Our understanding of contributors to mental health—not just the symptoms but the emotional, physical, and environmental causes—has grown exponentially over the past 30 or so years, from the impact of diet and exercise to the myriad social determinants of health. The evolution of care delivery, however, hasn’t kept pace. This results in missed opportunities to help more people more effectively. 

This isn’t to say treatment has remained stagnant. Modalities have evolved in recent decades—EMD, group therapy, telehealth, etc. But care is still centered on the 50-minute, face-to-face session and/or medications—a model that is prohibitively expensive for some and logistically challenging for most. This approach also leaves patients completely on their own for the days and weeks between sessions.

At the same time, demand for care has exploded since the start of the Covid pandemic and shows no signs of slowing. At the very least, there is a need and perhaps even obligation to figure out how to scale care to more people without diluting efficacy. But what if we could both scale care and improve outcomes for the vast majority of those in need of support?

We can. Here’s how.

‍Speed up outcomes with continuous therapist support

Real life—and the friction of incorporating change—happens between scheduled sessions. Don’t leave people on their own here. Give them continuous access to therapists to speed up and lock in change.

At the same time, decouple support from the time-intensive model of weekly hour-long sessions. With asynchronous and chat-based models, therapists are able to deliver more frequent and more targeted support in far less time, which frees them up to help more patients. 

This both improves outcomes and reduces costs. Traditionally, therapists are able to support between 20 and 50 patients at any given time. In the Meru Health model, which offers four traditional face-to-face video calls plus unlimited asynchronous text support, panel size is up to 150 patients. That’s an increase of 300% to 750%.

Address the physical components of mental health

The world is catching up to the physical inputs of mental health, from the established connections to diet and exercise to emerging science around simple breath. For example, a 2023 study in the journal Cell Reports Medicine, led by Stanford neuroscientists, found that cyclic breathing exercises are more effective than mindfulness practices at reducing stress.

In our research at Meru Health, we’ve found that our program-specific HRV biofeedback breathing practices increase the likelihood that participants will achieve clinically meaningful reductions in symptoms of depression and/or anxiety. 

Mental health care providers have an opportunity, if not an obligation, to evolve treatment models along with the science to better address the entire ecosystem of mental health.

‍Lean into the research

On the note of research, only about 3% of mental health apps are clinically validated. In simple terms, there’s a lot of digital junk out there peddling junk science. If you’re building new models of mental health care without establishing that they work and how they work, you’re doing a huge disservice to those who need care and those who want to provide it. 

Since our founding, we’ve contributed to the published research on digital mental health, HRV biofeedback, and long-term outcomes of various behavioral health interventions. Our independent and peer-reviewed publications cover research we’ve done with independent institutions like Stanford and Harvard. And we’ve even taken the additional step of having our outcomes independently verified by the third-party Validation Institute.

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