Blackbird Health Nests A Fresh $17 Million To Become The Gold Standard In Precision Mental Healthcare

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While calling attention to the importance of mental health in America isn’t new, the pandemic and past four years have brought the issues into focus. Whether the crisis is getting worse – or it’s always been bad but the stigmas around discussing mental health publicly and seeking treatment have waned – the demand for services has skyrocketed amid a seriously strained provider supply.

In the digital health space where tech-driven care models have the ability to expand the reach of available resources, venture dollars have flowed into solutions that range from self-service meditation and tele-psychiatry all the way to emerging psychiatric treatments like ketamine and psychedelics. By Q4 of last year, while it represented a slowdown from previous years, nearly $1 billion was invested in behavioral health startups for 2023.

Now it seems like technology-driven mental health startups are everywhere, yet there still is a huge unmet need for young people. Behavioral health support for children and adolescents is in tremendously dire straits. The American Academy of Child and Adolescent Psychiatry reports that there are just 14 psychiatric specialists for every 100,000 children in America. Approximately 16% of young people suffered from a major depressive event in 2023, more than 20% of teens have contemplated suicide, and studies have shown that increasing use of social media is having an ever-rising impact on young people’s sense of well-being.

While there are many underlying factors driving the growing problem, diagnosing and treating mental health among young people is not as easy as just scaling resources. Yes, the actual number of providers and appointment availability are very real barriers, but the capacity issues also can be attributed to the ongoing and sometimes slow process of getting individuals on the right mix of treatment approaches. Two young persons experiencing signs of depression may not respond similarly to the same approach, because they could have differing root causes affecting their mental state – be them learning or developmental disabilities, biological factors, brain chemistry, environmental issues, etc.

However, a typical provider may start them both out on the same therapy simply out of prior experience, but these assumptions could result in dramatically different outcomes and take more time to make adjustments. That means availability of appointments, already stretched to its limits, is even further affected. It’s not too dissimilar to what often happens when treating heart failure – where medication titration can take six to nine months to get just right – which can suck up crucial cardiology resources.

That’s why Blackbird Health, which focuses exclusively on children, adolescents and young adults, is part of an emerging crop of technology- and data-driven mental health providers that are trying to enable more precise and personalized mental healthcare. The company announced today that it raised $17 million in Series A funding led by Define Ventures with additional participation from Frist Cressey Ventures and GreyMatter. Blackbird currently operates three brick-and-mortar clinics – including two in Pennsylvania and one in Virginia near Washington D.C. – with a care team of approximately 40 child and adolescent psychiatrists, prescribing nurse practitioners, psychologists, therapists, speech pathologists and other support staff.

A Fledgling Mental Health Practice Prepares to Leave the Nest

Blackbird’s first iteration was founded in 2014 by Amy Edgar, APRN, CRNP, FNP-C, and was originally called Children’s Integrated Center for Success. She started the practice after struggling to find the right kind of support for her child.

“I felt the standard of care I saw with my daughter was not good enough, and at a certain point in my life I felt like now was the time to change things. So we met as a family and decided I was going to bootstrap a practice with a mission to do it the way it should be,” said Edgar. “We worked with families and brought on some innovative tools and diagnostics to look at root causes [of mental health issues] to get a deep understanding of the child and family.”

After a few years, Edgar then teamed up with child and adolescent psychiatrist Matt Keener, MD, and relaunched the practice under its current name (Blackbird Health). The two fused together their unique experiences to refine the care model and community-centered approach as it is today, which aims to help kids achieve better outcomes faster. Though she thinks the category of “precision mental health” is loosely defined, Edgar believes Blackbird is the “gold standard” among the growing field.

Following the rebrand, the practice continued to grow steadily, but it wasn’t until April 2022 when they would meet Blackbird’s current CEO, Tom Peterson, a veteran digital health entrepreneur who previously served as co-founder and COO of Evolent Health. Peterson’s own family experience with Blackbird made him a believer in the model and compelled him to first become an investor and an advisor – then later take on the role as CEO. Now he’s ready to scale the model nationwide.

“My previous experience with the behavioral health system was one of lots of trial and error and long-time destabilization, where we felt we weren’t identifying the underlying causes and developing treatment plans that addressed them,” said Peterson. “I was looking for a clinical model that took on these issues, and when I found Blackbird, I immediately saw a pretty fundamental difference in the approach and the outcomes.”

Blackbird offers hybrid (virtual + in-person) services that combine neuroscience and computational models to better diagnose and treat patients. It bills itself as having an “understand first” approach that takes “trial and error” out of providing care.

New Blackbird patients go through a detailed intake process that starts with a neuroscience-based assessment that helps its interdisciplinary clinical team gain a deeper understanding of each individual. Insights from these screenings then may lead to specialty evaluations like Autism and developmental testing, cognitive screenings, speech and language evaluations, and even physiological or genetic testing that helps inform medication selection and dosages.

Leveraging 50 million data points across its 10-year database of patient encounters, Blackbird then applies the computational models to determine which “biotype” best fits the young person. Blackbird’s biotypes are clusters of individuals in its database with similar characteristics. The idea is that more specific diagnoses and previously successful treatment approaches achieved for others may indicate a more appropriate path for a specific patient – and thus reduce the time it takes to get them on the right mix of therapies.

“What you generally see in mental healthcare is that patients go through a narrow door, and your care is then dictated by the door you go through. So if you go to a psychiatrist, you’re getting evaluated for medication; and if you go to a therapist, you’re getting evaluated for therapy approaches. But our approach looks across eight different domains, and with the detailed intake process and additional evaluations, we get a broader sense of root causes and our treatment plans are more diverse,” noted Peterson.

What that effectively means, for example, is that an ADHD diagnosis for a child may not be as simple as that. Peterson said they have five different types of ADHD diagnoses that more precisely describe how the condition manifests in each child, whether it’s more physiological in nature versus a speech and communication challenge.

Showing Outcomes Is For The Birds (and Payers)

Because of its more precise diagnosis and treatment plans, Blackbird reported it has a “very high patient-retention rate,” with 85% of its patients with depression and/or anxiety experiencing clinically significant improvement in their symptoms. Additionally, while the company did not provide specific figures, it also reported its integrated and tech-backed care programs resulted in lower usage of medications and reduced ED utilization among its patients.

Those are interesting points that would likely interest payers. Emergency department utilization is very costly to payers, as is long-term use of prescription drugs. Unlike many physical health conditions that may require medication for a short period of time, people taking medications for mental health may be on them for decades – if not for life – which can also create side-effect profiles that also need to be managed. These issues add significant costs to the system, especially when they’re starting in childhood years.

Peterson says that Blackbird works closely with payers to ensure its services are in-network as much as possible and makes the unit economics around reimbursement work by taking a community-centric approach and by focusing on patient density in a given market.

“We really are focused on building relationships in local communities and building community density. A lot of digital mental health companies are focused on broad geographic areas to find patients, whereas we are focused on how to build density from within,” said Peterson. “I have weekly to monthly meetings with payers to figure out what their needs are in terms of capacity and outcomes and am building strong relationships to demonstrate greater value. And we’re being paid for that value.”

Peterson also said payers like the in-person aspect of Blackbird’s hybrid model, particularly because they believe it’s important in pediatric mental health.

Making contractual relationships work economically with so many payers could be considered somewhat of a differentiator for Blackbird. Many mental health practices (and notably psychiatrists) don’t even bother taking insurance because of the reimbursement challenges – an issue that exacerbates access problems.

Blackbird Spreads Its Wings

Now with Peterson onboard and flush with new funding, Blackbird has plans to meaningfully expand market by market.

“We’re working with our payer partners to expand in markets where they already operate, so our growth plan is really to go to those contiguous states. And, through our relationships with investors, we may look to de novo regions where they also have strong payer relationships.”

Another strategy for Blackbird’s growth plans is partnering with pediatricians, health systems, schools and local community groups in the new markets it wants to expand to establish a strong referral pipeline, generating that “community density” Peterson referenced.

Chirag Shah, a partner for Define Ventures who was a driver behind the investment, sees a powerful market opportunity for Blackbird and its tech- and community-driven approach.

“We believe that mental health is delivered best comprehensively, so we look for companies that can deliver multiple facets together in one unified platform. Blackbird represents that well because they support a wide variety of underlying conditions and causes,” said Shah. “No matter the diagnosis, no matter the treatment, no matter the severity, Blackbird is there for kids. The best way to get to the clinical outcomes that everyone wants to see is through a holistic model.”

While Define has invested in other companies that offer mental health, either as part of their clinical model like women’s healthcare provider Tia or through a collaborative care model like Concert Health that works with traditional health systems, Blackbird is the VC firm’s first youth mental health investment.

Shah also said Define appreciated “how detailed the diagnostic approach was.”

“It’s not as easy as diagnosing a child with ADHD or depression. There are many phenotypes underneath that help explain why certain symptoms are present. That’s not only important for initial diagnosis, but it’s more important for care delivery so kids are getting the right kind of care in the right way the first time.”

Now that Define is part of Blackbird’s cap table, Shah said the firm’s role will be to work with Blackbird to ensure it continues to have a “consumer-focused” mindset while also leveraging Define’s roots in Silicon Valley to provide guidance on innovation.

“Healthcare used to be about how we bring services to people, but now it’s about how we bring people to those services,” he said.

Standing Out Among the Flock

As the field of technology-enabled mental health providers continues to expand – and investors’ checkbooks remain more closely guarded for the foreseeable future – simply expanding access to providers won’t be enough to sustain the landscape. Companies are going to need to differentiate significantly both through their care models and their ability to drive improved health outcomes with better unit economics. And some won’t, meaning there will likely be a few failures and a lot more industry consolidation in 2024.

That’s why personalized approaches like Blackbird’s present an intriguing opportunity and might just meet the moment. However, Blackbird isn’t the only one offering more personalized and precise mental health. Companies like Spring Health with its $2.5 billion valuation are proving there is tremendous interest in a smarter, more data-driven approach to mental well-being. Brightside Health is another provider leveraging “technology-enabled symptom-cluster analysis” to guide its treatment plans.

Regardless of the competitive landscape, Blackbird Health has both a lot of market potential with a team of experienced leaders – not to mention some respected investors – charting its future course. While scaling any brand in healthcare is hard, especially in the mental health ecosystem where the economic challenges can be great, there is seemingly a lot of sky for this Blackbird to take flight.

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