Shortly after receiving a diagnosis for depression seven years ago, Ahmed Abu Elhaz was hard-pressed to find psychotherapy services that were professional, reliable and cheap.
The glaring market gap inspired the young Egyptian entrepreneur to set up Shezlong, a Cairo-based start-up that provides online counselling services to Arabic speakers around the world from the comfort and privacy of their homes, in addition to addressing the social stigma around seeking mental health support.
Negative attitudes towards mental illness have meant that women in some countries have inadequate access to the required support, says Mr Abu Elhaz. Those battling mental health issues are often considered to have weak faith or poor resilience and people who try to seek professional help are often subjected to shame or ridicule, he says.
“There is major social stigma in talking to a therapist or going to a psychiatry clinic and this is one of the big reasons behind starting this company,” says Mr Abu Elhaz.
The entrepreneur recognised the need for quality mental health services in the Arab world before the outbreak of Covid-19. However, demand grew after the onset of the pandemic as grief, stress, financial uncertainty and feelings of isolation took their toll on many.
“The pandemic highlighted the symptoms more clearly because people stayed at home and were confronted with themselves or their partners. Before that, they were distracted with daily routines but now the pandemic has made their troubles clearer [to them],” he says.
Even before the onset of the crisis and lockdowns that followed, the Organisation for Economic Co-operation and Development said in June report that one in every two people had experienced a mental health condition at some point in their lives while one in five were living with a mental health condition at any given time.
Since the start of the pandemic, stress levels have increased, with cases of anxiety and depression doubling in some countries.
“Definitely demand is greater because the symptoms show more and people see the need for therapy,” says Mr Abu Elhaz. “They are staying home more and have more time to prioritise.”
Shezlong has grown from an operation with three therapists in 2015 to more than 300 counsellors from 18 countries. They serve 80,000 users from 80 countries, with Egypt and Saudi Arabia being the biggest markets.
The name Shezlong is derived from chaise longue, the French word for the long reclining chair typically associated with psychologists’ offices.
Mr Abu Elhaz says providing mental health therapy in Arabic is important as it allows users to connect better with their counsellors.
“There are a lot of Arab expats looking for a solution in their native culture and language,” he says, referring to Arabic speakers in the US, Canada, Europe, Australia and Asia.
In Egypt, Shezlong offers online counselling sessions that start from 100 Egyptian pounds ($6.40) while rates for users outside the country range from $30 to $100, with the company coming up with several promotions.
Clients are typically between the ages of 25 and 45 years. About six in 10 are women and they are a mix of professionals, homemakers, mothers and couples.
The company is riding the telehealth wave that began during the pandemic and is helping to eliminate the stigma associated with visiting a therapist’s office.
“Telemedicine gives people more privacy than going to a clinic: you are in your own home, you are more comfortable and you do not need to worry about transport headaches or waiting lists at the clinic,” says Mr Abu Elhaz.
“The accessibility, convenience and variety give telemedicine an edge over traditional clinics.”
He believes telemedicine is here to stay even after the pandemic has been brought under control.
“It has become a culture, like Uber or Careem,” Mr Abu Elhaz says. “Why go to a clinic when you can stay at home and do a session online?”
Shezlong’s revenue, users and sessions grew by three and a half times last year, compared to 2019, but meeting demand remains an issue as there are fewer therapists in the Mena region, he says.
Mr Abu Elhaz called for more regulation and oversight of the profession across the region to ensure that therapists are qualified, ethical and professional.
Shezlong’s therapists are accredited by the government, have health ministry licences, hold at least a master’s degree in their field and have between four and eight years of experience, he says.
The start-up is now focused on boosting its business by signing up more employers directly to cover the costs of its services.
Despite mental health care becoming a necessity rather than a luxury, it is not covered by many insurance companies in Egypt and other Arab countries, says Mr Abu Elhaz.
Shezlong, which last year closed a funding round for an undisclosed amount from investors such as Singapore’s AAIC, is now seeking to raise additional funds.
The mental health platform is currently in talks with investors in the Gulf and Europe to raise $2 million and expects to close a deal in the next three months, says Mr Abu Elhaz.
It will use the funds to hire more therapists, ramp up marketing in the Gulf, open a new office in Riyadh, grow its business-to-business model with more outreach to employers and introduce artificial intelligence tools on its platform.
“We want to build different products, achieve vertical growth by introducing texting therapy or life-coaching and expand horizontally by opening new markets,” he says.
Founder: Ahmed Abu Elhaz
Sector: health technology
Size: more than 30 employees and average annual revenue in excess of $1 million
Investment stage: Series A
Investors: Endure Capital, 500 Startups, A15, HIM Angels, Karim Hissien, AAIC
Q&A with Shezlong founder Ahmed Abu ElHaz:
What is the next big dream you wish to make a reality?
Making mental health accessible to Arabs living in the region and in the diaspora all over the world through Arabic-language therapy that is culturally sensitive.
What new skills have you learnt in the process of setting up your company?
I learnt how to create a product that people can use in their daily lives, as well as managing people and ensuring they love what they do.
How has the Covid-19 pandemic affected your business?
The pandemic has affected our business in a very positive manner since we provide mental health services online.
How important have mental health services been during this global crisis?
During the pandemic, mental health issues were on the rise because people’s anxiety was running very high.
Where do you see your business in the next five years?
We aim to expand horizontally by opening new markets while growing vertically by launching new products.
What changes in health care should patients expect in the next decade?
We expect post-pandemic health care to better connect all stakeholders – including hospitals, doctors, insurance companies, patients and governments – digitally.