New husband-and-wife startup connects kids with a mental health professional within days

It’s a painfully common predicament: When you really want to find a mental health professional, it can take months to get an initial visit and even longer to develop trust and a rapport, perhaps start on medication, or sort through insurance complexities. But maybe that wait feels too long or the process too daunting, so you give up. Maybe you start to feel better for a while, maybe you don’t — but the next time it feels acute, you’re back at square one.

And if you’re a parent trying to navigate that wait for your child, you can feel even more helpless and overwhelmed.

“A lot of these families have been looking for answers for years and not getting them,” says Kurt Roots, co-founder and CEO of Bend Health. “Or they’ve been getting treatment but didn’t realize it was the wrong treatment.”

To provide those answers, he launched Bend Health in February 2021. He spent nine months building a proprietary platform from the ground up. His wife, board-certified child and adolescent psychiatrist Monika Roots, joined the company in August and Bend Health opened to patients that fall. They run the fully virtual, interdisciplinary telehealth treatment solution out of Lodgic Everyday Community on Madison’s west side. Harnessing a slate of remote practitioners including psychiatrists, psychologists and mental health coaches who provide customized treatment plans to children ages 1 to 17, Bend Health is already set up to serve clients in 39 states.

What are they hearing the most so far?

“Oh my goodness, thank God we could get in,” says Monika Roots.

It works like this: Parents or guardians go online and fill out a questionnaire with their child that assesses things like anxiety, depression, trauma and stress (later other measures of social determinants of health are also evaluated, such as food insecurity and housing stability). Parents and children separately record and upload a one- to two-minute video explaining what’s going on. From there, the Bend Health team communicates by email, text or phone to recommend a care plan and create a user-friendly portfolio for the family. The intake process takes about 20 minutes and, typically within 48 hours, kids have a teletherapy appointment set through an online scheduler (set at times that even include evenings and weekends), and the matched practitioner has a significant head start on the child’s situation, personality, family dynamic and individual needs.

“Since COVID, the number of kids with mental health concerns has increased from 20% to 44%,” says Monika Roots, citing an October 2020 medical journal and a 2018 study asserting that 80% of kids don’t receive treatment at all. At the same time, a provider shortage is pushing a lot of behavioral health care to pediatricians who may not be equipped or have support to deal with the problem, leading to misdiagnoses in 61% of kids. Even children with appropriate diagnoses are often on the wrong medications or have little to no tracking or support between the prescriber and primary care providers — not every client needs medication or even a diagnosis. Many kids are dealing with stress and anxiety related to school or social life that could be managed with a mental health coach.

“Not everybody has a diagnosis, but it doesn’t mean that you can’t use some help or some skills,” she says.

Although the model is brand-new — nothing like it for kids currently exists in the United States, the Roots say — the entrepreneurial couple is hardly new to this space, nor is Bend Health their first startup. Kurt Roots has been in tech for more than 20 years, beginning as a programmer at Oracle Corp. Monika Roots saw patients in clinics for years and actually began practicing telehealth in 2007. “Back in the day it was a TV, a lot of clunky technology, plus the person on the other end had to have the same technology — so basically you had to go to the clinic to access telehealth,” she says. In 2011, they started a company together, called CogCubed, to objectively measure behavioral health conditions. Five years later, it was acquired by Teladoc, where they both signed on as executives and “created the first behavioral [tele]health national solution. It didn’t exist,” says Monika Roots — in part because most people believed effective therapy could only occur in person, a misconception that lingers today, although the pandemic has changed a lot of hearts and minds.

Monika and Kurt Roots (Photo by Romulo Ueda)

“What’s so counterintuitive is that when you have a mental health condition, you do not feel like leaving the home,” says Monika Roots, who left Teladoc to work for Sanvello, another mental health company that offers teletherapy and telepsychiatry but is only for adults. “You have depression, low energy, low motivation. So the chance that individual will ever get to care is so low that, really, virtual care for mental health has just always made sense.”

Unfortunately, she adds, most practitioners are still trying to bring their existing brick-and-mortar models online exactly as they are — which she says isn’t scalable without improved efficiencies. Further, demand for mental telehealth solutions is up, driven by factors such as a provider shortage, social isolation wrought by the pandemic, decreasing stigma among kids around getting help and better detection of mental health needs among primary care practitioners and pediatricians. Other challenges abound, including the siloing of health care systems and the fact that mental and physical health often operate in separate, parallel worlds for individual patients. And though companies like Sanvello have embraced telehealth and are doing it well, they don’t treat children — a patient population with far more complexities.

“Kurt and I had heard this hesitation for quite some time,” says Monika Roots — they are parents of two children, and Kurt Roots says he was also strongly influenced by his experience of growing up with a brother who has autism. “And we were like, ‘Hey, you know what? Let’s go do a great child and teen mental health solution.’ ”

Bend Health is innovative not only because it focuses on kids and teens, but also because it has created its own electronic health records system optimized for youth mental telehealth and designed to integrate with larger systems to keep primary care providers, mental health practitioners and families on the same page. Bend Health also conducts monthly follow-ups and keeps primary care providers informed. “Because we know that if you treat the mental health with the physical care together, you result in the best outcomes,” Monika Roots says.

Families can try the program free for 30 days; from there, it’s a subscription model costing either $79/month for coaching or therapy, or $199/month for coaching or therapy with medication management.

Although health systems vary widely around the country — some rural communities don’t even use EHR and nearly every state in the country has a “severe shortage” of child and adolescent psychiatrists, according to the most recent workforce maps from the American Academy of Child and Adolescent Psychology — the Roots are finding that the need is the same everywhere: behavioral health care delivered to kids where they are, when they need it, and in a format they innately understand (probably better than their parents).

“Kids get it. In fact, they like it more,” Monika Roots says, adding that when she had a psychiatric care practice, she purposely sought out office spaces that looked and felt like a home. “When you can actually see them in the comfort of their own home, maybe they’re on their bed, there’s a comfort level there that they actually open up more.”

Maggie Ginsberg is an associate editor of Madison Magazine.