Russell Glass, CEO, Headspace Health: Meditation and Mental Health Support for the Masses

This is Outside In and I'm Charles Trevail. Today I'm with Russ Glass. Russ is the CEO of Headspace Health. He set up a business in 2018 called Ginger.

Those businesses have merged with Headspace to create Headspace Health. So Russ, we're here today to talk about the issue of mental health. Welcome. Thanks for having me, Charles.

Excited to be here. Let's start by talking about mental health and then we'll come on and talk about your business and what you're doing there. You have this wonderful term that I've seen you use. Talk about brushing your brain.

Why do we need to brush our brains nowadays? Where's this mental health epidemic come from? Well, it's a good question. I mean, let's start with sort of foundation.

Actually, My father-in-law is a child psychiatrist for his whole career. And one of the things he said is, we are dropped on this earth knowing that we're going to die one day. The human condition is very unique, right? We're the only creature that knows that we have a finite time on this earth.

And so I think a lot of mental health issues, or he thinks a lot of mental health issues, just start there. I think today we're in a very unique period in the world where the confluence of events, the global pandemic, the climate change issues we're facing, the wars, the polarization from a political standpoint, the economy, all of these things have mental health attributes to them, right? They affect people's mental health. And so today, as much as any time in recent history, we're seeing a confluence of things that are leading to significant mental health issues.

Just to give you some stats, the World Health Organization estimates that one in eight people around the world, so a billion plus, have a diagnosed mental health condition. And 60 plus percent of those people are not getting any kind of support for those issues. It's a staggering number of people. So that's 600 million people, if my math's right.

Yeah, I mean, you could argue it is the societal issue of our time. I've been writing a diary since I was a teenager. I never reread it, but I did go back and I reread what life was like for me when I was 18. I won't tell you exactly how old I was, but that was in the late 1970s.

Life was so simple then. In fact, we were bored a lot of the time because life was so simple. It's not like that. You and I both share having daughters.

Yours are a little younger than mine. But the world that they have grown up in is so complex. They have very few coping mechanisms, I would suggest. And I'm using your app, by the way.

I love it. I use the Headspace app. The work you're doing is really great. Well, tell us a bit about the merger to start with, because you have a business strategy.

You're bringing these businesses together. Tell us how that's going or a little bit about what it is and then how it's going. Sure. Headspace Health is we really brought two, not only leaders, but really kind of two category creators together where you have Headspace, which is really bringing mindfulness meditation to the masses.

Right. So trying to help people understand the power of brushing your brain. On the other side, Ginger, which really invented the category of on demand virtual mental health care. And by bringing these two companies together, the idea is to bring the world the first comprehensive end-to-end mental health platform where wherever you are in that journey, you come in, we assess you and help understand what your needs are, and then guide you into the place that's going to be most helpful, whether that be self-care and headspace, building a resilience and mindfulness practice, whether that be behavioral health coaching, or more clinical therapy.

counseling, psychiatry, medication management, and right-sizing cost and scaling the care that we're able to deliver. So it's a wonderful ambition. How do you ensure people are getting the right care? How do you help them select the care they need?

There are a few ways we do it. One is we spend quite a bit of effort from a R&D standpoint on machine learning and artificial intelligence, we have huge data sets now from over a decade of doing this, monitoring how people are doing over time, understanding what interventions have actually been most useful and helpful, and then feeding that back so that we can make predictions on the kinds of things that are going to be most useful. Just I'll give you an example. Today, our AI is more predictive than our coaches and therapists are in terms of what content is going to be most engaged with by our members.

We're able to, in an automated way, help people understand what sort of personalized pathway is going to be most helpful. And so when someone comes in, we're doing quite a bit to understand what their needs are going to be. And then we make some predictions based on that. But then we also have a team, a behavioral health coach that is interacting and understanding what the needs of the person are and can guide where that person should be.

That is just such a huge change compared to the way the mental health system works today. Where basically everybody who comes in is thrown into a morass of trying to find a therapist. It takes weeks to find somebody who's available. Most therapists don't take insurance.

It just becomes incredibly difficult and friction filled for somebody to get access to care. And it's usually not even the right level of care. Yeah, I've seen that from a personal point of view. And I've also seen it work the other way, Russ, where it's not been your product, but someone I know very well has got into doing therapy for the first time.

And they've done it through an insurance company in an employer scheme. And I said to them, how's it going? And they said, well, it doesn't work. So I don't believe in any of it.

It was because they had kind of got themselves into the wrong level of therapy for what was required. They required something a little more serious. You know, I've had a look at your stuff and there's obviously a big difference for people who know between meditation, mindfulness, coaching, therapy, psychiatry. But I wonder if that's clear enough for the...

I totally take that what you providing is way way better than the current system and all the problems within the system I just wonder if it clear enough for people to navigate and how you dealing with that issue if at all You hitting on one of the most I think, impactful areas here, which is most people don't know I need to go see a therapist or I need medication or I need to build a mindfulness practice. Most people know I'm not feeling well, right? They know I just don't feel quite right.

I'm not getting the joy out of life that I once did. I'm having panic attacks or I'm feeling super stressed to the point of anxiety. They may not even know it's anxiety. Sometimes people will just feel a crushing pressure on their chest or they'll get stomach aches or they'll get back aches.

And so important that when people show up, there's a guide, there's a handholding, there's a, hey, what's going on? And applying both technology, applying understanding about these different symptoms and what they might mean, applying rigor and evidence-based care allows us to get that person to the right place, support them the way they need to be supported. We need to meet people where they are. It's weird if you think about it that mental health is probably the only condition where you're asked to use the organ that's having trouble to solve the problem.

we got to take as much of that as possible off of that person so that we can help them get to where they need to go. So tell us a little bit about how you do that. One of the things I've heard you say in the past is how the use of chat, for example, is breaking down some of the stigma around mental health. And I can believe that.

But tell us some of the other ways you're doing that, because you've got a great product. And I'd love to hear a little bit about that. The first thing we recognized pretty early on is the importance of prevention. If you think about mental health, one of the reasons that you have 600 million people around the world that haven't gotten care is that there's still stigma associated with it.

Now, it's reduced over time. We see particularly younger populations are more willing to raise their hand and say, I'm not feeling great. I'd like to get support. But there's still a whole bunch of stigma.

So it means that people aren't taking care of themselves early enough, you know, before things get more acute. Well, you talked about brushing the brain, right? I love that analogy because we don't brush our teeth because we have a tooth problem today. We brush our teeth because we're trying to prevent tooth problems.

That's where we start with mindfulness and meditation. It's really allowing people to strengthen their resilience, strengthen ability to manage the ups and downs of life, brush their brain, so to speak. But it's really low stigma. It's easy to get started.

You mentioned using the app. My life is completely different since I started meditating about nine years ago now. I'm a different dad. I'm a different husband.

I'm a different CEO because of what meditation has done. Just 10 minutes a day has done for me. That's where we're trying to help people understand just the intense, immense ROI of 10 minutes a day of self-care. But then our next step, your point is to chat-based behavioral health coaching.

And the chat is, it's kind of like when you go to an airline and you're trying to deal with support, it's easier to click on chat and try to get the simple things dealt with versus, you know, getting on the phone and having to have a whole conversation. It's similar here where it's just a much easier thing to start chatting with someone. So our behavioral health coaches are available 24-7. Within two minutes, you can engage and start having a conversation via chat, we see the effect of that.

Our outcomes, we measure our outcomes. Our outcomes are as high on chat-based behavioral health coaching as they are in video based therapy, which is pretty amazing. But then some people need more. And that's where our evidence-based therapists, our counselors, our psychiatrists for medication management come in, in that step care team-based environment.

There is an enormous shortage of professionals in this field. And obviously the fact you're using technology, you're sort of democratizing the product and the market, but are you, are you still finding it hard to get the staff you need, you know, even through this technology system you have? It is certainly one of the most in-demand resources. And we're fortunate to have a brand in Headspace Health that people want to work for.

We have a, if not the best, one of the best work-life balances in a field where, you know, 60% of mental health professionals call themselves burned out right now, globally. Providing compassion and care for all of these people when you are also going through what the world is going through today is hard. It's challenging. And so part of our way of thinking is we have to support the providers in addition to supporting our members.

But a lot of what we're trying to do is reduce the number of people who need to go to these limited resources. We're trying to keep them in self-care. We're trying to keep them in behavioral health coaching. Where appropriate, one of the paradoxes of the space is that you have so many people who don't get care, but you also have a lot of people that get far too much care.

Right. Right. It's the forever therapy, years of therapy syndrome. Sometimes that's required, sometimes that's appropriate, but very rarely.

In a sense, I've got this analogy now of you almost being like the primary care system, you know, taking the strain away from the specialists and the hospitals. You're out there with the, if I say the mass market, but trying to deal with people's mental aches and pains. That's right. You don't want a cardiologist looking at every scrape.

And just like you don't want your clinical therapist looking at every mental health issue. You talk about the use of technology. Tell us what exciting stuff you might have coming down the line. I mean, we've all been wowed by chat GPT.

You know, there must be some wonderful opportunities for you in these areas. There are certainly some incredible opportunities. I mean, if you look at the last four years, use of technologies like our smart answers platform where we predict what a coach is going to answer with and we provide that to them. They then have the ability to edit before they send the response.

But we're already using large language models to automate and help support a lot of our providers. Over the last four years, we have increased our efficiency by about 25% a year, north of 5% a quarter, through technologies like this, through our automated notes platform, where we listen to a conversation with our technology and automatically summarize the notes so the provider doesn't have to create those notes. They can just review them and lightly edit them. I think in the future because of the progress ICS probably gaining speed in terms of efficiency creation So if it been 25 over the last number of years we think we probably can accelerate that in terms of continuing to bend that cost curve and create efficiency through technologies like ChatGPT.

I mean, we should say today that while incredible is not accurate enough, nor sort of skilled enough in the world we're in to be of much use, but it can be used very effectively. And this is kind of where we're using it to support providers and support experts that know how to use it, you know, intelligently. But it's not yet at the point where you can just leave it to its own devices. That would get pretty scary pretty quickly.

How's your merger coming on? You brought these businesses together, what, a couple of years ago now, I guess. I think I heard you speak on a podcast six months after the merger, you can give us a quick update on that, Russ. How's it going now?

It's going great. Although the line between the merger and great is not as straight as it might seem to your listeners, right? It was hard. It's a merger of equals.

So both companies were kind of around 500, 600 employees each, give or take. And so today we're probably about a 1200 person organization. But again, like a lot of change. And it starts with when you bring two organizations like that together, you have two of a lot of roles and you don't need two of a lot of roles.

How you build culture and how you sort through all that, it's tricky. Then, you know, we're doing it in the middle of an economy that's changing rapidly. Kind of early last year, we started to see inflationary pressures and that's created what we're all feeling today. and recessionary spend patterns.

And that's been tricky. So doing a merger during a big shift in economy, and then while there are global pandemic pressures. So all of that, I think, has led to a road that was more complicated than I thought it would be. We've had to really focus on our people and our culture and lean on the mission to get through all that.

We're now at a point where things are getting exciting. We just launched our integrated product. We actually just announced that we're expanding that integrated product into the UK and then beyond. It's starting to get more fun, but it was challenging for a while.

Yeah, well, I think you're quite unusual in that you, I don't know how many people running, you know, relatively, I call it medium-sized organizations have been through the merger process where two brands of the same size come together and it is a genuine merger. I'm not sure that many people, I mean, people have done mega mergers and a lot people in Silicon Valley are doing startups. I'm not sure. So many people.

And actually, with 500 on, I have some experience of that size of company and bringing them together. They're small enough where you're supposed to know everybody's name. Certainly on the side you were on before the thing. And then everyone wants to know who's winning.

Who's winning? Who's going to come through? What's the leadership team? Is this a straight deal or is it all pre-arranged?

I mean, I'm sure you've had your own dynamics. What have you lessons learned, Russ, in the process? A lot of lessons learned. I mean, first of all, I'm not sure if merger is actually ever a good idea from the standpoint of like someone should acquire someone else.

Right. And you should decide that up front because even that sets a tone of what is this? And it sets a set of expectations. The merger, even just framework, is complicated because you have to make all of those decisions downstream of that versus making that decision up front.

So that may be one learning to me is try to force the decision of who's acquiring who. Having done a few of these before, I, you know, maybe a little bit naively was like, oh, I've seen this. You know, I know how to do this. We'll just go this way.

But the truth is, each one of these is quite different because the people are different and the cultures are different. And I'll tell you one thing that we did get absolutely right. And that is the industrial logic of this is super powerful and super strong. Like bringing these two platforms together is a industry changing, market changing force.

And that plus the other thing we got right is the culture fits. These two companies are very mission driven companies. Everybody's in it for the same reason, to transform mental health care for the health and happiness in the world. So when you've got the industrial logic right and you've got the culture right, you can get through a lot.

Yeah, yeah, absolutely. So, Russ, I have a kind of a plea and I often put this out there to people like yourselves. I love the idea of members first, customers first, et cetera, et cetera. I actually went and had a look at your terms and conditions before this call.

So you know where I'm going on this. Yeah, yeah. That is not written in a member's first way. You know, I remember people at the height of Facebook's problems, like, what should they do?

And I remember saying to someone on someone else's podcast, well, if I was Mark Zuckerberg, I'd actually co-create my membership conditions and legal T's and C's with my customers. So I would create transparency because I think it creates problems within organizations when the kind of the marketing position is one and the legal position is another. I don't know. I don't personally, I don't know what to do about that.

If you go and look at my organization, it has exactly the same stuff, I'm sure. But how do we find our way through this? Yeah, it's a great call out and great research. What I would say is, it's not an excuse even, but it's as we've been bringing these two organizations, the first thing that we've done is focused on our B2B business.

So focused on the fact that, you know, these two platforms together and in a unified experience really helps enterprises support their employees. And so we're supporting some of the largest enterprises in the world, the Starbucks of the world and the Adobe's of the world and the Paramount's of the world, the United Airlines of the world. And so the first thing we've focused on is the integration of those two experiences. We haven't really touched yet, but it's coming, the consumer side of the world.

It all should feel easy to consume. It should all feel tied with the brand promise. It should all feel like it's consistent. And so we got to fix that.

Well let me help you with it because I a customer of yours and I read the T and C and I thought oh my goodness there all this great stuff on here And yet you telling me you not a health care provider and you not you know you have to indemnify me of every all of all of which I get But I at the end of the day, that's kind of when the rubber meets the road. You know, there's large organizations. I'm dealing with a big telco at the moment from on a personal matter. I cannot find my way through the system.

So the rhetoric is customer care and the reality is not at times. But what does the future look like, Russ, in terms of where you're going next? Where's the energy? What can we expect?

The app has got so much stuff on it. I've probably only been on it a couple of months, but it's got a ton of stuff on there. What does the future look like? I'm super optimistic.

We are really trying to design a product, a system like you'd want the mental health care system to work. With that as our true north to try to deliver as much support and evidence-based care at as low a cost as possible, we want to expand this to as many people as we can. First, it's bringing these two capabilities together so that we have the prevention, we have the self-care along with the full spectrum of care. And then it's expanding that to as many audiences as we can so that, you know, we de-stigmatize, we bring up the loved Headspace brand to as many people as possible.

We put the right assessment together so that people get to the right level of care. We get them in and get them out as soon as possible with the outcomes that they want. And we use technology to scale that and improve it over time. That's what we're doing.

I feel so lucky that I get to wake up every morning and focus on it and bring something that, again, has changed my life. I'll tell you, like when I when I sold my company to I sold my company to LinkedIn, very fortunate and we had a great ride there. But when I showed up at LinkedIn, I wasn't sleeping very well. I just had my third child.

I had some imposter syndrome. I was struggling with anxiety and I actually discovered Headspace because Jeff Wiener, the then CEO of LinkedIn, brought Andy Pudicombe, the founder of Headspace, to talk to the staff. So there's all kinds of things we could dig into there. Jeff recognizing way back in 2014, the importance of talking about this with the LinkedIn staff is an amazing cultural aspect to what Jeff brought to LinkedIn, compassion, right?

But in that meeting, I downloaded Headspace because because Andy was talking about how mindfulness can change your relationship with anxiety, can change your relationship with stress. Downloaded it and I started to meditate. And I meditated about 10 minutes a day for a couple of weeks. And I was in a meeting and it clicked because four people around the room, I remember the room I was in, but four people around the room or having a conversation that I knew would trigger my stress response, my anxiety response.

And it didn't. And I watched it and I said to myself, huh, I feel a little anxious and I let it go. And literally since that day, I've had a very different way of interacting with stress, whether it be kids, you know, as we all know, they can be stressful, whether it be with my wife, whether it be in sports, you know, activities that I'm participating in, it's been life changing. And I want to get that to as many people around the world as possible.

I have to tell you this, Russell, I must have just gone through the thing on the app with Andy where he calls it something like naming the problem. He call it, note it, note it, because I actually went through that last night because I was feeling a little stress last night and I just parked those anxieties and just by naming them, noting them, putting them away. They haven't gone, but I know what they are now. So very, very powerful stuff.

Just another quick question on that, that I wanted to ask you a little earlier in the chat. Do you have the same problems the gyms have? They get sign up, because I did find myself, I downloaded you and then I was on for a couple of weeks and then I dropped off and then I thought, oh, actually, oh, I'm going to do this interview today. And I got back on it and I'm on again.

But you must see those trends. And I guess I'm hoping you've got plenty of good technology and nudges and things there to keep people going. But that must be an issue for you generally, I would imagine. It is for sure.

We're all human and habit changing humans is hard. Many books over many thousands of years have been written about it, right? Yeah. We are spending a lot of time thinking about how do we help people stay with the practice and you know how do we help people accomplish what they want to accomplish with mindfulness meditation i will say some churn is which you're talking about right some churn is good churn right you know i think that for instance if we build a resilience practice and someone gets to the point where they're so proficient at it an expert at it that they don't need our app anymore that's a win right right now it's not a win necessarily from a you know subscription revenue standpoint.

But our mission is actually not subscription revenue. Our mission is improving the health and happiness of the world. So some of this is positive churn. For those where it's not positive, we want to give them capabilities and use technology in a positive way to help them stick with their practice until they get to the point where either they don't need the app anymore or they've built a habit that they're continuing over time.

Russ, this has been a really great chat. The subject is obviously very relevant to many, many people in the world today. what I would say to people is you know like me go have a look at the Headspace app and it just takes 10 minutes a day and you can get something out of each of those 10 minutes and build as you say build your resilience for this anxious world that we live in so Russ good luck with your business thank you for the mission that you're on on behalf of all our listeners and come back and speak to us again sometime I would love to thank you Charles really enjoyed the conversation today Outside In is hosted by Charles Trevail, CEO of the Interbrand Group, which includes Interbrand, the world's leading brand consultancy, and C-Space, a global customer agency.

Outside In is produced by Daniel Sills. If you like what you hear, leave us a review on Apple Podcasts or wherever you listen to Outside In.