At a glance
When it comes to mental health, NZ has some sobering statistics. Each year, for example, one in five Kiwis experience mental illness or significant mental distress.
Yet help is not always at hand. He Ara Oranga – the 2018 report of the Government Inquiry into Mental Health and Addiction – canvassed people from all over NZ who experienced challenges with access, wait times and quality when engaging with mental health services.
Put simply, demand for our public mental health services outstrips supply.
For Kiwi company Clearhead, however, it’s a problem that’s presented an opportunity for fresh thinking – to develop a digital therapist available in your pocket and around the clock.
Designed to provide all the core support you’d expect from a human clinician, Clearhead’s mental health and wellbeing platform provides users with mental health assessments, diagnosis, triaging, referral to mental health professionals, patient education, producing a treatment plan and monitoring clinical progress.
“What we’ve basically built is a superhuman clinician that’s available 24/7 in your pocket and can deliver that support at scale,” says Clearhead CEO and co-founder Dr Angela Lim.
And it can do it all in English and te reo Māori.
Māori face mental distress at almost two times the level of non-Māori, explains Lim, and are disproportionately affected by poor mental health outcomes. So, to help address these inequalities, Clearhead built a te reo Māori chatbot from scratch and released it on its platform during Te Wiki o te reo Māori in September.
Making the leap
Lim is a medical doctor, clinically trained in paediatrics. But when she started Clearhead with CTO and technical co-founder Michael Connolly in late 2018, she had also already amassed a decade of experience in health IT – mostly in governance roles.
While this gave her a taste for the health IT sector, she says the tech initiatives she often saw, while needed, generally offered incremental improvements on what was already available.
“I saw solutions being created that weren’t really going to offer the outcomes we wanted to see; I wanted to use technology in a transformative way.”
Finding product/market fit
Attaining a Callaghan Innovation Project Grant – which contributes 40% towards a business’s R&D costs over two years – helped Clearhead produce the first iteration of its platform.
Developed over seven months and co-designed with more than 500 Kiwis, including 200 clinicians, its focus was to navigate users to available supports. The online platform helps users gain early awareness of their mental health challenges and refer them to appropriate existing services.
Initially Clearhead provided this version of the platform to users for free, with the intention that it would prove itself a cost-effective tool for adoption in the public health system.
But, despite many efforts, that business model failed to launch.
Then when COVID-19 hit, Clearhead realised it needed to respond in a way that better meets NZ’s rising tide of mental health challenges – evidenced by a four-fold increase in suicidal intent expressed on Clearhead’s system post-COVID-19 and a three-fold increase in those turning to alcohol to cope with their challenges.
An obvious development was adding telehealth capability to the platform, but Lim says the crisis forced the business to take a more fundamental look at the value it was offering.
“Our first version was a triaging and awareness-raising system that helped people navigate to existing support – but a lot of that support was to systems that were already overwhelmed. Or, if we navigated people to third-party digital supports, which is helpful, we couldn’t guarantee a seamless user experience,” she explains.
“That’s why with Clearhead 2.0 we focused on developing a digital therapist experience from start to finish, where the user experience is consistent.”
The business developed its own content and resources and expanded the platform to encompass a complete digital therapy experience – moving from building users’ awareness of their mental health challenges through to developing their mental health literacy, resilience, and mindset and behaviour change skills.
Clearhead is now offering the product as a corporate wellbeing solution, working with employers to provide a premium version – including the ability to fund therapy appointments delivered in person or via telehealth on the platform – to their employees. Currently 8,000 Kiwis use the platform each month.
“We had to keep tweaking the product until we could find a market that would be willing to pay,” says Lim. “We’re now at a point where we’re finally no longer pre-revenue, and Clearhead’s achievements are only possible because of Callaghan Innovation’s support allowing us to pursue a strong R&D-first approach.”
Lim says alongside the financial support from the agency, Clearhead’s Callaghan Innovation business innovation advisor, Mark Robinson, has been crucial in helping the startup connect to key contacts and navigate doing business in the health system.
Robinson says while there are a large number of platforms in the mental health support space, it’s the quality of the team behind them that will determine who succeeds.
“Yes, being successful starts with having a good idea, but ultimately it’s about being able to execute,” he says. “Within the health sector, to do what Angela and the team have done in such a short amount of time is virtually unheard of, and that’s down to sheer drive and determination.”
With increasing access to mental health support a core purpose of the business, a freemium version of Clearhead will continue to be available to all, but this month [November 2020] the company is also launching a paid-for premium version.
With the help of a Callaghan Innovation R&D Loan, the company is able to continue to invest in R&D to create a platform to meet the needs of international markets as it looks to expand offshore.
“We already have interest in Asia, Australia, Europe, America – we just have to pick where we want to prioritise,” says Lim. “Within the next eight years we want Clearhead to be a unicorn – a $1 billion global company – and as synonymous with digital mental health as Google is to search or Facebook is to social media.”
Updated: 4 November 2020