Latest / The Mental Health Evolution / Ep 31: The Relationship Checkup with Dr. James Cordova and Matt Rubin of Arammu

Transcript

Ep 31: The Relationship Checkup with Dr. James Cordova and Matt Rubin of Arammu · The Mental Health Evolution

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  (Transcribed by TurboScribe. Go Unlimited to remove this message.) I sort of tell people like mental health care is this tertiary
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  model.
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  The only thing that exists is crisis care.
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  Like we should probably be doing things proactively, like imagine what the
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  world would be like if we had a preventative proactive approach to
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  mental health care where it became normal for our kids to go
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  to their pediatrician and then walk down the hall and talk to
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  a therapist for half an hour.
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  Not because anything's wrong, not because they're in crisis, just because
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  that's how you can detect things earlier and head them off before
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  your only option is a lifetime of taking pills.
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  And when I say that to people, they're like, oh, you're right.
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  Welcome to the Mental Health Entrepreneur Podcast.
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  We are here to inspire creative ideas and connections for entrepreneurs and
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  advocates working to address our mental health crisis.
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  As you listen, I hope you will experience new ideas and motivation
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  to innovate in your business, your community, and in your life.
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  Welcome back, everyone, to this innovative episode of the Mental Health
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  Entrepreneur Podcast.
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  I'm your host, Rachel Harrison.
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  And with me today, I have Dr. James Cordova and Matt Rubin
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  of ARAMU, which promotes a checkup and maintenance-based model of mental
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  health care.
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  Welcome, gentlemen.
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  Thank you.
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  It's nice to be here.
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  Great to have you here.
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  Yeah.
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  So let's dig in.
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  How did ARAMU come to be?
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  It's like the long story or the short story?
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  Whichever one you feel like.
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  When I was in, actually, when I was an undergrad, I volunteered
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  at a crisis center.
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  One of the jobs that I had at the crisis center was
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  just to pay attention to and to track why people were calling
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  in in crisis.
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  And month after month after month, the leading cause that people were
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  calling in for were relationship issues.
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  So that just really grabbed my attention in terms of it seemed
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  to me at the time as an undergrad, right?
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  Like, if you want to have a big impact on the quality
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  of people's lives, it looks like relationships is the place to do
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  that.
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  That was at the University of New Mexico.
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  I went to the UW, University of Washington in Seattle, to study
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  with Neil Jacobson and John Gottman, learned about relationships from John
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  Gottman's perspectives and couples therapy from Neil Jacobson's perspective.
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  And as I was sort of heading from grad school to my
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  job at the University of Illinois, one of the things that sort
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  of struck me as sort of everything was coming together is the
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  field of relationship health then and still now is sort of akin
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  to the field of like physical health or dental health in the
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  1930s.
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  It's like a century behind all of the other health fields because
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  it's completely focused on reactive tertiary care, right?
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  And we don't actually think about it as a health system.
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  We think about it.
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  I'm not even sure exactly how to articulate how we think about
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  relationship health.
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  We think about relationship satisfaction of whether or not you're happy or
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  unhappy, right?
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  So it's on this continuum of happy and unhappy.
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  And what we know from decades of scientific research is that how
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  you're doing in your primary relationship has a significant impact on all
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  your other health systems, your physical health, your mental health, but we're
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  not treating it like a health system.
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  We're not thinking about it as a health system.
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  And therefore it's antiquated, right?
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  Like people don't think about seeking professional guidance, professional help,
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  professional care on a regular sustained basis in the same way that
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  they do for their bodies, for their teeth, for their mental health,
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  honestly, for their cars, right?
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  Like this is the sort of thing that you maintain.
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  And that was a thing that was missing.
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  If folks were suffering in their relationships, they went to couples therapy,
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  usually after years of suffering in their relationships, right?
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  Which is really in terms of like healthcare, you know, on par
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  of waiting until a tooth has been hurting you for years to
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  go to the dentist.
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  Right.
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  And then like, Oh, what are you going to do?
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  We're probably going to pull that thing.
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  Yes.
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  What felt like the innovation to me was regular care, what we
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  need, what really sort of made the difference in the other healthcare
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  systems was preventative, regular healthcare maintenance.
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  So what I really focused on was developing something that could be
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  scientifically proven to be effective in that sort of repeatable way.
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  And so initially I developed at the time we were calling the
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  marriage checkup, and then since then have expanded to just the relationship
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  checkup.
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  And the idea is for it to be the annual equivalent of
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  like your maintenance for your car, like a tune up or your
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  regular dental checkup or your regular primary care visit so that you're
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  getting regular healthcare in a preventative and early intervention kind of
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  way, rather than just like you're on your own, your most intimate
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  relationship is a total DIY project and good luck with that.
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  And maybe when it starts to break down, you might go seek
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  care.
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  Oh, yeah.
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  I mean, I can attest to most couples coming in when it's
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  pretty much at the very, very, very end.
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  Right.
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  Yeah.
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  No.
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  And that's that's what we know from the research literature that the
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  bias for couples therapy at this point for all of us in
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  the community is it's a last ditch effort kind of thing, right?
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  It's a relatively rare couple that thinks of it as something that
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  you do before the last ditch effort.
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  So I developed this intervention called the relationship checkup and have been
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  studying it as an academic for 20 years, 25 years.
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  And we've done all sorts of randomized control trials and expansions and
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  have definitely shown that it works.
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  And then my university, Clark University in Worcester, was looking for things
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  to get behind in terms of intellectual property.
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  So they actually approached me and asked, like, would you be interested
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  in like spinning up a business from this?
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  And I had been for a while, but just sort of like
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  as most academics, like doing academic things.
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  And so when they approached me, I thought, that's a really great
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  idea.
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  How do we even start?
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  And then that's when I met Matt.
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  Yeah, I'm sitting here thinking, how does Matt fit into this picture?
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  So I'll let Matt take that part from here.
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  Cool.
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  Yeah, I actually went to Clark.
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  So they're my alma mater.
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  But my degree was in international development, social change, went into
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  entrepreneurship, you know, my first job out of college.
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  And so I bounced around a whole bunch of startups.
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  I just sold one and was looking to figure out what was
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  next.
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  And that's when the mutual friend was like, you've got to meet
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  this professor at Clark.
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  I'm like, oh, those two things sound great.
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  And so I met Dr. Cordova and his research partner, Dr. Gray.
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  And they told me this idea for this relationship checkup.
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  I've just gotten married.
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  I was like, I think we're good.
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  And he's like, no, no, that's the point.
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  That is the point.
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  And so we try to check up.
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  It was definitely outside of my comfort zone.
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  I had my own sort of prejudices around mental health and just
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  sort of like, oh, well, we don't need this.
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  But we tried it.
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  My wife has her own mental health diagnoses.
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  And this was enlightening, transformational, just in terms of helping us better
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  understand each other and how to work together and like understand how
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  her diagnoses impact her brain and like, how her mind works and
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  how I can play better into that.
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  So we did it.
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  And I was just bought in hook, line and sinker.
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  Like the world needs this, like the couples need this.
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  And that's sort of where we got started was we know this
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  is going to help couples.
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  And over the years, we've really started to understand, especially as we've
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  gotten to scale, the impact that this has on couples.
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  It has been great in private sort of industry as we've rolled
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  out.
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  But also there's impact on the providers where in just one hour,
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  providers are able to make such a significant impact.
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  I think the last research we did on it was that one
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  checkup has the same clinical impact as 12 long-term therapy sessions.
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  And so in just an hour, a provider is able to see
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  a much greater impact that would normally take them months to see.
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  And so it's like that immediate gratification that like sometimes is lacking
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  in this space is something we had no idea was going to
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  be a benefit.
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  But as we've rolled this out, it has been great.
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  And some of those issues with just sort of the demand for
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  mental health services, not enough providers, like being able to do something
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  this clinically impactful in just one hour and get like two people
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  in and like James was talking about, the relationship kind of underpins
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  all these other mental health issues.
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  And so by addressing that quickly and effectively, the sort of ripple
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  effect throughout mental health is something we didn't, at least I didn't
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  fully realize the full impact that this could have.
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  And so being able to see this now at scale and the
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  impact it's having both on the providers, patients, the couples, but also
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  like the industry as a whole, where you're actually able to start
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  churning through some of your wait list because you have a tool
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  that is super effective and doesn't take 12 or 24 sessions, just
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  takes one.
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  It's been an awesome ride for the past, I think, eight years
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  that we've been incorporated now.
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  Amazing.
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  Yeah.
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  So I imagine kind of like a primary care model with the
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  checkup, a lot of people come in and it's like, listen, you
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  have these couple of things.
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  Here's some tools you can use to work with that.
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  We'll see in a year.
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  But what about the couples that come in and it's like, okay,
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  wow, there's a lot more here and there might be more support
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  needed.
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  Yeah, that's a great question.
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  And we designed the checkup to really be the relationship health equivalent
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  of your primary care checkup.
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  And so as in any checkup, the idea is come as you
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  are.
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  And what we found in our research, thank goodness, is that we
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  are able to attract couples across the spectrum of relationship health and
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  satisfaction from really healthy, newlywed couples who just want to get started
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  early on maintaining their relationship health and the quality of their
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  intimacy and connection to couples that just have a couple of issues
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  that don't seem to go away and are really creating friction, but
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  they're not destroying their relationship.
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  They're just sticky.
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  Right.
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  And then they're also able to come in and get the help
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  that they need so that those things don't become more and more
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  corrosive.
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  And we also get couples that are really struggling, that are severely
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  distressed, that have been severely distressed for a long time.
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  And like any checkup, what we're able to do is help folks
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  that just need a little bit of help, keep folks healthy that
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  are already healthy.
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  But if you're really struggling, we can sort of get you started
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  on reorienting towards the relationship and starting to get some really good
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  tips and tricks for how to begin to move forward, including being
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  able to do referrals for longer term care.
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  Right.
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  So that's one of those things where sometimes couples are like, do
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  we really need?
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  I'm not sure.
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  And what a clinician is able to do is help them make
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  that discernment.
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  Like, you guys are good.
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  What we've got for you here is probably enough for you.
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  Try this out.
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  And if you're still struggling in six months, come back and see
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  us again and we'll figure out what the next step is.
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  Or you guys could probably use four or five sessions of more
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  intensive care or 10 sessions of more intensive care.
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  These are the people that we would recommend that you see.
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  So we're able to sort of do that kind of warm handoff
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  to more intensive care if couples need that.
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  But the broader goal is if couples are getting regular care, they're
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  less likely to find themselves in a place where they need longer
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  care.
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  I love that model.
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  I think that's amazing.
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  Do you ever find that it's difficult to get people?
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  I mean, kind of like Matt was saying, like he had some
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  barriers to coming in initially because they were like, I'm fine, I'm
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  good.
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  Yeah, I think one of the things that we've benefited from is
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  that the idea of a checkup is something that people just get.
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  Right.
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  And so checkup, tune up, regular maintenance, you know, that kind of
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  idea of like a stitch in time saves nine.
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  People understand the concept.
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  And you get actually a significant number of partners in couples that
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  will just resonate with that idea of like, oh, right.
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  Why didn't I thought of that before?
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  Regular checkups just make sense.
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  And of course, there's still some skepticism, right?
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  Oftentimes what we find when we've done our research is that particularly
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  husbands can be like anything that even smacks a little bit of
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  therapy.
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  Like, please, I don't want to do that.
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  But something that sounds like a checkup, what they tell us is,
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  well, I wouldn't have done therapy, but a checkup didn't sound bad.
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  And then when they come in and they meet us, the experience
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  that they have is, oh, that was actually good.
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  It was fun.
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  It was interesting.
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  I felt like I felt heard and cared about.
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  And I felt like I left with real things that I can
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  do, right?
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  In some way, versus like, I felt like I had my head
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  shrunk.
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  Yeah, no head shrinking.
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  No head shrinking.
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  That's right.
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  There's definitely a lot more of like a viral or like peer
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  to peer referral, organic sharing that happens with the checkups to where
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  like, not many people you meet are super open about like, Oh,
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  my, you know, significant other and I just entered long term therapy,
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  or I started seeing therapy myself, this idea of this, like, checkup,
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  tune up, whatever you want to call it.
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  You know, it's fun, like the approach is strength based.
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  So it's not Alright, so why are you here?
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  It's like, so how did you meet?
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  And so it's almost like being interviewed on a podcast for an
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  hour.
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  It's fun.
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  And so like, people then go back and tell their friends, like
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  we did this checkup, like everything was great.
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  And then we did it and everything's even better.
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  And so there is sort of this like natural effect.
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  And that's sort of what we started to see from our existing
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  clients.
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  They're like, this relationship checkups great.
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  How else can we use this checkup model?
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  And that's, I think, where that sort of like systemic shift in
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  the industry of why is mental health, the only tertiary care health
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  system, like that's what we're really hoping to sort of help usher
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  in is sort of this primary care checkup approach.
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  And I think being able to start with relationships, which underpin everything
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  makes all the sense in the world, you get two people in
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  for the price of one.
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  So like the benefit is doubled.
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  It's been great.
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  And that being able to overturn that more hesitant participant also helps
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  with that shareability, where like, if you get that person that was
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  like, I was a little unsure, and then I did it, and
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  it was great, they're gonna go and convince more people like them,
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  that like therapy is not as scary, or the checkup isn't as
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  scary as they might think.
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  I mean, there's definitely been a shift, I'd say, both in sort
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  of like the Zoomer generation, and I think what Gen Z, but
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  also since the pandemic, like I think a lot more people are
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  a lot more open to this idea of mental health.
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  And when we get in front of them and get to tell
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  them about like, a proactive approach, that seems all better to them.
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  So there's definitely I think, starting to be a shift in mindset,
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  we're seeing less hesitancy and more just kind of openness and willingness
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  to try it.
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  Yeah, that's great.
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  And I assume this is not something that's funded by insurance.
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  Actually, it is funded by insurance, especially in states that are starting
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  now to do the you get to get an annual checkup or
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  an annual mental health checkup.
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  Yeah, it can be billed for that.
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  And you can also, it depends on the insurance and the clients,
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  but there are codes that you can use for either assessment or
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  for seeing somebody with one of their family members.
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  For those folks where their insurance doesn't cover it, it's something that
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  you do once a year.
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  Well, I was thinking about that, right?
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  That investment piece is not the same as paying that same amount
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  every week or something like that, if it's regular therapy.
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  Yeah.
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  Even just looking at some of the like asynchronous mental health apps
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  out there that have sort of a freemium model, just paying for
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  a checkup out of pocket is still like about the same price
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  as an annual subscription to one of these like freemium apps.
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  And so do you want an asynchronous app or do you want
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  someone who's trained and has been doing this for a while to
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  do a checkup that has like clinical evidence-based background?
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  If it comes down to price point, like I'd still rather have
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  an actual human helping me than like using some piece of technology.
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  I think that it's such a valuable point, right?
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  Because one of the things that we're convinced by is what's going
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  on inside of our intimate relationships is quite complicated by its nature.
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  And we aren't always in the best position to have any perspective
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  on that.
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  So when you're trying to do it on your own with like
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  an app or with a book, that's helpful.
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  Like it's not going to help you see what you can't see.
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  In the same way, like you might look at a mole on
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  your arm and think, eh, that's probably fine, but you probably want
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  to get an expert to look at it to actually tell you
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  whether it's fine or not.
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  Right.
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  And that's what the checkup model that we use provides is that
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  we have trained experts that this is what they do and they
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  know what they're looking for.
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  I think one of the things that I'm most excited about about
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  podcasts like yours is just this opportunity to get this change in
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  how we think about it.
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  So I just want to like come talk to you and to
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  your listeners to just like say the words relationship health care,
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  relationship health care over and over again, right?
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  To start to get people to think in those terms.
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  Like how do I think about my relationship as something that deserves
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  regular care?
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  Well, yeah.
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  And you know what strikes me when you say that is just
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  knowing what I know about the mental health field.
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  When a couple comes to therapy, we have to choose the identified
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  patient.
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  Right.
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  And then we have to give a mental health diagnosis to that
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  one person.
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  I mean, even that lens of of insurance billing is all about,
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  well, it's really about what's wrong with someone.
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  Right.
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  And not even like, yeah, we may be doing couples, but we're
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  not billing it insurance wise in a way that makes sense for
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  this idea of relationship health care.
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  Exactly.
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  It's all been individual health care.
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  Right.
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  And so that's fascinating to me.
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  It really is a paradigm shift.
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  And I think one that we are all coming around to so
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  much post-COVID that our relationships matter so much and that loneliness
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  is a big thing and isolation has been a big thing for
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  people.
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  So why not treat our relationships in the way that we would
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  any other type of health care?
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  So I love it.
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  Exactly.
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  You know, and one of the things that I've been the most,
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  I guess, both delighted and surprised is that the segment of our
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  country that is actually taking this the most seriously is the military.
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  And as in most things, people might be surprised to hear.
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  But if you think about it, it makes sense.
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  Like it's almost always the military that's innovating the next wave of
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  something.
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  And the military has been laser focused in a way that the
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  civilian sector hasn't been in recognizing that what is affecting the health
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  of our service members is their relationship.
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  And we need to be able to address that health system at
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  scale.
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  And so they've actually been our biggest supporters and the most interested
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  in what we're doing because it is brief, because it's attractive and
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  because it's evidence based and because it's scalable, because it's, you know,
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  the vision that we have is everybody everywhere should be able to
• 20:22
  get a regular relationship health checkup annually.
• 20:26
  Right.
• 20:27
  And so we've built it in such a way that it can
• 20:29
  be scaled.
• 20:30
  And the military wants to really have they do if they want
• 20:33
  to have a major effect on the quality of their service members
• 20:36
  lives and their health.
• 20:38
  This is the sort of thing that you need.
• 20:41
  To your point earlier, you just can't hire enough tertiary clinicians to
• 20:45
  meet the demand that isn't scalable.
• 20:48
  Yeah.
• 20:48
  Sort of piggyback on that.
• 20:51
  We've sort of looked at our existing clients and they've been able
• 20:55
  to pivot a certain proportion, usually around like 10 to 30 percent
• 20:59
  of their time they're starting to do checkups in.
• 21:01
  And that kind of equates exactly to the number of cancellations they
• 21:05
  have, where if one of their normal patients is going to be
• 21:08
  on vacation in a couple of weeks, they can't take someone off
• 21:10
  the waitlist to become a long term client, but they can do
• 21:13
  a checkup.
• 21:14
  And so we've seen a lot of providers sort of doing that
• 21:18
  model.
• 21:18
  And when we've looked at that at scale, there's actually enough mental
• 21:22
  health providers in the country today that if they just spend 10
• 21:25
  percent of their time doing checkups, everybody in the country can get
• 21:28
  some sort of mental health care.
• 21:30
  And if you have a tool that's brief and 12 times more
• 21:33
  effective than a single long term therapy session, it kind of makes
• 21:37
  sense to embrace this model.
• 21:39
  And that's where you can actually start impacting sort of the supply
• 21:42
  and demand.
• 21:42
  You can start impacting sort of the increasing price of private pay,
• 21:47
  which we've seen astronomical hourly prices that some people are charging,
• 21:52
  because that's just where the supply and demand graph is going, is
• 21:56
  that, OK, supply is low, demand is high, prices go up.
• 22:00
  And so we're really hoping that can sort of be the wave
• 22:03
  of the future where we don't need some drastic, oh, we need
• 22:06
  to start sending more and more people to get their masters or
• 22:09
  their doctorates because we just need a huge supply influx of mental
• 22:13
  health professionals.
• 22:14
  We actually have the workforce today.
• 22:15
  We don't have the model to do it.
• 22:17
  And so that's, I think, sort of the innovative piece for us
• 22:20
  is like, you know, we're screaming it from the top of the
• 22:22
  mountaintops of like, if we just shift the system to a primary
• 22:26
  care approach, we're going to have less people entering long term care
• 22:28
  because we're going to start getting to people early and often, which
• 22:31
  is going to help reduce some of the supply issues where everyone's
• 22:35
  in long term care.
• 22:36
  And we're going to start preventing issues from getting so extreme that
• 22:39
  you get to the we're going to relationship therapy because this is
• 22:44
  our last ditch effort.
• 22:45
  Like we don't want people getting to that point because they're doing
• 22:48
  early and often maintenance.
• 22:50
  I'm curious for you, Matt, you were coming at this more from
• 22:53
  the entrepreneur side.
• 22:54
  What has it been like to sort of take that lens into
• 22:58
  this product and into the mental health industry?
• 23:02
  There was a lot of learning that I had to do.
• 23:04
  You know, I kind of been in like sports and tech for
• 23:07
  a while coming into the mental health field.
• 23:11
  I think it's it's relatively clear that there's a lot of room
• 23:15
  for improvement.
• 23:16
  To James's point earlier, it's a little bit of an antiquated system.
• 23:19
  I think part of the issue is the health systems are in
• 23:24
  the health system in this country is incredibly complicated.
• 23:26
  And even the people we talk to at insurance companies aren't always
• 23:29
  so sure how insurance works.
• 23:33
  Everyone has their own horror stories.
• 23:36
  We did DNA testing when my wife first got pregnant and the
• 23:40
  office like sent our blood out of state and because they did
• 23:43
  that, insurance wouldn't cover it.
• 23:45
  Like how am I supposed to know that as a patient to
• 23:48
  tell our doctor's office not to send our blood out of state?
• 23:51
  It's just a complicated system.
• 23:53
  And so it's slow to move, right?
• 23:55
  We had that barge like jammed in the Suez like a year
• 23:58
  or two ago.
• 23:59
  That's my viewpoint of mental health, like just a health care system.
• 24:03
  It's like jammed in the Suez and it's really difficult to unwedge
• 24:07
  this barge.
• 24:08
  And it's going to take a lot of hands to do it.
• 24:10
  But I think sort of with my entrepreneurial lens, I'm starting to
• 24:14
  see a big shift where there's more and more startups in the
• 24:17
  mental health field, which is a good thing.
• 24:20
  Not all of them are evidence based.
• 24:22
  I think not all of them are attacking the problem the right
• 24:24
  way.
• 24:25
  I'm biased because I think we're attacking the problem the right way.
• 24:28
  But yeah, it's starting to get to a really good place.
• 24:30
  And I think what's been great for the work that we've been
• 24:35
  doing is sort of this brief and effective the way people's brains
• 24:39
  are wired these days.
• 24:40
  People want their information quick.
• 24:42
  They don't want it long term.
• 24:44
  They want it to be super effective and impactful.
• 24:46
  I want to be able to Google it something and have it
• 24:48
  be the top couple results.
• 24:50
  I want to be able to go to like chat GPT and
• 24:52
  get something good really quickly.
• 24:54
  That's sort of where our head's at.
• 24:55
  And what's beautiful about this checkup model is it delivers that.
• 24:59
  James and his lab did an adaptation for perinatal care.
• 25:02
  And we were talking to sort of embedded providers in the OB
• 25:07
  departments.
• 25:07
  And they're talking about how often people mention their relationships as an
• 25:11
  issue at that 20-week, six-week postpartum, nine-month postpartum where
• 25:15
  you see sort of these influxes in PPD, maternal suicide, maternal substance
• 25:20
  abuse, all terrible things that we wish we could fix.
• 25:22
  But the problem is they ask for help and the system's overwhelmed.
• 25:26
  And they can't see that couple or that patient because they have
• 25:30
  a waitlist.
• 25:31
  And so by the time they come off the waitlist, the baby's
• 25:33
  already there and their world's upside down and they're scrambling and they
• 25:35
  don't know which way is up.
• 25:36
  And that's where instead of just doing long term care, if we
• 25:39
  build a primary care checkup model, we can start addressing these issues
• 25:44
  in real time effectively and quickly so that these people can help
• 25:48
  themselves.
• 25:48
  And James alluded to this earlier, but can't be undersold.
• 25:51
  This idea of like, I can Google what do skin cancer moles
• 25:54
  look like and try to make my own best guess.
• 25:57
  But chances are I'm going to terrify myself.
• 25:59
  Chances are I'm not going to get the answer right.
• 26:02
  I'd rather have a professional look at it.
• 26:04
  That's sort of where mental health is today, where people are trying
• 26:08
  to do it on their own.
• 26:08
  We're following TikTokers or Instagram people, but they don't have access to
• 26:13
  care.
• 26:13
  And I think what's beautiful about this is opening up that pipeline
• 26:18
  of there's a way that we can make the supply better so
• 26:21
  that more people can access it, so that more people don't have
• 26:23
  to rely on Google for their relationship issues or their mental health
• 26:27
  issues.
• 26:28
  That just can't be acceptable in the country anymore.
• 26:31
  I love it.
• 26:32
  Your passion is really inspiring.
• 26:35
  I love it.
• 26:36
  I can just feel that both of you are really trying to
• 26:39
  make a change in access to mental health.
• 26:42
  I just want to leave you with this one question, maybe for
• 26:44
  each of you to answer.
• 26:45
  What is just one thing that you would like people to know,
• 26:49
  whether it's people accessing care or entrepreneurs who are thinking about
• 26:53
  starting something new?
• 26:55
  What would be your one thing to leave people with?
• 26:58
  For me, that one thing is that the key to health is
• 27:05
  prevention.
• 27:06
  If you want to have good physical health, take good care of
• 27:10
  your body.
• 27:11
  If you want to have a really strong relationship, do preventative relationship
• 27:16
  care.
• 27:18
  If you want your car to last for a long time, do
• 27:21
  maintenance.
• 27:22
  It's well changed.
• 27:23
  Exactly.
• 27:23
  And you can't do it on your own.
• 27:25
  It's too complicated to do it on your own.
• 27:27
  We as a community need to cooperate by providing the professional services
• 27:32
  that people need in order to, if you're going to have long
• 27:36
  -term health, prevention is the key.
• 27:38
  I think for entrepreneurs, it's okay to dream big.
• 27:43
  I think it's possible to make big changes.
• 27:47
  You just have to be willing to dream it.
• 27:51
  Yeah, I love that.
• 27:52
  James, that sounds like you've been hanging out too much with me.
• 27:56
  The degree I had, international development and social change, we were tackling
• 28:00
  big issues like world hunger.
• 28:02
  That was stuff we'd debate in the classroom.
• 28:04
  And I think what really helped me from an entrepreneurial standpoint is
• 28:07
  you've got this huge problem, but how do I address hunger today?
• 28:10
  I'm just one person.
• 28:12
  How am I supposed to do that?
• 28:13
  So I think that's where, yeah, we want to change the system
• 28:17
  here to a preventative approach.
• 28:19
  And we're starting that today with this approach to relationship checkups.
• 28:23
  This is going to be hopefully the drop in the bucket that
• 28:28
  makes it overflow.
• 28:29
  For my leave behind, I'll take a more entrepreneurial take on it.
• 28:34
  Although James went surprisingly entrepreneurial there.
• 28:37
  I know.
• 28:38
  Did that shock you?
• 28:40
  No, no.
• 28:41
  For eight years now, I've been imprinting entrepreneurship into James's brain.
• 28:47
  And he's been imprinting the relationship healthcare and this mental health
• 28:52
  field on my brain.
• 28:53
  So it's been awesome.
• 28:54
  I guess to me, some of the best business ideas are the
• 28:57
  ones where whoever you're talking to says, oh, that makes so much
• 29:02
  sense.
• 29:02
  Why didn't I think of that?
• 29:04
  The greatest ideas are so simple that it's like, I could have
• 29:08
  come up with that.
• 29:09
  And when I'm out talking to people, networking, which every entrepreneur
• 29:13
  listening, there's nothing better than just pressing the flash and meeting
• 29:17
  people.
• 29:17
  I tell people mental health care is this tertiary model.
• 29:22
  The only thing that exists is crisis care.
• 29:25
  We should probably be doing things proactively.
• 29:28
  Imagine what the world would be like if we had a preventative,
• 29:32
  proactive approach to mental health care, where it became normal for our
• 29:35
  kids to go to their pediatrician and then walk down the hall
• 29:38
  and talk to a therapist for half an hour, not because anything's
• 29:41
  wrong, not because they're in crisis, just because that's how you can
• 29:44
  detect things earlier and head them off before your only option is
• 29:48
  a lifetime of taking pills.
• 29:50
  And when I say that to people, they're like, oh, you're right.
• 29:53
  There is no primary care model for mental health.
• 29:56
  It makes so much sense to that we should do that.