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Welcome to The Census, your weekly roundup of what matters in behavioral healthcare.

Today, we’re breaking down:

• The psychobiome and behavioral health care

• All your latest news headlines in under two minutes

Let’s dive in.

- Shân

P.S. This mail is designed to be scannable. Skim read away.

Total reading time (without skimming:) ~4 minutes.

On our radar

What we’re watching this week 

🦠 The psychobiome and behavioral health care

As research on the gut-brain axis grows, so do psychobiome startups — and patient enthusiasm. 

The psycho-what now? Also known as the gut-brain axis, the psychobiome is a community of gut microorganisms (bacteria, fungi, and viruses) that play a role in health and behavior. 

And psychobiome-therapeutics are coming for behavioral health care.

Here’s our snapshot of the space.

1. Firstly, and crucially: People are *very* curious about the idea that their gut health can impact their mental health, as evident in the graph above.

They want to know more — and they’re willing to experiment.

So, psychobiome therapies are getting a little ahead of the science, as these $15k poop transplants claiming to cure autism show.

2. But actual gut-brain axis research is quickly evolving.

Before 2013, there were no published studies on the gut-brain axis on PubMed. Now, 100+ new papers are being added each year.

This means reputable psychobiome therapies will start to enter mainstream behavioral health care. 

Here’s a non-exhaustive list of where research currently stands:

• Autism: The potential of stool samples to detect autism, microbial transfer therapy as a future autism treatment, and what we know about the gut-brain axis and autism thus far

• Addiction: How microorganisms in the gut can make people more vulnerable to substance use disorders

• SMIs: Probiotics as a potentially effective treatment for bipolar patients, gut dysbiosis as a core factor in OCD, gut bacteria’s impact on depression, and the gut-brain axis’ role in PTSD

• Eating disorders: Why the gut microbiome should be considered as part of standard anorexia treatment

3. Psychobiome startups are attracting investor cash. The most recent example is Holobiome’s $6.6M March raise. Expect activity to ramp up as more studies are completed. 

• Due diligence will, of course, be key (a reminder of uBiome’s infamous $60M fraud fiasco is helpful, if not necessary, here) 

4. In closing: It’s now clear that gut health plays a crucial role in behavioral health. However, we don’t know yet whether psychobiome changes are a cause of behavioral disorders, or an effect — e.g. due to diet, stress, or medications. 

So, for now, the best option is to optimize overall gut health, both for ourselves and our patients. Here are six science-backed tips. 

Let’s gut (🥲)  to your news headlines.

Catch up quick

This week’s top stories

Latest news

💲 US spending on behavioral health topped $280B in 2020, with SUD treatment exceeding treatment for mental health conditions by nearly six to one.

🎉 Legislators are advancing a landmark bill through the Senate that would authorize $2B for autism research and training.

👏 Addiction treatment for seniors on Medicare may soon become more accessible thanks to the new Residential Recovery for Seniors Act.

⚠️ In a surprise to no one, doctors are now warning that weight loss drugs like Wegovy may trigger eating disorders in some patients.

💔 Over 40 experts and organizations have issued a joint statement calling on governments to prevent assisted suicide in eating disorders, after a study found 60+ cases of assisted suicide ‘with little oversight.’

😵 Parents are suing a North Texas behavioral center after a video surfaced showing a therapist throwing a non-verbal autistic boy against a wall.

🧑‍💼 Teladoc is ‘urgently’ restructuring its underperforming mental health company BetterHelp, looking to insurance deals to offset rising customer acquisition costs.

💊 MDMA is on the brink of becoming medicine, but participants in studies the FDA will review told WSJ they “felt pressure to report positive outcomes.”

🎯 Conservatives are targeting the federal spending that’s led to the highest insured rate in American history — and Medicaid is in the hot seat.

😲 There are at least 100 privately owned mental health homes in Santa Clara — and many residents allegedly ‘live in absolute squalor.’

🗺️ Iowa announced the boundaries of seven behavioral health districts, designed to increase access to mental health and SUD treatment services.

💰 The US Senate Finance Committee has approved $8B+ in behavioral health funding.

📈 CMS’s new funding rule for inpatient psychiatric facilities includes a 2.5% net rate increase and a 72% increase for electroconvulsive therapy.

📊 Addiction treatment providers are diversifying operations and building key payer, employer, and community partners to boost revenue growth. 

🚫 Acadia Healthcare has closed five centers in the last month amid comments that existing facility bed expansions are “one of [their] best uses of capital.” 

🪖 Tricare users’ out-of-pocket fees for outpatient behavioral and mental health would be capped under a new bill — cutting patients’ costs by ~48%. 

👻 Point32Health’s behavioral health navigator program is combating ‘ghost networks’ and matching new patients directly with providers.

🧑‍⚖️ Vertex has been granted priority review for a first-of-its-kind non-opioid painkiller; the FDA’s decision is due January 2025.

🚬 Almost six million Americans started vaping nicotine last year — and ~12% of all vapers are underage.  

😞 Finding a therapist for their kid is “like a part-time job” say many New Hampshire families.

🚔 Biden has ordered federal agencies to coordinate and intensify efforts to disrupt the supply chain of fentanyl and other synthetic opioids.

🚨 The Justice Department is starting a pilot program to reward whistleblowers who expose healthcare fraud schemes involving private insurance plans. 

🤑 Healthcare is the costliest industry for data breaches, with 2024 breaches costing an average of $10M each.

🤯 Meta is (still) running ads on Facebook and Instagram that steer users to online marketplaces for cocaine, opioids, and other drugs.  

👀 Hmmm, that’s interesting: a list of all the HIPAA violation cases for 2024 so far. 

Expansions, launches, & partnerships

🏥 Prince George’s County opened the first 24/7 behavioral health crisis stabilization center in Maryland.

🤝 Talkspace announced a new in-network agreement with Humana Military / TRICARE East.

🏛️ SUD provider Bradford Health Services opened their Trinity River Recovery Center in Dallas, TX.

✅ Magellan Healthcare Inc. is now serving as the state-wide contractor for the Idaho Behavioral Health Plan that launched on July 1st.

Funding rounds & investor moves

💸 Recently formed Tulip Hill Healthcare acquired two detox centers in Nashville (read our interview with their COO here). 

🤑 Mental health benefits firm Spring Health announced a $100M Series E round — valuing the company at $3.3B.

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Studies & opinion pieces

💡 How closed loop referrals can improve behavioral health outcomes (opinion).

☀️ Adequate vitamin D levels may enhance cognitive functions related to impulse control in anorexia nervosa (study). 

💔 US preteen suicide rates rose ~8% (!!) each year from 2008-22, with girls 8-12 years old recording the biggest spike (study).

😞 And, most young people who die by suicide in the US do not have previous mental health diagnoses, suggesting that mental health problems are being missed or undiagnosed (study).

🫂 The upstream cause of the youth mental health crisis is the loss of community (opinion). 

📝 Entrepreneurship in autism therapy presents an especially unique set of challenges that distinguish it from other industries (opinion).

That’s it for this week! See you next Wednesday with a special edition we think you’ll particularly enjoy.

- Shân

P.S. You can email me here if you want to share any feedback, or let me know about a business I should be featuring.

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