Pioneering Virtual Mental Health Solutions for Families with Naomi Allen, CEO and co-founder of Brightline

[00:00:02] Hey everyone, welcome back to the Outcomes Rocket Founder Stories. I'm so excited you tuned back in to another episode of our podcast. Today I am so lucky to have Naomi Allen with us. She is the CEO and co-founder of Brightline. A little insight on Brightline, they are the behavioral healthcare.

[00:00:24] Naomi started Brightline in 2019 to reinvent the way behavioral healthcare is delivered for children, teens and their families. As we all know, this area of attention and behavioral health is a massive opportunity, especially for this age range. So I'm excited to host her to chat more about that. She's done a lot of really great things before Brightline. She was chief growth officer at Livongo. Before that she was with McKinsey.

[00:00:52] So excited to bring all those interesting experiences to what she's doing today. Naomi, thanks so much for joining us.

[00:01:00] Thanks so much for having me, Saul.

[00:01:02] It's my pleasure. So look, let's kick this thing off. Before we jump into Brightline, I really want to get to know you better, get the audience and viewers to know you better. What inspires your work in entrepreneurship and in healthcare?

[00:01:18] Thanks. I've always worked in healthcare. I'm a child of a physician and coming out of college, had the opportunity to go work in operations at a hospital. I was at Deloitte Consulting and did hospital ops work. And this is in the mid nineties. And it was really, I think the birth of the use of technology to drive improvements in hospital operations and got to see firsthand how technology can save lives.

[00:01:42] Kind of funny story about early, one of my first experiences in healthcare. I was working at a hospital and somebody had actually, an indigent patient had died trying to get admitted into the ER.

[00:01:53] And we did a bunch of work and just cobbled together all of this paper-based records. And we found out that the ER wasn't able to really support and treat new patients because they didn't have a place to offload the patients into admitting beds in the hospital.

[00:02:07] So we did a bunch of work around re-engineering how patients were discharged in order to create capacity in the hospital beds in order to get people that needed to be treated from the ER into the hospital and admitted.

[00:02:20] So really interesting work. I fell in love with using technology to drive operational improvements to save lives. And that was the beginning of my career in tech enabled healthcare. Fast forward a few years later, I went to business school and came out of business school, was at McKinsey and then left McKinsey in 08 and have been in startups for the last 15 years.

[00:02:39] So as a founder at Cast Light Health was there for eight years, had a chance to really drive a lot of the early intervention, early innovation in digital health. And then I spent about the last, gosh, almost seven years now in care delivery and different care delivery companies.

[00:02:53] And Brightline was a journey that my family was on seeking mental health services for my oldest child a number of years ago, really before COVID and before people were talking about youth mental health.

[00:03:04] Now, obviously everybody talks about youth mental health, but even before that, so many families were seeking high quality, affordable access and care.

[00:03:13] And frankly, the mental health services for kids and families are just really fragmented and not very consistently high quality.

[00:03:19] So it's been a delight for the past few years to get to innovate in this area.

[00:03:23] Thank you, Naomi. I love the background, all of your experiences, and this is personal for you.

[00:03:29] So I love that you're bringing all the things that you've built, the frameworks that you've developed, culminating to this point where you guys are really helping in this area of behavioral health for kids.

[00:03:41] Talk to us about what you guys do at Brightline and how you're adding value to the healthcare.

[00:03:47] Sure. We have a full platform of care for kids age zero up to 18.

[00:03:53] That's a family-focused care model.

[00:03:55] So what that means is we have a technology that has digital interventions.

[00:03:59] We've built a few hundred digital interventions that are available to families 24-7, on the go, whenever they need them.

[00:04:06] We have a coaching team that delivers skill building and skill enablement for kids and families.

[00:04:13] And then we have a full therapy and psychiatry team that delivers clinical care.

[00:04:17] So really the full range of support services for families.

[00:04:20] And we treat the most common challenges that families and kids engage with.

[00:04:24] So for young kids and families with young kids, that's often early signs of being on the autism spectrum, disruptive behaviors, acute tantrums, sleep disorders for the really young kids.

[00:04:37] And then as kids start to be about six or seven, we start to see higher incidence of anxiety, early signs of ADHD, maybe even in that eight, nine range, some kids that might have depression.

[00:04:48] And then a large portion of the kids we treat are adolescents and teens, and they have the full gamut of everything you can think of the kind of youth challenges right now in terms of depression, anxiety, loneliness, ADHD, signs of self-harm, et cetera.

[00:05:02] So we really have a comprehensive platform that treats a broad set of acuity and needs, and it's all virtual care.

[00:05:09] So it's convenient for families.

[00:05:11] About 75% of the counties in the U.S. don't have a child or adolescent psychiatrist.

[00:05:16] And about half the counties don't have access to pediatric trained therapists.

[00:05:21] So really have created a way for families to have high quality in-network access to a broad variety of mental health services for kids and families.

[00:05:29] That's great, Naomi.

[00:05:31] You guys cover a lot.

[00:05:32] And so tell us a little bit more about the model.

[00:05:35] It's virtual care.

[00:05:36] Help us understand how you guys are going to market with it.

[00:05:39] Sure.

[00:05:40] We've had two main go-to-market engines.

[00:05:42] The first one that we started with was creating insurance relationships.

[00:05:47] And that's really critical because, as you may know, Saul, so many pediatric therapists don't accept insurance at all.

[00:05:54] And so in order to create those insurance relationships, we really had to demonstrate that we were following high-quality measurement-based care.

[00:06:01] So we started with first principles, what do families need, interviewing a bunch of families, and then what's the best-in-class clinical care that we can provide.

[00:06:10] And we built our clinical programs and measurement programs first.

[00:06:14] And then we started to work with insurance companies to get that covered in networks.

[00:06:18] So we've taken a really, I think, clinical outcomes and family-first approach to our go-to-market.

[00:06:23] And then we started to get insurance contracts.

[00:06:26] And through those insurance contracts, we added employers as our customers.

[00:06:31] So right now we have a little over 600 employer customers.

[00:06:34] We are serving customers as large as Amazon, Costco, all the way down through very small mom-and-pop employers.

[00:06:41] And they provide Brightline as a covered benefit for their employees.

[00:06:45] So we partner with those employers to make Brightline available to the families that are employed there.

[00:06:50] And then a couple of years ago, as the youth mental health crisis started to really gain awareness and visibility across the country,

[00:06:59] we also started to see a growth in public sector opportunities where either state or local or municipal governments were trying to figure out how to help the families in their geographies.

[00:07:10] And so we bid on and won a contract with the state of California.

[00:07:14] So we also provide services that the state fully funds for kids 0 through 12 in California for our subclinical offering, our Connect platform, and our coaching services.

[00:07:25] So two really important engines, I think, that are serving different constituents and different populations across the country.

[00:07:32] And then we're starting to work on some really important new innovation where we're opening up our insurance contracts to be broader network coverage,

[00:07:40] which means that we could receive member referrals from schools or from other providers that are seeking in-network care for their patients.

[00:07:49] Really starting to work on how do we open up the network access to create more access for families that need high-quality care.

[00:07:57] That's fantastic.

[00:07:58] Thanks for sharing that.

[00:08:00] There's certainly great opportunities for many people, it sounds like now,

[00:08:05] to access Brightline suite of really self-service, but also coaching solutions for behavioral health.

[00:08:12] It seems like California is pretty ahead of the game on a lot of things mental health.

[00:08:17] Help us understand that, because I've had a couple conversations, state of California has come up.

[00:08:21] Are they ahead of the game?

[00:08:22] I think for sure in terms of the kind of the breadth of the vision and the commitment to the investments there.

[00:08:28] I think California so often leads the way for the country in terms of thinking about macro level trends and how do you solve them structurally.

[00:08:37] Governor Newsom, I think, is really in the first partner.

[00:08:39] I think I've really been leading a lot of thinking around mental health across the country.

[00:08:43] But we are seeing other states.

[00:08:45] I certainly am excited by Governor Hochschild's announcements coming out of New York.

[00:08:49] She's definitely driving a lot of innovation and investments in New York state.

[00:08:53] We're seeing some really good work in Illinois and Pennsylvania and other states.

[00:08:56] I think California is not alone.

[00:08:57] I think that there is broader awareness of the country and we're starting to see more and more states really try to crack open.

[00:09:04] Like, is it access to more intensive outpatient, inpatient services, school-based services?

[00:09:10] Do we partner with a party that can span a lot of the support like a bright line?

[00:09:15] So we are seeing a lot of really thoughtful work being done across multiple states now.

[00:09:20] Appreciate the landscape view there.

[00:09:21] That's very interesting.

[00:09:22] And folks, a lot of great things happening in behavioral health.

[00:09:26] Just exciting to see the advancement that is being made by companies like Naomi's.

[00:09:32] They're making it possible for access to be a thing.

[00:09:36] Whereas before, it was always like, we don't have enough supply.

[00:09:38] We can't do that.

[00:09:40] Like, a bunch of excuses have turned to, now we have solutions.

[00:09:43] So this stuff isn't easy to do, Naomi.

[00:09:46] So I want to, as a founder, give you a ton of credit for what you and the team have been able to do.

[00:09:52] As you've been building the company, what would you call out as differentiators for you guys that really help stick out beyond other services that do similar things?

[00:10:02] Yeah, I think it's really critical that we are measurement-based and we measure every single family that comes through.

[00:10:10] We're establishing a baseline and measuring their progress.

[00:10:13] In the pediatric space, so much of care is not measurement-based.

[00:10:18] Many clinicians are trained in more play-based modalities or other modalities that can be effective but don't have a consistency of knowing what does a clinical outcome look like.

[00:10:29] And so I think that's been really important for us is that's been the core drumbeat for us day one is quality, high-quality outcomes that are measurement-based that we can stand by.

[00:10:37] I think the other aspect of that is we measure outcomes not just for the child but for their parents or caregivers.

[00:10:44] And that's really critical because as any parent who's had a child have behavioral health stuff going on, you know that if you're having a hard time, you're not able to really be there and show up and be the support for your child who's going through behavioral health challenges.

[00:10:57] So we do measure caregiver stress and strain because if we can help drive those down, then we have an opportunity to really have that caregiver, that parent support their child's behavioral health journey more effectively.

[00:11:08] So measurement's a big part of what we do and focus on quality is a huge part of what we do.

[00:11:13] We extensive training and case consults with our clinicians.

[00:11:16] But I think the other piece that's really interesting is how do you get ahead of the challenges?

[00:11:22] So often families will wait years to start to seek mental health services for their kids.

[00:11:28] And then when they start that journey, they all of a sudden realize they may be facing a year-long wait list.

[00:11:32] And that's even if they're willing to pay cash.

[00:11:34] And so how do we really help provide these on-ramps that make it easy?

[00:11:39] They normalize the idea that, hey, every family may need a little behavioral health coaching at times, skill building early.

[00:11:46] Half of all severe mental illness manifests before the age of 14.

[00:11:51] But as a country, we often wait to get services when kids are in high school.

[00:11:57] Like that's where you start to see a lot of the activity happening is when kids are in crisis.

[00:12:01] So how do we unravel that?

[00:12:04] We believe that early intervention and that preventive services are key to that.

[00:12:08] So that's why we've leaned in heavily with our digital interventions and our coachings.

[00:12:12] We have about 20 coaching programs that we've measured outcomes against as well.

[00:12:16] So that's, I think, really important because it provides families with a low stigma way to start to get the types of supports they need.

[00:12:23] So I think that's really critical.

[00:12:24] And we also believe that there's a lot of opportunity to support children and families through ages and stages.

[00:12:33] So if I'll tell you just in the case of my family, one of my kids had a number of things going on when he was five that we got support around.

[00:12:40] And then as he started to inch towards middle school, had a spike in anxiety again.

[00:12:44] So how do you get in there and really support that child again?

[00:12:47] And so when you deal with pediatric and youth care at different life stages, there's going to be a flare up of potential needs and challenges.

[00:12:54] And so how do we get ahead of that and create a longitudinal home for families to have support?

[00:13:00] So start early, provide the early interventions, and then grow with that child and that family as their needs evolve.

[00:13:06] Take a family approach and then make it measurement-based.

[00:13:09] That's the golden ticket to really crack you open some of these challenges.

[00:13:12] And I think a lot of the work that we do that is really critical is parent-facing because really digging in with families of how do you support your child in this journey?

[00:13:21] How are you dealing with your own challenges, whether that's anxiety or depression as a parent?

[00:13:25] So how do you really show up to have the type of impact that you need to help support with your child?

[00:13:30] That's great.

[00:13:30] Love the evidence-based approach.

[00:13:32] The focus on the parents.

[00:13:34] I love ages and stages.

[00:13:36] That really sticks.

[00:13:37] Love that a lot.

[00:13:38] And it sounds like a really nice framework that helps you guys shine.

[00:13:42] Building is hard, and we oftentimes learn more from our setbacks than we do our successes.

[00:13:48] So founder stories here, what's been one of your biggest setbacks in creating the company?

[00:13:53] And what's a key learning that came from that's made you guys stronger?

[00:13:58] Well, I think when we started the company, we were in the same mindset that I think everyone has been in mental health,

[00:14:07] which is there's a massive gap in supply and demand, notably a lot more demand than there is supply.

[00:14:13] And we spent a lot of time getting ready to have our first customer launches.

[00:14:18] In order to launch a national employer that has employees all over the country, you have to go build a 50-state therapy practice, psychiatry.

[00:14:25] You have to do a bunch of things and invest heavily up front.

[00:14:29] You have to build the insurance contracts to be that covered benefit.

[00:14:32] So we were about two years into a pretty heavy set of investments and efforts when we started to launch our first customers.

[00:14:40] And I think what was so just eye-opening was despite us knowing that there was massive gaps in supply,

[00:14:48] and despite us knowing that there was a youth mental health crisis,

[00:14:51] employers really oftentimes weren't that keen to drive awareness and adoption.

[00:14:56] And it's been, I think, a real effort in the business in the past couple of years of partnering with employers to say,

[00:15:03] how do we even let your employees know that this service is available?

[00:15:07] It's a new category, right?

[00:15:08] People often know that there's mental health services for adults for themselves because of the EAPs have been focused on that.

[00:15:14] But how do we really create awareness around the idea that there's family mental health services?

[00:15:19] So I'd say that's been the biggest eye-opening is we launched our first batch of like 45 customers.

[00:15:24] I think one-one, I'm trying to remember my year, is a one-one-22.

[00:15:28] Like that was two years ago.

[00:15:29] And we were like, voila, here we are, world.

[00:15:32] And it was like pin-drop silence in terms of member acquisition.

[00:15:35] And so it's just a real journey to actually start to work on that member acquisition

[00:15:39] and then drive awareness and engagement and de-stigmatizing.

[00:15:42] What's super interesting around youth mental health is the youth themselves,

[00:15:46] teenagers, adolescents, even young kids, they're raising their hands saying,

[00:15:50] I need more support.

[00:15:51] I'm struggling with X.

[00:15:52] My friends are getting coaching or therapy.

[00:15:54] And so the kids themselves are often now really open to getting services and virtual feels very comfortable for them.

[00:16:02] They like it.

[00:16:03] And so, but we have to drive awareness because the parents are often like,

[00:16:07] Ooh, I don't know about virtual care.

[00:16:08] And is my kid really, if they get therapy, what's going to, what is the stigma going to, what's going to happen?

[00:16:13] And so we find ourselves doing a lot more awareness building and barrier busting at the parent and caregiver level

[00:16:19] than I think we expected because the youth adoption is there.

[00:16:23] It's really getting, getting my generation on board with the idea of seeking services for their kids.

[00:16:28] Yeah, no, that's, uh, that's fascinating.

[00:16:30] And you never know what those barriers are going to be,

[00:16:33] but it's all about quickly identifying them and doing something about it.

[00:16:37] And you have, right?

[00:16:38] You have, it sounds like you definitely have.

[00:16:40] And so look, really appreciate you coming onto the show, Naomi, sharing the amazing work you guys are doing at Brightline.

[00:16:47] What call to action would you leave our listeners with as sort of things that they should be keeping in mind

[00:16:53] as they care for their kids or look to cover their employees or members?

[00:16:59] I think the biggest thing is for parents to know that kids are really strong and resilient.

[00:17:03] And if you are struggling, if you're struggling with your child or you're seeing your child struggle,

[00:17:07] just taking that first step, first call with a coach, first appointment with a therapist,

[00:17:11] seeing a school counselor and seeing if your child needs support because getting on the path early really matters.

[00:17:17] And kids often get better.

[00:17:19] Kids are really resilient.

[00:17:20] Mental health early intervention is really high impact for kids and families.

[00:17:24] I'd say for employers, please visit us at Hello Brightline.

[00:17:27] If you're interested in learning more, we'd be delighted to have conversations with employer prospects.

[00:17:32] And then same for help plans and partners.

[00:17:34] We're just excited to continue to build that ecosystem.

[00:17:37] Naomi, thanks for that close.

[00:17:39] Nothing more from my side to close.

[00:17:42] That was such a great call out.

[00:17:43] Folks, remember in the show notes, you'll find ways to get in touch with Naomi as well as her team at Brightline.

[00:17:50] So make sure you check those out.

[00:17:51] This has been a phenomenal interview with Naomi Allen, CEO and co-founder of Brightline.

[00:17:58] Let's do some stuff for our kids that's really going to help them get what they need.

[00:18:02] Naomi, thanks for you and what your team does.

[00:18:05] Thank you so much.