It’s no secret there’s a ballooning mental health emergency in the U.S., a crisis of especially sobering proportions among teenagers. But in a society where people can access everything from laundry services to furniture construction on demand, mental health care still ranges from logistically complicated to downright infeasible for Americans who can’t afford to pay for treatment out of pocket.
“If somebody can actually see a therapist, that’s a huge step towards recovery,” says Benjamin Lewis, co-founder and CEO of Limbix, a company developing prescription digital therapeutics for teenagers.
Roughly 3.2 million adolescents experienced a major depressive episode in the past year, according to a National Survey on Drug Use and Health in 2019 — a figure that’s likely risen during the pandemic. Yet growing demand for mental health services has coincided with a shortage of therapists and a morass of financial hurdles for patients and providers alike, which together create a perfect storm.
Limbix was born from the desire to mitigate this storm. The San Francisco-based start-up, launched by Lewis and co-founder Jon Sockell in 2016, is developing mobile apps designed for pediatricians to prescribe after observing symptoms of mental health disorders in teenage patients. By 2025, there will be a projected shortage of more than 200,000 mental health providers; already, patients wait 25 days on average for a first appointment, according to a Psychiatric Services study from 2015. Meanwhile, teenagers often face added logistical or financial barriers. “Sixty percent of teenagers with depression get no treatment whatsoever outside of primary care,” Lewis says, while among the remainder who do, a “good chunk…don’t get minimally adequate treatment because they don’t have enough sessions.”
Lewis brings to Limbix a blend of engineering chops, product experience and entrepreneurial energy. After studying engineering at the University of Michigan, he worked for Microsoft’s XBox Live before returning to Ann Arbor for business school. Over the next decade, Lewis worked in product at Google and launched two companies, one of which was acquired by Facebook.
He later shifted his sights to mental health care access, leveraging his business acumen to assemble a versatile team with expertise ranging from the FDA, to medical devices, to cutting-edge user experience. Limbix has zeroed in on behavioral activation, a core component of cognitive behavioral therapy (CBT). After testing a preliminary app for adolescent depression in 2019, the company gained funding to launch its Stage 2 virtual clinical trial. The second wave of Stage 2 two trials is now enrolling, and Limbix plans to run a Stage 3 pivotal study in 2021 — a key step on the path to FDA approval.
What, exactly, would success look like? From a scientific standpoint, Lewis says his team will look for a “clinically significant reduction in depressive systems” — which translates to at least a five point drop in a patient’s PHQ-8 score, a questionnaire metric used to monitor severity of symptoms. But in broader strokes, Limbix wants to shift the mental health care landscape by eliminating barriers to care and providing treatment that meets teenagers’ needs — wherever they are.
Even with big ambitions, Lewis understands that app-based therapeutics could draw criticism. “A skeptic might say that software can’t realistically help teenagers who are suffering. That only a trained therapist can really help, and that it’s the patient-therapist connection that ultimately works,” he says. But he points to internal studies from 2020 which yielded effective results, saying, “A pure app-based solution won’t work for everyone. But it can help — especially when psychotherapy is difficult to access.”
Above all, he’s energized by hope that technology can close a gap causing tremendous financial costs and severe human consequences. He nods to the $250 billion the U.S. was projected to spend on treating mental and substance use disorders in 2020 alone, and to the far-reaching nature of the problem itself.
“Problems impacting teenagers don’t just go away when they turn 20,” Lewis says. “We’ll all be better off if teenagers are able to get the care they need.”
Digital therapeutics for adolescent mental health
