International Yoga Day 2019: Why Indian Healthtech Startups Need To Focus On Mental Wellness, Not Fitness

The International Yoga Day (June 21, 2019) is always accompanied by huge photo spreads and front-page coverage of how people around the world celebrated one of the most ancient forms of fitness and wellness.

In India, the International Yoga Day has become an occasion for political leaders to break out their yoga mats and perform a few asanas in public, but the reality is that more than the fitness aspect of yoga, India is desperately in need of the mental wellbeing that this activity espouses. For generations, yoga practitioners have extolled its virtues in helping them attain inner peace and keep stress-related disorders away.

While India has a huge tradition of yoga, a lot of the times, this is positioned as a fitness activity, when in reality yoga can teach us a lot about mindfulness, mental wellbeing and de-stressing.

As a relatively young country in terms of the age of the population and the maturity of its digital economy, India is in a unique place as the hyper-connected everyday lives of Indians is resulting in poorer mental health and lack of acknowledgement of wellbeing disorders. While Indians are adopting technology en masse to deal with everyday chores and tasks, it is indeed taking a toll on their lifestyle and mental health.

The biggest indication of this comes from the World Health Organisation, which revealed last year that India is the most depressed country in the world, followed by China and the USA. India is in the top-three most affected countries when it comes to anxiety disorders, schizophrenia and bipolar disorder.

A WHO study on behalf of the National Care Of Medical Health (NCMH) states that at least 6.5% of India’s population suffers from some form of serious mental disorder, with no discernible rural-urban disparity.

According to reports from the Ministry of Health and Family Welfare, India needs around 13K psychiatrists to meet the demand for mental health professionals, but only has about 3,500 until October 2018. That results in one psychiatrist for over 200K Indians. In terms of clinical psychologists, the demand is for 20K professionals, whereas the availability is around 1,000, and similarly in the cases of psychiatric social workers and nurses.

Technology can help address this gap, just as it has done for health care access. Within the overarching healthcare ecosystem, the situation is similar to mental healthcare; inadequate supply and uneven distribution of medical professionals. While many healthtech startups are striving to solve problems in improving access to medical professionals through telemedicine or virtual healthcare, there is far less happening. In many cases, mental wellness products are clubbed with fitness and wellness apps, which don’t always do justice to the severity of the problem faced by those with mental health disorders. The clear and present need is for startups, products and services that have dedicated themselves to mental wellness.

Wellness And Mindfulness Tech Startups in India

In terms of investment activity, some wellness startups have been receiving high-profile investments from celebrities and marquee investors. At present, the overall fitness market in India is valued at $3 Bn and is said to be growing at 18%, with a mere 4% of the market comprising of organised gym chains or digital fitness startups. But workouts and fitness activities are just two aspects of overall health and fitness. Many startups such as Cure.fit vertical Mind.fit, Yourper, Headspace are focussing on mental wellness as well.

This week, Bengaluru-based AI mental health startup Wysa raised $2 Mn (INR 15 Cr) in a pre-Series A funding round, to further strengthen their technology and for expansion. Prior to this round, the company has raised $1.9 Mn from multiple angel investors.

Founded in 2015 by Jo Aggarwal and Ramakant Vempati, Wysa is an AI-based ‘emotionally intelligent’ bot. It is a virtual coach that combines empathetic listening with evidence-based therapeutic techniques like CBT, meditation and motivational interviewing.

Jo Aggarwal, cofounder, Wysa, stressed that the platform’s USP is the anonymity it offers to those who use their services. “People are scared to be seen or judged for what they are going through. We combine the free AI with unlimited support from a qualified therapist, still anonymously, over chat to make it easy to get help.”

Wysa claims that over 1 Mn interventions have happened on the platform, which is an impact equivalent to about 3 Mn hours of in-person therapy. But a lot more needs to be done.

According to WHO estimates, India’s burden of mental health problems is massive at the moment. For every 100K people, the organisation found 2400 disability-adjusted life years. This means among the lifetime of every grouping of 1 Lakh in the population, 2400 years cumulatively are spent managing mental disability or trauma.

Mumbai-based fitness startup SARVA had raised about $6 Mn – $8 Mn from celebrities such as Jennifer Lopez, American baseball player Alex Rodriguez, Indian actress Malaika Arora, and along with fitness brand Zumba. Besides yoga, SARVA focusses on offering mindfulness and wellness solutions through a hybrid online-offline model, encompassing state-of-the-art wellness studios and lifestyle products, backed by an interactive digital platform.

Another startup working to solve lack of mental health support is Bengaluru-based YourDOST, which had raised $1 Mn in Pre Series A funding from venture capital firm SAIF Partners and others in 2016.

Also on the wellness end of the spectrum. Mumbai-based online psychological wellness platform InnerHour had raised $450K in its first round of funding from financial advisory firm Batlivala & Karani Securities, investment firm Venture Works and others.

International Yoga Day 2019: The Under-Addressed Wellness Tech Space

Despite these startups taking strides to meet the mental wellness gap, this segment is currently under-addressed in the Indian context. The National Institute of Mental Health has claimed that technology solves problems such as access, anonymity, mental health education and support for patients. But at the same time, it says that challenges around mental health data of patients, regulation and proven expertise on such platforms.

The NIMH also noted that smartphones are a crucial element in the mental health technology chain. Platforms such as Dr Patricia Areán’s BRIGHTEN study, which used technology to screen, deliver interventions and conduct trials can be really helpful for younger patients.

The BRIGHTEN team used technology to recruit, screen, sign-up, conduct tests and assess patient response. It showed that technology can be used to make a difference in the mental wellbeing of patients, because it is an interactive medium and not passive like traditional counselling tends to be. The platform used a cognitive training app that urged participants to solve problems and there was a companion mobile-sensing app that promoted daily activities based on the user-reported mood, function and passive analytics such as communication, activity or location data on the device.

While the study was conducted in the US, it had promising results when it came to targetting the rural audience. “We were able to successfully recruit individuals from 8 of the 15 most rural states in the USA without any targeted recruitment efforts,” the study’s paper said. This can be a huge boost for economies such as India, which have an even greater share of rural stakeholders, where mental health care is often out of the question.

For India, the problem is that technology is being used in a more gradual manner to influence psychological intervention, than it was for other sectors such as ecommerce or logistics.

Between 2009 and 2015, the NIMH awarded 404 grants totalling 445 Mn for technology-enhanced mental health intervention, including for studies of computer-based treatment. It called on entrepreneurs and startups to submit their innovations for digital health technology to develop assessment, detection, prevention, treatment, and delivery of services.

While the initiative by NIMH is heartening, the reality is that technology is not being given the mandate it needs to help solve mental wellness. The focus of the government through its International Yoga Day 2019 programmes has been on physical fitness once again – just as it has been in the past. While that is commendable in isolation, the bigger issue as highlighted by the WHO report from 2018 on depression is around solving India’s mental health and wellness problems.