Why We Launched Cerebral, a Mental Health Telemedicine Company.

Starting from a mission

It began with the mission: to improve access to treatment for anxiety and depression.

That is why Dr. Anh and I started Cerebral, a telemedicine company offering high-quality, comprehensive care and medication management for depression and anxiety.

After several months in stealth, we launched last Wednesday across 7 states: California, Florida, Georgia, Maryland, Ohio, Pennsylvania, and Texas.

Why tackle mental health?

Despite increasing attention brought to mental health and the challenges in accessing treatment, 57% of Americans with a mental health disorder have never received treatment.

Nearly 50,000 Americans commit suicide each year and 492,037 people visited hospitals in the U.S. due to self harm in 2017.

We cannot accept this as status quo.

What do I know about this?

When I was 16, I started feeling different.

I felt isolated and alone, regardless of how many people I was surrounded by at any given time.

When I woke up in the morning, I just felt like laying in bed. I didn’t know what was happening to me.

My parents were always supportive of me, including when I came out to them as gay before my senior year of high school. In fact, both of my parents had made careers out of empathy: my dad as a psychiatrist and my mom as a psychotherapist.

While I was able to muster up the courage to tell them “I’m gay,” I couldn’t muster up that same courage to tell them — or even myself — something that mattered much more than my sexuality: “I’m depressed.”

It took me nearly a decade to realize that it was because of internalized stigma that it took me so long to seek treatment for the first time.

Other things held me back, too. Wait times, cost, and the exhausting process of trying to find the right provider all prevented me from getting treatment.

After I began taking antidepressants and getting the care I needed many years later, life got so much better.

Why act now?

After I began treatment for anxiety and depression, I began wondering: what could I do to help others get treated faster than I did?

As I dove into this question, a close friend of mine introduced me to Dr. Ho Anh, who was the Medical Director of Hims at the time. Anh loved his work at Hims, but when we started talking about the opportunity and impact we could have on mental health, I could tell he was up for the challenge of tackling a complex, life-changing field like mental health.

Together, we began digging into some of the gaps in access to mental health treatment, like average initial consultations of $500, inhumane wait times, and the lack of ongoing support many experience when taking psychiatric medication and managing potential side effects.

A new model of care

Cerebral is rethinking the process by which people are treated for anxiety and depression. The client signs up for a comprehensive subscription, which allows them to schedule an initial visit to be held via a video visit within days of signing up. This is in contrast to 3 month average wait times to see a psychiatrist in traditional practice.

If the client is prescribed medication during that visit, it is mailed to them every month in discreet packaging. The client is assigned to a care manager, who works closely with the prescribing provider to support medication management and provide psychosocial support to the client.

A high-quality, well-trained team composed of a prescribing provider and a care manager is key to the success of our model.

So why do you hire care managers?

In traditional practice, prescribing providers often lack the time to check in with the client with enough regularity and to properly support the client through potential side effects of the medication.

With the introduction of care managers in our model, a member of our care team can have a live video call with the client at least once per month to make sure that we are helping them track towards positive results and manage any side effects that may occur.

Through monthly video calls with the client, the care manager can quickly flag when a medication or dosage adjustment may be needed — either due to side effects or efficacy — and make sure that the client can speak with the prescribing provider to make those needed adjustments within days, not weeks, of a potential concern with the medication. The effective collaboration between the care manager and the prescribing provider is the key to successful outcomes for our clients.

Additionally, it is important to note that getting better isn’t as simple as just taking medication, and our care managers are there to help the client supplement medication treatment with other modalities. During monthly calls and more, care managers may employ evidence-based techniques such as behavioral activation, problem-solving treatment, and motivational interviewing.

Data-driven progress tracking

One of the unique benefits of the Cerebral model of care is the utilization of standardized metrics to measure outcomes. Every month, clients respond to standardized clinical symptom-rating scales which, coupled with video check-in calls with a care manager, allow the client and clinical team alike to track progress over time.

Dosage and medication adjustments are common in psychiatric care, so checking in regularly to figure out when changes to a treatment regimen are needed is important. Additionally, the use of symptom-based rating scales allows providers to leverage data to make clinical decisions.

Referrals to traditional therapy

We believe in the power of comprehensive care, and our care managers and prescribing providers alike know that medication alone may not be enough for many of our clients.

That is why we support our clients who seek traditional psychotherapy. In fact, we refer many of our clients to in-person therapy options, including formal therapy partners.

What does success mean for us?

Success, to us, is determined by the extent to which we have achieved our mission: improving access to mental healthcare and, ultimately, saving lives.

We are just beginning the fight to make treatment for anxiety and depression more accessible for all.

First, we seek to provide easy access to the highest quality medication management for anxiety and depression using telemedicine.

If we can do this successfully at scale, we will expand to provide a broad array of options for anxiety and depression, such as cognitive behavioral therapy and mindfulness.

Ultimately, we will know we have achieved success when all people with mental health needs are able to access care affordably, efficiently, and without wait times.

Can I see what Cerebral is all about?

To learn more, check out our website at GetCerebral.com. Together, we can destigmatize mental health and improve access to treatment for anxiety and depression.