An investigation into Mindstrong’s unraveling, Cerebral layoffs, and DEA looks to restrict telehealth

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Inside Mindstrong’s unraveling

Mental health tech startup Mindstrong generated instant buzz when it launched in 2017 with a plan to develop a “digital biomarker” that could analyze a person’s typing and scrolling patterns on a smartphone to gain insight into their mental state. That pitch drew $160 million from Silicon Valley’s top investors, such as General Catalyst and Optum Ventures. A star-studded executive team — including Tom InselPaul Dagum, and Rick Klausner — drew formidable research and tech talent from companies like Google.


But just a few years after the company began raising venture capital, Mindstrong’s operations have all but unwound. What began as an innovative effort to build an entirely new tool for measuring mental health eventually became a run-of-the-mill counseling site. Now, the company plans to lay off most of its employees, shutter its office, and dismantle its therapy services.

I spoke to 10 former Mindstrong employees, including founders, data scientists, product designers, and clinicians, to examine what went wrong. Many of them had joined because they found the company’s mission compelling. But they also felt intense pressure, including from investors, to commercialize a product they didn’t think was ready. “A lot of that pressure fell on me, and I ended up spending way too much time on the road talking to people,” Dagum told me. “That time should have been spent in the lab.”


Those pressures — and how Mindstrong handled them — carry a warning for the rest of the mental health tech industry. Read my full investigation. 

Even more layoffs at Cerebral

Management troubles facing mental health tech startups extend far beyond Mindstrong. Cerebral, the beleaguered online prescription company that dialed back prescriptions for controlled substances under federal scrutiny, is laying off another 15% of its workforce, Business Insider reports. The layoffs — the company’s third round in less than a year — will affect about 285 employees and take place over several weeks.

As we’ve reported, Cerebral is one of many companies adjusting to rapidly evolving regulations, expectations from patients and investors, and clinical standards almost in real-time. In addition to a series of layoffs, Cerebral has also pivoted its business: Just last spring it said it would halt online prescriptions for some controlled substances including Adderall following a Justice Department investigation into its prescribing practices, though online prescriptions have long driven the company’s rise to prominence.

DEA proposal restricts telemedicine prescribing

The Drug Enforcement Agency’s move to again tighten prescribing regulations  has drawn censure from telehealth lobbying groups including the American Telemedicine Association. The proposal would require in-person visits before patients could get virtual prescriptions for controlled substances like Adderall and medication used to treat opioid use disorder. Previously, those requirements had been waived due to pandemic-era regulatory flexibilities. The DEA’s proposal is open for comment for the next month. (I also welcome your comments, including on how the proposal might affect patients.)

The rules are “significantly more restrictive than is warranted,” ATA’s public policy lead Kyle Zebley said, and risk leaving patients without access to critical mental health and substance use treatment. Foley & Lardner‘s Nathaniel Lacktman has a comprehensive explainer here.

Epilepsy screening tool shows promise…in mice

NIH-funded researchers think artificial intelligence might outperform humans in detecting epilepsy in mice, suggesting that the tool might eventually be used to automate anti-epileptic drug testing. Researchers described their method of detecting “behavioral fingerprints” in an article in Neuron. The machine learning system only needed one hour of video to identify epileptic mice, and didn’t need to have witnessed an actual seizure.

Such a system could help process large animal study samples, speeding up the discovery of treatment. “[C]urrent behavioral assessment practices in epilepsy research constitute a major bottleneck,” they wrote.

NEJM launches new AI-focused medical journal

Also from the academic circuit, the New England Journal of Medicine‘s parent group will soon launch a new publication intended to assess and evaluate artificial intelligence in clinical medicine. It’ll be published online-only every month.

While the Food and Drug Administration has approved medical devices and software relying on artificial intelligence for diagnostic purposes, “the uptake in the medical community has failed to meet expectations,” the NEJM Group wrote.

“For a given AI tool to be used, evidence that it will perform in a safe and effective manner must be demonstrated using randomized controlled trials designed to test the tool against an established standard…Unfortunately, there is currently limited high-quality evidence of this type available for many medical AI systems.”

Jobs and deals

  • AI-based revenue cycle management company CodaMetrix has raised $55 million in a Series A round led by SignalFire. Other participants included Frist Cressey VenturesMartin VenturesYale MedicineUniversity of Colorado Healthcare Innovation Fund, and Mass General Brigham.
  • Rural health and remote monitoring and telehealth startup Homeward Health is partnering with Blue Cross and Blue Shield of Minnesota to offer care in 14 counties in that state.
  • Nicholas Tatonetti is Cedars-Sinai‘s new vice chair of computational biomedicine and associate director for computational oncology.
Source: STAT