Hi friends,

There’s a question I get asked a lot…

“What mental health companies are you excited about?”

I struggle to answer this.

Despite spending most of my time analysing this industry and speaking with founders and investors, I never have a good answer off the top of my head.

Not really good enough is it?? Tut tut.

So today, we rectify that.

In this article, I share the seven startups that I am most excited about right now. I tell you what they’re doing and why I think they are interesting.

Let’s get into it.

But first… a quick announcement

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Starting next Monday, you’ll get a weekly email with everything that happened in mental health. I’ll cover business news, fundraising announcements, regulatory news, the latest research and more. Essentially, everything you need to stay up to date with what is happening in your industry.

I’ve been posting these on LinkedIn for a while and people seem to like them. So now, I’ll send them straight to your inbox. Woo!

OK so let’s actually get into it now… what are the mental health businesses I’m most excited about?

1. TownHome Health

One-liner: A non-traumatic alternative to hospitalisation for mental health crises.

What do they do?

TownHome Health is a small, New York based startup creating compassionate alternatives to psychiatric hospitalisation.

In a mental health crisis, many people end up at the emergency department. Some of my ED doctor friends tell me that about 25% of their cases are mental health related. Many of these patients end up getting admitted and while some of them do need a stay in hospital, many don’t. They get admitted because there’s no alternative. This is often pretty traumatic for the patient, expensive for the payer and demanding on the hospital.

The TownHome founders, Charles Raisch and Donna Friedman thought there was a better solution for these people in non-dangerous, mental health crisis.

Instead of going to an emergency room or inpatient psychiatric unit, individuals can stay at a TownHome Crisis Respite. These spaces are calm, home-like residences, staffed with trained peer counsellors and clinicians. Stays are typically two weeks long, during which guests receive 24/7 support, counselling and care in a comfortable environment.

The copy on their website explains their vibe well:

“We believe in kind, calm, make-yourself-strong, stay out of the hospital kind of care. See your doctor, do your errands, keep on living kind of care.
Get back on your feet kind of care.”

I feel like this copy would go hard with a good rap beat…

I don’t know about you, but if I had a loved one in a mental health crisis, I would much rather they spend time in a TownHome than in a hospital.

Why is it exciting?

• Firstly, this is a big market. There are around two million, non-dangerous behavioral health crises each year and it’s easy to see that psychiatric hospitals are rarely the best place for those people to be.

• Secondly, they claim some very impressive results. For patients who stay at a TownHome for two weeks, future hospitalisations were reduced by 75%. They also claim to be able to save payers over $25k per person per year. If they actually are reducing hospitalisations by the rate they claim, I’d believe those cost savings.

• Finally, I love seeing physical space innovation like this, developing new spaces that meet the actual needs, clinical and otherwise, of the people they are built for. A lot of mental health innovation is digital, but I believe there is huge potential for more creativity in how we use physical spaces to care for people. TownHome is a great example of this.

2. Slingshot AI

One-liner: building the first foundation model for psychology

What do they do?

Slingshot is an AI research lab building the first foundation model for psychology.

OK, what does that actually mean?

The Slingshot founders believe that Generative AI can scale access to care through conversational AI agents. Essentially, they are betting that an AI model built from scratch, with the specific goal of supporting people with their mental health, will outperform general foundation models (like ChatGPT). For the last year or so, they’ve been building this foundational model and training it on relevant data from mental health providers around the world.

For a while, I wasn’t sure whether they were going to build a consumer-facing app or just sell their foundation model to mental health companies, but they now have a consumer app called Ash that’s in private beta.

Ash looks like most other conversational AI agents. It can talk with users via text or voice, remembers past conversations, and provides support and coaching. They’re training their model to learn a range of therapeutic modalities, from CBT/DBT to ACT and IFS. I’ve used it and have to say, it’s pretty good!

They’ve got a very experienced founding team and have raised $40M from Andreessen Horowitz. If you believe AI Coaching, AI Therapy or some version of all this will become a thing, Slingshot is probably where you would place your bet.

Why is it exciting?

• Foundational approach. While there is no lack of businesses trying to build AI agents for mental health, Slingshot is one of the few building a foundation model. We are so early in our understanding of how these models can work for helping someone with their mental health and it’s going to be cool to see what they learn along the way. Hopefully they decide to share some of these learnings with the rest of the ecosystem!

• Consumer focus: Another way they are different, is that they have a much stronger focus on consumer. Their lead investor, Andreessen Horowitz, has a major thesis around this - that the biggest company in the world will be a consumer healthcare company. They believe the healthcare system (especially in the US) is structurally broken and riddled with misaligned incentives (hard to argue with that) and that true disruption will come from a vertically integrated business focused entirely on building for the consumer. Who knows where Slingshot will go in the future, but right now, I see them highly focused on this channel - trying to build a consumer app that people will love and will make them better. Right now, they don’t seem too worried about how they’ll get paid for delivering these kinds of outcomes. I love it when a business has the chutzpah to actually build for users first. “Build it and they (payers) will come” is a bold strategy in healthcare, but we need pioneers like Slingshot to give it a crack!

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3. Ampa Health

One-liner: making TMS more accessible

What do they do?

Ampa Health is making Transcranial Magnetic Stimulation (TMS) more accessible, in order to improve outcomes of mental disorders.

TMS is nothing new, it’s been around for a while and has a strong evidence base. But it has two drawbacks. Firstly, it’s expensive. Secondly, it’s pretty inconvenient - patients have to visit the clinic up to thirty-six times for a course of treatment.

Because of these reasons, I suspect neuromodulation techniques like TMS are generally under-utilised relative to their efficacy. That’s what Ampa are trying to solve.

They’re developing new neuromodulation technology to bring down the cost and make TMS more convenient for users. To do this, they developed a signature offering called the “One Day” treatment - an accelerated therapy session that delivers targeted brain stimulation through TMS and yields fast results.

I just watched this video from Dr. Jonathan Downer on this topic and if you want to go deep, would highly recommend it.

Why is it exciting?

• Like TownHome, they have super impressive claims about their results, stating a 70% remission rate for depression and anxiety from their One Day treatment. If those results hold, that is hugely significant. For context, psychotherapy has an average response rate of 36%for Generalised Anxiety Disorder. Now, these metrics are not perfectly comparable, but they give you a sense of the kinds of response rates expected from front-line treatments for many mental disorders.

• In general, we need more alternative treatments for mental disorders and I think neuromodulation is underutilized. We know that medication doesn’t work for many people or comes with side effects. Psychotherapy has similar challenges around efficacy. I’m all here for players like Ampa (and Flow) who are making proven neuromodulation treatments more accessible.

4. Throughline Care

One-liner: easy access to a verified network of crisis hotlines and helplines.

What do they do?

You probably haven’t heard about Throughline. They’re a small, New Zealand-based business that has built a software solution to a niche problem experienced by some of the world’s biggest companies. Let me explain.

Say you’re a platform like YouTube. You need to be able to provide crisis support to your users. But when you operate in over one hundred countries, with multiple languages, how do you make sure you’re giving your users the right crisis support details? That’s something you really don’t want to mess up.

Throughline maintains an up-to-date directory of suicide hotlines, crisis text lines, domestic violence helplines, and more across 100+ countries. They then make this available to businesses through an API, embedded widget or web app. Pretty cool.

Why is it exciting?

• Niches get riches. Throughline found a very specific problem and built a neat software solution for it. It’s clearly helpful to their customers and has an impact on hundreds of millions of users by ensuring they get access to accurate crisis care services. I’d love to see more businesses like this in Mental Health - ones that find a small but very specific problem and build a really clean solution for it.

• They have a clear business model. Alongside a product that solves a clear problem for customers and users, they've developed a very simple business model (selling directly to the platforms). Such a clear and powerful business model is rare in Mental Health and it allows them to make money from the good work they do. Win-Win-Win as Michael Scott would say.

• Their traction. I mean, look at the companies they have as customers. Google, Roblox, Discord, Paramount… Dream logos for any business.

  

  Throughline’s customer base

• What’s coming next. I don’t think I can share much about what they are trying to build next but it’s really exciting (I know, sorry for being a tease). They have a great first product, a strong business model, a team I really like and they are now turning their attention to another very important problem in mental healthcare. I’d keep an eye on them if I were you!

5. Metabolic Psychiatry Labs (MPL)

One-line description: treating serious mental illnesses through metabolic and nutritional interventions.

What do they do?

OK, this is a very interesting business. Born out of Stanford, they are pioneering metabolic psychiatry as an approach to treating mental illness. Their protocol combines metabolism (the chemical reactions in the body's cells that change food into energy) with psychiatry, to understand how what we eat impacts our mental health. Told you it was interesting!

There’s an emerging body of evidence in this space suggesting that what we eat has a significant impact on our mental health.

MPL combines evidence-based nutrition and metabolic therapeutic approaches to address dysfunctions like insulin resistance and inflammation.

In practice, they provide a remote care program where patients start with lab testing, get a customised care plan, conduct remote monitoring through a smart scale & keto meter and get access to resources like specific recipes and metabolism-friendly restaurants.

Why is it exciting?

• Strong results. MPL report clinical symptom improvement in 79% of patients. They’re also already integrated with big payers, including Medicare.

• A novel approach. By integrating metabolic health with mental health, MPL opens up a whole new therapeutic avenue that could complement or even substitute standard treatments for some individuals, especially those not helped by medication or therapy alone. Similar to the role of neuromodulation, we need more effective treatments in our toolkit. While it’s unclear how this field may develop and what level of evidence will exist for these kinds of metabolic treatments in future, I’m excited to see smart people pursuing it.

• It’s scalable. If this works, it can be super scalable. All care is delivered remotely, and if the primary intervention is changing what we eat, then it should be pretty affordable too!

6. Limbic

One-liner: clinical AI to enhance therapy efficiency and outcomes

What do they do?

Limbic makes clinical AI solutions to support different elements of therapy. Their core thesis is this; to solve the supply-demand challenges of mental healthcare, we need to give more leverage to clinicians. Whilst they do this by increasing efficiency, they’ve also found that their products can increase efficacy as well.

When I wrote a deep-dive on Limbic last year I used this graph to demonstrate how they think about enhancing human psychotherapy.

So far, they have two primary products;

• Limbic Access: an AI tool supporting intake and assessment

• Limbic Care: a clinical AI companion that provides conversational support and guided CBT interventions

In a recent THR Pro article I wrote about how AI will lead to the unbundling of therapy and a world of Therapy 2.0. In that world, the role of a therapist will change, focusing on the human elements of care that cannot be replaced and supervising a number of AI agents that support patients with all other elements of care.

This is the future Limbic is betting on, moving through the different jobs completed by a therapist and (where possible, safe and clinically effective) developing AI agents to do those jobs instead.

Why is it exciting?

• They have traction and results. They’ve been adopted by over 40% of NHS talk therapies and have demonstrated impressive clinical results.

• They’re one of the only pure SAAS companies in mental health. Most mental health businesses are still tech-enabled services businesses. Not Limbic. Whilst they have a strong clinical commitment, from a business model perspective, they look much more like a software business. At a time when we need some business success stories in this space, we should all be shouting for Limbic.

• Their team is ridiculously talented. They’re super smart and serious operators. That’s just a killer combo for a startup.

7. Tacklit

One-liner: an operating system for mental health care delivery

What do they do?

Tacklit is another successful business flying under the radar in mental health. They’ve built a modern software platform that mental health organizations (from private clinics to hospital programs) use to manage and improve their services. It includes electronic health records, scheduling, billing, secure telehealth, outcome tracking, and patient engagement tools all integrated together.

It also layers in analytics and AI to support leadership in managing their care delivery, care quality and risk management. For example, Tacklit can automate routine paperwork, send personalized exercises to patients between sessions, or flag clinical insights from data.

One of the things I really like about Tacklit is that it’s designed to be flexible, allowing it to be easily used for new care models - for example, leveraging a non-clinical workforce.

Why is it exciting?

• They’re actually moving the needle on time savings. A lot of businesses claim to save clinicians time but it looks like Tacklit is actually delivering on this promise, reporting an average of 16 hours a month saved by each staff member that uses Tacklit. That’s a lot!

• Making it easier to integrate new innovations into clinics. In this article alone, I’ve mentioned several new innovations from TMS headsets to conversational AI agents to metabolic psychiatry care programs. There are hundreds of more innovations like these, and that’s great. But I always wonder, how are all of these going to fit into our mental health system? How will clinicians manage these new solutions and fit them into their care plans without becoming overwhelmed? How will administration and billing work for all these new offerings? Having a strong operating system underlying all patient care will make this much easier for clinicians and providers.

• Building with open architecture. To facilitate this strategy, Tacklit is building with an open architecture. This will make it easy (or at least easier) for other point solutions (say Limbic’s intake and assessment tool) to be adopted by clinics.

Alright, that’s all for this week. I hope you found it valuable.

As always, reply to this email and let me know what you think. I’m always keen to connect with folks building impactful mental health organisations.

Keep fighting the good fight!

Steve

Founder of The Hemingway Group

P.S. Connect with me on LinkedIn if you haven’t already

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