The Hidden Cost of Mental Health Inequities

Mental health inequities across the US are racking up an annual tab of over $477 billion, and a new report from Deloitte and the Meharry School of Global Health didn’t offer a particularly rosy forecast given our current trajectory.

If left unchecked, the authors expect the annual burden to reach $1.3 trillion by 2040, a brutal total considering the “avoidable and unnecessary expenses” behind it.

Drawing on data from government agencies and Komodo Health, the researchers identified four primary cost drivers stemming directly from mental health inequities.

  • Avoidable ED utilization resulting from untreated or undertreated mental health conditions. 2024 Expenditures: $5.3B
  • Chronic physical conditions linked to mental health’s role as “the invisible counterpart to physical health.” 2024 Expenditures: $23.9B
  • Productivity loss due to mental health-related unemployment and missed work days. 2024 Expenditures: $116B
  • Premature deaths from suicide, substance use disorders, and mental illness associated with comorbid conditions. 2024 Expenditures: $332.2B

Disadvantaged populations are disproportionately impacted across all four categories due to a “legacy of policies” creating structural inequality, and the report lays out several solutions taking different routes to the same destination: equal access for those who need it most.

  • One way to get there is to address the provider shortage by integrating behavioral care with primary care. Not only do PCPs already manage areas like depression, but they’re also experts in the chronic conditions more prevalent among mental health patients. 
  • From a regulatory standpoint, Congress should look at reimbursement policies that “create unintended barriers to treatment.” A prime example is Medicaid being “woefully underfunded” to ensure access to care for the 40% of nonelderly beneficiaries with a mental health or substance use disorder.

The Takeaway

If the moral argument for addressing mental health inequities wasn’t enough to inspire action, this business argument should be just as compelling to payors and employers. Although the answers to the problem are obviously easier said than done, the report succeeded in framing up the massive cost of not solving it at all.

Brave Raises $40M for Medicaid Mental Health

Serve a large need. Serve it at scale. Serve it well. It’s a popular playbook for many mental health startups, but Brave Health is looking to put a twist on the model with $40M in Series C funding.

Brave’s strategy differs from employer-focused mental health providers like Lyra and Headspace in its commitment to Medicaid members, no easy path considering only a third of psychiatrists accept new Medicaid patients.

To serve this population, Brave employs nearly 200 behavioral health providers and supports them with a tech stack that’s one part teletherapy tool and one part engagement platform.

  • These providers offer virtual counseling, therapy, and psychiatry, while the priority is to get Medicaid patients referred to mental health services into care as quickly as possible.
  • This engagement component is key. Brave boasts an 80% contact success rate and has received 23k referrals this year alone through partnerships with payors and hospitals.

The fresh funding will be used to help Brave expand beyond the 18 states in which it currently operates, and to accelerate the activation of more value-based contracts.

  • After entering its first VBC contract with Molina Healthcare of Texas earlier this year, Brave’s now signed two others to push the total number of lives it could potentially cover under risk-based arrangements to over one million.
  • It’s also likely that we’ll see Brave double down on partnerships with other startups in the Medicaid space, building off of existing relationships with MedArrive (in-home care) and Doula Network (maternal mental healthcare).

The Takeaway

Brave’s “you can’t treat who you can’t reach” approach is fairly unique among its cohort of VC-favorite mental health startups, but its focus on Medicaid sets it even further apart from competition. By taking ownership of getting members into treatment as well as their care journey, Brave seems well-positioned to deliver results for both health plans and the patients they serve.

Lyra Expands Into New Mental Health Conditions

Mental health benefits provider Lyra Health recently announced a trio of new solutions designed to address complex conditions such as alcohol use disorder and suicidality.

Lyra is seeking to effectively support the employees often overlooked by traditional health plans, such as those with serious mental illnesses and substance use disorders.

The new offerings will launch in early 2022 and include:

  • Lyra Reset addresses problematic alcohol use through virtual therapy, group sessions, symptom assessments, peer support, and medication. Lyra Reset promotes a durable recovery by providing resources for the entire family.
  • Lyra Dialectical Behavior Therapy for Suicidality combines virtual therapy sessions with therapist-prescribed skill-building lessons to help patients decrease suicidal thoughts.
  • Lyra Concierge provides personalized support for children, adolescents, and adults who need help accessing specialized mental health support or rehabilitation facilities.

The Trend

Many new digital mental health companies are focusing primarily on patients suffering from depression and anxiety, a large market given the pandemic-fueled climb in mental health disorders. 

However, as these companies begin to mature (Lyra has raised $680m and is valued at $4.2b), many will expand into other serious conditions.

This trend has the potential to help patients find specialized care that fits their needs, while also supporting employers looking to maintain a healthy and productive workforce.

K Health Acquires Trusst, Sets Sights on Mental Health

Digital primary care provider K Health announced its acquisition of text-based therapy app Trusst for an undisclosed sum, expanding its services into the rapidly growing online mental health arena.

  • Trusst offers a proprietary mobile platform that has the look and feel of regular text chats, adding a layer of familiarity to sensitive conversations with a therapist. To use the service, patients download the Trusst app and fill out a short questionnaire about their symptoms before being connected to a licensed therapist.
  • K Health provides a public symptom checker that funnels users into an AI-guided assessment of their health concerns, then allows them to connect to a physician via a telehealth call or explore treatment options through its paid service.

Both companies share a similarly lightweight digital-first approach to healthcare, providing services without the cumbersome overhead of many competitors, and expanding access to mental health professionals who would otherwise be prohibitively expensive or difficult to reach. K Health intends to fold Trusst’s services into its existing offerings, which include 24/7 access to primary care providers and prescriptions for as low as $12/month.

The Hottest Space in Digital Health

According to Rock Health’s H1 2021 digital health funding report, the virtual mental health space attracted over $1.5b during the first six months of the year, making it the leading clinical focus for new digital health capital. 

That definitely seemed true last week. The K Health acquisition took place one day before  Headspace and Ginger’s blockbuster merger, and the timing is far from a coincidence.

With so much investor attention on the space and a limited number of mental health service providers, companies are quickly staking claims through M&A activity, and K Health is betting that Trusst’s text-based therapy could be the answer to meeting the growing demand for accessible mental health services.

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