to Urban’s statements. BNF Capital had not responded by time of publication.

A former Urban masseur, Cosmin Tudoache, was last year jailed for five years for raping a woman who had booked his services on the Urban app.

The woman we spoke to who alleges a sexual assault by an Urban therapist (Urban denies the assault took place) told TechCrunch that as a consequence of her experience she no longer allows men in her home without someone else being there: “I no longer do 121 training sessions with my male fitness coach and my home cleaning company has an alert on my account to say I cannot have male cleaners. It has fundamentally affected my life for the long term,” she said.

Egyptian health and wellness platform Esaal raises $1.7M to scale across MENA

There’s a vast unmet demand for medical consultation in developing markets like Egypt due to low doctor supply. As of 2018, Egypt’s doctor to citizen ratio stood at 1:2,000; you can paint a picture when you walk into any government hospital and see long queues.

These problems and pandemic-changing habits have resulted in an uptake in doctor-booking and consultation apps across Egypt and the wider MENA region.

Esaal, one such platform that has witnessed immense growth in the last two years, is announcing a $1.7 million seed investment from A15; this brings its total funding raised from the VC firm to $3 million since its launch in 2018.

Esaal isn’t only in the business of consultations on physical health. It also addresses problems in other segments, such as mental health and nutrition.

According to reports, there’s a growing mental health crisis among MENA populations where 35% are experiencing frequent stress, 29% are suffering from depression, and obesity records new highs among adults. For most people, these illnesses linger due to the stigma associated with going for therapy or talking about issues affecting their mental state.

“There is high demand when it comes to needing to talk to someone specialised in mental health. But most people have a fear of going physically to a centre to see a therapist or psychiatrist. It’s not common still; people would love to do it,” said Fadi Doss, Esaal founder and CEO.

Doss further narrated how he’d browse on social media platforms and see people feel comfortable sharing personal problems, sometimes behind pseudonyms, while receiving feedback from other users who weren’t specialists in the subject matter. That trend pushed him into developing a platform that captured this virtual opportunity but with therapists on the other end.

“We decided to have a platform that connects the user to the expert, where he or she can get a personalised and real answer for health concerns in a straightforward and smooth way,” he said. “And if we talk about nutrition, it’s becoming a bit trendy here in the region because obesity among adults is becoming quite high. We can see people started to care much more about their nutrition and wellness.”

Esaal has enlisted over 350 consultants on its platform. They provide consultations on a broad range of issues, including anxiety, physiotherapy, paediatrics and nutrition. Users access these services via an app (text, video/voice calls and in-person visitations) and pay with cash, credit cards, Vodafone and Fawry.

Esaal

Image Credits: Esaal

The Egyptian healthtech company also employs a B2B2C model where it has partnered with over 10 medium to large companies to provide these services to their 5,000+ employees. Esaal currently charges subscription fees and on-demand consultation fees with plans to make money from in-person visitations in subsequent updates.

Like most healthtech platforms, Esaal was one of the beneficiaries of the pandemic-induced lockdown that opened up opportunities in healthtech. Between 2020 and 2021, its user base grew 55% and currently stands at over 1 million. The company’s revenues and ARPU also increased 250% to $4.4 million in 2021 and 130% between 2020 and 2021.

Doss said Esaal services are available in 7 other countries across MENA and the GCC: Saudi Arabia, Tunisia, Kuwait, Qatar, Bahrain, Palestine and Iraq.

The company’s revenues show that it has run a capital efficient business with just $3 million, an investment that came in tranches since 2019 from its sole investor, A15.

“They have been prudent in the deployment of capital to date, demonstrating outstanding efficiencies in unit economics, which has enabled their expansion ambitions,” said Karim Beshara, the firm’s managing partner on the investment. “We are proud to see their growth and enjoyed building the business with them throughout the last four years. There is so much more to come from Esaal and this sector.”

Esaal’s capital efficiency is one way it stands out from its competition, Doss claimed. He also stressed another subtle difference: while other platforms focus on doctor consultations, mental health, or nutrition like Vezeeta, Meddy and Shezlong, Esaal merges the three verticals into one.

The online health and wellness consultation platform plans to use this investment to scale across MENA, invest in product and brand development and hire more talent. Esaal expects a revenue CAGR of around 50 to 60% between 2021 and 2025.

“There’s huge potential going deeper inside every country we are currently in and penetrating more countries in the region. Yes, we launched in eight countries, but I believe the potential is still enormous, and we can get multiples upon multiples in the coming four or five years.”

How compassion and inclusivity are helping Kindbody change the fertility industry

When the topic of fertility comes up, we often hear hushed tones discussing someone else’s or their own journey through infertility. Sure, celebs have begun talking about it, but we’re rarely taught about it in health class. Nor is it typically a topic of discussion over holiday hors d’oeuvres.

At a time when the world is fighting inequities around health and welfare, reproductive healthcare continues to be largely ignored in the conversation. The science and medicine around fertility are presented with an air of complexity that, more often than not, leaves patients feeling lost, scared and alone.

To change a system that’s reactionary instead of proactive is far from simple. To even make marginal improvement, one would need to thread the needle of education, accessibility and perhaps place compassion over profits and growth.

Kindbody appears to be one of the few startups in the space well on its way to tackling this behemoth of a challenge. Its approach is also drastically different from most fertility service providers — it has savvy, intelligent marketing; a tech-enabled and fully virtual care facility; a focus on compassion; and ample customer education to help patients feel involved and understood.

The company today has 12 outlets in ten cities in the U.S. and is fast ramping up its scaling efforts with over $154 million raised so far. Aiming to be a one-stop shop for fertility, gynecological and wellness services, Kindbody provides services to heterosexual couples, single mothers by choice and members of the LGBTQ+ community.

Gina Bartasi launched Kindbody, her third fertility startup, in 2018, after her own journey helped her understand just how broken and antagonistic the system is. With an eye toward inclusivity, holistic care and reducing the friction in the patient process, Bartasi and her team have created one of the few companies in healthcare making a difference.

The first thing I noticed on my fertility journey was that every physician I saw in the fertility industry was an older white male. Gina Bartasi, founder of Kindbody

In this first part of this TC-1, we’ll explore Bartasi’s journey, the problems in the fertility space, the difference that clear pricing and communication can make, and how eliminating the white coats and display of degrees around the offices has helped Kindbody become one of the preferred destinations for fertility treatments.

Addressing how we approach fertility

Bartasi originally ran a media company in Atlanta, but sold it after getting married and relocating to New York City to be with her husband. When she was 38, she and her husband decided to start trying to have a baby, and, like many women a decade ago, were met with an experience that was far from the warmth and care one would expect at such an intimate time.

“The first thing I noticed on my fertility journey was that every physician I saw in the fertility industry was an older white male,” she told me. “I was treated as a subordinate, like the doctor was all-knowing and our mission was to do exactly what he said, even though I was paying $25,000, whether or not I had any success.”

Gina Bartasi, founder of Kindbody

Gina Bartasi, founder of Kindbody. Image Credits: Kindbody

This experience prompted her to launch her first fertility startup in 2008, Fertility Authority, a content platform and fertility clinic review website for those facing infertility.

A few years later, in 2015, the company was renamed Progyny after it was bought by Kleiner Perkins and TPG Biotech. The content platform was maintained, but the company’s focus pivoted to selling fertility benefits to self-insured employers.

While a fertility insurance solution seemed like a great idea, the reality of how healthcare is set up in the U.S. made for some significant roadblocks.

HelloHero raises $7.7M seed round for an online “healthcare system” for kids’ therapy

In a field that ranges from text therapy and AI chat bots, to guided meditation, some mental health startups are pursuing a different niche: therapy for kids. And kids only. 

HelloHero, a company focused on teletherapy for kids up to 21 years old  (the average user is 10 years old), announced a $7.7 million dollar seed round on Wednesday, with a $4.5 million line of credit from Silicon Valley Bank. This round of funding follows a rebrand for the company, and plans to dive deep into data-driven teletherapy. 

HelloHero is the brainchild of founder Syed Mohammed, who struggled with dyslexia as a child, but wasn’t diagnosed until adulthood. After benefitting from therapy as an adult, he has focused on building out a teletherapy program offered through schools or directly to families. That platform was initially called Enable My Child (founded in 2018). But the company has recently rebranded to HelloHero. 

So far, HelloHero has provided teletherapy for 3,800 children total, about 1800 of whom have been served this school year. 

HelloHero isn’t the only player in the teletherapy for kids space (DotCom Therapy, a company founded 2015 to provide therapy through school districts closed a $13 million round this year as well). Although HelloHero does hit some similar notes seen in other teletherapy companies (largely, leveraging clinical expertise to get therapists into schools that may not have them), it’s approach is very technology-focused. Mohammed has spent a lot of time thinking about about using technology to improve therapy itself, and building tools to connect schools, insurance companies, and parents. 

“What we’ve built here is the healthcare system that is connected to payers; that is connected to their families and children; that is connected to therapists,” Mohammed told TechCrunch. 

Any child who uses HelloHero begins with a treatment plan established by a therapist. After every session of therapy delivered using HelloHero, therapists and parents are asked to evaluate the clinical progress a child is making. All of that data is collected by HelloHero’s platform, which, as Mohammed explains, is used to tweak the plan from week to week.

“We have generationally improved how progress is tracked,” argues Mohammed.  

That’s not the only benefit of collecting information this way. Session-level data that links therapy to clinical progress (or lack thereof) has already proved to be a powerful asset for companies.

On a vastly larger scale, ieso, a UK-based text-therapy company which closed a $53 million Series B round in November, has also asked participants to evaluate their progress over the course of treatment. The result is a massive dataset linking certain therapeutic techniques to clinical outcomes (which has resulted in published research). That dataset has become a major attraction point for investors. 

HelloHero appears to be building an outcomes-linked dataset of its own, and has aims to using it to provide more automated therapeutic tools. 

Mohammed plans to develop a data-informed tool to guide therapists through their own sessions. It would provide advice in real time on a therapists’ screen while in-session, based on what has worked (and not worked) before. 

In HelloHero’s current platform, advice is already provided before or after sessions are completed, says Mohammed. But the company plans to bring real-time “on-screen intelligence” to life within the next year. 

Aside from on-screen intelligence, HelloHero has looked to set its platform apart on the backend. HelloHero has built its own electronic medical record system, and a payer platform that’s “connected” to private insurers and Medicaid. 

“I asked our Chief Technology Officer, how much code do we really have, and he explained it: think about us like a regional bank. That’s how big our technology is,” Mohammed said.

As far as the therapy itself goes, HelloHero has two arms of the business: the first is based on direct collaborations with schools. The company is in contract with 500 school districts, and more than 100 are actively providing therapy.

The second arm is a direct to family program, which offers specialized courses for kids and parents (programs include screen time management, or feeding difficulties, as examples). Now, the direct to family programs constitute about 8-10 percent of the business, says Mohammed. Going forward the company plans to invest more in this aspect of the company.

As for this round, the company also plans to focus on recruiting expertise in three areas: insurance integration, child psychology, and technology. 

 

10 ways founders can manage their mental health while fundraising

Entrepreneurs’ mental health and stress management started to be more widely discussed amid the pandemic, but for many seasoned entrepreneurs, the topic is still taboo. Now that the world seems to be inching toward a new normal, some founders, investors and mental health experts find themselves asking whether we need to consider mental health moving forward if it wasn’t an issue before the pandemic.

We do. For one, it absolutely was an issue before the pandemic. Furthermore, what drives the mental health epidemic among entrepreneurs is their propensity to accept risk.

What drives the mental health epidemic among entrepreneurs is their propensity to accept risk.

“Entrepreneurs bring in a lot of vulnerability into their jobs, and when combined with the risks they are required to take, the vulnerability can be exacerbated when those risks don’t work out,” said Michael Freeman, a clinical professor of psychiatry at the University of California San Francisco School of Medicine and founder of Econa. “And in most cases, it doesn’t work out, and so they are more vulnerable to feeling mental health symptoms and entering a downward spiral. The reverse is also true. When entrepreneurs are knocking it out of the park, they are vulnerable to a different set of mental health challenges.”

So how do we address these issues and train entrepreneurs to sharpen and maintain their mental acuity, particularly when things get tough while fundraising?

It’s simple: prevention and awareness. In terms of prevention, Freeman said it comes down to destigmatizing entrepreneur mental health differences, celebrating entrepreneur mental health superpowers and adopting a downside-prevention lifestyle.

“With mental health, as is true with many things medical, an ounce of prevention is worth a pound of cure,” Freeman said. “For entrepreneurs who want to prevent mental health issues, they need to start by taking a lifestyle risk factor assessment.”

According to Freeman, there are five ways entrepreneurs can support their mental health. (If you or someone you know is feeling hopeless and depressed, please call the National Suicide Prevention Hotline at 800-273-8255.)

  1. Sleep. The most significant role of sleep is to help your brain power up and stay awake during the day. Allowing your mind and your body to recover can have a profound preventative effect. You can’t pitch if you can’t keep your eyes open.
  2. Exercise, and make sure you sweat. Entrepreneurs should get at least 45 minutes of exercise a day, including an intensity that makes you sweat twice a week. It not only has health benefits: It enhances executive functioning, meaning it improves your ability to focus and get things done. It also helps you regulate your emotions when you’re listening to a VC completely shred your idea so you don’t become despondent after a call. When you’re fundraising, your ability to think clearly can be the difference between getting a yes and a no.
  3. Get and keep friends that have nothing to do with business. Entrepreneurship is a lonely profession at times. Aside from work, you want to have a small but engaged circle of friends and loved ones, and be careful not to let your relationships devolve into the blur of work. Keep those relationships and allow them to support you when work gets rough.
  4. Eat well, and eat strategically. Many entrepreneurs live at or below the poverty line at some point in their journey, and when you’re under pressure with limited resources, eating junk and fast food is the wrong tradeoff to make because they aren’t good for cognitive functioning, among many other health consequences.
  5. Address mental health concerns in weeks, not months. When entrepreneurs don’t manage concerns quickly, they can turn into adverse outcomes. “If mental health symptoms are prolonged … it can lead to more severe mental health consequences,” Freeman said. “The adverse personal outcomes include anything from experiencing more serious mental health issues to disrupting social relationships and performance falloffs at work. The adverse business outcomes that may result include bankruptcy, losing employees, alienating strategic alliance partners and scaring away potential investors.”

Awareness begins by gaining an understanding of the factors that could exacerbate your stress levels and impact your ability to complete a successful raise, and then planning accordingly. Things that could raise your stress levels include everything from your pre-raise financial status and health history to gender, race, industry attitudes, institutional barriers and even citizenship.

“Entrepreneurs of color, immigrants and women are far more conscious of the glass ceiling,” Freeman said. “It can be a factor in your mental health while you’re raising. … People from groups that have been otherized in one way or another have different obstacles that are difficult to overcome overall, as well as from a mental health perspective.”

Kerry Schrader, the co-founder of SaaS platform Mixtroz, knows all too well how these things can impact you while fundraising. Although she and her daughter Ashlee Ammons did eventually raise more than a million dollars, the pressure of potentially being the next Black women to do so was overwhelming.

“We stopped holding onto the pressure of being the 37th and 38th Black women to raise over $1 million,” she said. “We got caught up thinking, if we’re not successful, then we will be the reason other Black women are not funded. Honestly, we decided to remove that additional layer of stress from our thinking and just focused on running a profitable business that people could get behind and hoping for the same grace the majority of our white male counterparts get upon failure: Another chance and more funding, which we knew was and still is not the norm.”

According to Schrader, there was little information available about how to manage their mental health while fundraising, leading her and her daughter to try a variety of methods before finding something that made sense.

Based on her experience, here are five more ways entrepreneurs can manage their mental health while fundraising.

  1. Find a counselor or therapist to help navigate your increased stress level. There’s a slow shift that has helped entrepreneurs reframe therapy from something that you do as a reaction to being overwhelmed to a preventative method that helps you thrive. “I leveraged BetterHelp to talk with someone while I raised,” Schrader said. “By communicating to a third party, I could say anything. Venting privately allowed me to reframe my conversations with investors more effectively. By having a qualified professional to speak to, I was able to shift my mindset from, ‘You’re doing me a big favor’ to ‘I have an exciting opportunity and I’m allowing you to invest early.’ Counseling helped a lot.”
  2. Give yourself an out. Goal-setting is a great way to keep things on track, but it can create an illusion that you’re not going to be successful if you’re not constantly moving toward a finite endpoint. “Initially, we started putting criteria for what actions we would take if we did not hit certain milestones,” Schrader said. “Instead of feeling like we could put ourselves in a position of failure, we had rules for when it would be time to end the business and go back to our careers. Having an agreed-upon ‘out’ with my co-founder … was great for my mental health. And here we are, years later, still in the game and mostly sane.”
  3. Leverage your team. You can’t go it alone. Be willing to rely on your team to move your startup forward and preserve your health. “Shortly after we closed our friends and family round, I was diagnosed with breast cancer,” Schrader said. “I was going to radiation, surgery and treatments while I was raising. I was pitching from the hospital bed. But when you’re fundraising, it never stops. That’s when my daughter decided it was time to commit full time. As a family, we realized we needed to lean on each other if we were going to be successful long term.”
  4. Remain flexible with your plans. When you’re just starting, you focus too much on set plans. But when you dig into the backstories of prominent entrepreneurs, you’ll find that they pivoted as needed and learned on the go. “There were times during our raise when we had to be able to cope with weekly, daily and even hourly changes to our plan,” Schrader said. “I describe it as buying a plane, learning to fly the plane and then looking for a hangar to refuel all at the same time. You can try to organize all you want, but I don’t know how much planning you can do.”
  5. Be intentional about the type of stress you’re willing to deal with for money. When you’re fundraising, the obvious goal is to secure a check. But some entrepreneurs agree to untenable terms in order to receive capital. It’s important to know your limits before you walk into the room. “When someone thinks they have the upper hand they will try to see how much stuff they can push you for. Don’t forget your why. … When you know what you can take without losing yourself, stand your ground,” Schrader said. “And remember, even as an entrepreneur, declining is always an option, specifically if the decision to decline protects your sanity.”

If you or someone you know is feeling hopeless and depressed, please call the National Suicide Prevention Hotline at 800-273-8255.

Meet the mobile therapy startup backed by Christian Angermayer’s re:Mind Capital

Mental health startup Ksana Health has received $2 million in seed funding led by re:Mind Capital, the mental health VC arm of Christian Angermayer and Apeiron Investment Group. It’s a move informed by two trends: passive data collection, and a burgeoning mental health crisis in teens and young adults. 

Ksana Health is an Oregon-based company founded two years ago by University of Oregon Professor Nicholas Allen, a clinical psychologist and director of the Center for Digital Mental Health. Ksana’s platforms focus on collecting data related to mental health, and transfer that data from user to healthcare practitioners through an app. It’s, in essence, a mobile therapy app with a highly detailed dashboard of patient information. 

The company has twelve employees, and other investors in the round include WPSS Investments, Panoramic Ventures, the Telosity Fund, Palo Santo Venture Fund, and Able Partners. 

So far, Ksana Health has one live product called the ‘Effortless Assessment Research System’ (EARS) which is designed for institutions conducting clinical research. Participants in clinical trials can download an app and opt-in to sharing data including movement, location (via GPS), keystrokes and patterns in written language content with the trial’s investigators (no specific messages are shared). The app’s connection also goes two ways: trial administrators can send out things like surveys to keep in touch with participants. 

The EARS product, says Allen, has already generated about $900,000 in revenue based on usage in clinical trials, but this most recent round of funding is geared towards another product called Vira, aimed at consumers. 

Vira will also passively collect data like exercise (via an accelerometer), screen time, keystrokes or location-based data via a smartphone or smart device. Screenshots from Vira’s dashboard also include sleep data, though that’s not specifically listed as a recorded variable on the company’s website at the moment. Instead of funneling that data to a clinical trial, the data will be accessible to a patient’s therapist. 

The user would give a therapist a personalized code which allows them to access data collected on their phone. Then, a therapist might discuss those habits, and program behavioral nudges to pop up on a phone during the day, reminding the user to exercise, or wind down before bed. 

“Basically what this system does is it allows some of the data that’s been collected by the way people use their cell phones in a day to day fashion [to be turned] into indicators of important health behaviors that we know are relevant to mental health – so things like sleep, physical activity, geographic mobility, mood, cognition, social connection,” Allen says. 

Vira is a major force of forward momentum for Ksana Health. The company was also selected as part of the insurance company Anthem Inc.’s, Digital Incubator program. That inclusion allows Vira to be trialled within Beacon Health Options, a behavioral health company with 37 million members. 

Vira has yet to launch, but the key audience, says Allen, is people 13 to 30 years old. Rates of mental health issues within this group have increased even before the pandemic. 

In 2019, a study in Abnormal Psychology analyzing data from the National Survey on Drug Use and Health found that the rate of young adults (18 to 25) reporting signs of major depression jumped 63 percent (from 7.7 to 13.1 percent) between 2009 and 2017. Meanwhile, there was no significant increase in the percentage of older adults experiencing mental distress or depression in that study. 

The answer Vira seems to offer is extremely detailed data on well-being that will be funneled to a therapist. Data collection in the mental health space isn’t unheard of – Some AI-based mental health chatbots do indeed analyze user conversations, but those conversations happen within the confines of an app. Vira, conversely, is capable of constantly collecting data on a variety of variables that are passively trackable by a phone, and have some bearing on mental health. 

Critically, there are no clinical trials of Vira itself right now, but the concept of the app is based on research that verifies each one of its’ individual parts. For instance, there is evidence that language used on social media can predict mood disorders, and that lack of sleep (or in some cases, excessive sleep) is linked to anxiety and depression

In some sense, Ksana Health is somewhat reminiscent of a cadre of software betting that improving mental health is partially a factor of increased vigilance of digital life, particularly among teens. A.I-based software like GoGuardian for instance, have been used in school to record students keystrokes or search histories, in an attempt to head off student suicides. 

GoGuardian was used in Clark County district in Nevada, the fifth largest school district in the country, and flagged 3,100 potential signs of self-harm between June and October 2020. 

https://techcrunch.com/2019/06/19/risks-and-rewards-of-digital-therapeutics-in-treating-mental-disorders/

Like GoGuardian, Ksana Health is also catalogs digital activity as an indicator of mental health (note the inclusion of key strokes and language patterns, not just health variables like exercise), but Ksana Health’s focus also appears to be less on flagging harmful behavior automatically, and more about providing an extremely detailed data dashboard to a human therapist. 

“Our focus initially is to keep, for want of a better term, a human in the loop,” says Allen. Ksana Health also isn’t AI- based, so it may be harder to scale, but Allen sees this as a benefit, not a liability. 

 “That’s why we’re focused on embedding this within practitioners,” he says. “There’s obvious appeal to the scale of a fully automated solution, you know you can scale it up very quickly. But I think the problems with safety are very significant in those systems.” 

This comprehensive array of data, but particularly the language component, says Jan Hardorp, a founding partner at re:Mind Capital, is one aspect that attracted the firm to Ksana Health. Hardorp will also have a seat on Ksana Health’s board. 

“We believe that language is very strong and variable, and then combined with other sensors, is a very good technological basis in order to assess and predict mental mental state and depression,” he says. 

The move fits within re:Mind’s somewhat unconventional approaches to mental health: Angermayer held a 22 percent stake in Compass Pathways, a company pursuing psychedelics as a fast-acting treatment for depression. That stake was worth about $316 million during the company’s September 2020 IPO. Angermayer’s other public investments span from cryptocurrencies to cannabis

Hardorp says that overall, re:Mind’s activities are focused on one third novel treatments (like psychedelics), one third brain computer interfaces, and one third into technology. Ksana Health fits squarely in that third category. 

Allen says the company is already planning clinical trials of the Vira program in addition to the pilot program with Beacon Health. But Hardorp notes that so far, the lack of clinical trials on Vira itself hasn’t given him pause. He takes the strength of the EARS platform as a signal that Ksana Health’s platform is viable in the real world. 

“We’re quite confident that it’s really the same technology. The Vira product, if you want, is really a new front-end to existing technology and algorithms,” he says. 

At the moment, the Vira platform isn’t commercially available, but Allen is anticipating a launch in the first quarter of 2022. 

 

ifeel, another well-being platform that blends self-care tools with 1-2-1 therapy, scores $6.6M

If the pandemic has been good for anything it’s been good for the therapy business and for startups targeting mental health, with VCs kept very busy signing checks. To wit, here’s another one: Madrid-based ifeel has bagged €5.5 million (~$6.6M) in Series A funding, led by Nauta Capital.

The startup was founded back in 2017 — initially as a consumer-focused therapy platform — but last year it pivoted to a hybrid business model, tapping into demand from businesses to offer staff emotional support during the public health crisis. So it’s available both to individuals via monthly subscription or as part of employer’s or insurance provider’s cover

It says that pandemic pivot has resulted in 1,000% growth in its b2b business.

Companies it’s signed up to offer its platform to their staff include AXA Partners, Glovo and Gympass.

“We have a total of 400K users on the platform (b2c and b2b),” says co-founder Amir Kaplan. “We have 100,000 eligible covered who have access to ifeel as a benefit (through our insurance and wellness partners or direct with ifeel).

“The 100K grew 10x from September 2020 and is the largest trend we are experiencing these days. Employees of 100 companies use ifeel on a weekly basis.”

ifeel’s platform delivers both live therapy sessions with licensed psychologists but also provides users with self-care tool such as daily mood trackers, recommended exercises and activities to expand the support available.

“By combining self-care and guided therapies, ifeel maximises engagement and retention of its users — with 90% reporting improved emotional and mental well-being after using ifeel,” it claims.

The startup is using AI technology in the self-care portion of its platform — to recommend “the most relevant” content or exercise to its users, per Kaplan. But he also says it’s looking at using the tech to assist the therapist practice by developing dedicated tools inside the platform.

ifeel has an international founding team, hailing from three countries (Israel, Italy and Mexico), and says its main markets so far are Spain, France, Brazil and Mexico. While its b2b and insurance network coverage extends to 20 countries and four languages (English, Spanish, French and Portuguese).

With so much competition in the mental health tools space — from mindfulness apps, to internet-delivered CBT programs, to therapy platforms — how does ifeel see itself standing out?

Kaplan suggests it has an advantage of being “global from day one”, and also flags a “strong technology integration focus” which he says has allowed it to plug into insurance companies and wellness players — to become a “main service provider”.

“Very early we partnered with global leading companies and we support them in many countries (compared to specific country players like in Germany and UK,” he tells TechCrunch. “The platform approach is different from ‘online therapy’ companies or ‘mindfulness apps’.

“We want our users to manage their emotional well being on our platform no matter the need. In this way we create millions of engagement events that are customized to the user’s needs and allow users over time to use different parts of our platform in different life situations.”

Daybreak Health launches online mental health therapy for teens amid the pandemic’s mental health crisis

Working with a team of ten trained mental health clinicians, the Y Combinator -backed startup Daybreak Health is working with Bay Area high schools to provide mental health support for teens. 

Alex Alvarado, Siddarth Cidambi, and Luke Mercado, the three co-founders of Daybreak Health, either worked with startups in the health care industry or consulted on the healthcare industry for a few years before deciding to launch their new startup.

For Alvarado, whose brother has been struggling with depression since he was twelve years old, the issue is personal, the founder said in an interview. It was only two years ago that Alvarado received a call telling him that his brother had attempted to take his own life after his decades-long struggle.

It was then that Alvarado began to confront just how broken current treatment methodologies were. His family had tried to find consistent care for Alvarado’s younger brother, but therapists were expensive, remote, had waiting lists that were weeks-long, and had difficulty related to teens (especially teens who weren’t white).

Alvarado’s brother isn’t alone. One in five teens in the US have or will have a mental health issue, Alvarado said, and the nation’s ineffectual response to the COVID-19 epidemic is only exacerbating the problem. Judging by the statistics, there are 7 million teens in the US right now with a mental health condition and rates of depression and anxiety are going up.

The team of ten clinicians that Daybreak Health works with have a deep experience with evidence-based care and Alvarado expects that most of the patients that they consult will be undergoing some form of behavioral therapy guided by those clinicians.

For teens who are experiencing less acute mental health issues, there’s a team of what the company calls “trained listeners” to provide support.

Alvarado and Cidambi both worked at the consulting firm Oliver Wyman and Mercado and Alvarado knew each other from Jiff, a healthcare startup focused on providing wellness benefits to employees at companies, which was eventually bought by Castlight Health.

To ensure their mental health bona fides, the company brought in Dr. Neha Chaudary from Stanford’s Brainstorm Lab, which focuses on innovation in mental health. “They’re actually the ones designing our clinical program from the ground up,” says Alvarado.

Image Credit: Daybreak Health

The company is currently working with 20 Bay Area schools and pediatric groups in the Bay area and is focused on treating teens aged thirteen to nineteen, says Alvarado.

Currently, both schools and pediatric groups are referring patients to the company, and the cost of care is covered either through insurance or through an $89 per-week fee.

“This is a full-stack therapy program,” says Alvarado. “It’s an improvement, in our view [on traditional therapy], because not only are you getting that invidividual one-on-one therapy, but you’re also getting curriculums around certain points in time.”

For the teens, it’s not only about specific interventions to prevent certain behaviors, Cidambi says. It’s also to build up coping mechanisms so teens can better respond to mental health pressures as adults.

Alvarado stresses that the program isn’t for any teen that’s feeling a bit stressed or for parents who’re just worried about their child’s performance. There’s an hour-long intake consultation conducted with both the teen and the parent before a teen can be admitted to the program.

And the company has already turned away some potential customers because they just didn’t need the treatment. “Our goal is not to just bring anybody into treatment.”

Alvarado would not say how many students are currently being treated from its Bay Area partner schools, and says that the schools are a mix of both public and private institutions in the Bay Area.

“Our main touchpoint at the school will be the school counselor or the wellness coordinator,” says Cidambi. Daybreak Health doesn’t pay for referrals but does reach out to school counselors to market its services.

The company is far from the only service out there trying to provide online counseling for teens, TeenCounseling is one service that boasts 5,000 therapists and offers its services from $80 to $100 per week.

“The beauty of what we’re doing is the marriage of the clinical program with the technology,” says Alvarado. “We always want to have the therapist involved. And we are developing a mobile app… that is to communicate… and enable patients to do some exercises on their own, but we never believe that it will be a standalone app.”

“People are in the fights of their lives ” with alcohol use disorders, and Monument wants to help

Over 14.4 million adults over the age of 18 in the United States exhibited some kind of alcohol use disorder and only about 7.9 percent of those people received treatment. Alcohol-related deaths kill roughly 88,000 people in the U.S. — making it the third leading preventable cause of death in the country. And alcohol-related illnesses cost the U.S. $249 billion.

For Monument founder Mike Russell, those numbers aren’t just statistics, but a window into his own life. The co-founder of Monument, a tele-health service that provides access to prescription medication and therapies to combat alcohol use disorders started the business after seeking treatment himself.

As Russell laid out in a Medium post announcing his company’s launch earlier this year, Monument was formed from the realization that Russell had about the availability of alternative treatment options which weren’t receiving the same attention as the rehab clinics and referrals to Alcoholics Anonymous meetings that represent the most common treatment options in the U.S.

Russell, a former nightlife promoter, used to be a professional drinker (the club promotion business demanded it) and even after he left the nightlife world to become an entrepreneur, he remained a binge drinker. That behavior carried through his first failed startup, VenueTap, to his second, more successful foray into the world of tech business creation with MyClean, an on-demand cleaning marketplace.

By the time his third, and most successful startup, Paintzen was acquired Russell said he recognized two things — the first was that his drinking was, in fact, a problem, and the second was that there were alternatives to AA and rehab that he could explore.

Those twin realizations led him to launch Monument, with $7.5 million in seed financing from the same group of investors that had backed him in Paintzen. Those investors, including Collaborative Fund, Lehrer Hippeau Ventures, Red Sea Ventures, Datapoint Capital, Corigin Ventures, and NextView Capital all bought into a thesis that’s captured the attention (and capital) of venture capitalists on both coasts — that treatments for drug and alcohol dependence are investable businesses. 

And while private equity investors are also financing networks of rehabilitation facilities as part of their push into healthcare — venture investors believe that the remote delivery of healthcare services can provide meaningful results without the same expenses that operating a network of locations can incur. It’s not the place, so much as the treatments that are available and the people offering them.

Unlike Tempest, another New York-based startup with venture backing focused on curbing alcohol abuse, Monument is working to connect people with therapists, using the platform as a gateway. Tempest’s approach is built around giving a host of tools as part of a subscription service to get people to stop drinking.

Funding for Monument closed in December 2019 and by January, Russell had penned his blog post and the company began creating its community of users looking for information about ways to overcome their disorders and connecting would-be patients with therapists and physicians who could prescribe medication to treat their conditions or offer cognitive behavioral therapy to try and do the same.

There are four facets of the Monument business.

There’s the free-to-access community of people looking for information and support around their decision to stop drinking and there’s also free group therapy sessions available for community members feeling increased urges to use substances because of added pressure from quarantine restrictions. This is similar to the kinds of therapy sessions that companies like Ro, Hims and others are bringing to market in the time of COVID-19. For community members who want to take the next step with their treatment, Monument there’s the one-time fee to see a doctor who can prescribe medication to suppress the need or desire to drink; and finally, Monument offers two tiers of therapy services for those who want either bi-weekly or weekly sessions.

“We connect members to physicians that understand the medication options or they could opt not to take medication,” said Russell. “[Members are] connected to a licensed therapist that focus specifically on co-morbidities.”

The medication only plan costs $19. A bi-weekly consultation with a therapist and an initial consultation for a prescription costs $149 per month and a medication management plus a weekly therapy sessions costs $249 per month.

So far, Monument has around 700 people on its network and expects to see more members come on board for the free community membership as it launches in California today.

“The treatement plans were available through New York, New Jersey, and Florida for our beta,” says Russell. “For launch it will be those three states plus California and Connecticut.”

While telemedicine providers are able to operate in all fifty states without licenses — thanks to changes in regulations made as a result of the pressures that have been put on the healthcare system from the COVID-19 outbreak — mental health providers still need to be licensed in the states where they operate. “We’re still required to build a supply of physicians, clinicians and therapists that are licensed in each state,” said Russell.

To get the new company off the ground, Russell turned to his co-founder at MyClean and Paintzen, Justin Geller and added Amit Klein, a data scientist as the company’s co-founder and chief product officer.

“The crux of this is data,” says Russell, of the importance of Klein’s role in the company. “As members go into treatment — we’re understanding health outcomes… Someone goes into a plan. Their diagnosis. We understand age, gender, drinking patterns, and then we can see if the treatment that they’re on is working or not.”

And Russell stresses that the company won’t use anonymized data or sell of its insights to third parties.

“It’s a binary outcome,” Russell said of the company’s decision to monitor the process. “We can track success… over time as we treat we build a data set and eventually it becomes personalized.”

The timing for Monument couldn’t be more critical, says Russell, given the increased stressors that the social response to COVID-19 is putting on people’s mental health.

People are in the fights of their lives with their struggles with alcohol,” right now, Russell said. 

“People are in the fights of their lives ” with alcohol use disorders, and Monument wants to help

Over 14.4 million adults over the age of 18 in the United States exhibited some kind of alcohol use disorder and only about 7.9 percent of those people received treatment. Alcohol-related deaths kill roughly 88,000 people in the U.S. — making it the third leading preventable cause of death in the country. And alcohol-related illnesses cost the U.S. $249 billion.

For Monument founder Mike Russell, those numbers aren’t just statistics, but a window into his own life. The co-founder of Monument, a tele-health service that provides access to prescription medication and therapies to combat alcohol use disorders started the business after seeking treatment himself.

As Russell laid out in a Medium post announcing his company’s launch earlier this year, Monument was formed from the realization that Russell had about the availability of alternative treatment options which weren’t receiving the same attention as the rehab clinics and referrals to Alcoholics Anonymous meetings that represent the most common treatment options in the U.S.

Russell, a former nightlife promoter, used to be a professional drinker (the club promotion business demanded it) and even after he left the nightlife world to become an entrepreneur, he remained a binge drinker. That behavior carried through his first failed startup, VenueTap, to his second, more successful foray into the world of tech business creation with MyClean, an on-demand cleaning marketplace.

By the time his third, and most successful startup, Paintzen was acquired Russell said he recognized two things — the first was that his drinking was, in fact, a problem, and the second was that there were alternatives to AA and rehab that he could explore.

Those twin realizations led him to launch Monument, with $7.5 million in seed financing from the same group of investors that had backed him in Paintzen. Those investors, including Collaborative Fund, Lehrer Hippeau Ventures, Red Sea Ventures, Datapoint Capital, Corigin Ventures, and NextView Capital all bought into a thesis that’s captured the attention (and capital) of venture capitalists on both coasts — that treatments for drug and alcohol dependence are investable businesses. 

And while private equity investors are also financing networks of rehabilitation facilities as part of their push into healthcare — venture investors believe that the remote delivery of healthcare services can provide meaningful results without the same expenses that operating a network of locations can incur. It’s not the place, so much as the treatments that are available and the people offering them.

Unlike Tempest, another New York-based startup with venture backing focused on curbing alcohol abuse, Monument is working to connect people with therapists, using the platform as a gateway. Tempest’s approach is built around giving a host of tools as part of a subscription service to get people to stop drinking.

Funding for Monument closed in December 2019 and by January, Russell had penned his blog post and the company began creating its community of users looking for information about ways to overcome their disorders and connecting would-be patients with therapists and physicians who could prescribe medication to treat their conditions or offer cognitive behavioral therapy to try and do the same.

There are four facets of the Monument business.

There’s the free-to-access community of people looking for information and support around their decision to stop drinking and there’s also free group therapy sessions available for community members feeling increased urges to use substances because of added pressure from quarantine restrictions. This is similar to the kinds of therapy sessions that companies like Ro, Hims and others are bringing to market in the time of COVID-19. For community members who want to take the next step with their treatment, Monument there’s the one-time fee to see a doctor who can prescribe medication to suppress the need or desire to drink; and finally, Monument offers two tiers of therapy services for those who want either bi-weekly or weekly sessions.

“We connect members to physicians that understand the medication options or they could opt not to take medication,” said Russell. “[Members are] connected to a licensed therapist that focus specifically on co-morbidities.”

The medication only plan costs $19. A bi-weekly consultation with a therapist and an initial consultation for a prescription costs $149 per month and a medication management plus a weekly therapy sessions costs $249 per month.

So far, Monument has around 700 people on its network and expects to see more members come on board for the free community membership as it launches in California today.

“The treatement plans were available through New York, New Jersey, and Florida for our beta,” says Russell. “For launch it will be those three states plus California and Connecticut.”

While telemedicine providers are able to operate in all fifty states without licenses — thanks to changes in regulations made as a result of the pressures that have been put on the healthcare system from the COVID-19 outbreak — mental health providers still need to be licensed in the states where they operate. “We’re still required to build a supply of physicians, clinicians and therapists that are licensed in each state,” said Russell.

To get the new company off the ground, Russell turned to his co-founder at MyClean and Paintzen, Justin Geller and added Amit Klein, a data scientist as the company’s co-founder and chief product officer.

“The crux of this is data,” says Russell, of the importance of Klein’s role in the company. “As members go into treatment — we’re understanding health outcomes… Someone goes into a plan. Their diagnosis. We understand age, gender, drinking patterns, and then we can see if the treatment that they’re on is working or not.”

And Russell stresses that the company won’t use anonymized data or sell of its insights to third parties.

“It’s a binary outcome,” Russell said of the company’s decision to monitor the process. “We can track success… over time as we treat we build a data set and eventually it becomes personalized.”

The timing for Monument couldn’t be more critical, says Russell, given the increased stressors that the social response to COVID-19 is putting on people’s mental health.

People are in the fights of their lives with their struggles with alcohol,” right now, Russell said.