Basketball going through hoop

As mental health companies gain more scale, power, and resources, how can we avoid losing sight of the ultimate goal — to translate these advantages into a more effective mental health system?

It is an understatement to say that the mental health landscape has dramatically changed in the last five years.

Multiple companies valued at over a billion dollars have sprung up, our workforce has seen a massive shift towards virtualization, and care is thankfully more accessible than ever. Our landscape is filled with companies growing rapidly, seemingly in a race to scale, and the road ahead appears to be one of consolidation and competition between increasingly large players.  As mental health companies gain more scale, power, and resources, how can we avoid losing sight of the ultimate goal — to translate these advantages into a more effective mental health system?

Here we could learn a lesson from the NBA’s move to add the three-point line.

In 1979, the NBA was a Goliath’s game, dominated by people who were 7 feet tall. From 1960 to 1979, 10 of the scoring champions were 7-footers and the majority of championship teams were built around centers. After a game is played thousands of times, competition points it in a certain direction — in this case, rewarding the tallest players who can shoot without fear of being blocked. A Goliath’s game, in my opinion, is no fun to watch — just pass the ball to the 7-footer and watch them do their thing. We appreciate the skill, but it’s hard to love a game where the little guy has no chance.

The NBA apparently agreed because in 1979, to make the game more exciting, it made a small change to the basis of competition: It introduced the three-point line for shooting from a farther distance. At first, nothing changed. Less than 1% of total shots made were three-pointers in the 1980 season. But over the next 30 years, the addition of a three-point line accelerated innovations in the way the game was played, things like pick-and-rolls, off-ball screens, stepback jumpers, and quick release shot techniques.  

As a result, it became possible for smaller, less bouncy players like Steph Curry to score in ways that were not initially thought possible. In 2022, 15% of shots made in the NBA were three-pointers. And the bottom line for the NBA? More exciting games and soaring popularity for the league. 

A seemingly small change to the basis of competition, combined with time and the power of innovation, can change the whole game. Human ingenuity is the most powerful resource we have, if only we let it thrive — in basketball, in healthcare, and in any industry. 

Octave has been a relatively small player in the mental health industry, but we’re working to make a real impact — not by growing to be the biggest, but by fundamentally rethinking what drives the industry and how to better align interests so we can all move forward. We have pioneered value-based care in mental health, measuring outcomes in relationships with large payers for the last four years and served tens of thousands of patients already.

As a former healthcare venture investor and then head of strategy at One Medical, I experienced firsthand the rollout of value-based care in the primary care sector. Ultimately, what I witnessed was too many misaligned incentives between payers and providers, a check-the-box mentality applied to value, and rewarding of questionable outcomes measurement. Today, the sector still has a long way to go in truly delivering effective primary care.  

In doing this work then and at Octave, I’ve come to conclude that we will not be successful alone. In order for us to really achieve our mission of providing more effective mental health care to more people, we in this space need to start thinking collaboratively, to advocate for shared interests and build shared infrastructure. For example, we believe that advocating for technology interoperability, common standards in outcomes measurement, and policy change will take shared action, not just smart competition. We will be meeting with leaders across the mental health landscape to help work on these common agenda items.

The recognition and demand for care is there, but there are still too many barriers to getting that care to people in the right way, at the right time. I hope that if we collectively can make the systemic changes as small and palatable as possible, we just might be able to change the way the game is played.

Sandeep Acharya is the co-founder and CEO of Octave, a modern mental health practice that’s creating a new standard for care delivery that’s both high-quality and accessible. With in-person and virtual clinics, Octave provides personalized, evidence-based therapy while pioneering relationships with payers to make care more affordable through insurance. 

A veteran in healthcare strategy and investing, Acharya previously led strategy at One Medical, responsible for launching and scaling several new services and overseeing the growth of its employer business to over 1,000 companies. Before One Medical, he was an investor, operator and consultant in the healthcare, retail, and technology sectors at Bain & Co, Bain Capital & Insight Venture Partners. Sandeep holds degrees in computer science and business from Wharton and Harvard Business School, where he was a Baker Scholar. In 2015, he was spotlighted on LinkedIn’s Next Wave of top professionals 35 and under.