How Charlie Health wants to tackle the loneliness epidemic

Loneliness is reaching epidemic levels, driving up cases of anxiety, depression, and contributing to record-high suicide rates. Carter Barnhart, founder of the virtual mental health platform Charlie Health, says the issue goes beyond simple explanations like social media overuse. Rather, she points to our collective inability to connect. Barnhart seeks to build a collaborative solution to help people relearn the power of authentic connection. (Note: Today’s Rapid Response includes mentions of suicidal ideation as well as sexual assault. If you or someone you know may be struggling with thoughts of suicide, contact the 988 Suicide & Crisis Lifeline by dialing 9-8-8.)

This is an abridged transcript of an interview from Rapid Response, hosted by Bob Safian, a former editor-in-chief of Fast Company. From the team behind the Masters of Scale podcast, Rapid Response features candid conversations with today’s top business leaders navigating real-time challenges. Subscribe to Rapid Response wherever you get your podcasts to ensure you never miss an episode.

Can you just give me a sentence or two about what Charlie Health is?

So, Charlie Health is a virtual mental health care provider that specializes in the high-acuity population. That’s people struggling with depression, anxiety, suicidal ideation, and self-harm. Our clinicians provide intensive support for individuals who need more frequent care than just once-a-week outpatient therapy. Typically, they’re transitioning from an emergency or residential treatment, or maybe you’re in once-a-week therapy and need to step up to something higher.

I’m wondering if you can clarify for me our expectations about mental health treatment being different from what works. You have mentioned “rich kid rehabs” versus the power of group therapy. Can you explain what that difference is?

I spent the first 11 years of my career running residential treatment centers. Part of a residential experience is group therapy. That group therapy—I saw how profound it was for individuals. And what I knew was, when we created Charlie Health, we needed to create an experience where people could hear “me too.”

We pair clients together based on their condition, age, the modality of treatment they’ll benefit best from, and their lived experiences.

So we can put them into a group where they see people who look and sound like them. In that group, the curriculum we deliver is based on all the data we have from previous clients who are similar to them. We’re able to constantly innovate on what that curriculum is to deliver the best possible group experience.

So I guess the more your system grows, the better, in theory, this treatment gets because it becomes more personalized, without necessarily costing you more to deliver that personalization.

And that’s what really excites me about Charlie Health. Historically, in behavioral health, as treatment programs have scaled, the quality has gotten worse. For us, because we’re able to leverage technology to really improve care delivery, our treatment gets better.

What do you think adults most misunderstand about the mental health of young people?

I think adults often want to blame social media. I see many parents reaching out to me to ask, “What do I do about social media?” They think social media is causing this crisis. “My kid is profoundly struggling because of Instagram, because of Snapchat.”

That’s certainly a piece of it, but it’s so much more. We can’t blame it just on social media. Our species, human beings, have been on this earth for 200,000 years. We lived in small hunter-gatherer groups as communal creatures where children were with parents all day, and the whole community acted as parents. The interests were communal, not individualistic and competitive but collaborative, connected. We’ve lived like that until about 15,000 years ago. In the context of 200,000 years, that’s about five minutes. We’ve only been living like this, in a disconnected society, for five minutes.

Modern society has exacerbated this disconnection. To heal this generation, we must focus on making people feel more connected. How can we foster genuine human connections for those who have experienced trauma? How can we help them heal and reconnect with their authentic selves?

I think young people are starting to catch on to that. You’ll see parties where they say, leave the phones at the door. They’re creating ways to prioritize connection because they know they need that. The misunderstood thing is there’s not just one problem. It’s not just social media. I wish it was that easy, Bob. If we could just take away social media and everything would be fixed, that would be great. But it’s not. We have to teach people to connect again. We don’t have to be this competitive society; we can work together.

Are there ways to use the big digital platforms for meaningful connections, or is that a trap?

I think there’s a way we can leverage technology for meaningful human connection. The goal should never be to replace face-to-face interactions. During COVID, we had people in rural communities who were isolated, and we used technology to bridge the gap. Creating safe spaces, especially for people struggling with mental health, can be powerful. Clinicians can guide and facilitate to show people they’re not alone. Social platforms can be powerful if we use them for good.

What’s at stake for the mental health of Americans?

I like to talk about hope instead of what’s at stake. We know we’re in a mental health crisis. The hope is, for the first time, we have solutions. We don’t just have to accept what’s happening. That takes partnerships between payers, government, individuals, schools, hospital systems. It takes collaboration—but there is hope. Treatment has been proven to work. That’s a message everyone needs to hear. As a hopeless teenager, I wish someone had told me this would get better. With the right form of treatment, you’ll feel better.

It’s our job to build this world. At Charlie Health, we’re building a world without suicide. We believe if every person has access to care when they need it most, we can build a world where suicide doesn’t exist.

For business leaders listening, your business has grown fast. Are there key lessons you’ve learned in scaling quickly?

So many lessons. For me, personally, I’ve learned I don’t have to be for everyone, and that is liberating. Since founding Charlie Health, I’ve learned not every decision will resonate with everyone, and that’s okay. We went from zero to 1,500 full-time employees in four years. Early on, I tried to accommodate every perspective, every person, thinking if I didn’t, I wasn’t leading effectively. But as we’ve scaled, I’ve realized trying to please everyone is counterproductive and unsustainable. Leadership is about staying aligned with your mission and values, even if decisions won’t be popular. This has allowed me to lead with clarity and purpose, strengthening our organization.

I get asked all the time, how do you balance the heaviness of Charlie Health? What we do is emotionally draining.

How do you recover? How do you show up? For me, having a purpose is most important. I’m happiest when solving a big or small problem, but a concrete one. That’s when I experience joy. I have to stay true to myself there.

So you’ve had this great growth. Where does Charlie Health go from here?

We’re live in 37 states today. I would like to be in all states. Five years out, I hope Charlie Health is known as the standard for measurement-based care in mental health, with a tangible reduction in suicide rates across the country as proof of our impact. I hope when we enter communities, they can say, because of Charlie Health, the suicide rate has decreased.