The Mental Health Journey That Brought Me to Two Chairs

My own journey with mental health feels recent, because I didn’t grow up with it in my cultural vocabulary.

But as I think about it, it’s not. I started therapy in July of 2014, and am coming right up on ten years of being an avid believer in it and a devoted advocate for the category. Why I started therapy in 2014 is a complicated one. It may have been the rude awakening of how hard being an adult felt at that time. It may have been the strain of having left one very challenging startup and not having a steady source of income in the very expensive city of San Francisco (I pieced together what I needed for monthly bills with five jobs at one point). Maybe it was the early growing pains of marriage, twenty-somethings deeply in love but woefully unprepared for the real work involved with not just getting married, but staying married. Maybe it was the universe giving me advance notice that I was about to lose my grandmother in five months and oh boy how I needed to get ready for the pain of that one. Who knows. Either way, I found therapy on Yelp. I had no idea what I was getting into, but it’s become a core part of my life in more ways than one since then. 

Despite all these triggers that sent me into the path of seeking mental health support, I grew tired of explaining my Indian heritage and family dynamics with a series of white, American therapists. Shortly after having my first child in 2020, I found my current therapist, an Indian-American woman, who is also a mom, who gets me in a way that has allowed us to get straight to the point. I am forever grateful for having found her, and I wish that I had found her sooner. 

This is what initially piqued my interest in Two Chairs in October of 2017 after a friend from college mentioned the company. It was entirely brick-and-mortar then. When I visited, I felt immediately struck by the focus on therapy. The quiet and calming vibe. The small, thoughtful touches that showed the patient mattered. And the bonus? You didn’t have to rely on hours of Internet searches via Yelp and Psychiatry Today. Sign me up! 

I met Alex Katz, the founder and CEO, a few days later at my firm Maveron’s offices in San Francisco. Alex had his own powerful, personal connection to the topic, which made me feel like I was in the presence of someone who truly cared. We discussed how society should pay just as much attention to mental health as we did to physical health. Alex emphasized the importance of quality, how he was building something rooted in measurement based care, how outcomes were core, and how the clinicians, whom he hired full-time as W2 employees, were the key to the success.

As a firm we had spent a lot of time thinking about the opportunity in behavioral health. What struck us when we met with Alex and the Two Chairs was three things - and I’ll ground you with the knowledge that this was at the peak, both in terms of behavioral health growth and the market more broadly. 

• Alex has always been a disciplined founder, no growth at all costs mindset and the business is both capital efficient and strong on clinical at the same time. 
• Referrals come from primary care physicians, for the most part, and they keep coming because Two Chairs is delivering. 
• On retention, patients stick around for the time they workout with their therapist (which is usually not forever, for good reason) because it’s working. 

The focus on W2 employees also felt differentiated, as I had spent time with a series of companies with a 1099 model. Investors might find the latter more attractive, but if you’re building a business for the long-term, you need therapists on staff who are carefully vetted and curated. As we’ve all learned in recent years, it’s all about the relationship between the patient and the provider. In our quest for efficiency and scale, that can occasionally get lost. But the team at Two Chairs knew exactly what they were building towards - and to their credit, that higher purpose has not wavered. 

My partner Dan Levitan and I invested in the business 3 months later, and we were off to the races with the dream of making mental health more accessible by creating a trusted brand in the space. 

When the pandemic hit in 2020, Alex and team pulled off a remarkable operational feat by embracing telehealth. And they did this while maintaining clinical rigor and a commitment to quality. Two Chairs now offers both virtual, hybrid and in-person therapy, recognizing that therapy should feel tailored. Not a one-size-fits-all approach for every patient. 

What’s the secret sauce? Well, the magic is in the research. Unlike most therapy where patients can sit in the chair for weeks and have no clear sense if they’re improving, Two Chairs takes a measurement-based approach. Clinicians know if they’re providing quality, effective care for their patient. And in-network health plans know there is an ROI on every dollar spent. It’s a win-win-win for all. The icing on top? A matching algorithm so that patients will know they’re finding the perfect therapist for their needs. This is only possible with the technology and a robust clinician base, both of which Two Chairs offers. 

If it sounds too good to be true, it isn’t. This is what we all deserve in mental health. And I believe it’s a step forward to solving the massive labor shortage we continue to see which is only getting worse. If we can match the right patient to the right therapist, and ensure that the care is working, we won’t waste vital therapist time and resources to the extent that we do today. 

As Two Chairs announces $72m of funding today, I can’t help but reminisce about those hours of Yelp searches and time in the chair with therapists that I couldn’t relate to. The decision to get help is such a powerful and vulnerable one and it should not be this hard to find support.