In Conversation with Kyle Robertson, Co-Founder & CEO, Cerebral

October 9, 2020

By Billy Deitch, Principal, Oak HC/FT

Following Cerebral’s $35M Series A, Principal Billy Deitch sat down with Cerebral Co-Founder & CEO Kyle Robertson to discuss shifts in mental healthcare and what’s next for the company. Kyle founded Cerebral, an online mental health platform, to offer high-quality, comprehensive care and medication management for depression and anxiety.

What’s the mission of Cerebral?

We are really all about our mission. Specifically, that is improving access to high-quality mental health care, and we’re doing that by building a comprehensive virtual counseling and medication management model.

My personal experiences with mental health are what led me to build Cerebral. Both of my parents are mental health clinicians, and I’ve had my own battle with debilitating anxiety and depression.

The path to getting care was littered with roadblocks, beginning with my own internalized stigma. I didn’t feel comfortable admitting to myself that I was depressed, let alone externalizing that by seeking care. Institutional barriers, too, held me back: wait times of two to three months for an initial visit with a psychiatrist and availability Monday to Friday from 9:00am to 5:00pm to see a therapist simply weren’t doable for me.

When I finally did access care, both antidepressants and medication management around it as well as therapy, it struck me: why did I, the child of two mental health clinicians, struggle for so long to access care? If it took me years, how long would it take others who weren’t as fortunate as I was?

It felt hopeless and inspired me to build a solution.

How is Cerebral leveraging technology to reduce barriers to high-quality mental healthcare?

The COVID-19 pandemic has precipitated a massive shift to virtual care. Our technology gives us the ability to reduce wait times by doing sophisticated supply and demand mapping so that our providers, counselors, and therapists are ready to work at the times they are needed most. Most of our clients can sign up and be seen within 10 minutes for their first visit, a far cry from the 2–3 month wait times that are typical to see a psychiatrist. When dealing with depression in particular, the difference in these wait times can make a world of difference; it can quite literally save lives.

Our technology also enables us to track patient outcomes. Most behavioral health practices aren’t able to track outcomes, which makes it incredibly difficult to monitor quality of care. By having our clients respond to symptom-based rating scales every month, we allow our clients as well as providers, counselors, and therapists to track and drive better outcomes. With this in place, if clients aren’t responding to care as they should, the clinical team can stage an intervention and introduce new treatment options. Without outcomes tracking, this typically requires a visit, and can be delayed by weeks or even months depending on scheduling.

Finally, technology allows us to match our clients to the right clinicians for them. We can use our matching algorithms to recommend the right clinicians for a given client based on modalities practices, demographics, and other insights, and then the client can scroll through recommended clinician bios and select who they think will be best for them. Therapeutic alliance and “fit” is clinically proven to be important to positive outcomes in mental health, so we invest much of our engineering resourcing towards ensuring that we provide that fit upfront.

At Cerebral, how do you find the right balance of automation versus personal contact with patients?

We do not, and will not, seek to replace the personal relationship involved in high-quality mental health care.

Clinical research shows that the therapeutic alliance a clinician develops with a patient has a massive impact on the quality of care. Cerebral has leaned into that and put a big focus on working with the highest quality clinicians.

In fact, automation augments or supplements the fantastic work of our top notch clinicians, powering better delivery of care to patients. For example, Cerebral can generate recommended counselors, therapists and providers to a patient. The patient makes the final selection and has the opportunity to test the therapeutic relationship, with the option to easily change their counselor, therapist or provider if it’s not a fit. Additionally, we use automation to track the aggregate success metrics of any given provider, so that they can get real-time feedback on client-reported satisfaction and client outcomes and continually improve the quality of the care they provide.

As we build out a mobile application, we’ll also leverage automation to share important and relevant information with patients. The information will be determined by a combination of technology and what the clinician believes the patient needs in that moment. For example, if a clinician notices a high uptick in a patient’s anxiety, we can send automated content catered to that client’s scores to help them work on their symptoms on their own before their next visit. At the patient’s next visit, the clinician will know what content was sent and can walk through the technique that may have been covered in the content that was pushed in more detail directly with the client via video call.

The COVID-19 pandemic has propelled patients and providers to quickly adopt virtual care, with $250 billion in care projected to shift to telemedicine due to the pandemic. Do you think this shift will continue in the mental health space in the long-term?

Clinical research shows that telemedicine leads to equal or better outcomes than traditional care, and behavioral health is particularly well suited to this modality. Unlike most areas of medicine, the clinician rarely has to physically touch or feel a patient to diagnose or treat. That’s really important to focus on when we talk about transforming the current system through shorter wait times, lower cost of care, and value-based care.

One silver lining to the COVID-19 pandemic is that insurers are considering the clinical research and coming to terms with how they reimburse for telemedicine, while also making sure they’re in line with parity laws.

That said, the most important piece is the patient’s comfort level in developing relationships with clinicians remotely. We’ve found that our patients feel comfortable with their clinicians, and that allows us to drive high quality outcomes. Our data shows that more than 75% of our patients are achieving meaningful reductions in their anxiety and depression.

Virtual care removes many barriers to treatment for patients, but what are the incentives for providers and payers to participate in virtual care?

I would segment this into payers and providers.

It’s important to recognize that we aim to help payers save money. Through virtual care, we can do just that because we are not paying for facilities. There is often a geographic cost arbitrage opportunity as well, as we may hire the best clinicians physically located in lower cost states and so long as they are licensed in higher cost states they can practice there as well. We’re also able to use supply and demand mapping to reduce wait times, which is a huge problem in mental health for payers. 80% of our clients can have their initial visit within 10 minutes of signing up. That number is staggering when you compare it to the typical two or three months wait time for an initial consultation with a psychiatrist.

What providers like about Cerebral is the flexibility in schedule and location; they can work anytime from anywhere. When you eliminate geographic and scheduling constraints, providers can focus on delivering the absolute highest quality of care without distraction.

You just closed a significant Series A. What’s next for Cerebral?

The Series A will allow us to continue making strides in increasing access to high-quality mental health care.

With this capital, we’ll be able to expand medication management and therapy to all 50 states — so anyone, anywhere can seek help. We are also working to partner with payers and provide in-network care to our patients, making Cerebral even more affordable and accessible.

We’ll also be enhancing our engineering capabilities to build on the matching algorithms for patients and counselors, therapists and providers. As our network of clinicians expands and we further build our matching capabilities, we will be able to provide increasingly precise recommendations for patients to work with the best clinicians for them.

Finally, the funding will support Cerebral in launching our connected health mobile app that brings care to the patient’s pocket. Patients will be able to send instantaneous messages to their clinicians and smart notifications will alert patients of their medication schedule so no dose is missed. Exclusive content and behavioral exercises will be curated based on outcome measurements, ensuring patients can meet their individual mental health needs.

With these initiatives, we will continue our work to ensure that anyone with internet connection can access high quality mental health care in a moment of need.

Lightning Round

  • I weren’t working at Cerebral, I would be… In school to become a therapist myself. Probably doing so virtually from a different continent.
  • What’s on your desk right now? 3 notebooks and a pack of pens… I still take my notes with pen and paper!
  • What one piece of advice would you offer to an entrepreneur? Don’t be scared of failure. Fail 5 times. Fail 20 times. If you haven’t failed time and again, you aren’t trying hard enough.

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