PsyInnovations: A Game Changer For Mental Health Care— Full

Ritvik Singh, Co-founder and CEO of PsyInnovations, discusses the problems faced by India’s population in accessing mental health care and the role in which his newest app, wayForward, is working to overcome these challenges.

Key takeaways from this episode of StartUp Health NOW can be found here.

[00:04] Unity Stoakes: Welcome to StartUp Health NOW! The weekly web show that celebrates the Health Transformers and changemakers reimagining healthcare. My name is Unity Stoakes and today we have a very special guest, the CEO and co-founder of PsyInnovations, Ritvik Singh.

[00:18] Music Intro

[00:56] Unity Stoakes: First a bit about you. You’re a serial entrepreneur came out of finance and now you are a Health Transformer. You’re actually in StartUp Health. Tell us about your journey, tell us about you, and then tell us about PsyInnovations and your mission.

[01:10] Ritvik Singh: Right. Before starting PsyInnovations I was a trader for over a decade. It was a fun fast-paced environment working in finance. Got me to work in three different continents. But while I was doing that I started not-for-profit medication reminder service in India. This was around six years ago and healthcare has some been something that’s been very important to me. I come from a family of doctors, so healthcare has been something very close to me. And then I got involved with this professor at the University of Michigan who wanted us to make an app for mindfulness-based research he was doing. That got me into mental health. I would say that those were the seeds for PsyInnovations and that’s where it started. Around 4,5 years ago we started thinking about it and about a year and a half, two years ago we started this company doing this full-time with the mission of making mental healthcare accessible to everyone. So, people talk a lot about providing healthcare to the masses, but mental health always gets neglected and we want to make it a priority.

[02:13] Unity: So, PsyInnovations. You’re focusing on cognitive behavioral therapy, or CBT, as it’s called in the industry. Tell us about that. What is that, what does that mean, and how can it help people?

[02:27] Ritvik: So, CBT is one of the most well researched therapy and techniques that is out there. It has been researched across the globe in various cultural settings and it has been proven to work over the last few decades. What’s new is over the last 5 to 6 years there has been research and computer-based CBT being as effective as in-person CBT. That is a game changer because then suddenly this technique can be made available to millions and billions and provide them solutions for managing mental health conditions. So, it has been effective for managing anxiety, depression, stress, a lot of different things. The core part of CBT is that your thoughts and heart patterns determine how you will feel, how you behave, what kind of stress, anxiety, depression you’re feeling.

[03:20] Unity: This is something that’s universal. So it can help people in the United States. You’re now in India as well so it can help people in India and throughout the world. Tell us about your strategies. Is that your goal to really focus on any particular region or more globally?

[03:38] Ritvik: We are focusing right now on India, but in terms of CBT, as I said, it’s been proven to work everywhere in the world. The thing that changes the science behind CBT remains the same in different cultural contexts but some of the examples, some of the base that it’s applied, that changes. What is important in a culture like the U.S. that’s going to be different than in culture like India or most Eastern cultures where even when you talk about work, people talk about relationships. So, what we’re doing is modifying some of our content, some of our example, some of the program that we’ve developed, but the science and the technology remain the same. Our focus right now is on that market because there is a massive dearth of experts out there.

[04:26] Unity: Let’s dig into that. I think that’s really a significant point you’re making. So, India, population of India’s 1.2, 1.3 billion people. How many experts are they’re focusing on this type of therapy in the real world and then, you know, what can technology do to really help that?

[04:47] Ritvik: Right. I mean I won’t have the statistics for number of people focusing on CBT based therapy but overall there are only three thousand psychologist registered there. Around three to 4,000 psychiatrists.

[04:58] Unity: So, it’s 3,000 psychologists for 1.2 billion people.

[05:02] Ritvik: Yes. I mean there’s massive dearth, even if you combine all of the experts out there, there is one expert per 180,000 people in that country. So, I mean, the numbers are just massive and you cannot provide, there is no easy solution for that.

[05:20] Unity: So, this is a game-changer really, I mean using a digital solution with a therapy that there’s a lot of evidence and a lot of validation around this approach, CBT. What kind of reception are you getting? Talk about some of the traction that you’ve been getting and how that’s going?

[05:41] Ritvik: So, in terms of traction we have just partnered like few weeks ago, we announced a partnership with Fortis Healthcare, one of the biggest hospital chains, and it allows us to reach a number of people, like, they have over 50 healthcare locations across the country. We’re working with healthcare providers, people who already have access to millions of people. So, there has been good reception from the healthcare community over there. In terms of people, individuals who are using that, we are seeing that the response is really greater. I already mentioned some of the things that people always come up with. Relationships are really, really important there. So, they want to apply concepts of CBT for their, managing their relationship,

[06:22] Unity: Personal relations.

[06:23] Ritvik: Personal relationships. Even at work. It’s not just about performance pressures. It’s all about relationships at work. So, all of these things that are quite important, like relationships with your colleagues, relationships with your boss. So, that’s a learning for that specific culture and for every culture there would be some small modification, but what CBT allows us is like massive amount of scaling.

[06:47] Unity: One of the things we’re doing at StartUp Health is really focusing on cross-pollinating innovations going on in different regions of the world. So, seeing business models going on in India where health consumerism is way advanced, mixing with technologies that may be more advanced in a place like Israel or Finland with opportunities in the U.S. I think you have a very unique perspective because you’ve been working here in the United States and now you’re building your business in India. Talk to us about some of the changes you’re seeing, some of the differences you’re seeing in a place like India. You’ve already talked about relationships. What else are you seeing?

[07:39] Ritvik: One of the most interesting things in a country like India is that most of the people have completely skipped a generation where they used a desktop or computers. They’ve gone from no internet to everything based on mobile. What that

[07:52] Unity: Leapfrog effect.

[07:53] Ritvik: Completely leapfrog and I see the same happening in the domain of therapy or counseling as well. People have not traditionally gone for therapy and now that they’re seeking therapy they’re going for either teletherapy. They’re looking for teletherapy solutions, they’re looking for solutions through their smartphone, because they use smartphones for everything now. And, it’s amazing how eager they are to look at these new solutions available through their smartphone. So, that’s one of the important learnings out there that people are eager to try out these new things, and the population overall it is young. Average age of the country’s is mid teens. As you mentioned, the health consumerism is is quite developed. Insurance coverages is in low single digits, so that means that your patient is your peer and they make the decision for everything.

[08:49] Unity: So, it’s a different business model.

[08:51] Ritvik: Completely. Completely.

[08:52] Unity: That’s interesting. Do you think, what’s your advice to other entrepreneurs? I think this is an interesting approach where you started your business here in the US now expanding your business in India. Would you advise that approach to other types of digital health companies or solutions that are now entering the market?

[09:13] Ritvik: I mean, I would say it is a great opportunity, but I would say that you have to enter carefully because there has to be some insight into the culture. You have to understand the lay of the land over there, the way people think, and you have to have understanding of who are the gatekeepers to the system there. So, even though individuals are making those decisions your experts are very important. So, I would say it is a great opportunity, It is a place where a lot of solutions are required but be careful before entering.

[09:48] Unity: Absolutely and so what are some of your biggest lessons learned? You entered the digital health space at a very interesting time five, six years ago when, really, this movement was really at the nascent stages. You’ve seen a lot over the last few years. What are some of your biggest lessons learned and morsels of wisdom that you would pass on to other entrepreneurs?

[10:13] Ritvik: One of the main things is be patient. Entrepreneurship and healthcare entrepreneurship, specifically, requires patience. I come from a finance background where you see results of your actions immediately, but in entrepreneurship we have to be patient. You have to build something valuable and you’ll see results over time.

[10:34] Unity: Your family’s in healthcare. They’ve been in healthcare. What are their thoughts on you now being in healthcare, but coming at it from a different perspective? You’re leveraging technology and you’re leveraging digital tools and really trying to come at it a different way. What advice do they give you as practitioners coming from healthcare?

[10:57] Ritvik: Well, the most important advice that they give is, I mean, you have to, at the end of the day, you have to think about the person who’s getting any kind of treatment. Mental health or any other kind of healthcare. You have to think about what they are feeling, what do they want, not just impose your solution on top of them. That’s one of the biggest insights, but they do understand the value technology brings. But technology should not undermine the expertise and experience of people on the ground. So, that is why the way we have placed ourselves is that we want to leverage the expertise rather than say that this is a replacement for an expert.

[11:34] Unity: Unpack that a little. Tell me more about that. How do you go into a place where there’s say, 3000 experts in area and then supercharge that with your technology. It’s an app platform?

[11:46] Ritvik: Yes. It’s an app plus web-based platform, so we’ve built in a way that it’s accessible on any platform. The main thing is there is a self-use aspect of the CBT component and the program that you can use, but along with that we provide the support of an expert coach or a counselor. So, the experts are there in the background as a check, as a person who engages the client or the other patient initially to understand what problems they are suffering from and how the program can be best used for them, how it can be modified. That’s the thing. They are our ears to make sure that we keep modifying, keep making it better, and experts opinion comes into play there. So, they always keep checking, but for most of the part, the user can use our program on their own.

[12:35] Unity: And you’ve got quite a bit of traction now. What’s their feedback been? What have clinicians, what type of things do you hear from them or the users from the experts side of the equation?

[12:46] Ritvik: So, experts, I mean experts including, I mean the top experts at hospitals at Fortis, they think this is the way forward, this is the way that

[12:57] Unity: What’s the name of the app?

[12:58] Ritvik: That is the name of the app. That’s name of our flagship product.

[13:01] Unity: So, it’s PsyInnovations, and your app is called “Way Forward.”

[13:06] Ritvik: Exactly. Exactly. So, that is, they think this is the solution for the future. There is no way an expert can reach every person in the country that large. Their input has been really positive on the whole world solution. They think this is something that can be provided at even as preventive mental health solution, provided in settings like schools, where, because anxiety starts really early in life, and most of the Asian- Eastern cultures there’s huge amount of pressure on students, exam related anxiety and stress is very high. So, they think this can be provided as a preventive solution as well. So, that’s something that we’re working on with them.

[13:49] Unity: You’ve seen a lot around the world over the last few years, especially in the digital health innovation space. What’s making you hopeful? What’s giving you energy and excitement today?

[14:03] Ritvik: I mean, we have already seen that so many people are using healthcare, digital health platforms through their smartphones, but what is exciting is what’s coming next in terms of AI, machine learning, how that can be used to increase the productivity of the experts and help them reach so many other people. The other thing that excites me is that some of these underlying techniques and science can be taken into different cultural contexts and applied, there has to be obviously, there has to be modification based on the culture. But it can be taken into different culture which means that there isn’t, there are so many solutions that have been built here that can be taken into other countries that are being built in India or China that can be brought here, that there is immense opportunity.

[14:49] Unity: I couldn’t agree more. So, fantastic. So, how do you stay healthy?

[14:56] Ritvik: Well, I’ve been traveling like back and forth between two countries so, well earlier it used to be going to the gym regularly, but that has completely fallen off the chart, but try to go do yoga or some exercise at home or wherever, like every day. Otherwise it’s easy to slip.

[15:14] Unity: So, thank you so much for all that you’re doing to really improve the world and for being a Health Transformer in in the StartUp Health community. It’s a great honor to have you here.Thank you.

[15:23] Ritvik: Thank you, Unity

[15:24] Chime