An Untapped Multi-Billion Dollar Industry


The tragic death of Aaron Swartz has moved the tech community, and triggered conversations about why he died. Something Aaron himself wrote about shines light on his struggle with depression — and the need for an evolution in how our culture thinks about mental health.

On Depression, and the Death of Aaron Swartz

Its a sobering fact that 1 out of 10 adults in the US suffer from some form of chronic depression. In fact, it is a top cause of disability in our country — and there are no signs of it improving. In 2012, the military suicide rate surpassed the number of combat deaths, and one-third of those deaths were soldiers never deployed to active duty.

There is a crisis here. As a culture we either stigmatize and ignore the problem, or treat it with antiquated approaches. It is time for a change, and for technology and startup communities to rise to the challenge.

Sadness and Depression Are Different

In talking about depression, it is important to clearly distinguish between what Aaron called sadness and a more severe mental dissonance.

“Surely there have been times when you’ve been sad. Perhaps a loved one has abandoned you or a plan has gone horribly awry. Your face falls. Perhaps you cry. You feel worthless. You wonder whether it’s worth going on. Everything you think about seems bleak — the things you’ve done, the things you hope to do, the people around you. You want to lie in bed and keep the lights off. Depressed mood is like that, only it doesn’t come for any reason and it doesn’t go for any either. Go outside and get some fresh air or cuddle with a loved one and you don’t feel any better, only more upset at being unable to feel the joy that everyone else seems to feel. Everything gets colored by the sadness.”

Our Culture Stigmatizes Depression

There is a stigma around depression in our culture. If you have a chronic physical ailment, that is more publicly acceptable than if you have an ongoing mental health issue. Because what employer would want to hire someone who could be a “mental health risk?” These are the worries that people struggling with depression often feel, which leads to embarrassment and silence, rather than better cultural understanding and action.

The Psychology of Happiness Both Helps and Hinders

A TED talk by psychologist and author Martin Seligman dives into the distinction between physiology for mental disorders and therapy for “normal” people who just want to lead happier lives. Psychotherapy is critically important for people with more serious challenges, like chronic bipolar disorder or schizophrenia. But it is also critically important for even mild depression. Perhaps the growth of positive physiology and pop-psych media exposes more people to the idea of self-awareness. But it also trivializes the need for more serious and thorough methods of treatment.

Psychotherapy Needs to Evolve

In my profession working with technologists and designers, I’m astonished at how little emphasis has been put on the development of tools, apps and software for mental health. Just take a moment and think of all the commercially successful startups in the areas of weight loss (DailyBurn), exercise and diet (FitBit), medical records and insurance (ZocDoc), or physical illness and disease (WebMD). But when it comes to software, consumer technology, or startups for mental health, there are simply none of note. Why?

I’ve been searching for great tools for therapists and patients for a while now. And I decided that maybe this is a perfectly untapped potential market to start something on my own in. I contact several psychologists to see if I could do a bit of customer research and uncover their needs/wants. The response has been minimal at best. Perhaps therapists have so much trouble with insurance companies, billing, and scheduling, that they’re wary of and disinterested in new approaches.

Can a Startup Transform Mental Health?

When Aaron Swartz wrote that “depression is not seen as ‘real’ enough to deserve more awareness” he speaking of something that is both a design and a business challenge.

Phsyotherapy has for decades been largely about “talk therapy” — hour sessions with a shrink, talking through issues. A few startups are making headway in the teletherapy space but that’s only increasing access to care, not improving it.

As a culture, we need a significant, data-driven impact on mental health issues and treatment. We need new startups and products finding ways to help mental health practitioners cut down insurance and policy clutter to provide consistent treatment and to optimize treatment. For patients, we need to go beyond just the casual efforts of the quantified self. Patients need better robust self-treatment tools, not digital mood rings.

That leaves us with a pretty impressive challenge: a broken $113 billion dollar industry, an audience of professionals that are resistant to change, and consumers that doesn’t know what they need. Sounds like the perfect opportunity for something big.