Launch HN: Inflow (YC S21) – Self-help app for people with ADHD • Hacker News Board

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#221

Post by texasbigdata » Fri, Oct 15, 2021, 5:01 PM UTC

PragmaticPulp wrote: post #169

> The average cost of an in-person ADHD CBT session in the US is $200-300 ($10k-$16k/year). This is not true at all. If anyone is considering ADHD therapy, please do not let such misleading figures dissuade you. For anyone with insurance, the average cost of a therapy session is often as little as a $15-25 copay. You could get 4-6 in-person, personalized therapy sessions with an experienced provider for the same pric…

The classic CBT (although not ADHD focused) book by David Burns is $8 on Amazon

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#222

Post by jdavis703 » Fri, Oct 15, 2021, 5:01 PM UTC

SyzygistSix wrote: post #213

jdavis703 wrote: post #205

Earlier quoted context omitted.

Are you in the US? I spent something like $200 on the initial appointment in the SF Bay Area. This was done without insurance, so that was the total cost. And I think I spent slightly less than 2 hours undergoing evaluation.

Yes, in the US. It was a very thorough evaluation. My niece's recent evaluation was similar to yours. My testing was conducted by a psychological services group that was recommended by my primary care providers, which is a service for generally poor people, like myself. Kind of weird but I don' know the process. Nevertheless, I hope the very thorough and documented diagnosis is worth it, as it makes clear the need fo…

Your doctor charged you $3k and diagnosed you with a mental illness but is unwilling to prescribe medicine? That feels like theft to me.

Can you at least see if they can start you on a non-stimulant pharmaceutical? Some people really like Strattera (I tried it and had horrible side effects that landed me in the ER, but I know other people who love it). Unfortunately I think Strattera is still patented, so it’s pretty pricey if you don’t have insurance. Make sure to look for coupons that will save you about 90% of MSRP.

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#223

Post by texasbigdata » Fri, Oct 15, 2021, 5:02 PM UTC

levi-epstein wrote: post #122

DaveSchmindel wrote: post #109

Disclaimer: I really appreciate the mission statement here. As someone who suspects they are impacted by some sort of undiagnosed ADD/ADHD, it's really great to know I'm not alone in these thoughts and that there are people trying to make solutions for it. That said, while everyone is up in arms about the payment model here, I'm more concerned with the nature of the app's content. What I was expecting to be an intera…

Thank you for feedback - really helpful! In terms of our current features, we have: - Short daily learning exercises that tackle a range of ADHD topics - Challenges to support the development and tracking of habits to help manage ADHD - A community of like-minded individuals - Live weekly events with psychologists & coaches where you can get any of your questions answered, or participate in group meditation and cowor…

Is this research based? Are you sure your "interventions" help?

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#224

Post by chrsig » Fri, Oct 15, 2021, 5:03 PM UTC

photochemsyn wrote: post #117

The ADD (1980) / ADHD (1989) world has always been fairly shady in my opinion. The argument that this disability was invented rather than discovered so that pharmaceutical outfits could push amphetamines on kids is fairly valid, and a lot of the 'adult ADHD' behaviors seem equally explainable as a side effect of amphetamine addiction: > "ADHD drugs, such as Adderall and Ritalin, increase levels of the brain chemical…

oh fuck off.

> In addition, there's no clear diagnostic test for ADD/ADHD (no way to even distinguish between the two)

they're literally the same thing. ADD got renamed to ADHD in the publication of the DSM IV.

> it's just an opinion based on the subjective judgements of psychiatrists

No, there are standardized screenings with recognized scales, as well as evaluations to measure attention span.

This can also be said for several mental illnesses: depression, anxiety, ocd...

>> > "ADHD drugs, such as Adderall and Ritalin, increase levels of the brain chemical dopamine and provide mental stimulation. This, in turn, allows users to become more focused and calm because they no longer need to engage in self-stimulating behavior."

Yes. that's the point. Give 20mg of adderall to someone without adhd and see how calm they are. That dopamine boost brings someone with adhd up to neurotypical levels.

I'd also say: consider how many people are diagnosed with adult adhd without ever having been on a CNS.

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#225

Post by chrsig » Fri, Oct 15, 2021, 5:06 PM UTC

symlinkk wrote: post #52

Does therapy actually work? I’ve always been under the impression that it was mostly placebo, and that only medication produces meaningful results. Happy to be proven wrong though

It depends on your definition of "work" -- the impairments will not be impacted, but you can learn a lot of coping strategies to live a higher quality life.

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#226

Post by JohnBooty » Fri, Oct 15, 2021, 5:06 PM UTC

what_is_orcas wrote: post #207

bserge wrote: post #158

Earlier quoted context omitted.

If it actually works, an app like this could be worth 10x the price. Getting rid of all the time waste, all the stress of AD is worth a lot.

Sure, but then isn't this just a "disability tax"? (I'm aware that the word disability is antiquated and not perfect here, but for the sake of being concise, this is what I wrote). The need for this app is a problem. Insurance should cover the cost of treatment (and insurance should be affordable and available; for transparency: I'm pro medicare for all, here in the US). Start ups have a bad habit of taking a systemi…

Most of the folks on this thread seem to be objecting to the opt-out nature of their subscription service. I agree with them.

On the other hand, you seem to be objecting to the very nature of money being charged for this app or any other healthcare service?

It's gross, and I do not love this aspect of capitalism. I agree with you to that extent.

But -- again, without ditching capitalism entirely -- what's the alternative? These folks are providing a service and that costs money. Aside from ditching capitalism entirely, what alternative is there to "charging $X to fix Y?" Literally anything amounts to a chronic or acute disability tax. The cost of asprin is a headache tax. And so on.

The best capitalism has been able to do is roll these sorts of healthcare costs into insurance premiums, so we can share the cost collectively to an extent. Unfortunately I doubt an app like this is covered by any plan.

The only other solution (within capitalism) I can imagine is if the creators of this app ran their company as a non-profit org. I have considered that in the past for a venture or two. But, the money would still need to come from somewhere.

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#227

Post by what_is_orcas » Fri, Oct 15, 2021, 5:08 PM UTC

danShumway wrote: post #121

As someone with ADHD, this sets off some (okay, many) red flags for me. Some thoughts: - Patient intake for ADHD is genuinely awful, you're right about that. The diagnostic/treatment process for ADHD often feels like it's designed to make people with ADHD struggle. - CBT is generally helpful, therapy is an important part of treatment. I've seen good results from it. - in-person sessions are expensive (although if you…

+1 on medication being a huge help. I deal with non-ADHD issues, but the same has been true for me: no amount of therapy was helping until I got meds figured out.

You make a really interesting point about diagnosis that I hadn't considered. Could an app like this _do harm_ by routing folks away from the traditional (albeit shitty) route of diagnosis and the subsequent treatment (insurance doesn't cover shit without a diagnosis)?

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#228

Post by JohnBooty » Fri, Oct 15, 2021, 5:13 PM UTC

mStreamTeam wrote: post #173

sebisaacsinflow wrote: post #146

Earlier quoted context omitted.

If we didn't build and charge for our app then we can't continue working on it and improving. We enable many people to get support they wouldn't be able to otherwise and significantly broaden accessibility compared to medication and in-person therapy. We're not a non-profit but we do need to improve our model.

Linux is free and somehow that has gotten decades of support. You can do good work for "your community" without putting profits first

    Linux is free and somehow that has gotten decades of support.

Most of the top contributors to Linux and other big FOSS projects do that work as a part of their salaried jobs at various corporations.

It's shocking that the myth of Linux being created and maintained by a bunch of dedicated outlaw nerds, typing away in their basements for free in their spare time (while presumably also working 50 hour weeks at their tech jobs, to pay the bills?) persists to any degree whatsoever in 2021.

Countless huge companies rely upon Linux in major ways, and therefore fund its development and maintenance.

Sources:

https://www.linuxfoundation.org/wp-content/uploads/2020FOSSC...

https://linux.slashdot.org/story/10/01/21/230201/75-of-linux...

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#229

Post by chrsig » Fri, Oct 15, 2021, 5:15 PM UTC

throwanem wrote: post #62

skeletron wrote: post #48

Earlier quoted context omitted.

I just downloaded the Android app to check, and it's a similar ratio as you describe for the Apple app store: £19.99 per month if paid monthly, but £7.17 per month (as £85.99 per year) if paid annually. And on my phone at least, the monthly payment option is also hidden behind a scroll down action: https://i.imgur.com/rV0bMTH.jpg , with the yearly subscription already selected by default. It would seem they're pushin…

It's really remarkable. I'm not too proud to admit that I spent a long time not really taking ADD/ADHD all that seriously. That was before I fell in love with someone who has ADD. Seeing on a daily basis the effect it has on him, and the extent to which, even with effective treatment, it remains a serious obstacle in terms of executive function and followthrough even for things he plainly cares a lot about - to say n…

Hey, as an adhd person that really gets frustrated when people don't take adhd seriously -- thanks for changing your stance.

it generally only gets portrayed in the media based on how other people experience people with adhd -- never the actual experience of the person with adhd.

i hope that changes in the future, so more people can have a similar exposure to it that you've had as a loved one.

Re: Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

#230

Post by SyzygistSix » Fri, Oct 15, 2021, 5:17 PM UTC

jdavis703 wrote: post #222

SyzygistSix wrote: post #213

Earlier quoted context omitted.

Yes, in the US. It was a very thorough evaluation. My niece's recent evaluation was similar to yours. My testing was conducted by a psychological services group that was recommended by my primary care providers, which is a service for generally poor people, like myself. Kind of weird but I don' know the process. Nevertheless, I hope the very thorough and documented diagnosis is worth it, as it makes clear the need fo…

Your doctor charged you $3k and diagnosed you with a mental illness but is unwilling to prescribe medicine? That feels like theft to me. Can you at least see if they can start you on a non-stimulant pharmaceutical? Some people really like Strattera (I tried it and had horrible side effects that landed me in the ER, but I know other people who love it). Unfortunately I think Strattera is still patented, so it’s pretty…

I think they will, but they may be too expensive for me to continue with. I only had the verbal report in a video meeting with them. In about a month I will get the written report, along with my regular doctor and my counselor.

They are not the only org that uses a process like this. Many have a longer, more thorough, more expensive process. I don't have a map of these services to navigate, so I'm a bit blind. I went with who was recommended to me. Hopefully having a thorough diagnosis that can travel with me wherever I go can be helpful. If this ends up helping me to address this and have some sort of success in life, $3k will be peanuts.