Khosla-backed Marble, built by former Headway founders, offers affordable group therapy for teens

Rates of depression, anxiety and suicidal thoughts are surging among U.S. teens.

A recent report from the Center of Disease Control found that nearly one in three girls have seriously considered suicide, and a significant number, 13% have actually attempted it.

Psychologists have various theories about what’s causing adolescent mental health crises.  

Some blame the increased use of smartphones and social media, while others believe that the isolation during the pandemic has played a significant role.

While the primary drivers of teen psychological difficulties are not well understood, the bigger challenge now is finding ways to solve the growing problem, given a nationwide shortage of mental health professionals.

Jake Sussman, who was one of the four co-founders of unicorn-size mental health network Headway, believes his new startup can help address the deepening crisis by offering online group therapy for children in grades five through 12.

After leaving Headway two years ago, Sussman decided to try something entirely different. He became a fifth-grade English teacher at a charter school in Brooklyn. That experience not only gave him an opportunity to teach kids how to write essays but also gave him a front-row seat to why the mental health care for children is currently broken.

Sussman’s school had one counselor, but despite that person’s best effort, they often couldn’t arrange timely help for students, he said.

“[Counselors] are not clinicians. They have massive caseloads,” Sussman said. “The best they can do is give families physical PDFs of clinics that all have long wait lists.”

He shared the story of Jamelia, an orphan who became depressed after her best friend left the school. Because Jamelia was covered by Medicaid, she had to wait three months to see a therapist.

Sussman realized that one way to solve the mental health professional shortage is to offer help in a group setting.

“Group care has been around for a long time,” Sussman said. “They’ve been studied rigorously. And they work.”  

While studies found that group therapy is as effective as individual therapy, this type of treatment is not often offered by mental health professionals.

Even though therapists in private practice can make more money running group sessions, group treatment isn’t popular with behavioral health providers because they are an enormous administrative challenge, according to Sussman. “You’re not going to find 10 kids, coordinate 10 schedules and verify 10 insurances. It’s too much work.”

Because of logistics, online group therapy may also be more effective than in-person treatment, according to Sussman.

“If you have two groups, and one is just 17-year-old girls who have anxiety and another is 17-year-old girls who have anxiety and are Hispanic, and identify as LGBTQ, that second group, all things equal, is going to be much, much more effective because it’s more specific,” Sussman said. “The second group would be virtually impossible to fill in person. How are you going to find 10 people who fit those criteria within a commutable radius of the group location?”

Marble, which Sussman started late last year with another Headway co-founder, Dan Ross, claims it can solve the logistics of organizing group treatment and, at the same time, help many more students without sacrificing quality of care. On Friday, the startup is coming out of stealth and announcing that it has raised $5 million in seed funding from Khosla Ventures, Town Hall Ventures and IA Ventures, with participation from Daybreak Ventures and Lorimer Ventures.

Sussman said Marble’s main competitors are school-focused teletherapy startups Hazel, Daybreak and Cartwheel, which partner directly with school districts. “Schools have budgets available for student mental health, but these budgets are fickle and fairly small,” Sussman said, adding that schools may pay for up to six private therapy sessions, but that’s not enough time to treat students.

Marble’s approach is different. The company partners with school counselors who have the authority to make referrals, Sussman said.

Instead of charging school districts for Marble’s services, the company works with insurance, including Medicaid.

Sussman explained that Marble’s approach is economically feasible because Medicaid will pay at least $20 a child for a group session. “With 10 kids in a group, we can make $200 for that hour, which means we can pay the therapist a competitive rate and still have enough money left over to actually build the business,” Sussman said.

Marble tested this approach with one school in New York City and intends to establish a relationship with hundreds of counselors throughout New York State during the next school year. “Counselors see the magic of not having wait lists,” Sussman said. “They realize it’s much better than what they’re currently using.”

While the company is starting its services in New York, it plans to expand to other states.