Lauren Lee is a Clinical Psychologist by background and training. She transitioned from clinical practice to industry in 2016 when the field of Digital Mental Health was forming and emerging. Since then she has held various leadership positions across the landscape of digital health and mindfulness companies in operations and program/product development. When she’s not spending time with her husband and their four year old daughter, she leads the science function at Headspace Health as the Vice President of Clinical product and content development. Becoming a parent was a transformative experience for her in deepening her awareness of her own emotional health and positive well being. She practices having a Curious Mind, one of the core values of her company and one of the core tenets of mindfulness practice, by asking her daughter questions everyday to better understand how she sees the world.
She received us today with a large smile at Headspace health offices in San Francisco to explain to us how she supports her company to create new digital mental health products or services.
What is the moment you realized you had mental health ?
It's interesting because it feels like it should be a simple question. To spot physical health is really apparent. The first time you stub your toe, or you scrape your knee, you're like, “oh, physical health, that's pain, right ?”. The culture within my family of origin did not talk about mental health. It wasn't something my parents had self-awareness of, and in that way I was delayed in my own awareness of the concept of mental health.
When I was younger, around six years old, I did not know that it was driven by anxiety, but I was playing with my hair, incessantly, and even breaking or pulling strands. Right now as an adult and a subject matter expert, I'm like, “Oh, that's a behavioral manifestation of anxiety, right ?”. At the time, all I knew was that I had this habit but I didn't know why, I just knew I felt a sense of relief from doing it.
I couldn't really articulate this connection until I was probably in college, around my early 20s. It was also the first time that I had access to mental health services through the Counseling and Psychological Services Center at my university. In a lot of ways that was such a pivotal experience, what triggered me actually going to my first therapy session, was deciding that I was not going to pursue biology as a major and become pre-med, and instead deciding that I was going to become a clinical psychologist, and changing my major.
This created a lot of tension within my family. I went to therapy, because my father wouldn't speak to me for several weeks, once I changed my major. Obviously, I had an emotional reaction to that.
That was when my own awareness really started blossoming, not about the academic understanding of mental health or clinical disorders, but the highly unique and personal ways in which individuals experience their own mental health, and once self-awareness is gained, the unique and personal ways one copes..
My interest in psychology and mental health started more academically, but this has obviously evolved over time where today, mental health is everything to me. It's at the core of my professional life and the focus of what we're trying to deliver on with our mission here at Headspace Health.
Mental health is not a disorder, diagnosis, or symptom profile. One’s ability to experience emotional responses to situations, awareness of what underpins or triggers that response, and sustaining a sense of emotional contentment and resilience in spite of everyday challenges are core features that I believe bolster mental health. In other words, we all have mental health, it is as essential to our ability to thrive as physical health is.
What do you want to improve in terms of the population's mental health ?
The reason that I specifically chose to focus a career in Digital Mental Health was to have the ability to impact the mental health of people at-scale.
I am a trained clinician, and my last full-time clinical role was developing the program that supported students at Stanford, who had experienced relationship violence and sexual assault. One of the things that astounded me was that, even within a prestigious and well-endowed academic institution, students still were not able to access mental health care with the frequency and duration that would be most helpful. The supply and demand conversation has existed in community models of mental health care much longer than it has been highlighted as a core challenge within digital mental health. What’s interesting is that the discussion has shifted not only from the challenge of not only equitable enabling access to care, but also as a critical business problem for any digital mental health company leveraging providers in their care model. In other words, changing the platform through which the care is being delivered still has yet to reveal significant impact at a population-level health scale on improving equitable access.
“The reason that I specifically chose to focus a career in Digital Mental Health was to have the ability to impact the mental health of people at-scale.”
The power of a software-led application is that because it's not supported solely by a 1:1 human relationship, it can scale. If we start from the evidence base that supports specific interventions for a person’s presenting concerns, imbue a product experience with the practices that are the rituals and norms off traditional mental health care, and marry it with person-specific data I believe we can translate many of the common factors underpinning traditional therapeutic process within a digital application.
Enter the skepticism of the field: “How do you know it works?”, “How are you trusting software to determine if a person is feeling/getting better?”, “Digital mental health is trying to replace licensed Clinicians!”. I hear the concerns, I hold the same concerns. As I have moved across this landscape I have yet to encounter a single business whose mission it is to tank the field of community-based mental health practice. And, these critical, and necessary, questions are the reason I have such confidence in the work we are doing at Headspace Health. From Headspace’s earliest foundations, this company has been a pioneer in prioritizing validation of the digital application as efficacious. Of course, this is a priority to ensure the safety and outcomes of our Members, but it is also a core value that promotes ethical and integrity-based product development. The same success metrics that power social media platforms, are not the same metrics that matter to Headspace Health.
This is a gnarly challenge! We have to find ways to bring to bear within digital products and applications the same ethics, standards of care, principles of practice, and privacy that underscore the mental health practice of licensed clinicians.
This is where we have the opportunity to also innovate with regards to the oversight of quality, embedding features of measurement based care within care, whether that's a software led intervention, or that's a human delivered intervention. This is how we keep ourselves accountable to the effectiveness of what we deliver. Many of these processes have historically been difficult to implement and adopt because of how manual the process is. That is another advantage of leveraging tech and software platforms to not only support scaling of access, but also to demonstrate it is possible to scale while doing so responsibly and while mitigating impact on effectiveness of the care. As I said, it is a challenge, but I love having the opportunity to support realizing this potential.
What is your proposed solution to solve this problem ?
The first is a macro environment solution, and this won't be controversial to other clinicians : you must have clinicians around the table when a company is making decisions about providing care. You need to ensure some equity in the decision making process with the folks that have the subject matter expertise.
It's incredibly important to have people that have a healthcare background, as well as the lived experience of providing these types of care and services that you're developing, selling and commercializing. Otherwise, licensed Clinicians will not be attracted to a company where they do not see that clinical subject matter expertise being valued.
I think the others solutions waterfall from that at different levels. What I have found to be so interesting about these forms of services moving into the tech sector, is that it's essentially like an American that only speaks English, interacting with a French person who only speaks French? The same challenges of communication, holding of mental models happen within organizations and the cross-functional teams that must rely upon each other for shared success. Clinicians are going to think very differently and communicate very differently than a product manager might. And to be clear, there is no ‘right’ and ‘wrong’ with these thoughts, I am just highlighting that they lead to different perspectives around ‘how’ we go about developing the ‘what’.
“you must have clinicians around the table when a company is making decisions about providing care“
We don't spend enough time ensuring that there's alignment about what our goals are, because we just don't understand each other. A large part of the solution towards being able to impact these problems is less about the specific product and services, and more about the internal working processes and relationship of the many cross-functional experts necessary to stand up any digital mental health solution. We need to enable all Clinical or Behavior Science subject matter experts to translate that knowledge into applicable everyday use cases that say, a designer, a product manager, and engineer can take with them and apply immediately. And if we were to do that, within a system at a macro level, I think some of the other challenges with adoption, engagement, and staying adherent/engaged with a treatment plan would have their downstream positive consequences. How do you develop a product that is intended to improve somebody's mental health if the product designer has a different concept of what mental health is than the clinician ? Because it's not like “Oh, I've got the vision and if we could just implement it”. The goal of my work is not necessarily to solve the mental health crisis but to improve communication and education about mental health.
“If I had a solution with regards to the digital mental health space, it would be this : stop telling people what they need to do.”
For Members and Clients, coming into these Digital Mental Health experiences, I think it’s a similar concept. People often know what they need to do, such as when one wants to quit smoking or alter their eating behaviors. If it was a lack of awareness about what you needed to do, all we would need to do would say “hey, just eat these vegetables”. If that was sufficient, then people wouldn't have the challenges that they have. It's not about giving people education or awareness. It's about reducing ambivalence and increasing motivation to actually take actions towards that. Whatever we're building is developing in this space. If we assume that everybody is going to be the ideal user, and will engage with it exactly as we predict we are doomed to fail. If we instead anchor on and honor what we know to be true about human behavior and the barriers to taking steps towards behavior change, that is where we unlock the experiences that people will actually want to use.
What are your plans for the future ?
Oh, well so many plans! Truthfully, Digital Mental Health as we know it today did not even exist a decade ago. The pandemic grew and intensified the attention that was being brought right to the subject of mental health. We were able to invest more money and resources to the solutions that could support people. But we were doing so at such a rate that was so fast! And, unfortunately, we are seeing some of the negative consequences of doing so amongst the competitive landscape.
When I think about the future, I try to think more broadly than my current role. I want to be a thought leader within mental health, but more specifically, at that intersection of digital mental health and the ethical use of technology, data, and metrics that powers these interventions and services.
“My plans for the future are really to continue to add nuance, and sensitivity and consistency into the conversations of what data matters.”
As I mentioned before core consumer metrics matter to the business and ability to sustain the business, they are necessary to focus on. At the same time, they are not the only metrics that matter when the outcomes we strive for are tied to improving the well-being and functioning of our Clients and Members. If we can marry those engagement metrics with outcomes metrics for our health outcomes or symptom reduction, I believe that is the pathway towards demonstrating that engagement with the product has enabled our Members to live the life that they want.
Is there an artistic work, or someone inspiring that had a positive impact on your mental health ?
There have been so many ! So really transparent, when I was preparing to step in and lead our science function, I was incredibly excited and really nervous. And I have a 90 pound mutt dog, he's a shepherd lab mix, and I walk him two miles every morning. One of my most favorite things to do, and which has a positive impact on my mind, is to listen to music while I walk him and visualize my feet hitting the ground and literally, like breaking the concrete and really owning my power.
Music has been incredibly therapeutic for me ! I've curated a playlist within the last year that has these very empowering songs. [Lauren is taking her phone to look at her Spotify playlist]. One of them is called “Superbloom” by Mr. Wives, there is also “Could have been me” by The Struts, “Cloud day” by Tones and I, “Dynamite” by BTS, “Joy” by Andy Grammer. Again, it is really tailored to my own personal tastes, I'm going to verify for you right there, there is a song called “Emerald”, it's from our Headspace soundtrack, I probably single handedly have driven the play count on that on Spotify. So those have really been inspirational songs for this time of life.
I think this is very in line with mindfulness. We spend so much of our life pushing against things, resisting, when the reality is nothing is actually in our control.
What I found is that listening to music has been one way across the different stages of my life, to support embracing change. Lyrics help me to make sense of what is in front of me, and granted me the power to broaden my interpretations that color my emotional experiences.
What is the best way to contact you ?
Interviewed by Thomas Cantaloup, on September 23, 2022
Photo credits : Thomas Cantaloup