Richard Andrews, CEO of Healios, is on a mission. Having identified a significant gap in mental healthcare provision, the company he founded is pioneering the world’s first digitalisation of NHS Mental Health Trust outpatient services. He talks to Jonathan Bryant, Partner at Erevena, about how Healios is helping families to feel better by bringing exceptional healthcare to anyone, anytime, anywhere.
What’s the background to Healios and your interest in mental health?
I previously worked for pharmaceutical companies supporting the development and commercialization of innovative medicines in areas like cardiovascular diseases and neurological conditions. This gave me a fascinating insight into the global health markets, with an international career spanning several years in the US and Switzerland. That was a starting point, but it was more through personal reasons that I moved into this area of healthcare.
I had family members and friends who were impacted by mental health and neurological conditions like dementia. Seeing their struggles and that of their families when they were unable to access care, or get the right care, pushed me to take a big leap. I wanted to try and fix a system that wasn’t working as well as it could. I quit my career in the pharmaceutical industry to embark on a personal drive to see if we could change the way care is accessed, in particular within mental health services. That was the starting point for Healios.
How did you take the idea for Healios forward from there?
I wanted to really understand what other families were going through, so I got approved as a clinical observer in a mental health trust in the south of England. This allowed me to accompany clinical teams on their visits to almost 100 homes, where I could see for myself the devastating impact severe mental health issues can have on families.
Families can be torn apart by schizophrenia, schizo-affective disorder, bipolar and other kinds of severe mental illness. I could see many families were losing hope after years of struggle. This was a very emotional experience for me as I connected with families who had been pushed to the limit by mental health challenges, but it helped me understand that families need as much support as the individuals with mental health issues.
It was also clear that families play a pivotal role in how someone moves forward with their mental health challenges. In some cases, families can make a positive difference and in others they might unknowingly make the environment worse for recovery. For example, are family members walking around on eggshells or not setting boundaries for fear of exacerbating the situation? This can be worse for the individual’s recovery because their challenges are being avoided. This was my ‘a-ha’ moment around the power of the family and the home environment.
How did you take this ‘family’ thinking forward with technology?
Everything Healios does is delivered online via our highly interactive clinical management platform Panacea. Once we started assembling a great team of people, we decided to build the world’s first online family intervention service for psychosis and schizophrenia. It followed a well-established evidence-based in-person approach that is recommended in severe mental illness clinical guidelines for all families but, for a variety of reasons, isn’t accessed by families often enough.
One of the reasons for this is that there aren’t enough trained practitioners available to deliver this kind of healthcare in person. From a practical perspective, it’s also difficult to get family members together in a room between 9am and 5pm on weekdays. We took this evidence-based programme and figured out how to deliver it online. Then we built the technology interface to make it happen. The entire family experience has been digitised, from the NHS referral and families setting up their own accounts to manage their interactions, to clinical sessions via online video with our specialist teams.
You describe family intervention as an essential strand of your DNA – what do you mean by this?
Our purpose is to help families feel better with access to the right support and this purpose motivates the entire company. When a family has a loved one with a mental health challenge or a neurodiverse condition such as autism or ADHD, it affects the whole family and can be very destabilising. You might see a family member having difficulty maintaining employment or staying well because they’re so stressed. That’s why our focus on involving the family alongside the person with a mental health or neurodiverse condition is so important to us. It’s in our DNA.
How did you scale your concept from development to rollout?
We launched a pilot in June 2013 and started to work with families. It was an amazing moment after several months of building the platform to actually start delivering this ground-breaking service online. As we gathered more and more family outcome data, we could show the positive impact our service was having, but we wanted to go further so we started to include the patient in this intervention. This approach was demonstrating great results when we achieved our first NHS contract with the Isle of Wight trust. We were contracted to deliver online family intervention for their early intervention psychosis teams. This was a brilliant start for us and from there we began getting more NHS contracts around the country.
Today, we still work primarily with the NHS and our goal remains for our services to be free at the point of care. We are positioned in NHS specialist care pathways as secondary providers of mental health services, starting when children and young people are referred in by GPs or schools to their local NHS Child and Adolescent Mental Health Services (CAMHS).
You have largely focused on children and young adults – can you expand on this?
After initially starting out in adult severe mental illness, we began to realise there was a massive crisis with children’s mental health services in this country. We started to explore this and discuss some of these challenges with NHS organisations. For example, limited availability of CAMHS left some young people waiting several months and even up to two years for certain assessments. It’s a sad reality that two-thirds of children in this country who need treatment for their mental health condition aren’t getting it. That’s two-thirds of one million children – and that figure has grown over the past year with COVID.
We built our first interventions for children’s mental health over five years ago, focusing on children with anxiety and low mood and delivering cognitive behavioural therapy (CBT) online. We started building out our clinical platform to connect the amazingly experienced clinicians at Healios with young people and their families.
How else have you added to the Healios story?
We have continued to build and today we’ve created the most comprehensive online CAMHS care management platform for children and young people’s mental health. We’ve also expanded over the years into neurodiverse conditions, for which we do complex work around autism and ADHD. As a result, we are organised around two highly specialized clinical divisions: one that focuses on children and young people’s mental health, where we carry out online mental health assessments; and another that focuses on all-age neurodiverse conditions.
For the first of these two divisions, the aim is to understand what challenges people are facing. Is anxiety an issue? Is it low mood? Is it a combination of both or something else that’s driving their daily difficulties? It could be signs of ADHD or autism; in which case they move over to our specialist neurodiverse clinical division. If it is a mental health-driven challenge, we’re able to offer a personalised psychological intervention through multiple therapy sessions. They also have access to some of our novel digital tools, including the ThinkNinja app, which is available 24/7.
In our specialist neurodiverse clinical division, we carry out complex autism and ADHD assessments for children and adults, and then provide a post-diagnostic intervention with the family to support them moving forward. This is all done online via our Panacea platform and with our team of clinicians.
Can you tell us more about ThinkNinja?
ThinkNinja is an app we developed a few years ago to help address the fact that so many children are unable to access support for their mental health, and more prevention and early intervention solutions are needed. It is built on an evidence-based CBT architecture and the whole idea is to support skill development in 10 to 18-year-olds so they can stay well and build resilience. If they have symptoms of anxiety or low mood, the app can help them understand more about these symptoms. In parts of the country where we have been commissioned to offer this, young people can also activate a text chat or video chats with our clinical team. This is a really nice way for children to access further support easily from the comfort of home.
Essentially, we have taken a clinician’s brain and personified it in the app with an avatar called Wise Ninja, wrapping it up with beautiful design and interactivity. Wise Ninja guides you through the app and coaches you to cope with feelings, such as stress.
What impact has Covid made on Healios and children’s mental health?
We made a decision at the beginning of COVID last year to make ThinkNinja freely available for all 10 to 18-year-olds across the country during the crisis. We felt it was part of our responsibility to help manage the impact of the pandemic on young lives and we received NHSX endorsement (this is the NHS procurement framework). ThinkNinja was the first app approved in direct response to the impact of COVID on children’s mental health. Within just a few months, nearly 20,000 young people signed up to use the app. It’s incredible to be able to help so many people during this stressful time.
COVID has seen a massive rise in the number of children unable to access treatment. We’ve seen young people struggling with being in isolation away from their friends and normal social networks. They are worried about catching COVID, either themselves or a family member, and many have felt trapped in homes where tension with other family members may exist. Our amazing clinical and tech teams quickly built COVID-related content and we have since followed that up with content around adapting to change, such as returning to school.
How do you fund your continued growth?
At the outset it was with personal finance, after which we attracted some angel investors. Then, when we needed more capital to grow, develop and innovate so that we could scale, we attracted funding from high calibre professional investors Albion VC. More recently, we’ve announced a further £7 million investment which was led by InHealth Ventures and joined by AlbionVC and our angel investors. This is great news and will help us reach more lives.
How does Healios attract talent?
It’s about how we communicate our purpose. We have a clear purpose to improve lives and help families feel better within the field of mental health and neurodiverse conditions, which naturally attracts people to Healios. We have a large clinical workforce and clinicians want to be part of an innovative company that is trialling new solutions and is focused on making an impact every day. We also have a large and growing non-clinical team, with roles across areas such as tech, finance and commercial. We use a combination of methods to attract this talent, one of which is partnering with great specialists like Erevena for our critical executive hires. Maintaining this talent pool is going to be part of our success going forward.
What challenges lie ahead for Healios?
One of our key challenges is around our relentless pursuit of developing new innovative clinical models to meet such a large need and the impact this continued drive has on our passionate staff. We’re invested in supporting our teams as a core part of our culture in this fast-paced environment. We want to continue to demonstrate the outcomes we’re making possible and to adapt to changing family mental health needs. We know we must find ways to bring more value to the families we help and to the NHS. Getting this right is an important challenge for us as we scale.