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by Peter Brietbart, Marta_Krzeminska
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CommunityGlobal health & developmentSpark WaveEntrepreneurshipMental health (cause area)Organization updates
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Summary

We’re excited to announce that Mind Ease, an EA-founded and led company focussed on providing anxiety relief via an app, is acquiring UpLift, a cognitive behavioural app for depression. Merging the products of the two companies, Mind Ease will aim to provide the best-in-class mental health app for both anxiety and depression. Our priority in the coming years is to merge these products, scale substantially, and use profits generated in high-income countries to ultimately give the app away for free in low-income countries. 

This update won’t spend time articulating why we think this is a potentially high expected value project, but for some discussion of the space please see this problem area report, this cause profile, this post about psychotherapy vs cash transfers, and this evaluation of Mind Ease.

What is Mind Ease?

Mind Ease: Anxiety Relief is an app that provides help for those suffering from symptoms of anxiety. The app includes interactive exercises based on techniques such as Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), and Acceptance and Commitment Therapy (ACT) as well as other evidence-based approaches, including mindfulness meditation. 

  The interventions are grouped into two types:

  • Calm Me exercises are designed to relieve immediate symptoms of stress, anxiety or panic attacks.
  • Explore activities are to be completed when the user is feeling calmer. They help each person understand their anxiety better, and help the user build skills that can benefit them in the future.

One of the strengths of Mind Ease is measurement. The app asks the user to record their feelings before and after every Calm Me intervention. This way it can measure the percent of increase of positive feelings, and decrease of negative feelings. Over time, this data helps establish which specific intervention works best for every user. 

The effectiveness of each exercise is verified by our own randomized trials, run through GuidedTrack and Positly, Spark Wave's study creation and participant recruitment platforms. We also use a data dashboard to keep track of each exercise’s performance, including the average reduction of self-reported negative feelings, per-screen drop-off rates, improvement in overall mood, and user-submitted feedback.

What is UpLift?

UpLift is an app focused on helping people who experience depression. It offers an 11-week program of structured, interactive sessions based on Cognitive Behavioural Therapy (CBT). It aims to be the best in class digital intervention for depression. 

A pilot, longitudinal study run by the UpLift team[1] found a large decrease in PHQ-9 depression scores from the first session (M = 9.45, SD = 4.11) to the final final session (M = 4.51, SD = 3.67) for those who completed the program (n=81). The mean decrease in depression score was 52.3%. There was also a decrease in GAD-7 scores for completers from the first session (M = 8.68, SD = 4.97) to after the final session (M = 5.38, SD = 4.37) with a mean decrease in anxiety score of 38.0%. While these results were very encouraging, they are from a pilot study of an early version of UpLift, which has undergone substantial improvements since then. The study was longitudinal in nature, but did not have a control group. We hope to run a randomized controlled trial to gather further evidence related to effectiveness, which controls for potential confounders, as well as ruling out regression to the mean effects.

Why combine the companies?

Many people who suffer from anxiety also suffer from depression, and vice versa[2]. As a result, an app which can provide solutions for both conditions is able to provide an all-in-one solution, which is more complete for individual users and health care providers.

The Mind Ease and UpLift content is strongly complementary. Mind Ease specializes in a fast feedback cycle for users (helping them reduce anxiety quickly whenever they need it). UpLift, on the other hand, has an in-depth program aimed at providing long-term mental health benefits. This combination of short-term and long-term focussed content has advantages over either one individually.

Both products have come out of Spark Wave, a startup foundry created by Spencer Greenberg to incubate companies focused on important social problems. Both UpLift and Mind Ease are built largely using GuidedTrack, which simplifies the technical challenges of combining them.

Ultimately, we think combining will result in a stronger product, with better chances at having substantial impact at scale.

Summary of Mind Ease Progress 

Since we last posted about Mind Ease, which was in 2018, we have:

  • Founded the UK company Mind Ease Labs Ltd
  • Raised £1m in funding
  • Grown the team from 3 to 12 people (~9 FTE)
  • Launched the Mind Ease app for the web, iOS, and Android
  • Developed a freemium business model
  • Gone from 3,500 installs in 2019 to 60,000 installs so far in 2021
  • Reduced a total of 35,000 self reported points of negative feelings (measured on three -3 to 3 scales) in 2021 so far
  • Maintained a 37% retention rate for annual subscribers, and a 67% retention rate for monthly subscribers
  • Expanded our psychological exercise and activity libraries substantially

Future plans

  • Implementing a machine learning exercise-recommendation algorithm, which predicts which intervention will help each user the most. It draws from our existing data set, the ongoing results from each specific user, and their demographic information (if provided) to suggest exercises that are expected to provide the highest reduction in self-reported negative feelings. This is also designed to allow the app to make better predictions over time as to what interventions will provide the most support to each user.
  • Bringing UpLift’s longform CBT content into the Mind Ease app. There’s still a lot of things to figure out here, and our recent Project Manager hire will be a huge help. Plausibly we’ll have three subscription types: anxiety, depression, and combined.
  • Creating a more substantive sense of user progress by adding a goal-oriented section called the Journey. Current plans for this include mood check-ins, automated entries of user activities, goal setting and some light gamification through the use of achievements/badges.
  • After profitability is reached, use profits from our freemium subscription model to offer Mind Ease for free in (some initially selected) low income countries. We think this is ambitious but plausible. Challenges include translation, cultural localisation, and distribution, but this is surmountable, and success would be of high expected value.
  • Fund and spin out a research arm that can develop novel insights into anxiety relief. If we can improve the state of the mental health field itself, that would act as a multiplier on our impact. Right now, we collaborate with Spark Wave to run studies that inform how to help people with mental health challenges, and it would be great to eventually scale this into its own organization dedicated to this purpose.
  • Run and publish an RCT showcasing the efficacy of the app for reliably reducing the symptoms of anxiety.

How can you get involved

If you’re interested in Mind Ease or UpLift, we'd love your help! Here are four options for things you could potentially do if you're interested:

  • Support us by downloading Mind Ease, trying us out, and leaving us a review on the Google Play Store, or the App Store. This helps more people find the app!
  • Send us feedback. We'd love to hear your thoughts, suggestions and (especially) critiques to help us improve Mind Ease. Please tell us how you think we can make the product better! You can send us feedback about the app or our approach at hello@mindease.io. If you do so, please put “EA Feedback” as the email’s subject line. If you notice any bugs we'd also really appreciate hearing about those.
  • Meeting us! Come chat to us during the Careers Fair at the upcoming EAG London (Oct 30 and 31, 2021). We don’t even need to “talk business”, we’d just love to meet you!
  • Work with us. Our team will be growing, so if you’re interested in joining, watch out for job postings at the Effective Altruism Job Postings Facebook group.

With thanks to Spencer Greenberg, Jacy Reese, and Michael Plant for their valuable input on this post.

_________________________

References:

[1] Liu, E., & Pluta, A., & Dobson, K. (2018, November). Pilot Study on UpLift A Computerized Cognitive Behavioral Therapy Mobile App for Depression. Poster session presented at the 52nd Annual Convention for the Association for Behavioral and Cognitive Therapies (ABCT), Washington, D.C.

[2] Groen, R.N., Ryan, O., Wigman, J.T.W. et al. Comorbidity between depression and anxiety: assessing the role of bridge mental states in dynamic psychological networks. BMC Med 18, 308 (2020). [available here]

Other:

Twenge, J. M., “The Age of Anxiety? Birth Cohort Change in Anxiety and Neuroticism, 1952-1993”, Journal of Personality and Social Psychology 2000, Vol. 79, No. 6, 1007-1021. [available here]

St. Sauver, et.al. “Why do patients visit their doctors? Assessing the most prevalent conditions in a defined US population”, Mayo Clin Proc. 2013 Jan; 88(1): 56–67. [available here]

McManus S, Bebbington P, Jenkins R, Brugha T. (eds.) (2016) Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital. [available here]

Mental Health Foundation, In the face of fear How fear and anxiety affect our health and society, and what we can do about it. 2009. [available here]



 

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Dvir Caspi2
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Hats off to you guys, well done! 

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