Pediatric mental health startup InStride Health picks up $30M to accelerate growth into new markets

Two years ago, startup InStride Health launched to provide mental health treatment for children and teens based on a program rooted in academic medicine, aiming to make high-quality care more accessible to families.

Now available in eight states, the company continues to build out partnerships with health plans to provide insurance-based virtual specialty treatment for pediatric anxiety and obsessive-compulsive disorder (OCD). InStride integrates clinical expertise, exposure coaching and support into daily life to engage kids and teens, according to the company.

The company pairs each child with a psychiatrist, a therapist and an exposure coach to provide real-time support using everyday tools like text and a video- and chat-enabled mobile application. InStride takes a three-pronged approach to supporting youth who struggle with anxiety disorders and/or OCD: addressing gaps in mental health treatment, incorporating care into everyday life and delivering lasting results, executives said.

The company has 158 employees and is approaching 1,000 patients and families treated. It's currently contracted with 16 insurers.

InStride Health closed a $30 million oversubscribed series B round, led by General Catalyst, to continue investing in the clinical quality of its services and expand to new markets. Previous investors .406 Ventures, Valtruis, Mass General Brigham Ventures and Hopelab Foundation also participated in the round.

“We believe InStride is at the forefront of helping to democratize accessible, high-quality behavioral health care through its unique clinical model and innovative approach to delivering care, and we look forward to helping them grow,” said Candace Richardson, partner at General Catalyst.

The startup raised $26 million in 2022, bringing in $56 million in total funding.

InStride was co-founded by Harvard-trained clinicians from McLean Hospital and healthcare and technology leaders to address a growing mental health crisis among kids and teens.

Mona Potter, M.D., and Kathryn Boger, Ph.D., co-developed the McLean Anxiety Mastery Program (MAMP) at McLean Hospital, a Massachusetts-based psychiatric hospital.

After almost two decades of working in academic medicine, Potter said she wanted to take what she had learned and build a solution to the broken pediatric mental health system.

A board-certified child and adolescent psychiatrist, Potter saw firsthand the impact of effective treatment for children and adolescents struggling with anxiety and OCD.

"[Dr. Boger] and I were working on an adolescent to dual-diagnosis, residential treatment unit, so these kids were coming to us with significant substance use disorders and co-occurring mental health issues like anxiety and depression. These kids were coming in and feeling so broken and so lost, and they were labeled as delinquents, and hopeless, and people had just given up on them," Potter said in an interview.

"We realized how much that anxiety, in particular, led them to where they were, and how just addressing these behaviors and not actually tackling that underlying anxiety was doing them a disservice. We recognized how debilitating anxiety can be, and how much it can balloon into multiple secondary tertiary problems that can derail a kid's life and a family's life," she noted.

Providing children and teens with the right treatment can be "life-changing," she noted. The outpatient treatment at McLean Hospital has proven to be effective, but Potter and Boger recognized the lack of insurance coverage and a long waitlist made it inaccessible to many families.

"This is not a story where there's not the right treatment; there is the right treatment, it's really about access," Potter, InStride Health's chief medical officer, said. "Parents were paying out of pocket, some were emptying out their 401Ks and they were taking out the college funds, They were doing whatever it took to get their kids help, but it broke my heart."

When the COVID-19 pandemic hit in 2020, the need for pediatric mental health service steadily grew, and families struggled to get timely care.

"I was getting calls from not only colleagues looking for care, but also now people in my community, friends were calling and co-workers, saying, 'Please help me navigate the system, my child needs help.' I could not get them into help, and I know the system," Potter said.

Potter and Boger, InStride's chief clinical officer, decided to take a model that worked well in an academic hospital and offer expanded, flexible access to mental health treatment, covered by insurance. They teamed up with John Voith, who has healthcare entrepreneurship experience, and James McElhiney, a software engineer and technology leader, to build InStride Health. Voith leads the company as CEO, and McElhiney serves as chief technology officer.

"It was important to think through healthcare, not only from that clinical quality perspective, but also from that business perspective of how do you scale up? How do you think about it operationally? How do you think about the financial growth? How do you negotiate with insurance companies?" Potter said.

Nearly one-third of youth in the U.S. will struggle with an anxiety disorder and/or OCD by the age of 18, according to InStride Health. This presents significant life and economic challenges for kids, their families and the healthcare system. Providers that offer specialty care for these conditions are in short supply, often have more than six-month waitlists and rarely accept insurance. 

InStride Health's care model is grounded in evidence-based care: cognitive behavioral therapy along with acceptance and commitment therapy, with an emphasis on exposure and response prevention. The company accepts most major insurance plans in Connecticut, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania and Rhode Island, with Maine coming soon. 

The company says treatment typically begins within one to four weeks of application approval, making high-quality care affordable and accessible to more young people in need.

"We’re on a mission to help kids, teens and young adults with anxiety and OCD. We aim to expand our specialty clinical services to provide the same care and accessibility we’d want for our loved ones," Voith said.

The company's services are fully virtual "by design," Potter said. "It's very active treatment. With our exposure coaches, their entire role is about engagement and motivation and doing that in-between session work. We're trying to take the treatment that they're learning and have them practice it in real life," she noted.

Unlike traditional clinical settings, InStride Health takes care out of the office, helping patients build and practice skills in the environments where their individual fears and anxieties are most present. This real-time, real-world approach accelerates learning and builds resilience, according to the company.

The InStride Health team also develops close, collaborative partnerships with schools, physicians and referring providers in the communities where they are serving children and their families.

Manuela Villa, Ph.D., a referring clinician from Boston Children’s Hospital, said she works collaboratively with InStride in the treatment of children and adolescents struggling with anxiety and OCD, citing InStride's use of evidence-based care combined with its ability to foster strategic partnerships.

"I’ve referred many patients to the InStride team because they truly go above and beyond to ensure that all aspects of patient care are addressed, and their unique approach results in excellent patient outcomes and high levels of patient satisfaction," Villa said.

There are a growing number of companies providing virtual mental health services for children and teens. 

Brightline, a company that uses multidisciplinary care teams to deliver virtual behavioral health to children, has raised $220 million, including a $10 million investment by Northwell Health, as part of its series C round.

Charlie Health, which launched in 2020, offers virtual high-acuity mental health care for teens and young adults. The startup aims to make virtual intensive outpatient treatment accessible to young people and their families, and the program combines supported groups, individual therapy and family therapy into evidence-based, comprehensive and personalized treatment plans.

Talkiatry, a national telepsychiatry provider, recently expanded its child and adolescent psychiatry services to five new states.

Online therapy company Talkspace inked a partnership with the NYC Department of Health and Mental Hygiene to operate a new program, called TeenSpace, to offer tele-mental health services to teenagers. The service will provide free virtual mental health services to more than 400,000 adolescents and teens in New York City.