The Global Burden of Disease Study (GBD) published in 2019, revealed that mental diseases were among the top ten leading causes of global healthcare burden and this healthcare burden had not reduced since 1990. There are multiple reasons that led to mental health not being given due importance in terms of treatment as compared to physical health. They include stigma, lack of sufficient funding and policies, lack of workforce and no continuity in treatment, among others. It is further fueled by socio-economic gaps within each country and a lack of internet access and awareness. 

Studies have reported that addressing mental health concerns has been critically low in low- and middle-income countries (LMICs). As LMICs account for over 50 per cent of the global mental health burden, it is crucial to increase public and private spending on evidence-based mental healthcare. Preventive healthcare strategies are also crucial to improve global mental wellness and may provide an effective method to reduce mental health-related risks and mortality. 

In most countries in the Asia Pacific (APAC) region, mental health is stigmatised and considered a personal weakness which has resulted in a lag in mental wellness development. The Asia-Pacific Economic Cooperation (APEC), a government organisation for economic cooperation across APAC countries, reported that mental illness accounted for more than 20 per cent of the total years lost and less than 50 per cent of the people affected by mental illness received evidence-based treatment. To address these mental health concerns, startups in the APAC region have new technologies for improving awareness of mental health, maintaining the privacy of a patient, improving accessibility, and reducing unwanted hospitalisation. There is also a rise in mental wellness solutions in the form of phone apps and other digital platforms which will enable a paradigm shift towards preventive mental healthcare in the next few years.

Telehealth and Conversational Solutions

The traditional irreplaceable method of tackling mental health issues is through psychotherapy. Since the COVID-19 period demanded shutdowns and restrictions on human interactions, telemedicine came to the rescue; resulting in the rise of several telemedicine services which addressed issues arising from self-isolation and anxiety. It also improved accessibility and continues to be a beacon of hope to emerging economies in Asia that lack equitable access to mental healthcare providers. 

Lissun (India) and SoulUp (India) are online programmes that help start a mental health conversation. Such apps are gaining traction in the country due to the quick unbiased help to its members. True Digital (Thailand) provides telemedicine services with mental health consultations and has a partnership with Thailand’s leading insurance company, Prudential Life Assurance, to offer improved access to patients. Similarly, Intellect (Singapore), an Asian mental health startup founded in 2020, has a partnership with Swiss Life Network to make its services accessible to other countries in Asia. There are many other startups in Singapore such as Ami, Heyy and Make Health Connect that are making waves across the continent for improving patient access and promoting mental wellness. An Indonesian startup called Tenang AI offers online consultation with a trained psychologist and has a chat feature available throughout the day. It is Gen-Z-friendly because of its chat feature and self-help activities that build a stronger mindset. 

These apps are here to stay as conversations are crucial to providing unbiased mental health insights and solutions as opposed to other self-help-based habit-forming apps such as journaling and meditation. 

Wearables

Wearables play a large role in providing instant details of mental health to healthcare providers. Neuphony, an Indian company, has developed a headband to measure the electrical activity Electroencephalography (EEG) of the brain and has a partnership with Microsoft for startups for growth. In Australia, companies such as WPP Health Practice and Ogilvy Health Australia have partnered with BioBeats to collect an employee's mental health data and provide personalised insights to improve it. Hollo from Hong Kong develops Digital Therapeutics (DTx) by monitoring biomarkers for depression. Although it is at a very early stage of development, it will be pivotal in providing evidence-based results in the future. Medtronic has collaborated with Medibio (Australia) to develop a wearable device that can detect depression and other conditions through electrocardiogram (ECG) and circadian heart rate variability.

Mental Wellness Apps

India is a front-runner in the number of app-based mental wellness startups launched in the past few years. It is followed by Singapore, Japan, China, Australia, Thailand, and Hong Kong among several other APAC countries. As mobile apps allow people to seek help anonymously, they have a high adoption rate. There is a rising government interest in maintaining mental wellness which is seen through initiatives such as MANAS Mitra. MANAS Mitra is a partnership with the Ministry of Health and Family Welfare (MoHFW) with the aim of channelling the existing efforts in the right direction for mental well-being in India. A Thai app called Sati was launched by The Department of Mental Health. It is an app that has many empathetic listeners for its patients, which is a unique concept.  Smiling Mind is an Australian app which is built to solve mental health issues in children. This app is co-funded by the Australian Government Department of Health, and NSW Government Education among a few others, similarly ‘Hello Sunday morning’ is an app that helps Australian citizens with alcohol addiction. This app is also funded by the Australian government. 

In the APAC region, there is a rise in funding for mobile applications for managing episodes of anxiety, depression, or insomnia. These apps offer solutions through guided meditations, relaxing music, exercises and breathing programmes. There are also some apps that help in healthy habit formation exercises such as journaling and meditation. These apps are becoming a part of business models such as employee benefits of multinational companies, hence it is gaining good clientele as well as private funding. An Indian app YourDost received $1.2 million in funding in 2016 from SAIF Partners; Amaha has clients like Godrej, Dailyhunt, and Shiprocket. Companies such as MindFi and Intellect (Singapore) and Yixinli (China) among a few have raised significant funding. In 2022, MindFi received $2 million in a seed funding round led by M Venture Partners and Global Founders Capital. In the same year, Intellect raised $20 million in a series A funding led by Tiger Global, K3 Ventures, JAFCO Asia, Singtel Innov8 and others. 

Gamification and Virtual Reality (VR)

The younger generation has several stressors arising from diverse reasons such as troubled childhood, peer pressure, and educational challenges which can usher in mental health issues. Thus, the approach to treating a younger generation is different from that of adults. Gaming and virtual reality are of interest to the younger generation. An immersive environment in virtual reality helps children cultivate problem-solving and critical thinking skills that can be applied to real-life problems.  An Indian app called MindPeers offers modern solutions such as neuroscience games and MindPeers Club that help to deal with different mental stressors in life. AXA Hong Kong, The Chinese University of Hong Kong (CUHK) and Oxford VR (OVR) have partnered to bring the first ever virtual reality mental health solution to Asia through a collaboration called “Yes I Can” to deal with social avoidance that is a symptom for anxiety and depression. Cognitive Leap (United States and China) is a VR solution that is designed to deal with psychological problems across the world and aims to create mental health awareness. Among a few other innovative VR solutions in Asia are CogniHab (India) and Jolly Good (Japan) which help promote mental wellness. Such apps will be immensely useful in addressing mental health concerns in Asian countries with a growing young population, such as India and the Philippines.

Large Pharma Investments and Partnerships

The growth of startups is also fueled by investments from large pharma companies. While most of the modern applications are based on tools such as Artificial Intelligence, VR, and Machine Learning, it is interesting to see pharma giants investing in these technologies to either enhance their offerings or for a suitable growth opportunity. In 2018, Takeda Pharmaceuticals partnered with Mindstrong Health to find digital biomarkers for mental health conditions like schizophrenia and depression. In 2022, Otsuka (Japan) invested $10 million in series A funding for an Israeli startup company GrayMatters Health for the management of mental health. In 2023, Japanese health technology company Four H partnered with a startup, Aculys Pharma, a biopharmaceutical company that develops solutions for sleeping disorders.

Mental health is a pressing issue that needs attention, and it is encouraging to see the progress made by many Asian countries. Two of the most populous countries in the world, India, and China, fall in this region, and the growth of these countries relies on the mental well-being of its people for high productivity. Hence it is imperative to pay special attention to mental health. The number of startups is growing in popularity due to their accessibility and demand in this region. Though there are mental health solutions developed in North America and Europe that are used in Asia, Asian solutions provide a better context and are better equipped to address regional barriers related to stigma, culture, and language. Thus, local APAC innovations are more likely to succeed. There is a need for inter-governmental bodies such as the APEC to improve mental health awareness and reduce social stigma associated with it. Partnerships of organisations such as the APEC with other private and public companies, especially in the digital health space should be accelerated to identify and address priority areas within mental healthcare. The emerging APAC startup landscape will help provide more evidence-based insights across mental health concerns which will help reduce the mental health burden in the next 10 years.

Lonita Lobo (L), Senior Research Analyst, Frost & Sullivan & Vandana Iyer (R), Industry Principal, Frost & Sullivan