Ep 35: Breaking the Stigma: Expanding Access to Mental Healthcare

Sanjula Jain  0:03  

Women make up 70% of the healthcare workforce but only 20% of its leadership. On Her Story, we’ll explore the careers of bold and influential women from Silicon Valley to Capitol Hill and learn how they’ve overcome the odds. I’m your host, Sanjula Jain and this is Her Story, a program where we explore what’s beyond the glass ceiling.

 

I’m delighted to welcome Solomé Tibebu who’s the director of The Upswing Fund and a leader and champion in the beaver health space. Solomé, welcome.

 

Solomé Tibebu  0:36  

Thanks so much, Sanjula.

 

Sanjula Jain  0:37  

So great to have you. You have just been an incredible pioneer in the behavioral health space. I didn’t even do your introduction justice because you have four or five different hats that you wear, so I’m excited to dig into that with you. Tell us where did the interest in the passion for behavioral health actually start?

 

Solomé Tibebu  0:57  

Thank you so much. I’m so excited to be here. How did it start? I had really bad anxiety and Obsessive-Compulsive Disorder issues. As an adolescent, the anxiety was so overwhelming panic attacks on a regular basis in middle school, running to the counseling office several times a day. Then the OCD was really challenging because, still today, OCD is so misunderstood. At the time, I didn’t know what I was experiencing, so you can imagine how challenging that was for me to even share that with parents or other people who could help me. It was challenging to manage it and it was a really impactful part of my life. Later in high school, I was trying to figure out resources online to find other teens like me who are going through what I was going through. I wasn’t able to find much, so I decided to create that resource myself, which I creatively named AnxietyInTeens.org.

 

Sanjula Jain  2:02  

That’s great. You got an early start from this personal experience. You and I have chatted a lot about the stigma that’s associated with this particular bad age. Tell us a little bit about how did your family factor into that? Were they supportive of this? How did they get you the resources that you needed at that time? What was that process like?

 

Solomé Tibebu  2:22  

I barely had the vocabulary or skills to articulate what my thoughts, feelings, and behavior are was all about. On top of that, my father’s from Ethiopia, and my mother’s from Poland. After we started talking about OCD and learning more about what it is, they said they couldn’t even think of what the alternative for OCD would be in their languages, so lots of challenges. Mental health wasn’t really something we talked a ton about at home, trying to navigate services and finding the right treatment. That was especially challenging because, of course, my parents did everything in their power to try to help me; we tried our best to find several therapists and different kinds of medications. With each one, I thought, “Wow, this must be as good as it gets. I’ve already tried that and that,” but it still wasn’t very good until I finally saw my fourth therapist. My fourth or fifth medication was the perfect combo to actually help me manage my symptoms. These kinds of challenges are hard to manage, no doubt, but they are very treatable and manageable. It just takes some trial and error to potentially find that right mix.

 

Sanjula Jain  3:43  

I think that’s so powerful. It sounds like you’ve really dedicated your career to making those resources available and accessible and helping educate our community it kind of all levels on what it takes to manage it, and that you can be supported. I know the first time that we met, I was struck by the fact that you’re just like so passionate about what you do, and you really are this doer, and you’re just so committed to the cause that in many ways. I wonder, at what point did you start viewing yourself as an actual leader? When you think about the various roles you’ve held in your career, do you view your entrance into that healthcare leadership space as more accidental or intentional?

 

Solomé Tibebu  4:26  

Really good question. Again, I’d say I still definitely struggle with this idea of saying I’m a leader in any kind of space. If there was one I had to pinpoint, it was actually right around college when I was invited to give a TEDx talk about my story and anxiety and OCD. I remember getting that invitation and how exciting that was but also working with the curators and collaborators of what I was going to talk about. Who am I to talk about this and tell this story? They were actually the ones to really empower me and say, “There are plenty of very clinical sessions and content online,” but apparently my story is a bit unique in that I had this personal journey and took action on creating resources around it. That alone is something that others could potentially glean from and it really motivated me to say, “If I can do it, then anyone can, so why don’t I use this platform to present that?”

 

Sanjula Jain  5:31  

I think at the heart of what you’re saying is there’s a little bit of this misnomer of what exactly leadership is, and we all have our opinions on that. At least for me, I think it’s all about having influence, and that’s exactly what you have had through sharing your story in the early days, so kudos to you for having the courage to do that because that’s not easy to do. I want to take a step back from Anxiety In Teens. You started that very early on. Now you’re at The Upswing Fund. You grew up in Minneapolis, which is where you started Anxiety In Teens, and—through many different routes—have found your way out on the West Coast now into San Francisco. What was that path like? What did you do after Anxiety In Teens?

 

Solomé Tibebu  6:09  

Who would have thought that I would still be involved in behavioral health? I definitely did not think much about that when I was 16 and started Anxiety In Teens back in Minneapolis, but it continued as an online resource. We did all sorts of peer support activities with students nationwide. We did events nationwide and that really piqued my interest in technology, mental health, entrepreneurship. When I went to college, I decided to be an entrepreneurship major, in which case my parents said, “Excuse me? Oh. What?” I knew that that is what I wanted to do. Around junior year, I got another idea, which was basically a mental health tech startup that would provide online CBT exercises for adolescents and adults and analytics for providers by analytics, and you’d like some very lightweight dashboards. 20-year-old me started this startup and got a little bit of seed funding, found the clinicians and programmers and we built the thing and worked with some local partial Dane residential programs. It was an amazing experience. 20-year-old me did not know what all goes into launching an enterprise healthcare startup, so ultimately it didn’t pan out, but really great experience. Now, over a decade later, there are like a million of these things. It’s amazing how the entire behavioral health tech space has really exploded. So that was the next chapter. After that, I decided to move to New York and started working for the largest behavioral health EHR software company, and had an opportunity to sell all sorts of ancillary products, patient portal, RCM whatnot to psychiatric units, IDD foster care, substance use, learn something about working at a real job and healthcare. That was a really great experience. After that, my next move was to San Francisco where I worked for some startups and venture capital funds investing in digital health broadly.

 

Sanjula Jain  8:19  

You would know these numbers better than I do. The last I remember doing some work in this, about 1/5 Americans struggle with a behavioral health disorder. I know within adolescence specifically that that number is even different. What how does that trend reconcile with the national trend?

 

Solomé Tibebu  8:35  

That is correct. On top of that, the pandemic has just emphasized how much more need there is to offer mental health services, emotional support services for adolescents and adults across the country. That’s why I’m thrilled to have the opportunity to now lead The Upswing Fund for Adolescent Mental Health, which is a philanthropic collaborative fund that supports organizations who are either providing mental health and emotional support services to specifically LGBTQ adolescence or Adolescence of Color or they’re national nonprofits that you could think of as systems enablers that are really transforming the entire ecosystem for mental health, specifically for adolescence.

 

Sanjula Jain  9:24  

When you think about the ecosystem over the last decade or so, you’ve seen this tremendous movement in progress, so to speak in more investments and more companies really focused on behavioral health, which wasn’t exactly the case. At the time when you were starting to think through this as a young teenager. What do you think has ultimately move that needle or created more attention or these platforms like The Upswing Fund where we’re now we’re actually focused on some of these issues that have persisted for some time but we’re really now starting to see some traction. Totally.

 

Solomé Tibebu  9:55  

There’s so much more funding and attention. Behavioral health is on the mind of everyone now, which is great, and I hope it continues. A lot of what has fed into that is consumer sentiment, this next generation. As they have begun to enter the workplace, they even expect those kinds of benefits to be there. I see a lot of employers investing in digital Behavioral Health Solutions as a result. Additionally, the connection between behavioral health and physical health anywhere you look in any kind of healthcare publication, health plans are talking about how the impact of behavioral health is, is or how they’re providing solutions for behavioral health are impacting a lot of quite frankly, expensive physical issues. That’s only driving further investment to want to adopt Behavioral Health Solutions. It’s been common sense for a long time, but now there’s a ton more data and behavioral health startups are adopting measurement-based care type of health, I say, solutions internally baked into their products that are better able to demonstrate that they’re providing those cost savings.

 

Sanjula Jain  11:07

I think that’s really powerful. The data has helped catalyze a bit of that movement and has held us all accountable to actually see if we’re making progress or not. From my limited knowledge of this space, you’re in the thick of it every day. A lot of it has been focused on let’s say kind of older adults or just the general adult population. What’s so unique about your vantage is The Upswing Fund and your own experiences with the adolescent population. Talk a little bit about some of the differences you see in terms of approaches that work for making resources and care more accessible to that population. What are the things we have to do differently? What are the things we get wrong about that population?

 

Solomé Tibebu  11:49

Young people have a much higher bar for user experience, so much more thoughtfulness around how we’re designing products specifically for them, it either has to match the experience of a lot of the big tech, social media companies that have invested millions and millions of dollars in their UI, or they actually have to be embedded or we have to think of how we’re actually leveraging those social media platforms to reach and engage adolescence, which is a tricky thing because, depending on the situation, social media is oftentimes part of the problem with mental health issues. I can’t even imagine. Thinking back as an adolescent, it was like, “Who is on AOL Instant Messenger?” and “Those three girls just logged off at the same time and no one replied to me.” Now with Instagram, it’s magnified, all of the different directions it could go. To leave it more on a positive note, there’s also so much more advocacy happening on these platforms, where youth are finding their voices finding their ability to share their stories in a much more scalable, interesting, and engaging way than I did on my forum with Anxiety In Teens. That’s one positive aspect. It can be difficult to develop tools and online resources for this population given different consents that are required, your COPPA laws for what you can do for 13 and under-year-old when do parents need to sign off to be able to connect young people to services. There are more aspects to think about.

 

Sanjula Jain  13:31

Did 16-year-old Solomé ever envision starting Anxiety In Teens? That one day you would be running this fund that’s affiliated with Melinda Gates and her foundations and exclusively focused on Adolescent Mental Health. Did you ever envision that?

 

Solomé Tibebu  13:47

Definitely not. In fact, the only thing I can think of is in Mrs. Payne’s classroom. We were talking about what we would be doing by the time we were 25 and I think my three things were I was going to be a famous gymnast, Mariah Carey, and live in New York City, so I only achieved one of those things by 25.

 

Sanjula Jain  14:12

Well, it’s not too late to cross off some of those.

 

Solomé Tibebu  14:15

It definitely is. No one wants to see any of that.

 

Sanjula Jain  14:18

I don’t want to gloss over that. That is a really big accomplishment to have this significant role doing this significant work. How surreal was it? What were you thinking at that time?

 

Solomé Tibebu  14:33

The Upswing Fund for Adolescent Mental Health is seated by Melinda Gates’ personal investment in incubation company Pivotal Ventures. They do a ton of philanthropy. But one area that’s been a major priority for them for a long time has been Adolescent Mental Health. I’ve had some exposure to some of the organizations they’ve worked with. I’ve been an advisor for several years now for The Velocity Fund, which is a venture fund investing in youth mental health and well-being startups that’s also funded by Pivotal. Same thing with the headstream, incubator, that incubator earlier stage, adolescent mental health and well-being startups, digital wellbeing startups. It was around a year ago now, I was where I am now: in the thick of planning my Going Digital: Behavioral Health Tech conference. I think Pivotal reached out like, “We’d love to talk to you! I’ve got the juicy idea,” so I got on the phone with them. Of course, I was totally overwhelmed to hear that they wanted to—especially as a result of the impacts of COVID, how much adolescents have been struggling, specifically underserved populations like LGBTQ youth and youth of color—carve out this fund. Of course, I was elated to have the opportunity to accept that invitation.

 

Sanjula Jain  15:54

That’s great. You’re right, you’re coming up on the one-year anniversary of that role. You’re in this “formal leadership” role now where you’re scaling a lot of the work that you have been doing for so long. What has been the most rewarding part of the work that you’ve been doing in the last year? What’s been the most challenging?

 

Solomé Tibebu  16:18

After standing up the fund announcing the two RFPs for one for direct service providers, the other for system enablers, nonprofits last fall, reviewing hundreds and hundreds of applications. Then finally, announcing our portfolio recently, we’ve had I noticed we have 88 organizations nationwide, an amazing mix across the country, different geographies, diversity of populations, one thing I’ll say is, we took the approach of funding a variety of really different organizations. So everything from larger mental health nonprofits that are more established and might have more immediate reach and scale to impact adolescence quickly, as a result of the pandemic. Two more emerging organizations that oftentimes, we’re the largest wonder to help them get to that next level. That ladder group is what was really exciting for me. It was a subset of organizations that were LGBTQ bipod-led who understood how to engage and reach the population we’re trying to reach in their communities. But they themselves, they’re very mission-driven, oftentimes underfunded, and really unseen. It was really exciting to have the opportunity to be one of their largest funders. One of the most impactful things is being able to play that role. I’m excited to learn what we can do to continue scaling their work because they really are a reflection of the population they’re serving. That’s really important.

 

Sanjula Jain  18:05

If you were to think about the last decade or so in behavioral health, you’ve seen this progress and there’s a lot more funding and companies, what are you most excited about for in the next decade? What are you hoping that we as an industry can move the needle on?

 

Solomé Tibebu  18:20

You can make the same analogy for for-profit startups. You’ve seen the statistics around how many venture capital dollars are going to bipod LGBTQ founders? It’s the same thing. If we’re talking about really serving the most underserved who have not historically had access to behavioral health services. Now, we need those to be the leaders to actually develop and scale those solutions. This last year has been a very challenging one in terms of all of the racial injustice that’s been in the news so frequently, but I do hope at least it’s it seems like it’s a catalyzing moment for a lot of companies, philanthropists, funders, of all sorts to investing in the next generation of leaders that I’m talking about.

 

Sanjula Jain  19:10

Absolutely. Speaking of leaders, in addition to The Upswing Fund, you wear many hats. I know you write this newsletter, you’re planning this big behavioral health conference, you sit on a number of boards, advise companies. You do so much I don’t know when you sleep. At what point did you realize that your leadership journey was going to be different because you were female?

 

Solomé Tibebu  19:33

As a woman of color, as a younger woman in a lot of the settings that I’m in, it really goes back to, I have a unique perspective. Even talking about The Upswing Fund, I don’t really think there are a lot of the organizations that we funded, they probably don’t have a lot of funders who look like me either. Thanks to Pivotal Ventures to have that kind of Outlook. I know, that’s an important aspect for them. But it does feel like a lot of pressure to and I definitely hope I don’t continue to be one of the few that have that background, but it’s important.

 

Sanjula Jain  20:11

That was one of the things you and I got to bond over. It’s so rare to meet not only women of color in these leadership roles, but also in a certain kind of age bracket two, and there’s probably a lot that you’ve experienced along the way of either being challenged or not taking seriously. Tell us a bit about some of those moments where, because of what you represented demographically, that it posed additional challenges that you had to overcome.

 

Solomé Tibebu  20:35

In a lot of the work that I do with different companies, whether they’re early-stage startups or more established health IT vendors, I’ve had an opportunity to consult many of them over the last several years. Early on, a lot of the questions are, “Okay, you don’t have a very traditional background in consulting or any kind of fancy MBA or anything like that.” Once we get into it and I talk about the real-world practical experience that I have working in, starting, and co-founding these kinds of companies and also my own personal experience using these kinds of tools, building them up. At the end of the day, that is what’s most relevant for them.

 

Sanjula Jain  21:18

Speaking of that village of people, what role have mentors played in your journey?

 

Solomé Tibebu  21:23

I have had an overwhelming number of amazing mentors from so many backgrounds. Starting from when I was starting my startup early on back in Minneapolis, none of it would have happened, had it not been for the support of more established healthcare entrepreneurs to show me the ropes and to help me navigate. That’s absolutely still the case to this day. Looking back, one thing college Solomé did a good job of was networking as much as I could, not really knowing what path or where a conversation might lead. Oftentimes, it was better than expected, and that’s still something I do a lot today.

 

Sanjula Jain  22:07

It always works out that way, doesn’t it? It’s great to have that network and have so much support and all those different colleagues and mentors often share great pieces of advice, but you’re also working through things that had not been done before. Is there a piece of feedback or advice you’ve received along the way that was either really difficult or you kind of just didn’t agree with?

 

Solomé Tibebu  22:34

Oh, I love that you pointed that out. Totally. Yes. Whether it was for my own venture, or even testing out some new things with The Upswing Fund? Half the battle is even acknowledging that no one has really done some of these things before. Especially as a younger person in entrepreneurship or any field, of course, it’s important to have humility and listen to people who have gone before us. But at the same time, no one’s perfect, and no one has all the answers. Many people are pretty eager to give a ton of advice. It’s also standing strong in your own conviction. That’s something I’ve struggled with, but it’s evolved and improved.

 

Sanjula Jain  23:19

Is there a trade-off or a sacrifice you think that you’ve had to make in your life personal or professional kind of along the way that’s allowed you to do all the things that you do today?

 

Solomé Tibebu  23:29

I definitely have no idea what’s going on in pop culture, at all. I have a lot going on, a lot of interesting projects. As you can tell, I kind of want to pursue all the things and that means missing out somewhere else. You can’t do everything all at once.

 

Sanjula Jain  23:48

Hence the Mariah Carey goal by 25. Okay, this all makes sense.

 

Solomé Tibebu  23:52

That was a good one to let go of, for sure.

 

Sanjula Jain  23:57

Do you have any like fun rituals or things that you do for yourself that are kind of like your timeout thing or a way that makes you more productive in a day? Whatever that is, ritual or hobby?

 

Solomé Tibebu  24:08

As I have gotten older, I’ve recognized how important that is not just because of exercise/diet whatnot, but really more personally, for me, in terms of my anxiety and OCD, it’s become quite apparent that when I’m not managing all of the lifestyle pieces, it’s just perfect breeding ground for that kind of anxiety and OCD to flare up significantly. When I was younger after I found the right therapists and, and medication and whatnot, and had my routines going and really was managing the OCD quite well. It was like, “Oh, wow. I overcame it. Why don’t I go give TED Talks and we speak about it?” After a few years of starting to let some of those healthy habits by the wayside, it was a perfect storm for the anxiety, panic attacks, and OCD to come back full force. That’s when I recognized, “Oh, well, this isn’t really something I overcame. This is something I’ll be managing for who knows how long.” Having those ingredients in place, (the running regularly, sleeping, proper diet)— I’m being a total hypocrite this week, but typically they’re on point and it’s actually quite important for me.

 

Sanjula Jain  25:28

That’s a really good reminder for all of us, though, because, in some ways, it’s not like a checklist item. It’s an ongoing self-management, self-maintenance thing. There are days and weeks or months, where sometimes we deviate from our norms, but it takes a lot of work and practice at it. You have to keep investing and doing this thing, so I think that’s a really good reminder for all of us. If you think back to younger Solomé, whether it’s 16 when you were just starting off and taking on this work, what advice would you give to your younger self?

 

Solomé Tibebu  26:01

It wouldn’t be to pursue these open doors, these interesting opportunities. Sign up for that business plan competition or go to that summer camp because sitting in a bunk bed at summer camp is where I thought of the idea for Anxiety In Teens. Who would have thought that the submission to that business plan competition is what would evolve to my startup to entirely leading to a career in behavioral health technology? Having the opportunity to explore different things, if you have access to them, you take advantage of any kind of opportunity that comes your way.

 

Sanjula Jain  26:39

That’s great advice. You have so many more chapters to write in your book and you’re just kind of getting started, but I’m curious, what do you think about the legacy that you’ll leave behind as this healthcare leader? What would be the title of your autobiography?

 

Solomé Tibebu  26:54

I definitely hope that it is Expanding Access to Mental Health Care. There’s a lot of really interesting technology and innovation. But innovation for innovation’s sake is really quite pointless. What really matters to me is that there’s a family like mine, with a young child with immigrant parents who don’t know how to access or navigate where to get the best mental health support services for their youth. That’s the kind of thing I absolutely want to transform.

 

Sanjula Jain  27:24

I think you’re already doing that, so thank you for all the work you’re doing. In some ways, I think you’re too humble to brag about yourself. On behalf of our audience, I want to thank you for the incredible work you have been doing from day one. Behavioral health generally, is a really difficult issue to tackle for so many reasons but, on top of that, you’re really getting at it, particularly at a subgroup population that a lot of people weren’t really thinking about. Through the work that you’ve done thus far, you have started to bring more visibility into the adolescent sphere, and we’re really excited to see what else that you’re going to take on in the years to come. Thank you so much for spending so much time with us today. It’s really incredible story and congrats to you for all the work that you’ve done so far.

 

Solomé Tibebu  28:09

Thanks so much, Sanjula. Really delightful speaking with you.

 

Sanjula Jain  28:14

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