COVID-19 Is Helping Us To Talk Openly About Mental Health
By George Goldsmith
We are living through a pandemic and a crisis.
The pandemic is COVID-19. The crisis is in mental health, but this isn’t a new crisis. Before the pandemic, it was estimated that one in four people experienced some form of mental health challenge. This number is likely to have increased over the last year, exacerbated by COVID and its impact on frontline workers, the economy, jobs, social interaction, education ... the list goes on.
There is a huge unmet need in mental healthcare. Every 40 seconds, somebody dies from suicide; this equates to over 780,000 deaths per year. And in those 40 seconds, 20 more people attempt suicide, equating to over 15 million people who have lost hope. These are statistics, but behind the statistics are stories of real people and painful suffering. We often say, “everyone has a story”. Here’s mine.
In summer 2012, our son, who was then at college, became really ill with depression and obsessive compulsive disorder. I’m an entrepreneur and have worked extensively in healthcare; my wife, Ekaterina Malievskaia, is a doctor. Initially, we felt fortunate to understand the healthcare system and have the resources to be able to get him help. But no matter which doctor or psychiatrist he saw, or which medicines and therapies he tried, he suffered and got worse and worse, less recognizable to us and himself with each additional treatment. Those of you who have witnessed this up close and personal understand how hard this can be.
Eventually, Ekaterina found some promising research on new approaches to depression including ketamine and psilocybin therapy. That started us on a path of accelerated learning about psychedelic substances and the potential they have to alleviate mental health suffering.
What was interesting about this time was that as we talked to others about the challenges we were facing, many began to tell us their own stories. Friends and colleagues we had known for years shared that they — or their daughters, sons, brothers, nieces — had also experienced mental health challenges. This was real, it was on a large scale, and it was growing. We all felt some relief in realizing we weren’t alone – and often wondered why we hadn’t shared this before.
NOT MUCH INNOVATION IN RECENT YEARS
Despite the best efforts of psychiatrists and the many healthcare professionals involved, the patient experience in mental healthcare today is poor. We learned that from our own brutal experience, and we heard it many times in the conversations we had with those we met along our journey to find help. There has been little innovation in psychiatry and mental health in recent years. The cost and complexity of discovering and developing new treatments in this area have been significant disincentives to pharma and biotech companies. And when existing treatments don’t work, doctors have little else to offer.
If we focus on depression alone, this illness affects more than 300 million people worldwide. About a third of these are not helped by existing treatments such as antidepressants. Patients are labelled as having “treatment-resistant depression”, although I would point out that there aren’t many patients who are actually resisting treatment! This represents 100 million people — that’s a large number for whom the mental healthcare system is simply not good enough. And that’s only the leading edge of our mental health crisis. Think about anxiety, bipolar disorder, anorexia, post-traumatic stress disorder (PTSD) … the unmet medical need is huge, and it’s urgent.
REGULATORS ARE LISTENING
COVID is likely to make this worse. Its impact on our mental health will extend months and years after the virus is brought under control. At the same time, it has brought mental health into the open and is driving conversations about mental healthcare and how to improve it, while helping to remove some of the stigma that still exists around this subject. Mental healthcare can be frustrating because there are so few options. But as awareness of these problems grows, let’s take this opportunity to have informed debates about how we bring evidence-based innovation to patients quickly and safely, and in a way that is accessible to all, regardless of ability to pay. Let’s focus attention on the patient experience in the mental health journey, and think about the person behind the statistic, and find a way to help them to achieve the outcomes they want.
Regulators have been listening for some time. They have seen that there is a growing mental health epidemic in which millions of people are overlooked and don’t have access to viable options and have backed innovation in this area.
COMPASS Pathways’ synthetic psilocybin, COMP360, was designated a Breakthrough Therapy by the FDA for treatment-resistant depression in 2018. We are developing a new model of psilocybin therapy, in which COMP360 is administered in conjunction with psychological support. The FDA and other regulators around the world have been supportive and encouraging. In fact, in addition to our own, many other studies and trials are now taking place around the world, with a range of psychedelic substances, and for a range of indications. There is renewed interest in mental health and how we manage it, and this is leading to more innovation.
We want patients to talk openly about their mental health, to feel empowered, and to have choices. We envision a world of mental wellbeing, a world in which mental health isn’t simply the absence of mental illness, but the ability to flourish. Let’s eliminate the stigma in mental health as we share our stories, transform mental healthcare, and enable people to access new therapy options that are shown to be safe and effective through rigorous testing in clinical trials.
In my story, our son did get well and is now far more resilient and leading a full life. I hope that, in time, everyone has a story that ends in a similar way.
George Goldsmith is Chairman, CEO and Cofounder of COMPASS Pathways plc, a mental healthcare company dedicated to accelerating patient access to evidence-based innovation in mental health.