4 questions with Brightline's CEO on scaling behavioral health

Pediatric behavioral health company Brightline announced a pivot last month involving organizational changes and a shift in the go-to-market strategy. This move meant less focus on jumbo employers—which requires a national footprint—and instead a more targeted push to patients and their families in a few select geographies. It also meant moving from telemedicine to hybrid care. What precipitated the change? What does that say about our industry? And is there anything fellow founders should take away from it?

Brightline CEO Naomi Allen wrote an in-depth blog post on the topic, describing the company’s evolution. But Second Opinion wanted to run a few additional questions by Allen, who was joined by one of her investors (our contributor, Alyssa Jaffee). We suspect Brightline will be the first of many companies to embrace a hybrid model, so we wanted to ask Allen about that. Plus, as we’ve argued in the past, brick-and-mortar is undervalued! There are also fascinating threads to pull here about the right ways to build in behavioral health.

As an aside, I’m enjoying this format—“4 questions with!”—and would love to hear your feedback. Keep the comments coming. It’s one of my favorite parts of the day to read them. Note: This post is reserved for premium subscribers only and edited for brevity.

Second Opinion: How did Brightline come to be? Can you share the story from the beginning and also touch on how that led you to employers?

Naomi Allen: I started the company because of a health crisis with one of my kids. When he was in therapy, there was no communication between sessions, no suggestions on how we might track progress, or work on homework to help him get better faster. There was just a vast gap between his appointments with no information or coordination. But science tells us that having families engaged in the child’s mental health services helps kids get better and stay healthier. Initially, we had a vision of wrapping that dyadic care model around hybrid care delivery where we’d see kids and teens in person in a clinic, and parents could support their child’s care with a parent-facing app. Parents could also have virtual sessions with a parent coach. But when Covid hit, we moved to virtual care and had great clinical outcomes. I saw that we could scale the virtual care model into states more quickly, so I raised our Series A to hire clinical staff and move into new states. Then, I started getting calls from employers. They told us that working parents were struggling and they were seeing mental health challenges with these kids first-hand. That took us down the path of 50-state expansion, plus a digital platform and a coaching team for families who told us their kids weren’t ready for therapy. By 2021, we were in the scaling model, commercializing through health plans and employers. By 2022, we had amassed an expansive network of hundreds of employer customers but didn’t see enough top-line growth with families signing up for virtual mental health care for their kids and teens through their employers. We started to realize that the mission we were founded upon, enhance access to high quality pediatric behavioral healthcare, was not being fully realized.