According to the World Health Organization (WHO), in 2019, 1 in every 8 individuals, or 970 million people globally were living with a mental health condition, most common of which are depression and anxiety. In 2019, WHO recognized burnout as an occupational phenomenon. Despite the fact that it is not classified as a medical disease, the pandemic has shed light on burnout’s strong damaging effect on people’s physical, mental and emotional state, beyond the impact on business performance and health cost to the economy. What is the reality check in this rapidly growing billion-dollar space? In a candid conversation with Georgi Natchev, CEO of Digiburn, a personalized digital burnout therapy and a continuous digital behavioural coach, we dive deeper into the burnout health space, the company’s business model and their value proposition, as well as the trends in the digital mental health space.
There is a worldwide outbreak with millions of people suffering from mental disorders, regardless of the quality of living standards. Two of the most common conditions, depression and anxiety, cost the global economy US$ 1 trillion each year. In 2019, WHO officially classified burnout as a mental illness. Chronic job stress / burnout is estimated to cost US companies more than $300 billion a year in health costs.
The pandemic has accelerated the need for on demand evidence-based self-help behaviour health programs and mental health DTx to improve population’s wellness. It has also accelerated employers’ demand for high-quality holistic wellbeing digital solutions for their employees. Many mental health and wellness solutions are part of the “welcome benefit package” for the employees. Different stakeholders including accelerators, incubators and innovative companies are looking for startups and digital health innovators that tackle workforce challenges in the healthcare industry at scale. Plexal, for example, has recently published a partnership opportunity on R2GConnect, the matching platform for the digital health industry, offering startups who have solutions that address employee burnout, retention, training, deployment, and workflow, a four-week acceleration program aiming at developing a pilot setup in a clinical setting.
The number of mental health apps available on Android and iOS operating systems worldwide is more than 8,500 and thereof approximately 750 apps address burnout. More than 53% of the digital mental health mobile solutions are found in the USA, Germany, France and UK markets, with around 500 burnout apps available in the same countries, which represent 67% of the total burnout apps globally. Apps are at the centre of solution ecosystems, allowing individuals to track and display measurements, build the right habits, get personalized interventions, and share results with HCPs and caregivers. Some of the digital mental health solutions are specifically designed to help physicians who face many barriers to mental health care themselves and suffer from high levels of chronic stress and burnout.
In today’s uncertain world feeling exhausted, overwhelmed, less capable at work, cynical and indifferent to one’s role are all signs of a burnout. Left untreated burnout can lead to depression and other chronic illnesses, substance abuse. Coping with chronic job stress takes time, open conversations about mental health and stress factors in the company, peer support system to lean on, the right specialist to talk to and self-help guided steps to help get better. Digital solutions and DTx specifically designed to address burnout and stress can transform the standard of care and make a difference to one’s daily moments and lead to a healthier life.
Together with Georgi Natchev, CEO of Digiburn, we explore the burnout health space, the company’s strategy for retention and engagement, their approach towards employers and insurers, as well as what is ahead of Digiburn.
Enjoy the interview!
Research2Guidance: Can you please introduce Digiburn briefly
Georgi Natchev: Digiburn App is a burnout check-up, a transformational 12-week self-growth journey, and a continuous digital behavioral coach. The App holistically integrates body, mind, and growth on three levels – theory, practice, and awareness. It starts with a better understanding of the body and mind’s needs, driving small-step adaptations, and building supportive habits.
We are living in times of change. The global pandemic proved to us how adaptable we are. We changed our professional- and personal life, obsessed with productivity, developed an “always-on” mentality, and let go of boundaries.
From an individual perspective, transition times require adaptation, recalibration of values, and establishment of new self-support systems. During the onset of the pandemic, we neglected everything health but COVID-19. A consequence is the current global mental health crisis, with an outspoken trend – a 27% increase in major depressive disorders in 2020 (Lancet, 2021), 74% of employees said they experience burnout at least sometimes (Gallup, 2021), 51% of the population in Germany reported being on the verge of burnout in 2021 (Statista, 2021), around 30% of employees in Europe have been in burnout in 2022 (McKinsey, 2022). This is yet to be amplified by the psychological burden of the war in Ukraine, economic-, and political uncertainty.
In the context of burnout, the trend is worrying because
Digiburn builds on the premise that every human is born good enough, with all the needed internal resources available from day 1. The App acts as a digital coach, guiding the user to reconnect with body and mind, prioritize stronger beliefs, and build supportive habits. Ultimately overcome and prevent the recurrence of burnout in the long term.
Research2Guidance: The conversation around human well-being is not new. A few years ago, the World Health Organization (WHO) recognized burnout as an “occupational phenomenon “due to stress. Why did you focus on burnout and not on medically diagnosed diseases like depression, where reimbursement is available, distribution channels are tested, and investments are still pouring in?
Georgi Natchev: Burnout and depression are close relatives, differentiated by their scope. The later stages of burnout can evolve into a fully-fledged depression. Burnout is an emotional topic for our team. Cumulatively we share multiple personal burnouts; some of us are at high risk; others experienced a complete company meltdown due to burnout; others are working with people going through burnout, and so on. Burnout is vastly under-solved, and so is mental health digitalization. All of the above made it our logical choice.
Research2Guidance: What is your solution, and how do you stand out?
Georgi Natchev: Digiburn bridges the gap between being curious about burnout and experiencing a big meltdown. It covers the entire cycle, offering initial assessment, structured three months of self-growth, and continuous digital coaching and monitoring. Like the frog, people keep boiling in the increasingly hot water until it is too late for a non-disruptive change. We can do better!
The journey begins with a validated burnout check-up, followed by our life-proven self-growth protocol, covering body, mind, and growth. Each module combines theory and practice and offers a set of interactive tools. The goal is creating a profound understanding, reconnecting with the inner self, and focusing attention where it matters. While the process devotes to the long-term perspective, it is only natural to address short-term needs. This led to the creation of an S.O.S. button that users love particularly much, bringing a variety of guided techniques for an immediate change of state.
We believe the future of mental health is based on digital phenotyping, personalized interventions, and daily monitoring of relevant metrics (e.g., digital biomarkers and digital behavioural patterns). Mental health has a direct and profound impact on all areas of life. It requires proactive attention and consistent, regular effort.
In addition to the self-help narrative, we are building a global online community. It unites all stakeholders under one roof – self-development aficionados, burnout endangered, burnout triumphants, and creators. The result is safe spaces, peer support, and courses by leading experts. We call it the BurnBright Club.
All of the above is meant to work elegantly as a self-help tool without needing a specialist. Still, it can serve as an expansion to specialist-driven interventions, adding monitoring, interactivity, and a digital behavior coach.
Research2Guidance: Interesting. What happens after the end of the 3rd month personalized journey?
Georgi Natchev: The 12-week course is sufficient for building fundamental awareness and planting the seed for more empowering beliefs and supportive habits. Creating profound, long-lasting change requires continuous, coherent effort beyond the three months window. Users are invited to stay within the App and Club so long they keep having meaningful added value, use the interactive tools, and experience empowerment.
Burnout is a highly personal, dynamic topic with risk factors continuously changing. Having a low-risk today by no means guarantees that the risk exposure is constant. In addition, burnout has a high risk of relapse due to persisting deeper-rooted causes and cognitive and behavioural patterns.
Lastly, there is plenty of talk about whether the individual recovers fully following a severe burnout episode. We may not have all the answers today, but we have our hearts at the right place for nudging regular exercise to improve the inner-balance, focus, adaptability, and stress resilience.
Research2Guidance: What is your strategy for engagement and retention? Awareness is essential but we can be aware that we need help and even know what we have to do, but still not doing it.
Georgi Natchev: A metaphor Peter Sage often uses goes like this „Knowing about something and not doing anything is equal to not knowing.“ Most people nowadays not only have the needed theoretical knowledge yet also have an awareness of something being wrong and have ideas for action. Nevertheless, any action is typically procrastinated, done inconsistently, or straight away ignored. Our mission is putting things into a more empowering context and nudging small-step daily action.
Engagement and retention are the Holy Grail in anything digital. We, as humanity, have reached a stage where all but very few of our needs are solved. To an extent, we are spoiled by variety, ease of access, the expectation of constant entertainment, and over-communication. Our attention span is worryingly short; we crave quick fixes and instant gratification. These pose a massive challenge for the entire Digital Therapeutics (DTx) vertical. Providers need to adhere to high medical excellence standards while competing for attention with leisure- offerings and cat videos. Many of the already validated Digital Therapies experience first 2-week drop-out rates beyond 50%, while only a handful of users complete the therapeutic program.
We are deeply obsessed with customer experience, user journey, and creating a delightful process:
All of the above is a crucial part of our DNA. Put into a practical perspective, only a year after launching Digiburn ver. 1.0, we are heading towards ver. 3.0, reflecting the intense learning and exploration of the user’s needs.
Research2Guidance: What trends do you see in the digital mental health space? Do you think digital mental health solutions will become a vital component of the standard of care?
Georgi Natchev: The digital mental health space has been enjoying a high degree of interest in recent years. Both in terms of pure lifestyle solutions – self-help, meditation, mindfulness – and more therapeutic-geared ones. Usage rates of lifestyle apps went through the roof after the first few COVID-19 lockdowns.
Another contributor is the growing number of clinically-validated apps approved for reimbursement in Germany – the DiGA list. Admittedly it is mainly Germany and the United Kingdom leading by example for Digital Therapeutic innovation and adoption, yet many more European countries are now obsessed with catching up quickly. On a general DTx note, 2023 ~ 2026 will be years of rapid development and European-wide coverage. It will be further reinforced by established players improving access and outcomes while tinkering with Go To Market strategies to become the default first point for care.
Digital mental health has already commenced. It holds massive upside potential (wink – digital phenotyping) and will lead to a long-expected leap-frog advancement in the otherwise stagnating mental health field.
Research2Guidance: What is your business model? How do you ensure your commercial success?
Georgi Natchev: We follow a hybrid of B2B2C and B2C.
Direct-to-consumer (B2C) contributes to our vision for health equity. Everyone in need deserves access. We are deeply obsessed with user- / patient-centricity, user journey, and health outcomes. The B2C channels help us stay nimble, innovate, and roll out updates quickly. It allows us to create a stronger connection with the user.
We have been exchanging regularly with organizations and insurers from the very beginning. This expands our scope by an additional layer for work environment monitoring. While we subscribe to an individual-centric take on burnout, corporations still have the potential to make better-informed decisions aligned with ongoing burnout-related factors.
Research2Guidance: Which countries / markets are of interest to you?
Georgi Natchev: Digiburn was born globally – even our team is based in 3 countries. We aim for Global coverage, starting with first steps within Europe. Some of our markets of interest include Germany, Spain/LATAM, the UK, and the Nordics. Digiburn 3.0 is available globally starting Feb-23, with planned translations to German and Spanish.
Research2Guidance: Paying out of pocket for your health in Europe is not that common. Yes, in some Eastern European countries, culturally, we are used to this, but not in the Western world. What kind of distribution channels are you using?
Georgi Natchev: Out-of-pocket payment for health is indeed exotic. However, considering the ongoing global mental health crisis and the burnout pandemic, individuals will need more options. As with anything mental health, there is no one-size-fits-all. It would take too long to rely only on insurers and enterprises to tackle the issue. An advanced burnout stage disrupts all life areas and is equally big of a liability to the individual and the insurer/employer.
Digiburn is available on Apple App Store and Google Play, with additional reach thanks to the online BurnBright community, completing elegantly the user needs across the entire burnout cycle.
Lastly, we praise authentic leadership by example. This is why we have been engaging with burnout triumphants (i.e., people who have already been through burnout) from the beginning. On the one hand, we highly value our triumphants for sharing their personal stories, empowering viewers to recognize warning signs earlier, and taking practical action. On the other hand, burnout triumphants are both sounding boards and dear partners for later growth.
We also look forward to working with open-minded specialists – coaches, psychologists, psychiatrists, and burnout-focused institutions open for a complementary behavior and monitoring piece to their regular practice.
Research2Guidance: What is your strategy towards employers and health insurers?
Georgi Natchev: Enterprises across Europe are well aware of the mental health crisis. The burnout polemic in Europe may lag behind North America’s, yet it is catching up rapidly.
The major challenge is employee activation. Employers struggle to establish communication, speak at eye level, and lead by example. A contributor to this is that burnout is already well-present across all hierarchical levels. This limits the capacity of organizations to act with empathy and deploy tools meaningfully. Another challenge is the rapidly declining use rate of meditation and mindfulness solutions (Apptopia, 2022). Employers are challenged by a combination of deteriorating mental health, decreasing loyalty, and overwhelmed leadership.
We put the user first. That’s all. We help the employee fall in love with the App by simplifying the big picture and chunking it down into small, easy steps, balanced for immediate and long-term impact. Falling in love means speaking at eye level, showing vulnerability, and offering unconditional support at scale – seasonal workshops, and content. Delivery is done by us or company internal champions, geared with our playbook.
Employers see Digiburn as the missing behavioral piece and anonymous feedback loop for work-environment monitoring in the context of burnout.
Insurers are excited to promote proactive health, especially in the mental health area. Tools like ours are hidden leverage for contributing to a long-term mindset shift for proactive health.
Research2Guidance: What will be the challenge in front of you when you conduct clinical trials?
Georgi Natchev: Aspiring for clinically proven software (i.e., Digital Therapeutic) brings plenty of challenges. In many cases, it either slows down innovation early on or completely shifts the focus on the “wrong” set of problems – anything but users-engagement, retention, and benefit. In our case, we are fully dedicated to the user journey, engagement and retention. We have some operational and regulatory expertise within the team and consult regularly. This helps us prepare on a high level for what is expected in 2024.
Research2Guidance: What is ahead of Digiburn?
Georgi Natchev: Even the longest journey begins with a single first step. I am very grateful for the hard work of our team and the support of all friends of Digiburn. Thanks to them, we made some first steps, derived learnings, and became increasingly adept at delivering excellence. For 2023 I wish us a handful of innovative corporate partners to validate and co-innovate the product-market-fit. We are also open to the right partner-investor to join us on the journey to a burnout-free society. The best is yet to come.
Research2Guidance: Georgi, it was a pleasure talking to you. Wishing you and your team at Digiburn all the best and a lot of success!
A burnout risk check-up. A life-proven 3-month self-growth course. A continuous digital behavioral coach. A set of powerful guided tools for immediate delight. Digiburn 3.0 available on Apple App Store and Google Play starting February 2023. For more information, please visit: https://digiburn.health/ and follow us on LinkedIn