More people have become comfortable seeking behavioral health help either online or in person, but problems persist when it comes to minority and underserved populations.

For individuals identifying as Black, indeginous and people of color (BIPOC), many have felt that mental health providers, overall, fail to address unique cultural circumstances contributing to adverse behavioral health conditions. Additionally, cultural stigmas about mental health have long been an impediment to many seeking out help.

Yet, a number of behavioral health apps have emerged that are targeting BIPOC individuals with offerings such as therapy, meditation and self-care. Additionally, large players in the digital behavioral health space – from Headspace Health to Talkiatry – have been active in creating new content for BIPOC users, promising to meet their cultural needs.

The BIPOC apps, in particular, have made their way into a digital behavioral health market that last year raked in a record $5.1 billion in funding.

Although BIPOC individuals such as African-Americans have traditionally had difficulty attracting capital for startup ventures, some BIPOC-focused mental health apps have managed to get investors’ attention. One of those platforms is looking to take its growth to another level with new services and new markets.

Hurdle Health’s big behavioral health play

Since its founding in 2018 as a digital behavioral health platform for Black men, Hurdle Health has been steadily making a name for itself. The Washington, D.C.-based platform kicked off last year raising $5 million in seed funding, which came one year after its participation in Morgan Stanley’s Multicultural Innovation Lab.

Hurdle’s Morgan Stanley experience also came as the nation was going through twin national traumas of the pandemic and social unrest following the death of George Floyd.

“I think that those two events together have really brought us to this inflection point of a deeper understanding of mental health,” Hurdle co-founder and CEO Kevin Dedner told Behavioral Health Business.

Dedner was inspired to create Hurdle after previously seeking mental health assistance and struggling to find a therapist that could address his own unique concerns as a Black man.

“Particularly for people of color, there is a deeper acknowledgement of the experiences that we are having in our daily life, where they may be microaggressions in the workplace or experiencing trauma vicariously through watching things on television,” he added.

Currently, Hurdle is available in six states. The company has contracts with a number of prominent payers including Aetna, Blue Cross Blue Shield and UnitedHealthcare. It also accepts Medicare and Medicaid in some states.

Hurdle’s team of in-network licensed providers – which last year grew by 100% – are trained to provide culturally responsive care to stressors such as racism, anger, substance-use disorder and PTSD. Hurdle currently has 75 therapists in its network, and it is in the midst of switching to a hybrid model of contractor and full-time workers, after previously being contractor-only.

Monthly payments for Hurdle’s services range from $129 for pay-as-you-go sessions to around $87 for four sessions per month. According to Hurdle, members receive therapeutic services 2 to 3 times longer than the national average.

“I’m surrounded by very empathetic people who will tell you that in their schools – which are highly ranked schools – they had one session a day devoted to supporting Black people, and one session a day devoted to dealing with Hispanic people,” said Dedner, who previously worked as a public health consultant before helping to found Hurdle. “We train our therapists in evidence-based techniques that help them improve their cultural humility and cultural responsiveness.”

Dedner believes that when it comes to building BIPOC-focused telehealth platforms, the barrier to entry is low. The greatest challenges for BIPOC-focused providers, he said, are the same as a number of other telehealth platforms – expansion and negotiating with payers across state lines.

So far, Dedner said that Hurdle has been fortunate, as it looks to be licensed in half the country by next year. Hurdle is also talking to payers about entering into contracts for value-based care, he noted.

“We have had a lot of success working with payers,” he said. “We’re working toward national agreements, we’re in-network with most of the major payers, and I am really impressed with how payers are responding to this moment.”

Hurdle is entertaining the possibility of raising more funds within the next year to aid its growth plans. As Hurdle grows, Dedner believes that mental health providers – both virtual and brick-and-mortar – could take note of what they are doing to reach more BIPOC communities.

“This is a business,” he said. “But if you haven’t faced the hard truth that the mental health care system as we know it was not designed for everyone — and your approach to care does not take that into account — at face value, you’re failing the people who you desire to serve.”

The future of BIPOC telebehavioral health

Jaclyn Satchel is quite involved in improving the mental health of BIPOC individuals, particularly for women. A Houston-based social worker with her own practice, Satchel has also written about the issue of BIPOC individuals in the digital mental health space.

Overall, Satchel said she does have worries about how outside investment can adversely affect the quality of behavioral health services.

“Investors are leaning into business professionals for direction on mental health,” she told BHB. “No one would invest in heart procedures without talking to a surgeon. That would never happen.”

Satchel believes that some venture capital firms – where a lack of racial representation exists – might be contributing to the growth of digital behavioral health providers at the expense of fully serving individuals from BIPOC communities.

“Venture capital largely is made up of people not reflective of those that they’re serving,” she said. “The leadership that controls the funds are not clinicians, and they’re not people of color. And how can you build something and serve someone with no lived experience at all?”

Satchel feels that some of the bigger telebehavioral health providers can make inroads with BIPOC individuals by employing more BIPOC therapists and structuring more BIPOC-friendly content. To her, however, it only goes so far and thinks more community outreach is needed in other ways.

“You can’t just say, ‘I’m just going to hire a bunch of Black therapists,’ and then not support the community in other ways,” she said. “Companies could help fund small community nonprofits that are going to be able to go out to a person’s home and check on them to see if they’re okay.”

Satchel is encouraged about the presence of BIPOC-focused digital behavioral health providers in the space – especially if there is more diversity at venture capital firms making funding decisions on BIPOC-led startups. But she is taking a wait-and-see approach to see if such momentum for BIPOC-focused telebehavioral health providers can sustain over the long run.

She is also concerned that the heightened racial and social awareness nationwide following George Floyd – which has resulted in more promised business investment in minority enterprises – will eventually ebb and have no impact on the growth of the BIPOC telebehavioral health space.

“I just hope that whoever those companies are pitching to partner with – whether it’s hospitals or insurance companies – only grows,” she said. “I’m just scared about it, because Americans get comfortable and forget.”