Mental health tech’s biggest winners are those who’ve aggregated supply. But there’s an even bigger prize waiting for those who can truly aggregate demand.

Hi friend,

In mental health, aggregators are everywhere.

These businesses aggregate the supply of clinicians in a given market and then offer it to people who want care. Many of them are now large, profitable businesses. Some bring in over $1B in revenue each year, and as a category, they have attracted more investment than any other.

But despite the success of some of these businesses, we have yet to see a truly dominant player.

In the US, even the largest mental health marketplaces are responsible for only a single-digit percentage of the market. They aggressively compete for users, clinicians and payers, with no business developing a position where they have true defensibility — and the growth rate and margins that would come with that.

This is not how aggregation plays out in other industries.

Usually, a handful of aggregators (or sometimes even a single aggregator) develop a dominant position with a very large market share. With this dominance, they achieve better unit economics, which further entrenches their leading position. Think of Uber in ride-sharing, Airbnb in vacation rental, Spotify in music, or Skyscanner in flight booking.

This hasn’t happened in mental health. Or at least, it hasn’t happened yet.

The reason is that no one has truly aggregated demand.

In this Hemingway Pro Report, I discuss why this is the case, how aggregation theory works in mental health and what businesses can do to organically aggregate demand and achieve dominance in this space.

Let’s get into it.