April Koh is the co-founder and CEO of New York City-based Spring Health, a mental health technology company providing comprehensive, clinically tested, and AI-powered mental health solutions for employers. With a background in sociology and computer science, she has been recognized as one of the most promising young entrepreneurs. Her company made Fast Company’s list of the World’s Most Innovative Companies in 2020, and Koh herself was on Forbes’ 30 Under 30 in Healthcare both in 2018 and 2020.

As part of our founder interview series, Crew Capital’s Dylan Reider and Sonia Damian sat down with April to discuss her entrepreneurial journey. In the following, they discuss Koh’s entrepreneurial path, her unique set of skills and experiences, her sources of inspiration, the challenges of scaling and the particular circumstances of the mental health space, and the ever-growing need for smart solutions to mental health issues.

On becoming a founder – entrepreneurship takes endless forms

From being a vocal advocate for mental health awareness to building a deeply impactful company in a space that is constantly evolving and posing new challenges to the founding team and beyond, Koh has thought long and hard about how her own origins and how her company came to being and how it differs from others.

For Koh, one of the primary inspirations for her journey has been her father who became a successful entrepreneur after leaving his corporate career. Typically, entrepreneurs begin with the idea of creating a company and only then look for a problem to solve. The idea upon which Spring Health is built first came into being during her time at Yale where she stumbled upon a research paper by a PhD student, Adam Chekroud, who would become her cofounder. For Koh, Chekroud’s research on the applications of data and machine learning on mental health was a jaw-dropping experience.

It was a beautiful application of technology to solve a real-world problem that so many people were facing. She went on to start a company saddled with a fresh new academic perspective, and then realized that the company could vastly scale the impact of Chekroud’s research.

Her takeaway from a rather non-traditional start is that entrepreneurship takes endless forms. Koh was always interested in building a company, but it wasn’t until she found purpose in an idea that could have so much impact (Spring Health now covers 5 million lives!) that it all came together. The passion and sense of purpose to face all the ups and downs are absolutely critical.

Humility, confidence, and quitting smart

There are of course many ambitious and intelligent people who set out to build companies, but, as we very well know, the vast majority of startups fail. Spring Health is still in its nascence, but Koh and her team have already built an impressive customer base and are making a real impact in the health category. Being the youngest female CEO of a venture-backed unicorn, Koh has traits, and qualities that have had a significant impact on her meteoric rise to startup stardom.

For Koh, it’s about a mix of confidence and humility; confidence to fully believe in one’s idea and to have thick skin when people inevitably question or reject the idea, and humility to realize that mistakes are a daily occurrence, and in the long term it’s about committing to learning from mistakes.

Koh states that humility comes from surrounding yourself with great people.

“I was recently asked in a company all-hands how I’ve pulled back on some of the details I focused on in the earliest days. I told our team that when you’re a perfectionist by nature, you can only hand over control if you have total trust that the people around you are not only smart and talented but also share your goals and values.“

It’s popular to tell entrepreneurs to never give up. Koh believes in a different approach that she refers to as “quit smart.”

“Whether it’s folding a company because the market fit isn’t there or simply reprioritizing between different products or investments, you need a specific framework and metrics to decide when is the right time to move on and try something new. You want to give yourself a lot of runway, but ultimately, it’s important to have an objective way of determining how and when to change course.”

Much of her thinking is applied in the context of her company and the surrounding challenges – and rapid increase – in mental health issues.

The US especially has been in the midst of a mental health crisis for years, and the pandemic accelerated many of the negative trends with one survey finding that more than a third of Americans report worse mental health since 2020. At the same time, there’s a major shortage of mental health providers that’s estimated to mean a supply gap of more than 15,000 professionals by 2025.

Despite these big gaps, mental healthcare has been technology-resistant in many ways.

“This has made it much more difficult than necessary to connect patients with the care they need, and to help caregivers treat patients better and faster. Spring Health covers more than 5 million lives right now. We’re thrilled by our growth so far, but we wake up every morning thinking about how many more people we can help.”

Role models, the importance of inspiration, and lived experience

Koh draws her inspiration and strength from women who started and scaled extraordinary businesses – whether Judy Faulkner at Epic, Sara Blakely at SPANX, Melanie Perkins at Canva, or Lynn Jurich at Sunrun.

She also mentions her sister who is “an absolute embodiment of kindness, resilience, and raw talent”. Consistency in good values is something that has greatly helped Spring Health and Koh’s entrepreneurial pursuits.

Her company’s values have remained the same even as the world has been changing rapidly.

“We built this company with a very clear purpose of improving access to mental health, and that’s our singular focus every day. One of the benefits of building a purpose-driven company is that you tend to attract people who share your values, which creates a virtuous cycle.”

Mental health touches all of us, either directly or through family and friends. In college, Koh suffered alongside a roommate who had an incredibly difficult time finding the care she needed, and she refused to believe that things had to be this hard. When she connected with her cofounder, they built a thesis around the use of technology and data to fill the huge gaps in access and treatment.

“It’s often said that the best ideas come from simply identifying these kinds of gaps. In our case, the stigma around mental health has contributed to a historic lack of investment and technology adoption in the industry. Fortunately, that’s now changing, and we’re grateful to be part of that change.”

Removing barriers with precision

Koh recognizes that the world is changing. The naysayers about mental healthcare and wellness are increasingly few and far between, and it’s important for investors to understand the new paradigm. Not only do most individuals see the benefit of mental health support, but the vast majority of businesses Koh speaks to understand just how important mentally healthy employees are to their bottom line.

“This isn’t a pandemic story. Even before Covid, the younger generations have done meaningful work to destigmatize mental healthcare, and the trends we’re seeing across the board are here to stay.”

In the coming years, the company will focus on scaling in order to maintain the best-in-class service for its members while meeting new market demand.

“And looking further ahead, we are aiming to build the largest and the most impactful mental healthcare company in the world, setting a new standard for the field throughout the world.”

What sets Spring Health apart from all other solutions on the market is the company’s Precision Mental Healthcare approach, a data-driven approach to mental healthcare that uses technology and services to deliver “faster, better, cheaper” care through precision every step of the way.

“With Precision Mental Healthcare, we seamlessly pinpoint and deliver exactly the right fit for each person — whether that’s digital support, meditation exercises, coaching, therapy, medication, and beyond. We have operationalized the cutting-edge using AI and machine learning to develop individualized recommendations to assist mental health professionals. A recent peer-reviewed JAMA study even found that our approach is the only solution of its type to demonstrate both clinical and financial improvements in the same sample.”

One of the most significant barriers remains the pervasive stigma around mental healthcare. Many are wrongly taught that there’s shame in asking for help, and companies are often under the misconception that investing in their employees’ mental health is not worthwhile.

“We’re thankfully seeing the tide turn on those ideas – perhaps accelerated by the pandemic – as more people come to understand just how seriously we should be taking this. Still, I am focused on continuing to push for this shift in mentality because every extra minute we take is costing our society happiness, productivity, and even lives.”

Reducing burn and hiring with purpose

Thinking in terms of reducing burn and extending runway is healthy because it forces any company to focus their investments on the things that will have the biggest impact. This is different from indiscriminate cuts, which can stifle innovation and sacrifice long-term growth for short-term cash flow.

“We’re fortunate to have significant revenues and a clear path to profitability that doesn’t require us to compromise on key investments. Having said that, we carefully manage our spending every day — and did so even before it was the “in vogue” thing to do.”

Being a purpose-driven company has the benefit of creating a somewhat self-selecting talent pool. People who want to work with Spring Health are excited about the impact their work can create.

“With this in mind, one trait we always look for is productive impatience. To be successful at Spring Health, you need to believe the status quo isn’t good enough and constantly look for ways to break through barriers.”

Any company that grows as fast as Spring Health needs to think about maintaining a consistent culture. You can’t communicate and collaborate with people the same way when you’re a company of 1,000 people as you did when you could all fit around a conference table.

“In our experience, it makes a huge difference to be a purpose-driven company, because we have a clear North Star. It’s not just about increasing market share or revenue, it’s also about scaling up the impact we can have in people’s lives. That has a way of making any differences of opinion seem small by comparison.”