A Future Peer-To-Peer Mental Health Network/Exchange
As we burrow into a deepening mental health crisis, could we rely on each other more than we do now for both meaningful interactions and sustained cost savings?
“If you want to make a society work, then you don’t keep underscoring the places where you’re different—you underscore your shared humanity,”
― Sebastian Junger, Tribe: On Homecoming and Belonging
A large handful of my dinnertime conversations since the sudden wave break of COVID-19 have centered around the torpedoing mental health of citizens all around the world, especially here in the United States, where the total death count recently passed 100K deaths (as of May 27).
The Washington Post, earlier this month, wrote:
“Just as the initial outbreak of the novel coronavirus caught hospitals unprepared, the United States’ mental-health system — vastly underfunded, fragmented and difficult to access before the pandemic — is even less prepared to handle this coming surge.”
Time and memory have a handy way of distorting memories past and tricking us into remembering things with a more positive hint than they were in reality, so it’s alluring to point to pre-COVID eras and say our mental health was better before this black swan event of 2020. Perhaps in comparison, this might be true. But from an absolute lens, we weren’t collectively thriving before the pandemic either.
Setting aside the fact that we’ve societally ostracized the discussion of mental health (though it finally seems to be finding its place in the mainstream discourse), there are economic blockers to quality mental health care that make seeing a well-educated and talented therapist a less than common occasion. You need good insurance. You need cash. You need both.
A crop of exciting startups led by intelligent, mission-oriented individuals are tackling the mental health access crisis by creating various therapist (supply) to patients (demand) marketplaces with varying flavors of difference:
Headway (NY) is minimizing the hassle of the insurance acceptance process so more quality providers will accept insurance to improve their reach
Two Chairs (Bay Area) is creating what I’ve heard as the “One Medical for mental health”
Frame (Los Angeles) offers similar marketplace dynamics and is also giving therapists the ability to record workshops to capture patient audiences at scale
These startups, without a doubt, are taking aim at an important and pervasive market in the USA and abroad. Most of their value propositions center around the standard method of connecting therapists with patients, which got me thinking:
With affordability and access in mind, could we establish a peer-to-peer marketplace, where we rely on one another during times of unrest (without therapists) that produces sustainable mental health benefits over time?
The idea came me after reading about Spotify’s incredible “Listening Together” feature they rolled out during COVID to bring the world closer together via simultaneous song listening:
Spotify saw that 30,000 people around the world pressed play on the same song at the very same time and developed a visual way to show these connections, to remind people they are not alone during a time of crisis.
Could we build something similar to connect us with each other to address our varying flavors of mental health?
I’ll cough up a definition of a peer-to-peer mental health exchange for reference’s sake:
(working) definition: a platform with network effects where citizens seeking to improve their mental health turn to those with similar mental health issues for peer-driven discussions that produce positive mental health outcomes and generate cost savings over time (vs paying for traditional therapy)
What would the peer-to-peer marketplace look like?
conceal a user’s true identity - initially, a user’s personally identifiable information (PII) would likely need to be masked so that users feel comfortable seeking/creating connections/groups without feeling as if the internet now has their dirty laundry ready to be aired (I catch myself typing this term “dirty laundry” because a) the internet likely does already and b) my labeling of mental health as dirty laundry is illustrative of the broader societal problem we’re chipping away at). It would be phenomenal if we get to a point in the future where we collectively feel ok with real names on the site (without revealing what you are discussing nor with whom)
modern-day user experience - interactive, elegant interface, minimalist design, effective filtering tools, polished profile experience, extensive user feedback/survey collection to ensure successful platform adoption and gauge user sentiment over time
“X seeking Y” outreach (a la the fantastic Craigslist days) - simple ability to find other human beings around the world who are going through something similar. If I’m a 28-year-old in NYC with mild-moderate career uncertainty/anxiety, I might really enjoy finding 5-10 similar folks who are going through something similar so we can lend each other helpful words of encouragement, a proverbial shoulder to lean on, or even professional leads (though this wouldn’t be Linkedin)
“give to get” profile / search & discovery model - only able to search for peers based on data attributes you are willing to provide about yourself. Using my own personal example again: If I want to talk with other 28-year-olds in New York City who are also happily unemployed and experiencing mild-moderate career anxiety, I need to input that I am: 28, living in NYC, unemployed, experiencing mild-moderate anxiety, source = career, etc. This would alleviate pressure /requirements to give away too much information about yourself until you’re ready to dive in
discussion/engagement: either 1:1 or group - find one person who you feel comfortable/excited to talk to, or find multiple and get a group thread going
best in class security/data privacy - privacy breaches would erode user trust in the platform here for obvious reasons
Revenue model(s)?
Monthly recurring subscription: $5/month (or something similar) - no more than the price of a cup of coffee or a sandwich each month to ensure affordability is consistently pinned atop the proverbial bulletin board. MRR would also eliminate need for advertising revenue and likely keep away handfuls of up-to-no-good trolls
Sponsored editorial content - capitalize on high engagement / sticky attention spans with thoughtful content that is both sponsored (Headspace, Calm, Breathe, or one of the many wellness companies/products) and helpful.
Marketplace for approved merchants with the platform taking a cut: would merchants eat into their margins for a potentially higher conversion rate (more engaged audience with a stated discomfort (cough, their mental health, cough))? There are a seemingly endless number of products that promote wellness - at home fitness products, meditation apps, CBD varieties, journals, meditation accessories, etc.
Concerns/question marks
1) Trolls and cyberbullying: we could/should send an entire post (read: month, year, decade) figuring out how to crack this nut. It’s intuitive to point to the plagues of internet trolling and cyberbullying on major social media networks and dismiss this idea as doomed. Trolls and bullies have harmed our public digital discourse. It tanks our mental health. Teens have committed suicide as a result. This is serious stuff. On a recent podcast recording with esteemed sociologist Jonathan Haidt, Sam Harris discusses how the creation of publicly-viewable digital conversations (where two people are conversing on a Facebook wall, Instagram post, or Twitter thread for all to see) could be a large culprit in turning the concept of a digital town hall into a malicious verbal gang bang (my words, not his). Without going too deep into the psychology behind harm of making 1v1 conversations available for all to see on these networks, it should be noted that for a p2p therapy exchange, there would be no public forum for discussion that would allow for the type of verbal gang bang we see on social media today. This would be less of a targeted reinvention of a chat room and more of a matching switchboard with the goal of fostering connections, not fostering dialogue. The dialogue would ideally happen outside of the platform itself on standard methods of communication (phone, WhatsApp, email, etc.).
2) Value add of p2p vs. speaking with a therapist: Therapists charge a high hourly rate (OK, 50 mins, not even an hour!) because of their education and their experience, both of which are certainly valuable (to what monetary extent depends on you the patient and your perception of value) and undoubtedly hard to replicate in a p2p environment. Therapists spend years of their lives adding to their education and deepening their perspective of the human experience, and its ails, via their work experience (the more patients they see, the better they likely become at asking better questions, identifying thought patterns, and being of value to future clients). It’s unlikely that a peer in this hypothetical p2p marketplace would get as much “wisdom” or tactical “value” from a peer conversation vs a conversation with a well-educated and seasoned professional. Yet how many of us have seen a therapist and thought something along the lines of “he/she is offering wise words/asking the right questions, but I don’t feel like they really get me / my situation fully”? How many of us continue to crowdsource knowledge from the friends in our lives we feel closest to? How many of us still feel distant from therapists and/or friends who “don’t quite get what I’m going through”? Lots of us! And yet there are 7 billion people on this planet. The numbers suggest that there is someone out there going through something very similar to whatever you’re experiencing (though the mind and the ego may not to hear that). In the same way Spotify saw that 30,000 people around the world pressed play on the same song at the very same time, it seems statistically probable that there is at least 1 other person somewhere on the planet going through something very similar to what I, you, we are going through.
I read Sebastian Junger’s Tribe (highly recommend) in April and have thought a lot about community since reading - it does a terrific job of highlighting the positive impacts that community, shared humanity, and a sense of purpose have in maintaining a well-functioning society and optimizing mental health among a soicety’s inhabitants.
We enjoy connecting with one another.
We enjoy providing for one another.
So many of us experience varying degrees of common mental health patterns/behaviors that underscore our shared humanity.
Mental healthcare is expensive, inaccessible, and traditional therapy is still significantly stigmatized.
Is there a future world in which we turn to one another more than we turn to therapists? Would a peer-to-peer network/exchange be a valuable ingredient in this future world? Would it help you as either a complement to, or replacement for, your current therapy efforts?
Share your thoughts! reedcfoster@gmail.com