The world in the midst of the pandemic is facing three crises: a medical crisis (the pandemic itself), an economic crisis, and (not to be underestimated) a mental health crisis

In March of this year, contemporary philosopher Zizek discussed this viewpoint in a media interview. He reminded us of the fact that in this era driven by progress and development, the real situation of human survival is worthy of attention, and people's mental health issues cannot be underestimated, especially during periods of pandemic isolation, economic downturn, and global social unrest.

According to data from the National Institute of Mental Health and the American Psychiatric Association, about 20% of adults have varying degrees of psychological or mental illness, and about 5% of adults have reached severe levels. However, less than 45% of the affected population choose to receive treatment through psychological counseling, medication, hospitalization, and other means each year. Even among teenagers who are generally considered to face lower social pressure, 17% of them experience psychological or mental problems, and only about 50% choose treatment.

This data means that every person we come into contact with every day, including you, me, and him, may have mental health issues. How do people deal with this issue in the healthcare industry? What kind of companies are making what kind of products, models, or therapies? Where are policies, capital, and demands guiding entrepreneurs in the field of mental health?

250 million 'hidden corners': Policy and capital exploration for years

This year, the disruption caused by the epidemic to social life has brought tremendous attention to mental health issues.

On January 27, the National Health Commission issued the Guiding Principles for Emergency Psychological Crisis Intervention in Pneumonia Infected by novel coronavirus, which incorporated psychological crisis intervention into the overall deployment of epidemic prevention and control, and required all regions to arrange work and develop work schedules according to the scope and number of target population and psychological crisis intervention personnel; On February 2, the Joint Prevention and Control Mechanism of the State Council in Response to the Pneumonia Epidemic Caused by novel coronavirus issued the Notice on the Psychological Assistance Hotline in Response to the Epidemic, requiring all regions to set up a psychological assistance hotline in response to the epidemic on the basis of the original psychological assistance hotline.

In addition to the fight against the epidemic, China has actually put the construction of mental health services on the agenda for a long time. In 2004, the Ministry of Health issued the "Guiding Opinions on Further Strengthening Mental Health Work", which proposed the principle of "prevention first, combination of prevention and treatment, key intervention, wide coverage, and legal management" for mental health work.

In 2012, China introduced its first Mental Health Law, which stipulated that medical expenses for patients with mental disorders would be covered by medical insurance in accordance with relevant national social insurance regulations. If there were still difficulties, priority assistance would be given by the civil affairs department; The policy also encourages and supports social forces to establish medical institutions engaged in the diagnosis and treatment of mental disorders and to provide mental health services.

In October 2016, the issue of mental health was also included in the "Healthy China 2030" planning outline, with relevant discussions such as "strengthening intervention for common mental disorders and psychological behavior problems such as depression and anxiety, and increasing early detection and timely intervention efforts for psychological problems of key populations".

In November 2018, the "Pilot Work Plan for the Construction of the National Social Psychological Service System" was introduced, which includes 17 key work contents, such as building grassroots psychological service platforms, improving the education system's psychological service network, and developing social psychological service institutions.

Looking back at this policy context, we can see that mental health in China is transforming from macro level attention and guidance to the implementation and construction of mental health services and platforms. In terms of policy implications, the mental health industry has reached a new stage and urgently needs platform companies with good solutions.

The issue of mental health is undoubtedly a major problem in our country. In May 2018, the National Health Commission announced at a meeting that as of the end of 2017, there were 243.264 million people with mental disorders among the 1.39008 billion population in China, with a total prevalence rate of 17.5%; There are more than 16 million patients with serious mental disorders, and the incidence rate is more than 1%, which is still growing year by year.

In the face of this severe problem, the existing supply of mental health is so insufficient that the industry urgently needs new models, technologies, and concepts to intervene.

There are no shortage of early adopters and innovators on good tracks, so good moods and psychology emerge, and some players embark on their explorations. Behind them, capital also began to pour in, giving them a blessing.

In the past year, there have been 10 financing events in the field of mental health in China, and the track has received over 200 million yuan in investment.

Compared to China, the financing scale in the field of mental health abroad is much larger, with 10 companies receiving approximately 1.8 billion yuan in investment

What kind of exploration have these capital favored enterprises opened up in the industry? What kind of solutions are available to treat people's psychology?

Two types of players, two paths

In medicine, there are three main criteria for determining whether a person's mental health problems are ordinary psychological problems or mental illnesses: whether there are hallucinations (such as auditory hallucinations, visual hallucinations, etc.) or delusions? Is there any problem with self-awareness, and is it possible or willing to receive psychological or psychiatric treatment? Is emotion and cognition reversed and confused, is knowledge, emotion, and intention unified, and is social function seriously damaged as a result?

'Yes' belongs to mental illness,' no 'belongs to ordinary psychological problems.

Based on this distinction, innovative enterprises in the field of mental health in China can be roughly divided into two categories: health service models for common psychological problems, represented by companies such as Yixin Psychology, Yuejian, and Depression Research Institute; The medical service model for mental symptoms is represented by Good Mood and Zhaoyang doctors.

Traditional psychological counseling institutions are mainly based on studios, where counselors and users are provided in a one-on-one offline format and charged by the hour. With the rise of mobile Internet, artificial intelligence and other technologies, the field of mental health has ushered in technological upgrading. From offline to online, the digital upgrading of the industry is the main innovation path.

Players of the health service model have brought offline psychological counseling to online platforms and designed health service products through video, voice, and text media; The players of the medical service mode have moved the psychiatric specialty in the traditional public hospital to the online. The mode is similar to that of the typical Internet medical enterprises such as Chunyu Doctor and Micromedicine, but they are deeply rooted in the field of mental health and intensively cultivated in the vertical field.

In different modes, two types of players are walking their own paths.

Health service model: focusing on psychological counseling and education, with core product content

Around the first year of mobile healthcare (2014), dozens of apps emerged in the field of mental health, with functional modules mainly including seeking medical advice, online consultation, psychological assessment, social networking, employee psychological services, psychological courses (paid or free), psychological education, etc., with a focus on psychological counseling.

From the publicly disclosed financing rounds and number of users, currently leading the industry are Yixin and Yuejian.

Founded in 2011, Yixinxing received millions of dollars in financing from early-stage investment firm Aurora Venture Capital in 2015, and tens of millions of yuan in equity financing last year. The psychological health services provided by OneMentality include psychological consultation, psychological assessment, psychological health science popularization, etc. Its "OneMentality" brand covers more than 10 content platforms, such as WeChat official account, Today Headlines, Zhihu, etc.

According to the brand manual data provided by OneMind, OneMind has 3 million paid users and 8 million official account matrix fans. Paid courses, original assessments, and psychological counseling are its three core businesses. Among the users of Yi Psychology, "urban young women", "well-educated", and "self growth oriented" are the main user profile tags.

Another leading enterprise in the mental health service model is becoming increasingly apparent. Yujian's three main businesses are psychological diagnosis, psychological counseling, and psychological education. In 2019, Yujian also received tens of millions of dollars in financing.

Psychological medical service mode: more vertical Internet medicine

In May 2020, the news of Good Mood completing a 125 million yuan Series A financing attracted significant attention from the industry. People cannot help but ask, has mental health become or is it becoming a lucrative field?

Good mood, founded in 2016, focuses on the field of central nervous system, and uses intelligent diagnosis and treatment system and Internet hospital service system to help users of mental and psychological diseases provide intelligent rehabilitation management and online medical services. Less than a year after its establishment, Good Mood received an angel round of funding of 50 million yuan led by Enhua Pharmaceutical and obtained all the medical resources involved in Enhua Pharmaceutical.

The Good Mood Platform mainly provides services such as continuing education for doctors, online communication, patient services, and patient management platforms, using data algorithms to accurately match users and doctors with mental health needs. Up to now, the number of registered psychiatrists and neurologists on the platform of Haoxin Internet Hospital has exceeded 29000, accounting for about 70% of the total number of doctors in this field. The number of registered users has exceeded 3 million, and the average monthly active number of users has exceeded 100000.

In the psychological medical service model, another company is called Doctor Zhaoyang. Doctor Zhaoyang initially existed as an online auxiliary diagnosis and treatment platform, mainly providing health consultation and doctor-patient communication services. Patients communicate one-on-one through multiple channels with specialized doctors in Zhaoyang Hospital, creating a safe, private, time-saving, and efficient way for psychiatric patients to seek medical treatment.

The positioning of the Internet medical platform that focuses on less consultation is slightly different. Doctor Zhaoyang is essentially an application that serves doctors. Doctors enter the platform to manage patients. Zhaoyang doctors provide appointment consultation, professional standardized pre diagnosis questionnaires, post diagnosis follow-up systems, and other functions for doctors on the platform, and match professional psychologists for joint treatment.

In August 2019, Dr. Zhaoyang obtained an A+round financing of nearly 50 million yuan. As of April 2020, the Zhaoyang Doctor Platform has more than 10000 practicing psychiatric doctors, mainly from the top ten public specialized hospitals in China.

The above are the two main models of mental health in China. In addition to vertical mental health players, most of the large Internet medical platform businesses actually cover the mental health module, such as Chunyu Doctor, Good Doctor Online, Skilled Doctor, etc. Their platforms can also meet the needs of users for psychological consultation, medical consultation, etc. This article focuses on the analysis of vertical fields, so they will not be specifically introduced.

From the perspective of investment and financing, foreign venture capital in the field of mental health is much more active, and the company Calm, which has already grown into a unicorn, is there any good model worth referring to?

The Stone from Other Mountains: Interpreting the American Calm, Why Can It Support a Valuation of $1 Billion?

In May 2020, foreign media The Verge reported that Facebook had agreed to pay $52 million to reach a settlement with employees of its content review team. The reason is astonishing, the review of the post caused them to suffer from mental trauma, which has been appraised by the court. The original text of the message reads: "Facebook acknowledges that content moderation can cause significant losses to employees, and this is a milestone recognition. Facebook has agreed to pay $52 million to current and former reviewers to compensate them for mental health issues arising from their work

Compared to the "shame" of facing mental health issues in China, Western societies may be relatively more open-minded. Calm, which started doing mental health business in 2012, specializes in a software that focuses on people's mental health. This software provides users with original audio content ranging from 3 to 25 minutes through subscription, and helps users improve mental health problems such as anxiety, excessive stress, and insomnia through various relaxation functions such as meditation, sleep aid, light music, and scenario simulation.

After four consecutive rounds of financing in 2019, Calm's current valuation has entered the unicorn sequence. According to 2019 data, Calm is the most downloaded sleep aid app on the App Store, with over 50 million downloads and an average of 75000 new users added per day. Newly registered users can enjoy a 7-day free trial period, and the platform will charge an annual fee of $59.99. If customers need a lifetime subscription, the fee is only $299.99, and the number of paid members exceeds 2 million. Collecting membership fees is the main way for Calm software to generate profits.

The CEO of the company revealed in an interview that Calm achieved an annual revenue of $150 million in 2019, doubling from 2018.

In the content module of software, sleep stories now account for a large proportion, and people's time spent on applications has also greatly increased, "said Alexia Marchetti, PR director of Calm. Many startups are trying to create user demand. However, they did not realize that 'sleep problems are so common and the demand from market users is so high that now a large number of users are buying our paid content instead of sleeping pills'.

In addition to user subscriptions and paid content, Calm is also exploring businesses such as psychotherapy, meditation retreats, and selling health products such as breathable clothing and yoga mats.

summary

The most profound discourse on mental health issues may have been first published in the book "Madness and Civilization" in the 1960s. The philosopher Foucault tells many interesting stories in his book, such as the exile of madness during the Renaissance and the confinement of madness under rational order in modern times.

In today's world where great progress has been made in medicine, culture, economy, and other fields, civilization may have given everyone this choice when dealing with psychological issues:

We can let our souls wander, or we can settle down in the cultural industry