It is a good time to talk to someone.
Before the pandemic, the World Health Organisation declared mental health a crisis, reporting that one in eight people globally had a mental health disorder and that depression was expected to become the leading cause of disease burden by 2030.
Then 2020 happened. Grief, isolation and trauma have been the three horsemen of this new apocalypse and solutions are popping up everywhere to address them.
Japan named a minister of loneliness to stem rising suicide rates. Singapore is offering Wysa, an emotionally intelligent chatbot, free of charge to residents for a year to help them cope with mental stress. Even Gwyneth Paltrow led a venture capital investment round in an accessible online counselling service in the US.
Abu Dhabi has its own solution.
Entrepreneurs Khawla Hammad and Inas Abu Shashieh developed Takalam, an online counselling platform that matches people or couples with licensed counsellors. Users have the option of one-on-one sessions through video, audio and instant messaging, and can opt to remain anonymous through the platform that was launched last year.
Ms Hammad and Ms Abu Shashieh came up with the business long before Covid-19 made them an in-demand darling of the capital’s growing start-up scene.
They met in 2009 while working on youth employment programmes at the Emirates Foundation.
“We clicked immediately,” says Ms Abu Shashieh. Ms Hammad interrupts her to emphasise that “we both like to get things done”.
While their paths diverged professionally over the next decade, they kept in touch and bounced start-up ideas off each other as they looked for ways to collaborate.
“We still own the domain name of one idea that didn’t work out, but maybe one day,” says Ms Hammad.
The idea they stuck with – Takalam, which means “talk” – came to Ms Hammad in a job interview.
Asked if she had any ideas for how to improve the quality of life for Abu Dhabi residents, Ms Hammad, an Emirati, thought for a moment.
She had just returned after living for several years in Washington with her husband, during which time she worked as an independent consultant for start-ups between the UAE and the US, earned a master’s degree in international business from Georgetown University and had a baby.
She loved the US but had postpartum depression and found it hard to access good resources to help.
She also knew of the rampant stigma of speaking up and receiving mental health counselling when needed – not just in the Arab world but in the western world, too.
“I suggested a counselling platform to help remove the barriers to getting help in Abu Dhabi,” she says.
She was met by blank stares from across the table. Her interviewers – all men – did not understand how that would help residents at all.
So, she called her friend. “I didn’t want to work an office job, anyway.”
Ms Abu Shashieh, who is from Jordan, said it touched on themes that were important to them – most of all, that the work would be mission-driven. They wanted to help people.
Part of their success will depend on whether they can ride the wave of telemedicine and sign on employers and insurers to cover the cost of Takalam’s services.
In the UAE, demand for counselling via telehealth services surged during the coronavirus pandemic, according to health authorities. The number of individual counselling sessions reached about 5,600 between April and October.
Over the past year, the pair – with the help of a rolling cast of university students they brought on as interns – developed a platform offering mental health counselling in Arabic and English.
Early on, even before they had built the website or vetted and brought on any counsellors, their pitch was rejected by Ma’an, Abu Dhabi’s social impact fund.
But they did not listen to their first “no”. They stuck with the idea and kept working on the platform.
“I would be up at 3am scrolling through LinkedIn,” says Ms Hammad, describing the process of finding licensed counsellors in the UAE.
Over the past year, they have brought on 40 counsellors.
Takalam also found an early home at the Innovation and Entrepreneurship Centre at Zayed University, Ms Hammad’s alma mater.
Noura Al Kaabi, Minister of Culture and Youth and president of the university, was an early supporter, calling it “a new beginning to increase the help-seeking behaviour within our community”.
From there, the start-up was invited to pitch at Gitex Technology Week in Dubai.
By this time, with a more honed pitch and proof of concept, Ma’an was ready to take on Takalam.
In the third quarter of 2020, the two co-founders joined a group of ventures tackling mental health, a social priority identified earlier this year by the Abu Dhabi government in response to the growing need for initiatives in the region to help negate the social impact of Covid-19.
This is a critical year for Takalam as it could determine whether it succeeds or fails.
They are being provided with office space at Hub71 and licence registration at the Abu Dhabi Global Market, Abu Dhabi’s financial free zone, as well as one-on-one mentorship and coaching through Plug and Play ADGM.
They are also receiving support with introductions to potential customers and investors, including major healthcare providers and insurers to support the cohort’s theme of mental health.
Takalam aims to scale up more quickly through contracts with employers, which is more lucrative than selling individual counselling sessions at $30 to $170 an hour. It is also looking to expand its services into Saudi Arabia, the Arab world’s biggest economy.
So far, with the added support of the incentive programme at Hub71, Takalam has been bootstrapped.
To support expansion, it expects to court angel investors this year.
Jerome Droesch, chief executive of Cigna Insurance in the Middle East, Africa and South-East Asia, told The National he sees a growing market in general for mental health services, as the region no longer considers it "a nice to have".
He says insurers are increasingly open to developing more innovative solutions that are accessible and cheap.
“Now it has become an essential need and organisations must be forward-thinking to understand that one size does not fit all,” he says.
For now, Ms Hammad and Ms Abu Shashieh are focused on educating the community about the importance of mental health.
They have been shocked by the amount of stigma that still prevails around talking to someone or even “just taking that first step”, as Ms Hammad calls it.
Arab millennial women are its first target demographic – a group they narrowed down after extensive surveys.
“If the women are OK, then the rest of the world will soon follow,” says Ms Hammad.
Q&A with Takalam co-founder Khawla Hammad
1. What successful start-up do you wish you had started?
The New York-based Talk Space for teletherapy. They are the market leaders and have been on top of their game. Even though they have so many competitors in the market, they were able to lead and position themselves uniquely. They continue to catch the attention of investors and recently closed a series D funding round of $50 million to help reach more users. The company is planning to go public soon.
2. What new skills have you learnt from launching your venture?
Since I ended up doing almost everything and wearing different hats to be able to get the company off the ground, I learnt many new skills in a short period of time that I would not have been able to gain in a regular job. All are valuable and important skills, where I got to appreciate the roles of each.
Although they were not always the things that I enjoyed, they had to be done. Things such as accounting, the handling of legal documents, human resources and even the smallest administration jobs that are typically easier to outsource. However, it is not always an option.
3. What is next for Takalam?
We plan to continue building our artificial intelligence and machine learning capabilities to add new features that would make our technology as “smart” and efficient as possible. This will help us future-proof our business by introducing features to help automate diagnosis and augment therapists, as well as monitoring between sessions.
Furthermore, during 2021, we plan to launch our services in the Saudi market, which is a huge step for us.
We are also interested in scaling up to test other much further markets such as North America, and carving out the niche of the Arab-American diaspora who may find solace in the familiarity of like-minded therapists who share the same culture, and most importantly, the approach with respect to stigma.
Last but not least, we are going to begin seeking funding from strategic angel investors and early stage venture capitalists who can help us scale up and calibrate our approach for the next stage of growth.
If you could do it all again, what would you do differently?
We are almost a year old, and considering the type of year 2020 was, I do not think there is too much we would have done differently from a strategic or conceptual level, in terms of positioning and mission. Arguably, there may have been some value in testing the concept earlier, as I had contemplated it for a few months before, so that may have allowed us to be hitting our stride during the lockdowns when people needed the service most, rather than building our technology at the time.
What changes in healthcare should patients expect in the next decade?
Things are already changing and we have noticed a big shift that happened due to the pandemic, where healthcare providers had to adapt to the new situation so fast and depend heavily on technology.
The industry will keep on evolving as we go and I imagine the use of virtual and augmented reality will be introduced to enhance the patient experience and increase accessibility, especially in remote areas. I also believe with the advent of genomics and predictive and personalised health care, there will be a great emphasis from people who are keen to look after themselves and stay healthy proactively, which is a positive thing.
Regulations and restrictive practices in terms of telemedicine that may have been driven by commercial and protectionist considerations will be removed. New vetting criteria for cross-border telehealth will come into play, democratising access and reducing costs, and increasing optionality amongst patients, which hopefully becomes a forcing function to elevate quality as a differentiator.