Latest / StartUp Health NOW Podcast / From EAPs to AI Signals: Rethinking Workplace Mental Health with Stephen Sokoler of Journey

Transcript

From EAPs to AI Signals: Rethinking Workplace Mental Health with Stephen Sokoler of Journey · StartUp Health NOW Podcast

• 0:00
  [on-hold music] We need to take the model and turn it on its head. We need to be proactive. We need to be preventive.
• 0:07
  We need to leverage all of the data that exists nowadays to be able to recognize when an employee might be in need and support them earlier, and that support is not limited to just mental health.
• 0:17
  [upbeat music] Steven Secola, founder of Journey. Great to have you here with me on "Startup Health". Thanks, Logan. Happy to be here. So eleven years, eleven million lives.
• 0:35
  You've been in this mental health, particularly mental health for employers space longer than most people. You've seen changes of attitude, changes of stigma towards mental health concerns.
• 0:46
  So let's start by telling me where are we at in twenty twenty-six in this world and kinda what Journey is, is providing right now. Sure. Yeah, I feel we've made a lot of progress. So that's the good news. Okay.
• 0:56
  I'm talking societally, in terms of the understanding of mental health, the availability of support. The challenge is not static, right?
• 1:04
  And so with things like social media, which we all now realize, you know, the challenges there, with AI both being here and coming at an accelerating pace, it continues to be more and more newer challenges that we just didn't have, nor did the human body evolve for.
• 1:20
  So societally, you know, maybe if you and I were having this conversation, you know, fifty years ago, forty years ago, thirty years ago, mental health would be mental illness, right? That was how the term was used.
• 1:31
  Now, when we talk about mental health, we're talking a lot about the full spectrum, and we understand people can be really struggling and they could be thriving, and there's clinical needs and subclinical, so we've made a lot of progress.
• 1:40
  The next evolution that we're starting to see is a focus towards preventive care, and that's not all that surprising because if we look at physical health, prevention is the name of the game.
• 1:51
  The sooner we can get to things, the better the outcomes, right?
• 1:54
  We all know this, whether it comes to an annual physical or a colonoscopy, and so we're starting to see a shift when it comes to mental health for the same thing. We know that preventative health is important.
• 2:03
  It doesn't mean that it's gonna get reimbursed the way that it should. So how are employers thinking about preventative health? What does it take?
• 2:09
  What are the levers to get them to see the value of preventative mental health? Let me go back to the first question 'cause you had asked me who Journey is, what we-- what we do. That's right. I jumped in then.
• 2:18
  So we are a proactive, preventive mental health company.
• 2:22
  Now, we are starting to see companies get smart to the fact that if you are catching things sooner, you're not going to miss work, you're going to be more productive, you're gonna have better conversations, whether that's with colleagues or with clients.
• 2:39
  You're not gonna perhaps turn over or burn out or hit the health plan.
• 2:43
  And I think we all know here in the States, especially for self-insured companies, every time somebody hits the health plan, it costs an arm and a leg, and those rates are going up at astronomical numbers.
• 2:53
  The idea is let's invest a little more upfront to keep employees, you know, to be a buffer so employees aren't hitting the health plan.
• 3:01
  So to your point, yes, it's something that some companies do recognize the importance. Sometimes it takes a powerful HR leader to say, "Hey, let's look at the numbers.
• 3:11
  Let's make the business case," which we as a company of course, you know, help our clients to do 'cause everything we've done has been studied clinically through Humana, through New York University, through Georgetown.
• 3:20
  We've done a lot of those studies. But it is still, to your question, it's still something where it-- the question comes up a lot. You mentioned new mental health challenges, social media.
• 3:30
  You mentioned reliance on AI and our new relationship with it. How are you thinking about evolving your programming?
• 3:37
  It's hard for me to imagine a typical EAP program for a large employer that's helping me with my social media use, but maybe I have an old paradigm.
• 3:47
  Like, how are the programs from employers shifting to address the times? Yeah. Let, let's talk about EAP since you mentioned it. So EAPs have been around for a hundred years. They started in the nineteen thirties, right?
• 3:58
  And for let's call it ninety of those years, there was very, very little evolution. It was a safety net. It was, you know, break glass in case of emergency. It cost very little.
• 4:08
  Companies didn't really get much out of it, you know, two percent engagement, three percent.
• 4:12
  But if something was to go wrong, the company, the EAP might come on site, or in those really significant cases when an HR leader didn't know what to do, they could direct someone to an EAP.
• 4:21
  About ten years ago, companies like Lyra Health came along, Sprout Health came along, and they really modernized the digital experience. They built their own networks of therapists, which made access better.
• 4:31
  They built digital tools, so it stepped into the twenty-first century in terms of the look and feel. So a much better experience. However, still fundamentally reactive, so waiting for the employee to reach out.
• 4:43
  And when we looked at this, we said, "Well, you know, it's good to provide really fast access to care. We wanna do that.
• 4:49
  We wanna make sure that employees can find everything that supports them holistically," which we'll talk about. But we need to take the model and turn it on its head. We need to be proactive. We need to be preventive.
• 4:59
  We need to leverage all of the data that exists nowadays to be able to recognize when an employee might be in need and support them earlier, and that support is not limited to just mental health.
• 5:09
  So for example, I just moved probably about a month back. It did. One year ago. Yep.
• 5:12
  I moved a year ago, and then the house that we moved into got sold, so now we've moved twice within one year and we have a two-year-old, and there are boxes everywhere.
• 5:20
  Not only are there boxes everywhere, we need to find new people to help, whether that's daycare or schools or just a handyman or who's taking care of just like the basics of life, right? Yeah. And we're quite fortunate.
• 5:33
  EAPs can help with those things as well. So the idea being we didn't start out to be an EAP. It's actually something where when we looked at market, we were like, "Okay, there is a line item for this. The budget exists."
• 5:47
  And so a company doesn't have to have, an employee doesn't have to have access to ten different things. Let's streamline it so a company can provide one really powerful, amazing thing. I don't like the name EAP.
• 5:58
  I think it's just one of those things that's been around for a long time. Has stigma, kind of dated, but companies understand that they need one.
• 6:06
  And so if you're gonna provide one, let's provide a great one that, to your point, also includes elder care, because with the sandwich generation, a lot of us are taking care of older parents and younger kids. Pet care.
• 6:17
  People are getting married later in life, and so let's make sure that if your pet is your child, people will miss work when their pet is sick. And to your question, we have content on the platform.
• 6:26
  We have therapists available for people who are struggling with social media or people who wanna get ahead of it. Same for AI, same for things like GLP-1s, like how do you make the decision?
• 6:36
  So we don't think of it as, while we are a mental health company and specifically a proactive mental health company, how do we take care of the whole person, which includes all of these challenges and of course many more.
• 6:47
  You, you alluded to this, but pet care, senior care, it all sounds amazing. It all sounds to me like a Cadillac plan, if you will. Talk to me a little bit more about the business case for this. In a tough market,
• 7:00
  some of these services are the first things to get cut. So talk to me about how you make that case to companies and kinda where the return is most evident. It's pretty simple.
• 7:10
  So traditional EAPs are, let's call it fifty cents, a dollar, a dollar fifty per employee per month. So let's just call it a dollar, just easy numbers.
• 7:19
  Then you have digital EAPs like Lyra and Spring, much, much better, higher engagement, better digital tools, better network. They're eight, ten, twelve dollars per employee per month, usually dependent on utilization.
• 7:31
  So on one hand, you have a dollar, on the other hand, you have, let's call it ten dollars, right? That's been the market. When we came in, we said, "Well, we wanna deliver something as good or better.
• 7:41
  We wanna deliver something that's proactive, that has higher engagement, that has better clinical outcomes, and is affordable."
• 7:48
  So we're able to deliver this really amazing product called Journey Proactive EAP as the first, and it's still only, preventive model in the two to four dollar per employee per month range. Okay. Okay.
• 7:58
  So yes, to your point, we are still two to three times more expensive than a traditional EAP.
• 8:05
  So far, almost all of our clients have upgraded from a traditional EAP to Journey, meaning they've had to make the case to say, "Hey," and if we target companies, large companies, so think twenty-five thousand plus employees, although we work with companies of all sizes.
• 8:19
  They are all self-insured, and they are all spending a tremendous amount of money on healthcare.
• 8:24
  And we say, "Well, we did this clinical study that showed when employees engage with Journey, employers save five hundred and eighty dollars per employee per year in healthcare costs."
• 8:33
  So hard dollar savings, not turnover or absenteeism. We're engaging about thirty percent of your population. We're currently averaging around thirty-four percent, which is about ten times a traditional EAP.
• 8:43
  You have twenty-five thousand employees.
• 8:45
  We're gonna get a third of them taking consistent action for their mental health, and for every one of those employees, we're gonna save you six hundred dollars in healthcare, right?
• 8:52
  So real hard dollar savings, and we put performance guarantees around this and things like that.
• 8:57
  So yes, it is still an investment, but it is one where the case becomes clearer and clearer, and now that we have companies like McKesson, which is a Fortune nine company. We six x'd their clinical engagement.
• 9:10
  Micron, which is a trillion-dollar business with sixty-five thousand employees, of which eighty percent are in APAC, supporting them globally.
• 9:17
  So as we have more of these case studies, Becton Dickinson, which just renewed for five years, which is pretty unheard of in this space, it's a business imperative. Yeah. Less people will turn over.
• 9:26
  They won't need the health plan. They'll make better decisions. It just makes sense. Where do the numbers stand right now in terms of the power of a program like yours to assist with recruitment and retention?
• 9:38
  Obviously, we've gone through different business trends of saying, "Hey, we need this kind of wellness program at the office in order to get good talent." Sometimes those decisions are made and not based off of data.
• 9:47
  But where do we stand now in terms of proving out, like, we need XYZ available to great employees in order to have the best? I haven't seen the business case for it.
• 9:58
  Prior to launching Journey Proactive EAP, which was in January of twenty twenty-three, we had a product called Journey Live, which we still have. And Journey Live complemented EAP.
• 10:07
  So if you have an EAP, a traditional one, and nobody's using it, that's pretty reactive, Journey Live is a good complement for that.
• 10:14
  And the reason I mention this is because that was a sort of evangelical sale where you'd talk to an HR leader, and they would say, "I care about proactive mental health," and I would say, "I care about proactive mental health."
• 10:25
  And then they would put it in place because they wanna attract people, because they say, "Hey, we care, and this is making a, a statement." The problem is it doesn't survive.
• 10:34
  So unlike the EAP, things like that, whether that's, we competed there with like Calm, Headspace, companies like that, that product would be, I'll say, really impactful but definitely more a nice-to-have.
• 10:47
  And when things were cut, it would be like wellness dollars, which is very different than an EAP, which is a clinical product, which offers at least Journey, substance abuse and adolescent care and things that are really very, very important.
• 11:01
  So I would say on the recruitment and retention side, it's a little bit s-softer and squishier- Yeah... versus the real, like, hard dollar healthcare turnover side. That makes a lot of sense.
• 11:12
  I think I read that you operate in many different countries, maybe a hundred and ninety plus. Is that true? Did I read that correctly? Yeah.
• 11:17
  We offer support in a hundred and ninety countries, therapies in a hundred languages. Yep. Okay. Well, you know, mental health is obviously very cultural.
• 11:25
  What are some of the things you've had to do to make Journey work across borders and boundaries? Hire people in those countries and regions. Therapists is obviously very clear, right?
• 11:35
  We're hiring therapists who are in those countries. That's a fact.
• 11:38
  When it comes to creating content, it's very tempting, and what a lot of companies in our space do is they'll just translate something from English to Spanish or French or, and now with AI, you just plug it in ChatGPT, it'll let it rip.
• 11:50
  However, it's not culturally appropriate, it's not representative, it's not respectful. So what we do is we hire actual human beings in all of these countries and regions to create the content. It is very laborious.
• 12:04
  It's expensive, it's time-consuming.
• 12:05
  But- If you're an employee who's in Uzbekistan, literally or actually yesterday I was showing a demo to a prospective client and she saw Armenian on the platform, and she's like, "Oh, I've never seen that before."
• 12:17
  And she has a digital program that's very robust in many ways, and it's like, well, yeah, because we wanna make sure no matter who you are, you can be seen by somebody like you, whether that's therapy, whether that's being in a community, whether that's on-demand content.
• 12:31
  Very, very important. We didn't really talk about that, but, you know, here in the States, 40% of our providers are providers of color, 12% are members of the LGBTQ plus community.
• 12:40
  Both of those are double the national average. On the platform, no matter who you are, what you believe, race, age, gender, political ideology, you can feel embraced.
• 12:49
  You can feel like it's for you, which from a mission standpoint we think is very important. Now, just to press in on that a little bit. Y- you feel like it's for you no matter who you are.
• 12:58
  How do you accomplish that, or how do you sort of think about that as you frame out the content to be that responsive? We wanna create a lot of different things for different people.
• 13:08
  At the same time, we wanna try to create a very personalized experience. So one example I'll use is it should feel like you're walking into a neighborhood bookstore. Like, "Logan, welcome back. It's great to see you.
• 13:20
  We know that you love romance novels, historical fiction," fill in the blank, right? Versus you're walking into an Amazon warehouse. It's meant to feel very human.
• 13:28
  So of course the platform learns, similar to a Netflix or a Spotify, what you like, what you don't like. If the company provides us with data, we can personalize it right out of the gate.
• 13:39
  So some companies will give us things like date of birth, gender, zip code, job type. So those are clues, right?
• 13:47
  Of course, every person is unique, but there might be things that a 65-year-old man might be more interested in than a 25-year-old woman. Right. Just a life stage thing.
• 13:57
  So we can present some of those as recommended and see what people do and how they engage.
• 14:01
  So the idea is we have a ton of stuff, content for neurodivergent employees, content on gender equity, on a whole host of things that other companies shy away from.
• 14:10
  We have a series called Breaking Silence, like Breaking Silence on Black Mental Wellness, support for the AAPI community.
• 14:16
  And the idea is not that it's meant to sit within Journey's four walls, but how do we bring it to life at a company where it's a unique one of one for them? Yeah.
• 14:25
  So for example, one of my calls later today is with Korn Ferry. We launched in a number of countries there. How do we make sure that what we're doing for Korn Ferry in,
• 14:34
  I'll just make up a country, in Poland, is going to really sing for their employees, where they say, "Wow, this is really for us."
• 14:41
  Which is why we built this really robust ecosystem where there's a web app, there's a mobile app, there's a Teams app, there's a calendar integration, there's a daily email, there's a break room app.
• 14:51
  So whether it's a manufacturing environment or a healthcare system or another type of environment, it can always be where people are and start to become part of the fabric of the company.
• 15:01
  I wanna shift gears slightly and move from sort of the business of Journey to burnout and mental health for the sake of our listeners.
• 15:09
  Well, you know, if our listeners are employees at one of the companies that uses Journey, then great, they can just go and utilize your great service.
• 15:18
  But a lot of folks who listen are entrepreneurs and are founders, small teams, and prone to burnout themselves, don't have a lot of support services around them and just consider their burnout and these feelings, uh, even a mental health crisis, they might consider it just part of the job.
• 15:34
  So I wonder if you just given your experience, you could speak to that founder who might be having those feelings but doesn't have an institutional support like Journey. Yeah. I'll start with my credentials.
• 15:44
  I've started, I wanna say many, maybe a dozen businesses or so from small businesses in high school to obviously Journey being my current project.
• 15:54
  A bunch of them have failed, some of them have worked, and so I can very much relate to your question.
• 15:58
  I was quite lucky in that I found meditation while I was living in Australia, or to say it differently, meditation found me.
• 16:05
  Now, this was before Calm and Headspace and everything, so I just picked up a book on Buddhism and that was that, really.
• 16:12
  To your question of, like, my advice, incorporating mental health into your day needs to become a habit or a ritual like anything else. Like, we know this when it comes to exercise, right?
• 16:23
  It's hard if you're just always trying to find the time versus if you have some sort of routine.
• 16:27
  Now, of course, as an entrepreneur, as a startup founder, as an employee at a company that may be moving fast and furious, that can be challenging, but do you have five minutes? Five minutes.
• 16:37
  Can you wake up five minutes earlier? Can you carve out five minutes at lunch?
• 16:41
  Can you end a meeting five minutes early or have, you know, Google has it where the hour-long meetings are actually 50 minutes and the 30 meetings, 25. Can you find just two minutes to just reset? Yeah.
• 16:54
  Just breathe, right? So it doesn't have to be a long formal practice. It doesn't have to be a silent meditation retreat.
• 17:00
  It doesn't have to be therapy or journaling, although I have done all these and I think all of them are amazing, but I'm very much a believer in crawl, walk, run.
• 17:08
  Like, start where you are and if you have very limited time, just something as simple as taking a few breaths to sort of reset your central nervous system can be very helpful.
• 17:18
  And there's tons of resources, whether it's YouTube or a Calm or Headspace, which are available for consumers, or many of the other apps, Waking Up, the Sam Harris app. And there's so many practices.
• 17:29
  It could be yoga, which is really associated with the movement of the body, but there's also the spiritual and mental reset of it, or just something a little bit simpler, taking a breath or writing down your thoughts.
• 17:39
  So the TLDR of that whole thing is if you can incorporate just a couple minutes in a daily habit, that can make a tremendous difference. I love it. You mentioned a lot of different apps, Calm, Headspace, among dozens.
• 17:52
  What's your take on that market in terms of are we oversaturated right now? Are we heading into some consolidation? Are we just scratching the surface of what's needed? What's your take?
• 18:03
  I'm smiling 'cause I, I'll answer it always. From a human standpoint, anything that is putting great tools in the hands of people, I'm a big supporter. So that's why I mentioned, you know, go use Calm, go use Headspace.
• 18:17
  You might find it super valuable, or, or any of the others, right? From a business standpoint, that's a different question. So you may have seen this.
• 18:24
  Sword acquired Headspace for somewhere in the $200 to $300 million range. I think Axios reported that yesterday. I had heard of it probably a month ago just being in the industry.
• 18:35
  When Headspace and Ginger merged, the valuation was three billion, and now they've sold for somewhere in the $200 to $300 million range, meaning 90% less. So being a consumer company is very challenging.
• 18:49
  Consumers are fickle unless it's our cell phone, where maybe we stick with that provider for a long time. When it comes to apps and things like that, we use it for a little bit, we fall off.
• 18:58
  Also, behavior change is really hard. Habit formation is really hard, especially when you're doing it by yourself.
• 19:04
  And so things that lack community and some of those things that make it a little stickier are very challenging.
• 19:09
  So from a business standpoint, I think those companies I'm not really bullish on, but from delivering really helpful practices to people, I think, you know, amen and more of it. A final word.
• 19:21
  What should we be looking forward to from Journey over the next six to twelve months? What's coming next? I, you know, I probably should've prepared for that question, but I'll give you a sort of a different answer.
• 19:30
  So I wrote a book called 'The Mental Health Advantage.' Nice. I interviewed CHROs and people leaders at Google and Accenture and many companies, and the book actually did really well.
• 19:40
  It ended up becoming an Amazon bestseller, and it was very surprising to me. I've spent the last two years writing a follow-up to that.
• 19:47
  So that book, the sort of subtitle is 'How the World's Best Companies Drive Performance and Wellbeing Through Proactive Mental Health.'
• 19:54
  The next book picks up where this one left off with things like AI and global instability and some of those challenges. And I interviewed even more people, chief medical officer at Eli Lilly, et cetera.
• 20:06
  That book should be coming out at the start of the year. And by the way, for the record, I'm happy to send anybody that wants, just email me, I'm happy to send a free copy.
• 20:12
  So this is not a plug for the book, but it is one thing that I do to take all of the great lessons.
• 20:18
  I spend all day talking to people leaders, and every once in a while I get a treat like this where I get to do some talking.
• 20:22
  But I spend all day just listening to people leaders, and they have so much wisdom on what worked and what didn't work in this environment and for this population, and how they made the business case.
• 20:31
  Being able to, instead of writing a LinkedIn post or something on Substack, have something that's a little meatier that people can have on their bookshelf and actually has some of this timeless wisdom has been great.
• 20:41
  So that's not a Journey thing. That is a me thing. But for Journey, we're launching some new big clients at the start of the year with some new products.
• 20:48
  Everything continues to be focused on this proactive preventive care, and we built this thing called Journey Signal, this real-time AI, and we're continuously refining that balance between providing amazing support where we're getting care to people sooner that could prevent somebody from burning out or turning over or worse.
• 21:07
  We all hear the stories of, oh, that person who ended up doing something terrible to themselves or others, the signs were there. Companies support mental health a full year too late.
• 21:17
  People are struggling a full year, and in two-thirds of those cases, the signs are there. So when it comes to Journey, we have Journey Signal out.
• 21:25
  We're continuing to build it and refine it and make it more powerful and also make sure that it doesn't feel like Big Brother and it's very respectful of privacy and bias and all those super important things.
• 21:37
  But that's one of the things that I'm incredibly proud of what we're doing, and I feel like we're still scratching the surface and being able to identify and help people. Stephen, thank you for sharing this update.
• 21:47
  Thanks for walking with me through this over the past few years, multiple interviews. You've been at this for more than a decade, and it shows that you've built a company that lasts.
• 21:55
  So congratulations on the progress, and we look forward to catching up with you again next time. Thanks, Luke. It was great seeing you. Take care.
• 22:03
  [upbeat music] And finally, an invitation to all of the extraordinary health transformers.
• 22:11
  Whether you are a startup, someone building the future of health, or whether you are an investor, funder, or buyer of the solutions out there in the marketplace, this is an invitation to you to join the Startup Health member community.
• 22:26
  Learn more at startuphealth.com. Look forward to hopefully seeing you soon. [upbeat music]