📱Masawa Minute 138

Not Just Apps: The New Playbook for Mental Health Innovation

This is the Masawa Minute — mental wellness, social impact, and impact investing snippets from what we’ve read, created, and witnessed firsthand — plus where you can get active.

This week, we zoom out from policy and progress to ask a bigger question: what business models are actually working in mental health today? From big exits to quiet shifts, we take stock of what’s scaling, and what needs to evolve.

This Week’s Story: What’s Really Working in Mental Health Startups?

We’re in a moment where mental health startups are still raising, still building, still getting acquired, but the path to scale is evolving fast, and the US is showing the way:

• Slingshot launched Ash, an AI-powered therapy chatbot trained on real clinical sessions and backed by $93 million.
• Sword Health expanded from digital musculoskeletal care into mental health with “Mind,” supported by a new $40 million round.
• Teladoc acquired UpLift, bringing therapy and psychiatry further into its core offering, following a dip in BetterHelp revenue.

What ties these moves together isn’t a singular sales strategy, it is adaptability. Each of these companies is positioning itself to plug into larger systems: health insurers, pharma partners, clinical platforms, or multinational employers. They’re not going direct to consumers alone and they’re not waiting on reimbursements to save them.

Why Single-Channel Thinking Falls Short

Too often, European mental health ventures focus narrowly on two tracks:

• Direct-to-consumer via subscription or freemium models
• Public payer reimbursement scheme through DiGA (Germany) or PECAN (France)

But both routes are slow, crowded, and often hit-or-miss financially fragile endeavours. The reality is: the most resilient companies are building in layers.

Take Sword Health — they’re combining a B2B employer model with clinical-grade tools and expanding across care verticals. Slingshot’s Ash is built not just for end users, but for employers and payers as well, embedding their offering into HR platform, coaching programs, insurance reimbursement flows, or digital formularies. And Teladoc’s acquisition of UpLift shows how valuable these solutions are when they can plug directly into existing payer infrastructure.

Orthogonal and Embedded: New Paths to Scale

The most promising mental health startups are entering through side doors: MSK pain, chronic illness, women’s health, even behavioral coaching. Their technology becomes the enabler, not the whole product.

And increasingly, scale comes from:

• Enterprise sales to insurers, health plans, and large employers (B2B2C)
• Integrating as modules or APIs into existing digital health, HR, or benefits platforms (platform integration model)
• Licensing validated digital tools to pharma, CROs, or digital health providers (companion apps, digital therapeutics, clinical trial enablement)
• Aggregating real-world data to offer analytics and insights to payers, providers, or pharma (data analytics and outcomes measurement)

Europe’s Move: Building Distinctive Mental Health Infrastructure

Get Masawa’s stories in your inbox

Join Medium for free to get updates from this writer.

Remember me for faster sign in

Europe needs to build its own version of this layered approach. There are signs of movement: Koa Health, Mindler, HelloBetter are developing multi-channel distribution and insurer partnership, but scale remains elusive. The challenge is regulatory fragmentation, risk-averse payers, and a shortage of capital willing to back companies through slow sales cycles.

But simply importing models from the US or elsewhere won’t work. Europe’s path to winning in mental health will require embedding its own strengths: deep public health expertise, a tradition of social solidarity, and a regulatory environment that, while complex, can be leveraged for trust, legitimacy and true competitive advantage. The next wave of winners will be those who build for cross-country and cross-channel adaptability, while showing local relevance. They will be clinically-evidenced for insurers, strong value-for-money for employers, modular for integration, and — crucially — shaped by Europe’s diversity, privacy values, and collaborative instincts.

The infrastructure for mental health is being built. The real question is: who will shape it to fit Europe, and who will own the future of mental health systems?

Masawa Community Spotlight: 🌱 ria’s Regenerative Investing Programme

We’re excited to share an offering from ria (Regenerative Investing Academy), the “think-do-be” tank of atreyu, which is launching their 12-week programme, An Introduction to Regenerative Investing, starting this September.

This immersive, developmental course is designed for investors, founders, and ecosystem stewards who are ready to move beyond transactional models and explore how capital can truly align with life. At a time when extractive finance continues to fall short, regenerative investing and systems investing are essential for those seeking lasting, life-affirming outcomes.

If you’re feeling the pull to reimagine your approach, or to let go of old economic templates in favor of something more holistic, grounded, and future-fit, we can’t recommend this programme enough. Learn more here.

Spotlight: Personal Stories That Break the Stigma

At a recent Imagine Dragons concert, frontman Dan Reynolds paused mid-show to talk about his experience with therapy, encouraging fans to seek help and speak out. Olivia Rodrigo has also made headlines — not just for her chart-topping music, but for offering therapy sessions to her tour crew and sharing her own mental health journey since age 16. In France, Stromae sparked national conversation when he performed his song “L’enfer” live on TV and spoke candidly about suicidal thoughts. (Franceinfo, en français)

This isn’t a one-off. Billie Eilish, Shawn Mendes, and Selena Gomez have each publicly addressed anxiety and depression. Gomez, in particular, has gone further, founding the Rare Impact Fund and Wondermind to increase access to mental health resources.

In Germany, Trigema’s former CEO Wolfgang Grupp shattered taboos by openly sharing his struggle with age-related depression and a suicide attempt. His honesty, rare among senior leaders, has triggered a national reckoning on mental health in business. Grupp’s call to seek help underscores that depression cuts across status. (Die Zeit, auf Deutsch). He joins leaders like Jenn Lim and Michael Phelps in proving that vulnerability is a mark of real leadership.

The message is clear: whether you’re on stage, at the helm of a company, or simply navigating everyday life — you’re not alone. And every voice helps.

What Else We’re Reading…

🚸 Europe Needs a Unified Vision for Youth Mental Health

The Z Zurich Foundation’s latest report, “A Vision for Youth Mental Wellbeing in Europe”, warns that Europe’s youth mental health crisis won’t be solved by piecemeal efforts. The report calls on policymakers, schools, businesses, and youth organizations to align around a unified vision and measurable goals, shifting focus from treatment to prevention and promotion. It also urges for more robust regulation of social media to protect young people’s wellbeing. (Zurich Foundation White Paper)

🦻The Silent Threat: How Hearing Loss and Loneliness Are Fueling Memory Decline

A large European study reveals a strong link between hearing loss, loneliness, and memory decline in older adults, suggesting that social isolation and sensory challenges can have significant mental health impacts across the lifespan. (Université de Genève) ​⁠

🥗 New Study Looks at Gut Microbiome, Psychological Wellbeing, Stress, and Resilience

A new study in Nature Mental Health shows that psychological resilience is deeply connected to the brain–gut microbiome system. Researchers found that people with higher resilience not only reported fewer symptoms of depression and anxiety, but also had distinct brain connectivity patterns and healthier gut bacteria profiles. The results suggest that supporting the gut microbiome could be a promising way to boost mental health and stress resilience. (Nature Mental Health)

Whether you’re building new ventures, backing bold ideas, or rethinking your own role in the ecosystem, thank you for being part of this movement. Let’s keep learning, iterating, and reshaping what’s possible in mental health — together.

With purpose,
The Masawa Team