Tripp: Digital Therapeutic Platform for Mental Health and Emotional Wellbeing.
Mental health has been the ugly ignored stepchild of health care for a very very long time. It is also an area lots of us are uncomfortable talking about, so much so that my TED talk on mental health was anonymous at first. Americans spend over $284B on mental health and wellbeing annually and the pandemic has exploded demand. There are huge efficacy, cost, and access issues which mean most people needing help don’t get it.
Until recently, it has also been an area where technology has underdelivered by not providing step-function improvements in efficacy. While meditation apps increase access, you are still practicing the same techniques people have been doing for thousands of years. Most meditation traditions also have an “upgraded” path usually mediated by some kind of drug (plant medicine). These drugs are now very popular in Silicon Valley with well-funded efforts underway to bring these to the masses. Is that the best we can do? Plant medicines that have been around for thousands of years?
I want technology to deliver a BETTER experience, leveraging all that we know today. Appling modern technology including AI, VR, wearables, and more to fix my mood quickly. Tripp leverages modern XR platforms to engage much more of the brain and autonomic nervous system at levels that traditional meditation just can’t reach. Tripp delivers the “upgraded” path to better mental health and wellness without the drugs.
I have been wanting to invest in Tripp for over three years. I ran into Tim Chang (partner at Mayfield) at an event and we were talking about the positive mental states we experienced at Burning Man. “Wouldn’t it be great if you could get to those states every day without the drugs?” he said. “I just invested in a company doing that.”
“I want to invest,” I begged.
“We just closed the round and we don’t even have a product yet.”
Undaunted, I met CEO Nanea Reeves (yes related to THAT Hollywood Reeves) and told her I wanted to be one of the first Alpha testers. She had heard my TED talk on the failure of the technology industry to address mental health. We had a crazy mind-meld around the positive mental health benefits of altered states. Nanea shared some of the underlying research they were doing to replicate those states without the drugs and described their evidence-based approach. We also talked about the huge missed opportunity of the VR/AR/XR companies to deliver anything other than more distraction. Delivering therapeutic benefits on those platforms was a very novel idea, and she was on it.
In 2019 Nanea came over to Upgrade Labs and strapped me into their first software app targeted at reducing stress running on the Oculus headset. We had quite a big business giving IVs and wanted something the patients could do during the 30-45 minutes, especially if that thing could lower their stress levels from having needles in their arms. Over the next 15 minutes, I was guided through a meditation and eye movement journey that raised my HRV by 30%. I felt calmer, and the data showed that my metabolism was in fact much less stressed. Tripp users report an average mood improvement of 25% after each session.
The effects were significantly greater than a normal audio only meditation (yes I did an A/B HRV test to compare). When I talked to the scientists, they explained the extra levels of engagement that come from the visual, audio, breath pacing, interaction, and eye movements deliver these increased mental health benefits. It is simply next level.
I invited them to the Upgrade Labs Conference to get feedback from 2,000 biohackers. It was one of the best-reviewed products at the Conference. They did not have a shipping product, but built a waitlist and closed some corporate trials. After the conference, I asked to invest again, “No, we have plenty of cash.” They had just closed a $1.7M NIH grant.
The company focused on corporate deployments in 2019 and early 2020, securing some impressive names, research funding, and filing 2 patents. They have completed 6 (two more in progress) clinical studies proving efficacy including addiction (3), depression(1), and Anxiety & Stress (2). They now have multiple programs for multiple indications across multiple platforms (Oculus and Sony).
While corporate deployments slowed in 2020, their DTC business has really taken off with growing to tens of thousands of subscribers logging over a million sessions. They are now a top wellness app on Oculus VR.
In late January of this year (2021), I reached out to Nanae again for an update and asked to invest (again). She said they were considering it. I went on vacation for two weeks and we caught up after. “I have a small piece left,” she said. “I will take it,” I said. Sometimes persistence pays off.
Trends I am betting on
Structural barriers remain for Mental Health. Mental Health has long been a second-class citizen to physical health. MDs get paid more, their institutions are larger and more prestigious, they have an aura of “hard science” around them. Mental Health has always been squishy and until recently lacking much “hard science”. When I go to an MD he runs lots of tests that feel really definitive. When I see a therapist he asks how I am feeling and says I should come indefinitely until I feel better. Soft science. Insurance companies have lower payments and limit the number of mental health and wellness sessions per year regardless of the diagnosis. Most mental health issues are systemic and multifactorial so they don’t fit well into the One Diagnosis – One Treatment structure that medicine and our insurance system are designed for. Our healthcare system is designed as a fee-for-service model, not outcomes-based. Outcomes in mental health are an order of magnitude harder to predict and deliver. I am betting that these structural barriers will remain for a very long time.
Technology increases access, reduces cost. Therapy and drugs are very expensive on a cost and time basis and are constrained by the supply of trained therapists and the expensive nature of getting FDA approval for drugs. A new software application delivered to a device we already have can be developed in months and delivered in milliseconds for near-zero marginal costs. There are already tens of millions more people meditating today with the instructor on their phone than when you had to drive to a temple somewhere. There are more people learning languages on their phones than in all the universities in this country. Mental health today is a very expensive, limited access product. Perfect for technology disruption. And not just your existing therapist doing a video call. Applications that can augment or replace your therapist at an order of magnitude lower cost.
Modern understanding leads to step-function improvements in efficacy.. Much of psychology was developed at a time when the prevailing medical belief was that the brain was a fixed-function organ after a certain age, immune to further development. It was not until very recently that the idea of lifelong Neuroplasticity became widely accepted. Today we know an order of magnitude more about the relationship between the brain, the gut, the autonomic nervous system, and mental health than even 10 years ago. There are structural differences you can see. Software developers can translate new understandings of mental health into treatments MUCH faster than the traditional research/development/FDA approval process can. I have seen brain scans of a non-meditator versus a 40-year meditator. Once you understand the starting point and desired end state, you can then ask the questions. Is there a better way? A faster way? A cheaper way? While I applaud training these tools to understand traditional therapies like meditation and plant medicine, there is a huge opportunity to innovate on that base to new approaches with step-function improvements in efficacy.
Increase of Personal Agency. As western civilization has “modernized” we have given up our personal agency to the market or government in ever more areas of our lives. Do you know how to grow your own food? Make your own clothes? Educate your children? Fix your car? Splint a broken bone? Your great grandparents did. Healthcare for most of us is nearly 100% outsourced to the “experts” with all the letters next to their names. The pandemic has been a huge bucket of cold water on the outsourcing trend and many of us have had to take up agency in areas previously ignored. Many of us have found that we get better results when we take more responsibility for our behavior and outcomes. Tens of thousands of people at home on their Oculus wanted a mental health solution instead of just another game. They couldn’t go see a therapist so they took some agency and tried this other thing. I am betting that people like agency and will apply that to more areas of their lives over time.