These are great points! FYI, jh is Jonathan Harris who runs TPP.
I’ll preface my response by saying that I’m not an expert in this area; Will and I mostly focused on the impact investing side of things, and Hauke or someone on the Mind Ease team could likely provide a better response.
My understanding is that most popular apps (e.g., Headspace, Calm) offer free versions to people [including people in low- and middle-income countries]. I suppose MindEase would have an edge if it offers the full (premium) version for free, but it still seems quite difficult to compete with highly popular apps like Headspace/Calm. What do you think? And has this model of offering an app for free in low- and middle-income countries worked for any apps in the past?
I think that Headspace and Calm may not be the right reference points since they’re not designed to tackle anxiety and depression, whereas Sanvello (formerly Pacifica) is. Headspace and Calm strike me more as “mindfulness apps” versus “mental health apps.” For instance, it doesn’t look like Mindspace and Calm feature any CBT exercises, whereas Sanvello does. I have paid access to Calm via my employer, and while I haven’t used it much, it looks like all it has are guided meditations. Reviews of Headspace and Calm support my initial impression and mention that they just have guided meditation and music. I expect that evidence-based practices specifically designed to target certain mental health conditions are significantly more efficacious than guided mindfulness meditations.
This distinction might’ve made it so that this Psychology Today review from 2019 mentions Sanvello as “the most popular” mental health app, ignoring Headspace and Calm. Regarding competition, it mentions that Sanvello has 2.6 million registered users, which is smaller than Headspace and Calm but still seems significant. It seems like other apps, including ones I’ve never heard of, have also been able to get decent user counts. For example, Moodpath reached 1 million downloads in 2019. Regardless of whether Headspace and Calm are competitors, Sanvello and other apps would still need to be competed against. Unlike other industries, like network effects with social media, I don’t think that the major mindfulness/mental health apps have enough of a moat to prevent other competitors from emerging.
My understanding is that Headspace and Calm offer their vast majority of their content behind a paywall. The Headspace review I linked to suggests free users get access to one-third of a “Basics” (introductory meditation) course before they need to pay.
What constitutes releasing an app for free as “working?” It’s commonly known that free apps get many more downloads and are the vast majority of apps on the iOS and Android app store, so I would expect that this would be a very effective user acquisition strategy (but perhaps not an effective monetization strategy, hence the social impact angle).
The Pacifica study that Hauke cites compares counseling alone to counseling + Pacifica. This seems like a comparison that would underestimate the effect of Pacifica. (It seems rather impressive that an app is able to have any effect above and beyond therapy, and I would imagine its standalone effect to be larger). Furthermore, I don’t think Pacifica will be Mind Ease’s main competitor—Headspace and Calm appear to be much more popular than Pacifica (here and here), and they also focus on mindfulness/relaxation. Are there any estimates of Mind Ease’s counterfactual impact relative to Headspace or Calm?
Sanvello (Pacifica) was likely selected because it is the most efficacious competitor in the same space. I’m not sure about how Hauke utilized the study findings in his report and his reasoning for doing so, so I’ll have to defer to him on this. I’ll let him know about your question!
It’s worth pointing out that the report uses a very conservative counterfactual user impact estimate that is much closer to Foster’s estimate than Hauke’s estimate due to “principles of robust decision making under uncertainty.”
Is the business analysis by Lionheart publicly available? (Apologies if you said this somewhere in your post).
It is not! TPP has not publicly released information containing private data from Mind Ease, which includes the business analysis and Foster’s report. That’s why the section on Mind Ease user data is not included in Hauke’s report.
Thank you for the info about startups! I’m still a bit skeptical about the mental health app space in particular; are there any statistics about the percentage of funded health/mental health app startups that succeed?
There isn’t too much information out there on startup success rates, and I’m afraid I’m not familiar with success data specifically about mental health apps!
Just to add that in the analysis we only assumed Mind Ease has impact on ‘subscribers’. This meanings paying users in high income countries (and active/committed users in low/middle income countries). We came across this pricing analysis while preparing our report. It has very little to do with impact but it does a) highlight Brendon’s point that Headspace/Calm are seen as meditation apps, and b) that anxiety reduction looks to be among the highest Willingness To Pay / high value to the customer segments into which Headspace/Calm could expand (e.g. by relabeling their meditations as useful for anxiety). The pricing analysis doesn’t even mention depression (which Mind Ease now addresses following the acquisition of Uplift). Perhaps because they realize it is a more severe mental health condition.
These are great points! FYI, jh is Jonathan Harris who runs TPP.
I’ll preface my response by saying that I’m not an expert in this area; Will and I mostly focused on the impact investing side of things, and Hauke or someone on the Mind Ease team could likely provide a better response.
I think that Headspace and Calm may not be the right reference points since they’re not designed to tackle anxiety and depression, whereas Sanvello (formerly Pacifica) is. Headspace and Calm strike me more as “mindfulness apps” versus “mental health apps.” For instance, it doesn’t look like Mindspace and Calm feature any CBT exercises, whereas Sanvello does. I have paid access to Calm via my employer, and while I haven’t used it much, it looks like all it has are guided meditations. Reviews of Headspace and Calm support my initial impression and mention that they just have guided meditation and music. I expect that evidence-based practices specifically designed to target certain mental health conditions are significantly more efficacious than guided mindfulness meditations.
This distinction might’ve made it so that this Psychology Today review from 2019 mentions Sanvello as “the most popular” mental health app, ignoring Headspace and Calm. Regarding competition, it mentions that Sanvello has 2.6 million registered users, which is smaller than Headspace and Calm but still seems significant. It seems like other apps, including ones I’ve never heard of, have also been able to get decent user counts. For example, Moodpath reached 1 million downloads in 2019. Regardless of whether Headspace and Calm are competitors, Sanvello and other apps would still need to be competed against. Unlike other industries, like network effects with social media, I don’t think that the major mindfulness/mental health apps have enough of a moat to prevent other competitors from emerging.
My understanding is that Headspace and Calm offer their vast majority of their content behind a paywall. The Headspace review I linked to suggests free users get access to one-third of a “Basics” (introductory meditation) course before they need to pay.
What constitutes releasing an app for free as “working?” It’s commonly known that free apps get many more downloads and are the vast majority of apps on the iOS and Android app store, so I would expect that this would be a very effective user acquisition strategy (but perhaps not an effective monetization strategy, hence the social impact angle).
Sanvello (Pacifica) was likely selected because it is the most efficacious competitor in the same space. I’m not sure about how Hauke utilized the study findings in his report and his reasoning for doing so, so I’ll have to defer to him on this. I’ll let him know about your question!
It’s worth pointing out that the report uses a very conservative counterfactual user impact estimate that is much closer to Foster’s estimate than Hauke’s estimate due to “principles of robust decision making under uncertainty.”
It is not! TPP has not publicly released information containing private data from Mind Ease, which includes the business analysis and Foster’s report. That’s why the section on Mind Ease user data is not included in Hauke’s report.
There isn’t too much information out there on startup success rates, and I’m afraid I’m not familiar with success data specifically about mental health apps!
Just to add that in the analysis we only assumed Mind Ease has impact on ‘subscribers’. This meanings paying users in high income countries (and active/committed users in low/middle income countries). We came across this pricing analysis while preparing our report. It has very little to do with impact but it does a) highlight Brendon’s point that Headspace/Calm are seen as meditation apps, and b) that anxiety reduction looks to be among the highest Willingness To Pay / high value to the customer segments into which Headspace/Calm could expand (e.g. by relabeling their meditations as useful for anxiety). The pricing analysis doesn’t even mention depression (which Mind Ease now addresses following the acquisition of Uplift). Perhaps because they realize it is a more severe mental health condition.