On this episode, we’re talking about new solutions for mental illness. Psilocybin–the active ingredient naturally found in psychedelic magic mushrooms–is increasingly being used to help fight what is often called ‘treatment-resistant depression.’ COMPASS Pathways is one bold healthcare venture on a mission to fight human suffering at scale using a combination of a one-time psilocybin treatment, ongoing therapy and digital tools. To discuss this new direction for mental healthcare, we are joined by COMPASS Pathways Co-Founder and Chairman, George Goldsmith, as well as Ed Bolton, Creative Director of Brand in frog London. George and his team at COMPASS Pathways worked with frog to communicate their story and carve a new category for investors and patients alike.
Listen to the podcast episode and read the full transcripts below. You can also find us on Apple Podcasts, Spotify and anywhere you listen to podcasts.
Learn more about the collaboration from our COMPASS Pathways case study.
Design Mind frogcast
Episode 33: A New Direction for Mental Healthcare
Guests: George Goldsmith, Co-Founder & Chairman, COMPASS Pathways and Ed Bolton, Creative Director, frog London
[00:09] Elizabeth Wood: Welcome to the Design Mind frogcast. Each episode, we go behind the scenes to meet the people designing what’s next in the world of products, services and experiences, both here at frog and far, far outside the pond. I’m Elizabeth Wood.
[00:24] Elizabeth Wood: Today on our show, we’re talking about designing new and powerful solutions for treating mental illness. For this discussion, we’re joined by two guests. Up first is George Goldsmith, Co-founder and Chairman at COMPASS Pathways. COMPASS Pathways is a bold healthcare venture that is piloting clinical trials in using psilocybin–the active ingredient naturally found in psychedelic magic mushrooms–to help fight what is often called ‘treatment-resistant depression.’ George will share how the venture was founded out of necessity, and how the business is on a path toward fighting human suffering at scale. Later in the episode, we’ll also be joined by Ed Bolton, Creative Director in frog’s London studio, who was part of a frog team that worked with COMPASS Pathways to help tell their story, and to share more about what it takes to communicate the value of innovative care models. But first, here’s George Goldsmith, Co-founder and Chairman of COMPASS Pathways.
[01:20] George Goldsmith: I think you have to be a little bit naive and a little bit crazy to be a startup founder, and really motivated by seeing something that you think you can make a difference in–to be naive enough to pay attention to what’s possible, and naive enough to not pay attention to the risks and just dig in and get started. And so when you see something that needs help, it needs to be focused on, you lean in. And I think that this is really what is a startup founder’s mentality: leaning in, not taking no for an answer, realizing that nos are just a path to yes eventually, and to keep refining, refining, refining until it sticks or until it dies. So I think that’s really the core mindset, certainly, that I brought to being a founder. Hi, I’m George Goldsmith, Co-founder and Chairman of COMPASS Pathways. I think that there’s a restlessness in all founders that when you see something that just isn’t right, and you think you could make a difference, you do it.
[02:24] Elizabeth Wood: In the case of COMPASS Pathways, George and his team identified a real problem area to try and make a difference in: the state of mental illness on a global level, starting first with treatment-resistant depression. Worldwide, depression is the leading cause of disability and ill health.
[02:42] George Goldsmith: COMPASS Pathways is a mental healthcare company dedicated to accelerating patient access to evidence-based innovation in mental healthcare to help people live happier and healthier lives. When we look at the impact of serious mental illness, it’s huge. It affects individuals. It affects families. It affects the workplace. It affects societies, and our ability to make a difference in people’s lives one at a time–to really reduce the cost of care, to reduce the self soothing that so many people try to do through substance abuse and so forth when they’re suffering. All of these costs have a tremendous toll at the individual level and the societal level. We’re working really hard with health systems, payers and individuals to understand what is the cost of this? And how do we reduce the cost at both an emotional level and a financial level? And we have a lot of work on both of those dimensions. At the end of the day, we’re looking to make movement in both of those sets of measures.
[03:48] George Goldsmith: My background, my experience, is as a cognitive scientist, a clinical psychologist and a computer scientist. I’m always trying to be really interested in: What is the problem? How do we work together better? How do we produce better outcomes together? And that’s been my driving force.
[04:07] Elizabeth Wood: George and his wife partnered to found COMPASS Pathways after seeing the limits of conventional mental health treatment firsthand.
[04:15] George Goldsmith: We created COMPASS Pathways because it was a desperate need. Having experienced the failings of the mental healthcare system in the case of dealing with problems our son confronted with depression and OCD, we saw that it was just very difficult to find help that was really helpful. And despite working with psychiatrists from all different parts of the United States, he was unable to be helped. He kept getting worse side effects of medicines. And that was painful enough for us as individuals, but when we started talking to our friends and we heard their stories, we realized that everybody has a story and something needed to be done. We figured somebody better do it and it may as well be us.
[04:56] George Goldsmith: Probably the most definitive moment was sometime in February 2013. My wife, who is Dr. Ekaterina Malievskaia, her son was very ill. So she spent her sleepless nights as a mother doing medical research. And in one of her sleepless nights, she discovered an article about psilocybin, which is the active ingredient in Magic Mushrooms being used for OCD, which is one of the things her son suffered with. So she woke me up the next morning and said, “Hey, you were in the 60s and 70s, what do you know about this stuff?” And so for me, it turns out, I had been very interested in this at that time and knew quite a bit. And that started our journey to meet researchers, and to work with the researchers who are very brave, supported by bold donors and to be one of those donors to help move the field along. And that was really the beginning of our journey to form COMPASS.
[05:48] George Goldsmith: Well like so many journeys, it’s been a long and winding road. I think what’s been wonderful about this experience is just meeting all the dedicated researchers, so many of the patients, other donors at the time. But what we realized was that the model to create small academic studies was not at all what was required to create global reimbursed access for this innovation. So that’s what inspired us to create COMPASS and really led us to form a company, build a world class team, and to look at a new model of mental healthcare. And I think this is really the core of what we’re doing is how do we rethink and reimagine what mental healthcare can be for people?
[06:29] Elizabeth Wood: There are many misconceptions about depression as an illness, and a real lack of broad understanding of the patients who suffer from it. COMPASS Pathways sees a real opportunity to tackle the crisis with innovative new care models and 21st-century tools.
[06:44] George Goldsmith: When we talk about things like treatment-resistant depression, we’ve never met a patient that’s resisting treatment. We don’t really see the depression resisting treatment. It’s really a failure of innovation. We just don’t know how to care for those people at this point. So we believe that we have to take responsibility for that. We have to look at: how do we develop new models of care that actually help people? So treatment resistance is something that’s really much more people being failed by innovation, not failing innovation. Secondly, I think one of the things that’s been really important for us is when we talk to experts about even the nature of depression, they often consider it a chronic and remitting disorder–something that goes on for a long time. If people get better, they get better for a while, but they can always fall back into it. And we’ve come to really wonder whether that’s a reflection of the state of the care that we provide or really the definition of the underlying illness. And we’re really seeking to understand that better for everyone’s sake.
[07:47] George Goldsmith: I think the most moving moment for us in this whole journey has been really seeing the impact we’ve had for those patients who have responded. Obviously, not everyone responds. But those who do respond from years often of suffering, to see their benefit, to hear about how they’ve had an impact from just participating in the trial really helps us through all the incredibly complicated regulatory work and day-to-day work of leading teams and working across many different countries, many different languages. But it’s always the North Star of the patient experience that keeps us going.
[08:24] George Goldsmith: I think there are many opportunities for excellence in the current healthcare system. And I think that the two major ones are really adopting 21st century technology to enable us to collect data to really inform patient experience. And the second is a greater level of accountability for outcomes across the system, and to really make sure that we are delivering value and are reimbursed for that value delivery, rather than just providing inputs.
[08:49] Elizabeth Wood: Psilocybin, once seen as a drug used only by fringe communities or with potentially dangerous effects, is increasingly being viewed through a new lens when it comes to healthcare. Countries around the world are finally removing the stigma around the natural psychedelic, and are slowly experimenting with regulation that is allowing its use to treat mental illness.
[09:10] George Goldsmith: We’re looking at psilocybin, specifically psilocybin therapy coupled with psychological support and digital tools because it really gives us the ability to test a whole new model of care. One that is where psilocybin is provided to patients once or twice, in a carefully supervised setting, and that the benefits can accrue for weeks or months for those people who respond. That’s a very, very different model of care. And so how do we bring that new model of care to challenge some of the existing approaches, which simply aren’t working for enough people? So we thought that psilocybin was a really interesting compound that had significant benefits and could really challenge existing frameworks that simply aren’t working.
[09:56] George Goldsmith: There are really three parts to psilocybin therapy. One is preparing patients to have them understand what they might expect from this powerful psychedelic experience that’s always conducted in a safe environment with a therapist supporting them. The second element is the actual experience itself, which is a very large dose in a carefully supported environment that’s beautifully designed–it’s more like a living room than a clinical room. We provide music that is a soundtrack for the experience to help people have a calm environment throughout this. People are encouraged to have an inner journey, so we provide eye masks for them so that this is really like a very deep meditation, and it can be quite a beautiful experience. And we also have the ability to provide support with a therapist should people encounter thoughts or feelings that they need to express or need to discuss. And then the day after we really help the patient process and understand: What did they learn from this? Now, this is a very different model than day-to-day medications.
[11:03] George Goldsmith: I think it’s critically important to have this integration of psychological support and for the medicine, because at the heart of psilocybin therapy, we’re really working with patients around their narrative, the story of their life, how they think about every new experience, how they think about their past experiences. And for people with depression or anxiety or OCD in various forms, they typically have a negative tint to that. And they play that negative story over and over and over again. And what psilocybin allows us to do is to free people from that story, and consider other approaches and other stories for their lives, other ways to explain their experience. And that’s a very, very different paradigm, and one that we’re extremely excited to be researching.
[11:50] George Goldsmith: Well, when we started, we thought that what we would hear was “You’re doing what to whom with what?” But in fact, what we found was that so many people have a story in their family and their friends who suffer with depression, anxiety, OCD, PTSD. It’s all around us, particularly after COVID. And so once people understand that what we’re doing is viewing this as any other medicine and therapy combination, the sensationalism goes away and people get really quiet and curious. And that’s a wonderful place for conversation.
[12:24] Elizabeth Wood: Of course, defining a new category within healthcare or any industry is not without its challenges.
[12:30] George Goldsmith: The biggest challenge we faced in creating a new category is to help people understand that care is more than medicine. And that when we think about introducing a new form of mental healthcare, we have to really focus on the care aspect, which is the medicine plus the psychological support, plus understanding how a patient’s doing over time. And those three things need to be integrated in a much tighter way than they have in the past.
[12:55] George Goldsmith: If you think deeply about the impact that we’re seeking to have, it’s simply to have people participate more fully in their lives at scale. And this is something that, you know, we’re currently facing huge challenges with post-COVID–people not fully participating in their lives, anxious, depressed. And if we could change that, imagine what the world could be.
[13:17] George Goldsmith: What we’re hearing from patients is a couple of things. One is for those patients for whom this is effective, and that’s about a third of patients right now–we’re looking at how to make that number greater, but it’s only about a third. So this is not a panacea to be very clear. But for those who do respond, a couple of things come out. One is that they’re very grateful for the experience. It actually has a profound effect on how they see the world, how they see their world. Number two, people share about how it has changed their relationship with their symptoms. Now think about that. This is actually a person who has been almost a victim of symptoms, now having their symptoms be a companion, something that they’re aware of–something that they can learn from, but aren’t bullied by. And I think this is such a different shift in mindset that people have found it really refreshing.
[14:09] Elizabeth Wood: For COMPASS Pathways, telling the story of the venture was core to communicating the value of its innovative care models. This was core to why they came to frog in advance of its Investor Day programming.
[14:20] George Goldsmith: I heard about frog in the early 90s when I was working at Lotus Software, and very interested in your early work on human interface design and the technology aspects of what you were working on in terms of technology design. So I’ve known about frog for over 30 years.
[14:37] George Goldsmith: As Co-founder of COMPASS, one of the things we really struggled with in creating a new category is thinking about how to tell this story, which is a different story, a different approach to care. We had been working with various communications groups and consultancies, but they never really fully understood the breadth of what we were trying to do. And when we reached out to frog, we were just so impressed by the combination of design skills, communication skills, but also business strategy. And that combination really appealed to us in terms of how we could tell our story more effectively, how we could think about the value creation story–not only for investors, but first and foremost for patients–and how we can communicate what we’re doing in a way that is compelling, human and really caring.
[15:27] George Goldsmith: The core part of working with frog on our value creation story was really understanding what value are we creating for patients? And how does that extend into creating value for health systems, and therefore, for our investors? Understanding the golden thread that connected all of those things is being at the heart of the unique patient experience we can create. When you’re creating something new that is complex, how do we extract the simple messages that then lead to this fairly significant change? And frog was instrumental in helping us do that.
[16:02] George Goldsmith: I think as a company that has been on a very, very fast track, our work with frog helped us consolidate where we’ve been, but also set a new path for us to go forward. So a new look and feel, a new way of talking about ourselves. That is just the beginning. It’s a new palette. It’s a new way for us to be thinking about what’s next. And we’re really excited about looking at where that takes us.
[16:25] Elizabeth Wood: Making change in the mental health space cannot only be considered on a case-by-case basis. To make a lasting impact, COMPASS Pathways is exploring ways to reach as many patients as possible.
[16:36] George Goldsmith: We cannot change mental health care without thinking about doing that at scale. And in order to do it at scale, we need these digital tools to be able to create a cadre of therapists globally, thousands and thousands of therapists who are well trained, and we can’t imagine improving the care that patients receive without understanding: What is that care what works? What doesn’t work in the real world? So actually, the machine learning that we apply to the sessions is critically important, obviously, always with the highest standards of privacy and consent. And then lastly, I think, for patients, it’s the 21st century. They do everything from their mobile phones. Why not prepare and be supported in their most important journey, the journey to having a healthy and happy life? So those are all critical pieces.
[17:26] George Goldsmith: So we have an app that helps people think about breathing exercises and do a variety of things that are helpful to them in the session so they can prepare for the session. And then technology really isn’t used during the session, except to provide high-quality music to help support people. But after the session, the technology really helps us assess how are they doing? Much in the same way that a family member might. Are they more active? Are they less active? Do they spend time talking about themselves more or engaging with the world more? Because all of these measures help us understand: How is somebody doing? And is their trajectory more positive, more connected? So many of these so-called mood disorders are really disorders of connection. People become disconnected from their lives, from their loved ones, from others. And what we’re trying to do is to assess: How much are they getting reconnected to their lives?
[18:19] George Goldsmith: Our next model is going to be working in other areas of significant unmet needs, such as anorexia nervosa, post traumatic stress disorder and others that we’re currently thinking about. So we’re really looking at: How do we reduce suffering at scale in areas of high unmet need? We like to work on the hard stuff.
[18:38] George Goldsmith: It certainly takes a village to transform mental healthcare at scale. We work closely with governments here in the UK, with the NHS, for example, with academic institutions. We have over 20 academic institutions that we’ve partnered with and worked with to deliver our Phase 2 trial that’s been published in the New England Journal. That’ll extend greatly as we move into our Phase 3. This has to be done together because we are all in mental healthcare together.
[19:05] Elizabeth Wood: We’re going to take a short break. When we return, Ed Bolton, Creative Director at frog, will share more about the work the frog team did bringing the COMPASS Pathways story to life.
[19:16] Sesh Vedachalam: Hi, I’m Sesh Vedachalam, Strategy Director in frog’s London studio. With the climate crisis worsening, business have a crucial role to play—not just in reducing harm but going further to create better outcomes for people, planet and the future of the business. We believe that now’s the time to move beyond sustainability and into regeneration. frog’s new downloadable tool, The Regenerative Compass, draws on a powerful and holistic mindset to bring users closer to more meaningful, dynamic and adaptive products, services and experiences. Check this episode’s show notes to find a link to download The Regenerative Compass today. Find out how to ask the big questions in order to shift mindsets and arrive at radical, hopeful and equitable visions for the future.
[20:00] Elizabeth Wood: Now back to our show. Next up, you’re going to hear from Ed Bolton, Creative Director of Brand in frog’s London studio. Ed was part of a multidisciplinary team working together to communicate the value of COMPASS Pathways for investors and patients alike. Here’s Ed now.
[20:17] Ed Bolton: Ultimately, what we wanted to do with this piece of work is to change minds by creating a new category with an innovative care model. That’s the combination of the compound, therapy and digital tools. And through that combination, we really want to try and stop suffering at scale and take on the mental healthcare crisis. My name’s Ed Bolton. I’m a Creative Director of Brand at frog.
[20:40] Ed Bolton: What’s rewarding about working with a company focusing on ending the suffering and the mental health crisis is that the more you start to think about it, the more you realize how mental health affects everybody. And everybody has a story, whether it’s a personal story or a family member or a friend who is suffering at some point from mental health issues. So being able to be part of a journey which is looking at innovative ways of solving the mental healthcare crisis was personally and professionally very rewarding for me and the team.
[21:12] Elizabeth Wood: Like many new to psilocybin therapies, the frog team had to become more familiar with the nature of psilocybin-based treatment, and absorb some hard truths about the enormous number of people who suffer from depression worldwide.
[21:26] Ed Bolton: There are lots of misconceptions about psilocybin treatment. I think a lot of people think it’s people running around the woods eating magic mushrooms and the psychedelic movement from the 1960s. This is not like that at all. It’s very rigorous. The important part is that it’s therapy-backed. So the therapist works with the patient and really understands the issues of trauma, where depression comes from.
[21:48] Ed Bolton: I learned a lot about depression during this program of work. 320 million people live with depression globally and 30% of them are not helped by first and second line treatments. They are diagnosed with what’s known as ‘treatment-resistant’ depression. It was really interesting to listen to George talking about this because it’s not the patients who are resisting the treatment and it’s not the drugs that are resisting the treatment. It’s a term given to people who have been failed by the usual healthcare pathways. And so really understanding this group and how often treatment-resistant depression people lead to suicide became a really interesting mission.
[22:24] Elizabeth Wood: Over the course of the program, the team learned a lot from the COMPASS Pathways team about the scale of the crisis they are trying to solve, which they then used to tell the venture’s story.
[22:34] Ed Bolton: We had a really impressive team working on COMPASS Pathways. It was a great mix of creatives such as designers, copywriters, visualizers, animators, alongside an impressive bunch of strategists who looked at the commercial strategy alongside the brand strategy, and also thinking of how we can articulate the innovative care pathway model.
[22:54] Ed Bolton: It’s great working with this type of client. You get to have conversations directly with the founder which influences your work, and there’s a real hunger from their side to achieve something. This is innovative unknown territory with the ultimate aim of getting these types of compounds approved by the FDA for the use of treatment of mental illnesses. So this is a personal mission. There’s a real mission here to achieve something.
[23:15] Ed Bolton: We know that people really suffer with depression, not from depression. And for many of these people, depression never goes away. It stays with them for the rest of their lives. When we learned about the high number of people with depression worldwide, we started to think about why. And there was a number of reasons that came up. Even though mental health is more widely talked about today, which is fantastic, there are many communities around the world which hide it from their friends and family because it’s seen as a shameful thing.
[23:42] Ed Bolton: A really important heartwarming moment for me was listening to the COMPASS Pathways leadership team talking about their own personal experiences of mental health. Whether it was their family members or themselves, everybody within COMPASS Pathways has a story, and in some cases some people have come out of retirement to join COMPASS Pathways on their mission.
[24:00] Elizabeth Wood: One result of the program was a communications campaign called “Everybody has a story.” Ed shared how the frog and COMPASS Pathways team landed on this platform, and what they were trying to achieve with its message.
[24:13] Ed Bolton: When we were working with COMPASS Pathways, we focused on creating a really robust commercial strategy for the business to look at increasing their investment overall. But equally important was focusing on the human suffering behind mental health. “Everybody has a story” was a line that George would mention in some of our meetings and it started to grow on us. We began to create some communications for it.
[24:27] Ed Bolton: “Everybody has a story” became a platform to get the human stories out there, the real suffering. We worked with a psilocybin patient called Kirk and did a documentary, or mini- documentary of him, in his friend’s house, talking very powerfully about his experience with treatment-resistant depression that was brought on by the death of his mother. How he suffered from it, how he started to find it very, very difficult to live with. He then did the therapy-backed psilocybin treatment and while it didn’t cure him, it gave him a completely different outlook on life. It gave him the tools and the processes to deal with his depression. It’s a really powerful two-minute documentary and we hope to do more of them because we really believe everybody has a story.
[25:19] Ed Bolton: When we decided to make the mini-documentary of Kirk, we first started off by jumping on a Zoom call and discussing with Kirk about how comfortable he would be talking about his experience. It’s obviously very personal. It’s very traumatic. So we wanted him to be comfortable with discussing these things on camera. He was incredibly warm.He was really up for it. He even suggested filming at his friend Anthea’s house. On the day, we worked with our production partner to turn up at the house, where we created the right type of backdrops. We spent the whole morning just interviewing Kirk. It was a really, really powerful testimony. Raakhi, the copywriter on the team, sat with him in the room. Everyone else left, and she spent two to three hours just talking to him about his experience. And by the end of it, everybody was in tears because it was such a powerful personal recollection of his experience with depression.
[26:14] Elizabeth Wood: The short documentary the team put a personal focus on a profound social problem. You can find a link in today’s show notes to the frog and COMPASS Pathways case study to see the video for yourself.
[26:25] Ed Bolton: The ultimate aim of the video was to show that everyone has a story. We showed it on their Investor Day to show the human side of what COMPASS Pathways is doing to connect it to the investor information that goes along with it. Part of our work was to look at COMPASS Pathways and create a new brand expression for them. We came across this idea of a graphic which represents the mind of a psilocybin patient, how we can start to influence and move and morph interesting graphical ways. And that became the cornerstone of our visual approach. Our work had a profound effect on their Investor Day. There was a 340% increase in investor inquiries about COMPASS Pathways from investors and there was a 33% increase in website traffic on the day.
[27:07] Elizabeth Wood: For the team, Investor Day was just one important step on the path toward expanding COMPASS Pathways’ reach–and not a moment too soon. The work is all in service of treating depression and other mental illnesses in new, deeply effective ways.
[27:22] Ed Bolton: Our generation is finally breaking down the stigma around mental health, but we are still just scratching the surface, especially around the serious mental illnesses such as PTSD, treatment-resistant depression, PTSD and anorexia.
[27:36] Ed Bolton: For me, I think the role of creative storytelling is really important in today’s businesses. It’s a way to understand information which really resonates with customers, audiences and in this case patients–to be able to communicate things which could be quite complicated, that don’t always resonate on a human level, and being able to attach it to a story which can really cut through.
[27:55] Ed Bolton: Throughout this project, I had the words of frog’s founder Hartmut Esslinger in my mind. He said that “form follows emotion” and it’s the idea that we can create things, whether they’re experiences or products or whatever it is, but they need to have an emotional connection to the customer. That was a really powerful insight on how we started to link the business model with the innovative thinking and the emotional side of what COMPASS Pathways does. We’re really looking forward to continuing the relationship with COMPASS Pathways and being a partner as they grow.
[28:26] Elizabeth Wood: That’s our show. The Design Mind frogcast was brought to you by frog, a leading global creative consultancy that is part of Capgemini Invent. Check today’s show notes for transcripts and more from our conversation.
[28:38] Elizabeth Wood: We really want to thank George Goldsmith and the team at COMPASS Pathways for sharing the story of the important work they do to fight mental illness at scale. Check today’s show notes for a link to the COMPASS Pathways site, for more on the work in the case study, and to see the short documentary titled “Kirk’s Story.” Thank you also to Ed Bolton, Creative Director at frog UK, and the rest of the frogs who helped bring this important work to life.
[29:00] Elizabeth Wood: We also want to thank you, dear listener. If you like what you heard, tell your friends. Rate and review to help others find us on Apple Podcasts and Spotify . And be sure to follow us wherever you listen to podcasts. Find lots more to think about from our global frog team at frog.co/designmind. That’s frog.co. Follow frog on Twitter at @frogdesign and @frog_design on Instagram. And if you have any thoughts about the show, we’d love to hear from you. Reach out at frog.co/contact. Thanks for listening. Now go make your mark.