Hi friends,

Over the last few years, I’ve been inhaling information on mental health.

Books, blogs, podcasts, conversations with the smartest people I can convince to talk with me. I’ve learned so much about the problems we’re facing and the solutions people are building.

I’ve also come across a lot of ideas - some of my own, many from others. Ideas for how we can start to move the needle in the right direction for population mental health.

On post-it notes, in book margins and in cringy voice memos to myself, I’ve been collecting these ideas.

In this post, I share eight of the ideas I am most interested in right now.

They aren’t all new and some are a bit whacky. But either way, I hope this post can start some conversations or maybe even spark some ideas of your own. If you have some, let me know - I always love chatting about this stuff.

So here you go, my non-comprehensive, slightly whacky list of interesting ideas in mental health.

Let’s get into it…

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1. Therapy Franchises

One of the fastest growing companies in mental health is a therapy franchise business called Ellie.

Ellie allows therapists to open their own clinic by owning an Ellie franchise.

If you start an Ellie franchise, you get support with finding the right real estate, with marketing, recruiting, credentialing, billing, a full tech stack and more.

At one point, Ellie was the fastest growing franchise business in all of the US!

Here’s what the last few years have looked like for Ellie.

• 2022 - 36 franchise units

• 2023 - 183 franchise units (and $8.2m in revenue)

• 2024 - already well over 200 franchise units with projections to exceed 300 by the end of the year

Therapy franchise businesses like Ellie are tapping into a few interesting trends.

First, many therapists want to run their own practice. The freedom and financial rewards are attractive but they have often cited their lack of “business” education as a barrier. Ellie make this easier by giving them a “clinic in a box”. With many therapists increasingly frustrated with the compensation and working conditions offered at large mental health platforms, owning a clinic franchise is an attractive alternative.

Secondly, it’s tapping into the need for brand in mental health. I’ve written about this before, discussing the potential for organisations to create real value by building stronger brands in mental health.

The value of a franchise is the value of its brand. If Ellie or others can create a strong and loved brand for their franchise, they can create a lot of value for patients, therapists and for themselves.

Therapy franchises are a great way to allow therapists to own their own practice. They make choice and access easier for clients. They give individual clinics access to the marketing, admin support and technology that many of the larger platforms benefit from. They have the potential to offer the best of local mental health and large scale mental health platforms, combined.

If they can also continue to iterate on the actual client experience, and improve that over time, then I’m super excited about the impact this business model might have on the industry.

2. Redefining Provider Training

There is a supply challenge in mental healthcare. We simply don’t have enough clinicians to meet demand. But the amount of supply is not the only issue. Quality is also a major challenge.

We’ve seen labour supply shortages in other areas of our economy - we don’t have enough software developers, data scientists or nurses. And for those roles, a bunch of organisations have sprung up to tackle that problem. They looked at exactly why we didn’t have enough people in those roles and then built solutions to solve those problems.

From Bloom Institute to General Assembly, to software solutions like Code Academy, these organisations have trained hundreds of thousands of professionals and have increased the supply of people working in these much needed roles.

I recognise that mental health roles are different for many reasons, not least the regulation of the profession, but I am still extremely interested in any organisation that is looking at ways to train more high quality clinicians and actually improve the supply side of our mental health system.

Resilience Lab are a good example. They looked closely at the experience of provisionally licensed clinicians and decided to build their own institute (The Resilience Institute) to tackle the problems these people faced in their training journey. Within their institute, they train therapists in their own clinical methodology (“The Resilience Methodology”), provide supervision and give them access to a wide range of learning modules.

I believe that Resilience Lab are actually starting to move the needle on the amount of qualified therapists in the US. But more than that, they are also increasing the quality standard of these therapists.

Any organisation that can do the same will have a meaningful impact on our health systems’ ability to deliver quality care to patients.

3. Improving Care Navigation

I recently tried to support a friend in getting help for his mental health. Navigating the system was a bloody nightmare. And that was for someone who studies that system for a living…

Over the last few decades, we’ve significantly increased the range of treatment options available to people with mental disorders. But how much have we done to help people find the right treatment? To engage with the right providers? To navigate the system in a way that gives them the best chance of achieving positive clinical outcomes?

For my friend, he needed someone to help him with all this. Someone that could have acted as a concierge, understanding his situation and guiding him to the right care and the right providers for his needs (and insurance coverage).

Mental disorders are tricky beasts because they reduce the patient’s ability to seek and engage with care. Anything we can do to take some of this load off them has huge potential.

Yes, there are questions around who pays for care navigation and to what extent it can be reimbursed, but I am very bullish on the organisations take care navigation seriously.

4. Expanding the Net of Care

Another way of tackling our supply problem is by expanding the kinds of people who can provide care. From peer support workers, to social workers, to teachers and families, there is a huge opportunity to expand the net of people who can provide evidence based support to someone struggling with their mental health.

Again, this is not a new idea. But I am seeing an increasing amount of evidence to justify further investment in these areas.

I just finished reading Healing by Thomas Insel (great book by the way).

He is an avid supporter of expanding the care net through peer support and other initiatives. In the book, he says that he was initially sceptical about the quality that could be achieved through these programs. But through his experience, he realised that as long as the right training was provided, peer support could not only provide higher engagement but also provide sufficient quality.

He calls out an organisation I’ve been following for a little while called Friendship Bench. This is a beautiful organisation in Zimbabwe that trained elders in the community (or as they call them, “grannies”) in basic listening skills, cognitive behavior therapy and behavioral activation. Combined with a simple bench placed in front of clinics, these “grannies” are able to support people struggling with loneliness, depression, anxiety and whatever else they may come to the bench with. There’s even an RCT demonstrating the impact of this intervention.

I’m long on peer support and expanding the carer net. It helps address our supply challenge, increases engagement and can provide cost effective options of care.

The cherry on top? The peers themselves tend to benefit from providing the care. It gives them meaning and purpose, something often in short supply in western societies today.

5. Solving the Wisdom Famine

On the topic of wise grannies, let me tell you a little story…

I was listening to a talk by John Vervaeke recently. Jon is a professor of psychology and cognitive science at The University of Torronto and has done extensive work on what he calls The Meaning Crisis.

When listening to John, he was telling a story about being in front of a class of students and asking them three questions….

1. Where do you go for information? Most people said Google.

2. Where do you go for knowledge? Books, blogs, maybe a teacher?

3. Now. Where would you go for wisdom?

When he asked his class this last question, they fell silent.

Did you have an answer?

There is a wisdom famine in western society.

This is especially true in younger generations. They’ve never had more access to information. But have also never been so starved of wisdom.

Wisdom is a somewhat nebulous term but in relation to mental health, I think of it as our ability to develop meaningful lives. Wisdom allows us to learn about ourselves, to find out what is truly meaningful, to find connection in the world and to build flourishing lives.

It’s easy to see how wisdom can therefore help us live mentally healthier lives.

Thinking about this made me realise something about my own journey…

For the last five years, I have been seeing a clinical psychologist. But I realised that I wasn’t go to see for her for clinical intervention. I had no diagnosis and was not engaged in any specific treatment.

I was going to see her for wisdom. I wanted guidance with big life decisions and help in developing a meaningful life. Those were the kinds of questions I asked her and the kind of support she gave me.

I don’t think I am alone.

Of course, many of the people who see a therapist do so for clinical treatment. They have a diagnosis and need care.

But there are also many like me, who see their therapist for a source of wisdom. Someone who can offer a guiding light.

From my own experience, therapists are excellent at this. But are there other, more suitable ways we can provide people with wisdom?

We used to go to elders or religious and spiritual institutions for wisdom. But as intergenerational connection and organised religion has eroded in western society, a wisdom famine has appeared.

If we can find ways for more people to access wisdom, I believe we would help them develop more meaningful, flourishing lives. Lives less likely to be challenged with mental illness.

It may also free up therapists to focus more on those people who truly need clinical intervention.

Perhaps our modern day “gurus” will be our new source of wisdom - Tony Robbins and co. They probably already are. Maybe it will be Chat GPT??

This is an incomplete idea as I don’t have a solution for how to cultivate and transmit something like wisdom, I just know that there is a wisdom famine and that solving it would make a lot of people’s lives better.

6. Encouraging Social Connection

There is one thing I am quite certain about... That helping people be more socially connected is one of the best things we can do to improve population mental health.

We are facing an epidemic of loneliness. Now more than ever, people need a support network, they need friends, and they need to feel part of a community.

Social connection is difficult to manufacture - just ask anyone who runs a dating app.

Therefore, the ideas I’m most interested in are those that create environments in which connection can grow organically.

I’m long on physical spaces, especially third spaces like what Patricia Mou is doing with The Commons. I love how Self Space use their mental health clinics for community events and how they organise IRL events for their customers and partners.

Hell, one of the most positive trends I can point to has been the rise of run clubs. A bunch of people meeting up in person to exercise outside and then grab a coffee and have a yarn... Well that’s surely one of the best population mental health initiatives I can imagine!

There is certainly a role in the digital world too. I like companies like Spoony which is building online spaces for specific communities like those who are neurodivergent, living with a chronic illness or disabled.

Loneliness is a killer. And we need to do everything we can to help people develop more positive social connections.

7. Evidence based TikTokers

Change of gear. Let’s venture to the world of TikTok for a moment…

A recent research report in Australia found that: “73 per cent of young people in Australia turn to social media when it comes to support for their mental health”.

More specifically…

“66 per cent of young people surveyed reported increased awareness about their mental health because of relevant content they accessed via social media, 47 per said they had looked for information about how to get professional mental health support on social media and 40 per cent said they sought professional support after viewing mental health information on social media.”

But how helpful is the content these young people (and adults) are seeing?

There’s a wave of social media creators tapping into this demand by creating engaging content on psychology and mental health. If you go on TikTok or Instagram, you’ll see them everywhere. Here’s an example of a video with over 13 million views on TikTok.

@emonthebrain

Do not do these things if you care abt your brain 🧠 #mentalhealth #brain #wellness #health #mentalhealthawareness #lifetips

A lot of this content is pop-psych BS with little to no evidence base. The content that gets seen, is that which is most engaging, not that with the most robust evidence base. The best creators tend to have the least grounding in evidence-based mental health practices. And the most evidence-based practitioners and organisations tend to be terrible at making engaging social content.

That’s a problem.

At best, people are implementing lessons that have no evidence for improving mental health. At worst, they are doing things that make their mental health worse.

I would love to see more evidence based AND engaging content on socials and think there’s a real opportunity for individuals and organisations to own this space. Is the solution as simple as an evidence-based organisation hiring their CEO’s Gen Z niece to manage their socials. Honestly, maybe?? If you can get her to stick to evidence based content, it cannot be any worse than what I see being posted by many of the big research orgs…

One organisation who do this really well is The Man Cave in Australia. I’d be very excited about more people trying to own this space.

8. Hopeful content

On the topic of content, I’d really love to see more hopeful content on mental health. Hope is incredibly important. It encourages people to seek and engage with mental health treatment. But I rarely see it talked about.

My own story is one of immense hope. As an 11 year old I really struggled with OCD. I was in BAD place. But with the right treatment and support from my family, I got better. Better to the point where I’ve lived the rest of my life symptom-free.

Before getting that help, I don’t think I had much hope. I just thought that was what my life would be like. Talking to friends who have gone through their own mental health journey, they often tell me the same thing.

We’ve been very focused on reducing stigma, telling people it’s OK to talk about their mental health and ask for help. A lot of art and media is focused on portraying the severity and usually the sad consequences of mental health.

Yes, both of these are important.

But I think we need to do much more to give people reasons to be hopeful.

I posted this a few weeks ago after watching the film Aftersun (spoiler: super sad ending).

Art, media and culture have a powerful role to play in changing perceptions of mental health.

So why don’t we make mental health more hopeful? Why don’t we tell the stories of how people got better? How they recovered? How they left their mental health challenges far behind them or learned to live full and meaningful lives alongside them?

We must paint a picture of hope. A picture full of texture and vivid colours that shows that people do get better, that encourages people to seek treatment and that motivates them to stay engaged.

And that’s just for patients. If you’re working in this industry, you need hope too. Hope that we actually can make a difference.

I really believe we have so many reasons to be hopeful about the future of mental health, so if you need your own dose of hope today, you can go and read about them here.

I hope you liked this post and that it sparked a few thoughts of your own.

As always, I’d love your feedback. If there’s a specific type of content you’d like me to cover, please let me know. My goal is to create the most helpful content for people running mental health organisations, so your feedback is highly valuable.

That’s all for this week.

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Keep fighting the good fight!

Steve

Founder of The Hemingway Group

P.S. feel free to connect with me on LinkedIn

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