Launch HN: Iona Mind (YC S21) – App-based cognitive behavioural therapy

Thanks and some great points here. As you say competition and differentiation are potentially really tricky in this sector. Really interesting to hear about your experience at ginger.io .

We're certainly not wedded to the chatbot idea, but it's just the best UX/UI we've implemented so far. The key we feel is to avoid becoming a boring, skippable content board, and maybe a chatbot isn't the final iteration of that concept, but it's the approach that has worked the best for us so far.

I agree that the key in this space will be to learn quickly and iterate to find a solution compelling to the user and payer. It's early stage for us, until the point we got into YC we had taken no funding, so I think there's a lot of scope for how we can expand and adapt our offering to the marketplace and we've already learned a tremendous amount.

We have ultimate long term aim of building apps which are certified Software as a Medical Device and get device-like reimbursement through healthcare systems. We certainly feel that's a place which is less competitive and more differentiated, there are a few companies in this space such as Pear Therapeutics, but unlike them, we feel it's important to start at the b2b and b2c end of the spectrum to build a product that people love before going through the lengthy and costly process of adapting that product becoming a fully certified medical device.

A worthy endeavour, but CBT doesn't help the physically broken. Brains break and malfunction just like other organs and no amount of telling them to fix themselves will work.

I built my custom "therapist", I know exactly what I need, but it worked sporadically for a while then just seemed like a complete joke.

Perhaps someone could fund a startup that would connect people with suppliers of medicine that is non addictive yet prescription only, like most antidepressants, anxyliotics and DNRIs.

There are still some countries where some are OTC, which is a godsend, but having to physically travel there is hard, slow, expensive and not for everyone.

And for absolutely asinine reasons governments got to eBay and online payment processors and all the sellers have disappeared.

I agree, CBT is certainly no panacea, and as mentioned in the post, for those at the moderate to severe end of the spectrum, or for those where CBT is ineffective, it may be the case that medication is the only viable solution.

Y Combinator has actually funded several companies looking at the usage of various drug-based mental health treatments, including Osmind (S20) and another company in this batch (S21) who are looking at the use of psychedelic therapeutics for mental health, although none are addressing your specific issue with availability / accessibility which is a tricky one with respect to legislation and regulation.

I'm curious about the middle-way chatbot you're building. Most chat systems are either "smart" scripts with intent recognition (RASA, Dialog Flow, etc) or anything-is-possible chaos (seq2seq, etc).

Can you explain more about how you're able to keep the conversation on track while leveraging the adaptability of a generative system?

We're generally more in the smart scripts camp at present. The conversations are graph based, with each node being associated with code that can look at the state of the user and any input. It may be that the input is a set of fixed options, or that the input is freetext. Usually in the event of freetext we're classifying that freetext, looking at the state and using these two things to determine the output and next node to go to.

It's still early days with the product and to date we've generally avoided anything that is generative, as you say, it's hard to keep on track and is hard to predict what the range of outputs can be. The next steps in development will most likely be to improve classification of freetext and use it more extensively within the app. We've also considered having individual nodes which use generative output (at least in part for the output), to go more to the generative end of the spectrum, but retain control of the conversation flow, however this is still at the concept stage for the moment.

We've seen some graph based / smart script engines where you can enter subgraphs where the output is essentially seq2seq until various trigger conditions are met (e.g. the text is classified a certain way), before continuing to another part of the graph, and this is another way the two approaches can be blended. It's not something we're looking at at present, and can also be potentially quite unpredictable.