Behavioral health technology startups are experimenting with a variety of approaches from integration with primary care providers and employer wellness plans to video interaction with therapists from home. Prevail Health, which combines peer support with a structured cognitive behavior therapy program, first focused on helping veterans cope with depression and post traumatic stress disorders. It’s launching a direct-to-consumer version of Vets Prevail this week.
iPrevail will be launched Thursday after six months in beta. In a phone interview with founder and CEO Richard Gengler, he said the peer support component would be free, but the company would charge $9.99 per month for users interested in taking part in its cognitive behavioral therapy program which spans several weeks.
Vets Prevail guides users who enroll anonymously through interactive questions to develop an initial assessment. It tailors a multistep program to their needs.
It combines calls with military peers who have been through similar experiences with reading assignments. By completing directed tasks, users get points that can be used to buy items such as gift cards for purchases.
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The consumer play was always a part of the original plan, Gengler said. If he could get veterans to warm up to this program, he reasoned, the mass market should be easier to penetrate.
Asked about the effectiveness of its program, Gengler pointed to a randomized control trial of Vets Prevail carried out from 2011-2013 with Rush University Medical Center in Chicago. The study was published at the end of August. Asked if he thought an assessment of a therapy program for veterans was comparable to civilians he said yes, although he pointed out that there was no standardized treatment in mental health.
The vision for its program is to get people who would otherwise not take part in therapy to get to a comfort level talking about their problems, if only with a trained peer. If the user is interested, they can get involved in its CBT program. It would be great to see data showing how many people using the peer support segment opt for the CBT program, but it doesn’t have any immediate plans to do clinical validation for its consumer facing program like what it did for its veterans program.
Spengler noted that in addition to Vets Prevail, it also have one for new mothers with postpartum depression called Mothers Prevail. About 80 percent of the content for the two programs is the same. A third one is aimed at students taking advantage of the GI Bill.
The challenge of treating conditions like depression is that many people don’t think they have a problem or they are not yet ready to acknowledge they do. Although an anonymous approach to therapy would seem like an innocuous approach, it’s hard to figure out which peers in its peer group pool will succeed in getting participants to pay for the program. Reimbursement remains the ultimate challenge.
Gengler notes that is tough to quantify the impact of improving mental health access on society but from a military perspective there’s more urgency. All you need to do is look at the Vietnam cohort to understand the cost of not dealing with veterans mental health issues, especially the link to chronic conditions.
“If we reduce crime as part of our program Aetna is not going to reimburse for that,” Gengler said. “We are past the tipping point of awareness, but there’s no consensus of who pays for mental health.”
The thing that Prevail Health and many companies are betting on is that the shift to outcomes-based care that Obamacare sets up will drive home the need to provide better mental health care access to avoid the costs associated with ignoring it.
Photo: Flickr user darcyadelaide
