In this episode, we chat with Russ Glass, CEO of Ginger, an on-demand mental health company. Through Ginger, Russ and his team are solving a massive problem that until now was often left without an adequate solution.

An estimated 1 billion people around the world go undiagnosed and when we consider the societal cost of large segments of our population that are mentally unwell, we begin to understand the significance of Ginger’s mission.

Prior to joining Ginger, Russ led products for LinkedIn Marketing Solutions and was formerly founder, president and CEO of Bizo, a B2B audience marketing and data platform which was acquired by LinkedIn in 2014.

We hope you enjoy the show.

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RJ: Russ, thanks again for taking the time and joining us, really excited to speak with you.  Maybe what we could do for our audience is give a little bit of background on yourself as well as Ginger and you can do that in whichever order you prefer.

Russ: That’s great, thanks a ton for having me, excited to be here.  I’m the CEO of Ginger, I have been here about two years now, a multiple time entrepreneur, really been an entrepreneur my entire life starting with a tennis racket stringing business in high school and on through college, and then for venture backed startups since I graduated from Duke University.  And my last one was a company called Bizo, which was in the B2B data space.  I sold that to LinkedIn after growing it for about six years and ran the Marketing Solutions Business at LinkedIn, I left there after three years to be dad.

I’ve got three small girls between 5 and 11 years old and wanted to spend some quality time with them so I took about a year, a year and a half to do that.  And realized that as an entrepreneur, I wanted to start to do things that really needed to exist in the world.  And started to think about what kinds of companies could be solving important problems, and as I was thinking about that I came across Ginger.  And Ginger is an on-demand mental health system, we’re trying to solve for the huge supply demand imbalance that exists in the mental health space, where far more people need access to care than there are providers to provide access to care.  And we are using a virtual, entirely digital approach with behavioral health coaches, therapists and psychiatrists available in all 50 states in 29 countries around the world in order to help crack this imbalance and make sure people can get real time access to care.

It’s really interesting, when I was looking at your background earlier that you were in a more traditional, let’s say technology entrepreneur path.  And  you still are but you’ve made this jump into a new segment.  And so it does sound like you had proactively looked for this type of opportunity, is that right?

Interestingly, yes, it is right, although I thought I would found another company because that’s typically what I’ve done.  And as I was ideating and thinking about ideas for a company that could have an impact on the world, I came across Ginger.  And the more I dug and saw the size of the problem there are 300 million people around the world that have a mental health condition that aren’t getting care today.  There’s an estimated billion people around the world that have an undiagnosed mental health condition.

And then I looked at the sort of societal costs of mental health issues and the NAH estimates that somebody with a mental health issue costs the healthcare system two and a half times what someone who doesn’t have a condition would cost.  And the individual impacts of having mental health issues, the fact that it’s hard to live your life when you’re anxious and depressed and certainly hard to maximize your happiness.  It felt like I was not going to come up with an idea myself that was as powerful and as impactful as what Ginger was doing and so I hopped onboard.

That’s fantastic.  And thinking about this whole mental health space, there’s obviously other companies that have popped up along the way, almost in parallel, there’s Headspace, there’s Calm.  And these solutions have been around for hundreds, if not thousands of years of trying to think about how to manage oneself, how to think about one’s thoughts and better try to lead a more calm, peaceful life.  How is it that technology, and in particular, Ginger can be used to help folks cope better with stress and other anxieties?

I think there are a few ways.  I mean I think your point’s a great one I think it’s literally been 5,000 years since we have been thinking about concepts on mindfulness and how to use different techniques, like breathing techniques to feel calmer, to reduce anxiety.  I think what’s happened in the modern age, and particularly in an aggressively accelerating away in the last let’s say 15/20 years is that we’re now in this always on information deluge.  And I think our brains were not evolved to handle the level of information that’s coming out of the always on nature of that information.

And we see this in particular with people who whose brains have been growing and they have had access to these devices since they were very young.  And we’ve seen sleep patterns get disrupted, which we know affects mental health.  We’ve seen this inability to calm the brain down, that used to be much easier.  So I think there’s a lot of changes that are taking place because of technology that have caused some of these issues.  Back to your question, I think what technology can do on the positive side is solve for the fact that it’s actually quite hard today to find providers who can help.

It’s quite hard today to, from a stigma standpoint even, get in the car, drive to someone’s office and be the friction involved, be willing to actually sit down and start to get care when you need it from a mental health standpoint.  With technology we can deliver super high quality care right from your living room, right from your couch.  You don’t even have to get dressed to get super high quality care today.  And that’s the first part is that’s a delivery mechanism.  The second part that’s really valuable about what we can do today is measure everything.  So we can have a deep understanding of how you’re doing, how that compares to what you were doing before.

What interventions are actually leading to positive outcomes.  And what have we seen in the millions of conversations that we’ve had prior that we can apply to you because what you’re dealing with is similar to a number of other people out there, and this is what we’ve seen work with those people.  So (a) it’s delivery, (b) it’s measurement.  And then finally we can bring all of the best evidence based paradigms to bear.  So we can bring exercises like mindfulness and breathing.  We can bring activity cards or what they call computerized cognitive behavioral therapy to the table that’s proven to work.  And we can use providers, like coaches and therapists in order to help motivate you to stay on that track and monitor that over time.  So all of that is really brand new in the last 5/10 years that this is even possible.

And I presume there’s  a spectrum of folks who have some mental issues, like that could be very mild issues, some stress all the way to very debilitating mental issues.  And so it sounds like you have behavioral coaches on the other end that help  treat certain specific cases.  How does that work, how do you match up  patient to the therapist so to speak?

It’s a great question.  Our system is designed around the concept that first of all, a lot of people need clinical care, so they need care that is provided by a therapist or a psychiatrist that is trained to handle more severe, more acute issues.  But the vast majority of people are what we would call subclinical.  They don’t have active conditions.  But they have the beginnings of what might turn into active conditions if not supported.  So they might have mild anxiety, they might have mild depression.  They might just have a lot of stress, and these coaches, these behavioral health coaches are resources that can help people understand what they’re going through.  Help them learn what options they have to take the next step.  And then practice those exercises, practice lifestyle changes in order to manage these conditions so they get better, or at least don’t get worse.

And the analogy I would use is a gym coach.  Anybody can go into a gym and lift weights.  But a gym coach will help you understand how to do it right, they’ll push you to do that next couple of reps.  And they’ll hold you accountable for continuing to show up on an every other day basis, or however often you want to work out.  That’s  what our behavioral coaches do for mental health.  They’re training, they’re helping to personalize your care pathway and they’re holding you accountable to continue to make these lifestyle changes that you need.  The way our system operates though is that you have these coaches that then can bring in other resources if needed.  So if you need more serious care or more acute care they can bring a therapist on the care team or they can bring a psychiatrist.

And do you go to the extent of helping people who want to, I  guess, better optimize their performance say in business or as a professional?

We’re not focused on things like what I would call executive coaching we’re not optimizing from the standpoint of what an exec coach or a business coach might do.  We’re entirely focused on the mental health aspects of it.  So it’s how do you reduce and maintain low stress levels?  How do you manage anxiety and depression?  How do you manage the mental health issues that might lead to substance abuse or other things like that?

And the business model, it sounds like you work through employers and so it’s a benefit that employers can provide their employees?

Primarily that’s correct.  The vast majority of our customers, we’ve got over 100 now, are enterprises that are hearing from their employees that they can’t get access to care.  They’re seeing these rates of mental health issues are skyrocketing.  And they want to make sure that they’re supporting their employees.  And so they bring Ginger in, we charge them on a per month basis for access to unlimited exercises, unlimited coaching and the platform.  And then we charge them when increased levels of care like therapy and psychiatry are needed, we charge them on a fee per service basis, that’s billed back through their health plans.

It appears that you’ve been growing nicely, I saw the sequential fundraisers and you’ve got very good backers.  How has the pickup been in terms of just the  the volume of users?

We more than tripled last year and we’re on track to triple again this year.  So significant growth, the pre Covid period we saw immense need and obviously as you can imagine, now in this period of time it’s exponential in terms of people’s needs.  We’re seeing a 2x increase in our critical service usage over the last two months.  We’re seeing almost a 100% increase, that’s plateaued a little bit interestingly.  So it’s now up but a 2x increase in just monthly active users.  And now it’s leveled off at that higher level and we think that we may see another spike again now that we’re seeing a spike in Covid cases and the realization that we’re in this for the long haul, this isn’t going to be a fast recovery.  So we expect to see it continue to climb but I think we feel fortunate we’re in a position to be able to handle the scale that is coming at us, because that’s really how we’ve designed this system to scale in a non-linear way with these kinds of needs.

Is the majority of usage just users accessing existing content based on what their particular needs are at that moment?

The majority of usage is users interacting with their coaches.  So, they build longitudinal relationships with those coaches, they get to know them, they build trusting relationships.  And as they are continuing to work on what they need to work on, those coaches are helping them continue to take those next steps.  Ultimately the goal is, give every individual the ability to manage their own mental health.  So give them the understanding of what triggers their anxieties or other issues.  Give them the understanding of what self-care can help when things do get triggered.  Give them an understanding of what helps them avoid getting triggered so that over time they don’t need a coach anymore.  But the coach is always there for them if they do have a relapse or something comes up that changes their mental health state.

And so  your coaches must be very well trained and I would think it’s important to keep them around for a long time, particularly if you have a user that develops a strong relationship with a particular coach or a therapist?

The coaches are incredible, I mean all of our providers are incredible, but I would say the coaches are uniquely special.  And they’re incredibly experienced, they’re incredibly well trained, they are able to show compassion at a level that is just astonishing.  And they’re full-time employees of ours; their turnover rate is very low.  And at the same time it can be a stressful job to be a behavioral health coach particularly in periods like this when the coaches are dealing with these stressors and anxieties just like everybody else is.  But then they have to turn around and provide care, like any doctor right now is going through a stressful period and any provider, caretaker is going through a stressful period, the same with our coaches.  So we spend a lot of effort thinking about how do we make sure that the care they’re providing is sustainable and they have what they need to provide this  care in a long term sustainable way.

Switching gears a little bit, you’ve had an incredible  run as an entrepreneur and even before that, working with venture backed companies.  You know,  more so being the entrepreneur and building your own company which you then successfully sold to LinkedIn.  What were some of the  key things that you learned about just business and how to be successful, if you’re trying to scale an organization or even earlier on, just you know, getting your business off the ground?

Sure, good question.  I think I would start with it’s always a combination of good thinking and good people, but there’s also luck involved.  I think any entrepreneur that doesn’t recognize that timing is part of it and being in the right industry at the right time is a huge part of success, I think is not being totally transparent.  I think luck’s a part of it.  But when I look at my failures compared to my successes, it almost always comes down to people.  And hiring the right kinds of people, having a meaningful and thoughtful approach to building a culture and then bringing the right kinds of people in that fit in that culture.  And when I’ve made mistakes it’s been because I’ve either hired the wrong people or I haven’t recognized when they were the wrong people and have kept them around too long.  And when I’ve been successful it’s been because I’ve surrounded myself with people who are just superstars and are able to figure it out and work through all of the challenges that startups throw at you as you scale.

Have you had a mentor or a coach who helped  guide you along the way and provide advice when you needed it?

I’ve got a few people that through my career I think have been impactful and meaningful.  I would say one is my dad; he was an entrepreneur and had a textile company, growing up.  I think watching him I learned probably the value of and importance of just ethics, and honesty, and transparency, that even in really hard times which the textile industry faced in the years when he was there.  I also learned the importance of being in an industry that’s growing and not shrinking, I think was a valuable lesson there.

There was a guy named Wade Monroe who in my first job and then first company, he was the CFO of a company called Trilogy that I joined right out of college.  And then was an investor at my startup, my first real venture backed startup coming out of there.  And, Wade really helped me understand the importance of planning, the importance of sort of financial acumen and understanding, how do you build a company with your lifeblood, finance is at the core.  And again, he reinforced that, he was such an ethical and transparent and honest person so there was a reinforcement there.  And Zoominfo’s CEO, Yonatan Stern who was a very successful entrepreneur, hired me to run products and then I ran marketing at Zoominfo, taught me the power of profitability.

I think a lot of entrepreneurs build companies always thinking about that next fundraise.  Yonatan built companies thinking about profits.  And it’s a very different approach but I think that balanced a lot of how I think about building companies.  It’s not just about growth and the next fundraise.  It’s really about how do you build a long term sustainable business.  And finally Jeff Weiner, the CEO of LinkedIn, who acquired my last company.  He and I have become close and I’ve never seen anybody build culture at scale and with compassion and really with an eye towards how critical values are, than Jeff.  Jeff has taken that to a whole another level and I’ve learned a ton about how do you do that, not just at a startup level, which I had learned and I think had very much built Bizo around those concepts, but then how do you scale that?  How do you bring that to a global company with 10,000+ people?  And Jeff has been an incredible mentor in that regard.

I’ve seen a lot of press on him as well as videos and he really does seem to embody a different  leadership that you don’t typically see in Silicon Valley or with tech companies.  And it is one of compassion, and it really seems to come through.  And  just touching on that for a moment how do you make that scalable?  How do you pass on  one individual’s ethos to an organization with tens of thousands of people?

First I think it starts with the people you hire.  So it starts with being very focused on the culture fit and the values of the kinds of people you’re brining into the company.  Because not one person can never scale that by themselves, they have to have people around them that are the right types of people and embody those values, embody the vision and culture of the company that you’re trying to scale.  Second is one of the things that Jeff would say is you have to repeat yourself to the point of being tired of what you’re saying because it’ll take about seven tries before everybody has truly heard it.

So the whole notion there is that as you’re building a company and you’re being very focused on your vision, your mission.  The values that you’re embodying and how you want to build the company, the strategies and the tactics, you have to repeat yourself again, and again, and again as a leader to make sure that everybody understands it.  That everybody really has a good sense for what’s happening, it’s not enough just to stay it once.  So that’s another piece of it.  I think then it’s consistency, I think a lot of leaders that struggle with this are not able to be consistent.  And when they’re not consistent they don’t build trust in the organization, trust is consistency over time.

And when you combine these things and you take great people that embody these values in the culture you’re trying to build, you repeat again, and again, and again what we’re trying to accomplish.  You give them a clear sense of where we’re going and why and they feel ownership over that.  And then you are consistent over time in how you’re going to approach everything you do as a company, you can really scale the type of culture you’re trying to build.

Well, those are very good helpful insights, I think to anyone leading an organization or even group.  We’re just about out of time here.  And again really appreciate you spending your time with us, you’ve been very generous and very much enjoyed hearing your story as well as what Ginger is accomplishing.  It’s a very important mission, so thank you again and we wish you and the company the best of luck.

Thanks so much, appreciate you taking the time to chat.