The Zac Clark Show - The Mental Healthcare System Treats People Like Criminals | Ariela Safira, Founder of Zeera

Episode Date: June 4, 2024

In this conversation, we dive into the mind of Ariela Safira, a visionary determined to revolutionize the mental health care system. Ariela is the founder of Zeera, a modern telehealth platform that aims to "spotify" mental health through the principles of group therapy and a modernized approach that speaks to today’s social media-powered society. She is a Forbes 30 Under 30 honoree, the recipient of the American Psychiatric Association’s Innovation Award, and one of Inc's Top 100 Female Founders. With Ariela, we explore the idea of creating a "Spotify of Mental Health," the importance of educational reform in mental health awareness, why our healthcare system is at its worst when people need it the most, how to foster supportive environments both in the workplace and personally, and how to move beyond the stigmatization and criminalization often associated with mental health and substance use issues. Please give it a listen as we uncover how to "mental health" for ourselves and others, guided by a leading voice in the field. Connect with Zac https://www.instagram.com/zwclark/ https://www.linkedin.com/in/zac-c-746b96254/ https://www.tiktok.com/@zacwclark https://www.strava.com/athletes/55697553 https://twitter.com/zacwclark If you or anyone you know is struggling, please do not hesitate to contact Release: [phone] releaserecovery.com @releaserecovery Check out Zeera: https://www.zeera.com/

All right, welcome back to the Zach Clark Show, where we are starting to build some momentum. And that's going to continue with today's guest, Ariela Safira. She's the founder and CEO of Zira, which we're going to get into all that. We first met and bonded over our love for mental health, which I appreciate. Incredible story, undergrad, Stanford, bachelor's and mathematics and computational science. And then you kind of like launched into this mental health journey, which we're going to get into, which included like going to Columbia and then dropping out and starting this company. So Ariela, I stopped there. Welcome.

Thank you. Thank you. I'm excited to chat today. My first question is if you've met Ariel, which many of you probably haven't, but I have now twice, you're immediately greeted by this hug and she hugs everyone. And so my first question, like, is that real? Is that like, what, like, is that? Yeah, I think so. Okay.

I just, it's so heartwarming. I mean, like, most people you meet, especially in New York City, it's like the hand goes out. Or it's like, you know, is that something that you've just learned to. Yeah, you know, I don't know if I shared this when we last hung out. But my dad was raised in a commune. very like earnestly hippie-dippy and I would probably attribute anything I do that has any semblance of kindness to him and many of you have said my dad's like the only man they know who like hugs and kisses as well so I probably was lucky to have that uh him inform my

hugging ways I don't think it's ever been so bluntly addressed like that though Well, I just, I mean, like, you were obviously greeted when you walked into our office and you kind of went down the line and hugged everyone. I was like, this is the energy we need. We need more huggers, I guess. No, hugs. I mean, oftentimes, especially in this work, when we're dealing with difficult clients, they're like, they just need a hug. Yeah. Like, that's a lot of times when, like, there's that, it's like, you just need a hug.

So I appreciate that. And I just appreciate, you know, everything that you're doing. You mention your dad, family. Where did you grow up? Like, where are you from? Like, where did you grow up? I grew up in New Jersey. Okay.

I love that. And both my parents were immigrants. So had a multicultural upbringing in the garden state. Amazing. Are you a proud Jersey born and bred? The more people insult it, the more proud I get. Okay. Yeah.

I'm the same way. Yeah. It's like, even with the, so my family, we go to C. Isle, which is South Jersey Shore, and it's beautiful. And most people that talk about the Jersey Shore think of the television show, which I get because it's like MTV and everyone knows MTV, so everyone thinks Jersey Shore and the whole thing. And I'm very, I take a lot of pride in introducing people to other. parts of New Jersey that are actually pretty beautiful. Yeah, we did Wildwood growing up, but I know Seattle City well. Yeah, wow, with the, uh, Mori's Pier and the, the, the amusement parks.

Yeah, of course. So you know it all. Still very close to my high school friends. So you go to school at Stanford and underachiever, I joke, impressive. And you're there and kind of your impetus or like you're, you're, you're starting to scratch the shirt or something like take me yeah I'm always very curious how people for me it's very clear like I was a drug addict I was shooting heroin I was drinking too

much I went to rehab and I was like I'm going to do this the rest of my life I'm going to try and pay this forward but for you how did you get into this behavior health care mental health yeah space yeah so when I was at Stanford a friend of mine had a very traumatic experience with her mental health trigger warning when you talk about suicide she had to to take her life and that was the first time I had ever seen mental health care you know she immediately went to um Stanford's inpatient mental health facility from there would go to another inpatient from there an outpatient meds therapy etc and had reached out to me once she um I couldn't name where she was when she reached out to me but I visited her

once she was an inpatient and it was the first time I had seen any of the mental health care system and I thought it made no sense and one of the first points I felt or thought was you know I walk in here and I feel scared how is she supposed to feel safe here right she in a lockdown like a psych ward or you don't really do you remember yeah yeah okay so an impatient psych ward 100% yeah in California in California and she was a college classmate of yours and and um yeah like this place completely lacks I mean at that point my I was like this place lacks warm I'm scared to be here, you know, and then she would move on to outpatient and, you know, as you know, have a roommate and, I mean, the whole environment, like, this is, I am not, I am someone who at this point feels very mentally stable and like, I'm nervous being here. How is someone who's in such a vulnerable state supposed to feel, grow here and develop here, feel safe here when like it's lacking? I didn't talk about hugs. It's like, it's lacking any semblance of like warmth. in safety, right?

And then once you get to talking, at that point I was functioning as a friend who was inquisitive, angry, you know, asking, like, you know, how are we, why are we moving her from one place to another? And like, why these meds? And does anyone know what our therapist said? And why is this her, like, agenda for the day?

And something that's so scary, I think, about mental health care, more than any other form of health care, is like so many loved ones. So I'm going to say so many loved ones let go. I don't mean they give up on their loved one or they don't care, but there's so much fear and panic. And like, I don't know what this looks like.

Like, oh, my God, she just did something that I would have never imagined doing. So I'm just going to trust what the doctor say. And I tend to lead maybe not with trust. And instead, you know, she still seems scared, right? And putting aside any clinical definitions of illness, I'm just like, she's horrified. And so I kind of, at that point, kicked off what would become a never-ending mental health journey and left college. I left Sanford, thought I would drop out entirely to start this company.

And after a year away, one of my advisors had told me that if I want to change health care without a medical degree, it's going to be tough. If I want to do it without a bachelor's, good luck. That's good advice. I mean, was it good advice or no? I'm happy I went. I'm happy. I'm happy. I left and that I came back after leaving.

I think being gone for a year, I had a tool sick. I know what I'm going to do with Stanford when I return and I'm going to make something. But you knew, I think, either way that you were going to... I didn't stop working on it. So I would spend those two years while at Stanford getting a tremendous number of grants from Stanford

to continue researching mental health care to travel to outpatients, inpatients. I interviewed countless psychiatrists, therapists, staff members, janitors of mental health facilities really just spent the remaining years learning why do we make the decisions that we make in mental health care? And then I would move on to work at IDO, New York, which is a design firm

to work on how can we redesign mental health care, then went over to England to work at what's considered the most innovative mental ward in the world. What was that like? More thoughtful, more thoughtfully done in the U.S.? I think most notably they put a lot of

they realized pretty early on that for the majority of people who end up in this inpatient mental health facility so they've harmed another person or they've harmed themselves for the majority of them this is the first time they're engaging with mental health care. And what they realize like we need to meet people so much sooner

if they haven't seen a clinician a mental health specialist until this very dangerous crisis moment And so one of the initiatives they launched was essentially figure out how can we integrate mental health care support, education, et cetera, earlier on. And so they sort of changed all of the libraries in the cities. We were centrally located beautiful buildings into free mental health classes, peer-led support on how do we talk about anger? How do we talk about being nervous and moving the conversation from clinical diagnoses that occur in the hospital to, These are everyday emotions we feel, and most of us have no idea how to navigate them, how to even name them.

And so I was there during the summer they launched that initiative in Liverpool. And, I mean, it's really meaningful to see intentional efforts towards early intervention. Yeah, education, prevention. Yep. I mean, I think a lot of the things that you're hoping to do is here, right? Yeah, 100%. And what's crazy to me hearing you say all this is, is I've worked in behavioral health care now for 12 years. And there's these varying degrees of a mental health episode or issues or however you want to classify them.

There's, you know, everything from, you know, I feel a little sad, feel a little blue, don't really know what's going on, maybe you want to talk to a therapist or maybe need to start working out or change something in my life to, I'm not so sure I want to be here anymore. And there's this drastic thing that, like, once you cross the line to hear to this, like, having a mental break or, like, really needing to be institutional. It feels like the entire system just fails. Yep. It's like once you get to the most serious level of this, but if you're saying, oh, like, oh, you go to a therapist. Like, it's very warm on the early, which has always been confusing for me. Totally.

I mean, I think that we treat people as criminals once they just, like, severely need care. I laugh out of sadness. Yeah, no, I get it. I'm laughing out of sadness with you. But I think we haven't built, like, for what it's worth, We need to meet people with far more warmth and support at crisis, but also we need to meet far more people before crisis. And just we're so bad at identifying, like, when someone is acting angrily, they're probably

struggling with their mental health. Like instead, we put people in a box of they're angry, or even worse, we'll say, like, she's a bitch. Right. Like any, hurt people, hurt people. Yeah. Right? Any bit of, like, lash out or frustration or short-temperedness you're seeing is almost

definitely coming from some form of, like, I'm not. not feeling mentally healthy but we don't we don't see that and say maybe you need support maybe you need care in fact we often see that we're like I'm gonna run away we make that person more isolated and so certainly a belief of zero just me personally is we need to we need to provide in the same way that we brush our teeth twice a day to support dental hygiene we need to offer that type of support to mental health care what is our brushing our teeth of mental health I mean I have some ideas that I that I that I do um I'm curious just to go back though so and I want to get back

to that sentiment but the this idea that for you and I'm not going to put words in your mouth that it took this personal experience like it took you really seeing this firsthand and that's oftentimes what I see is people will be haters or negative or you know the classic like just you know take a walk around the block or like you know whatever it is people say to people that are struggling with their mental health until it hits their home or it hits someone, their wife, their brother, their sister, their aunt and uncle. And then they're like, oh, shit, this is like a real thing. Like, my nephew just tried to take his own life or did.

And then all of a sudden it's like, let's wake up to the thing. I mean, the reality is I would venture to bet for most people, you know multiple people in your life who have seriously contemplated suicide. I have no doubt of that. And they probably didn't tell you, right? to your point of like we treat people like criminals. Have you? Have you, have you gotten to that? Yeah. Yeah. Of course. Yeah. Like I think most people, like, what would it be like to not be here? Yeah. I think most people, I would say most people have thought that. I certainly, and I've gone through, not just thinking it, but real dark, it's like an entire nine to 12 months of just real depression, suicidality. I haven't actively attempted, but certainly gone through the months of darkness. And, didn't reach out for care I mean something that's even more

it's not just that the care system treats like a criminal it's also you lack all motivation when you're in that place so the last thing you're doing is thinking let me actively try you don't want to support yourself

unfortunately right and so often it's like a loved one for me it was a loved one it's my best friend you really came in and intervened but often in that moment you're like really lacking the drive to make things better

when you were going that 9 to 12 month period when that was that when you were in this work like you were actively yeah yeah and something i like can recognize in myself like i was at a point where i knew i knew what therapy was i knew what psychiatry was i had interviewed countless therapists right and still the system was not wanted maybe because i knew it so well it wasn't a system i wanted to be a part of and you couldn't this is fascinating so you couldn't ask for help or you just didn't i've never shared this in an interview so here we go well it's a safe place and and

And I think it's important to just acknowledge that you're helping someone. Yeah. Like truly. Because when you say I've thought about it, I can say back to you, so have I. And I think your point that many people have. Yeah. No, I'm not saying that I've attempted and I'm not saying that those thoughts have become so intrusive that I've really, you know, stood at the ledge and thought about jumping. However, you know, as a human being, we can't avoid the grave.

I can't avoid the grave. And so like this thing, this like death and not being here and on those stressful days, like would it just be easier by just fucking throw in the towel right now? Yeah. Yeah. I mean, I think it's funny because before I was coming to this,

I was watching one of your videos where you shared like one of your most powerful tools is your story. And I thought a lot of like I don't do a good on you for telling it because I do think that's the most powerful thing you can do and it takes a lot of courage and it's not something I can, I can as comfortably do, but I do believe once you do, many more people can speak to. I've had this issue, and I've had the same concern. So I certainly, I think suicidality is the, I don't know if it's the most crisis point,

but it's both kind of the most severe and also, I would argue, perhaps the most common. I think anyone who's had questions of, like, things are so hard. It doesn't take long for your mind to think, why do I do this? Right? And we know it's contagious, right? Clinically speaking, we've proven, like, once one person takes their life, we know that it's more likely for others around them to do the same. I might be using the wrong language.

No, you're fine. But I do believe it's the most human to ask those questions, and it's so isolating that we never share with others that we've asked them. Yeah. We should be proud of yourself. That's really brave. I appreciate you sharing that with me. And I just feel like in some ways,

way that I see this world that we both find ourselves in and I agree when you say mental health is just as if not more important than physical health and spiritual health I I believe that because I know when my mind is right everything else follows I just like I feel like with my story because I know what I know about the mental health care the behavioral health care field we owe it to each other to share our stories because the truth is there isn't enough help out there. Yeah. And so there's this pull for me to kind of say to people, come on, like, let's try this out. And when you're able to be honest about some things, like watch, I've had this experience.

And it's been 99% positive. I totally believe it. Well, also, when you say there's not enough help out there, like help doesn't have to be seeing a live therapist, right? Our brains are so broken that we think, like, the only form of working on your mental health is talking live to a therapist. There are more forms of mental health. We haven't, you know, our society hasn't stamped them as, like, this is health care. They haven't stamped them as, like, your insurance backs this.

And that's part of the work I think both of us care about doing. But the reality is there are so many, there are alternative ways to support your mental health and work on it regularly outside of seeing a live therapist. But we need to help people. We need to define that for people. help fund it for people and make that more a normal part of our everyday lives. It's also interesting because when I look at the mental health crisis, and I believe there is one, a lot of it has to do with this thing.

Oh, yeah. The phone and technology, but the reality is a lot of the mental health resources and we'll get into Zira and some of the stuff you've done are available on the phone through technology. And it's like, you know, I kind of believe it's like if that's the way that we're going to get people, then that's totally. Well, I think it's that it's not the phone alone. If we removed it, we'd all be mentally well.

People weren't all right before the phone, to be clear. And I think it's certainly social media has introduced many negative behaviors for folks. But also, like, the world, you know, I am not someone who's religious. My parents were different religions. But I can recognize that it's not just that we introduced social media in certain ways. It's that we remove, I think we're removing religion had a huge impact on us. And religion was a source of community and support and safety for so many. Again, I'm not someone who follows a religion or there are a lot of problems with religion,

but I do think something that it aimed to provide was mental health care, right? How do I give you a place on a regular basis that you can feel safe in, even if you're not doing well in your relationship, in your family, in your job? How do I make sure you feel whole and desired and wanted? How do I build a confession booth, a place for you literally to share your problems? Like, religion knew these first principles that we're now recreating in a mental health care system. But I think our generation ignored or just never had really the religious infrastructure that our parents' generations did. And again, there were a lot of problems with religion.

But it's not only that social media came to life. It's that we lost, for lack of that a word, this wholesome community sensation that society had for so long. and then tried to recreate it with a tool that wasn't built to recreate that. Right. Yeah, I mean, for me, yeah, when you talk about religion, politics, like any of these, like, are we, and mental health, like, are we giving people the opportunity to be curious about their experience with whatever, like, your experience with religion is your experience. Like, for me, I grew up Presbyterian.

I went to church on Christmas and Easter with my dad. It was a beautiful memory that I will always have. for the rest of my life, stopped going to church at all in my 20s because my drug habit had gone through the roof. And then found myself in a program of recovery that was spiritual in nature. And now I pray to a God that I don't, you know,

I don't know, like what's up, God? Like, you know, it's not some white dude in the sky with a beard, but it's, I believe in something. Yeah, yeah. And that's my religion. And that's like, that's where I've gotten with it. And I have friends that, you know, go to church every Sunday or, and everything in between.

And so it's fascinating to hear you say that you're not necessarily religious, but you believe in some of the early things that kind of like religion figured out or had right, maybe? I think that the concept of religion is right. And it's that, like, I don't think any one religion got everything right, right? Or I think it's so. But I think what religion was trying to do is to build, is to build. safety you know purpose like they're just these first principles like why are we here right and why do we choose to keep being here and what notions do we want to instill on the next generation

and their generation thereafter and in the absence of religion like school doesn't ask you that like the places that we teach people how to be people are not are really kind of just focused on jobs and making a job doing math right and not on like so like what and so I do I so believe in a lot of like why we built religion I think I believe in you know so many parts of what is prayer and again the confession booth etc of like how do we feel present right and how do we like just spend time asking ourselves what do we want right when we think of like what is a prayer what are we asking for and I'm not someone who has spent much time defining who is the person we're praying to or not but I have spent time to find like what is my version of call it a prayer

call it an affirmation, call it, whatever you'd like. But the idea of, like, defining what is it I want and what do I want to bring to the world and acting on it and having belief is something that I think religion is really good at instilling in people, just belief in yourself and a community and doing. And I have so much belief. I believe we can change the world if we want to.

And I think... You better to do what you're doing. We will. We both will. So there are many good things about religion. And I think removing it entirely kind of really hurt us. I'm almost connecting like this whole idea of confession to therapy. Like for me, like when I sit down with my therapist, which I do and I talk about often, it's like sometimes that's just 45, 50 minutes for me to just confess.

Like I'm just going to let it rip and you're going to hear this and hold this space. And maybe in some ways that's what therapy was born. from. I don't know. I mean, I early days of zero, which at the time was called Real, as you know, I really wanted to do this, like, campaign of putting confession booths throughout the city and having a like come to just share it out. And I do think a core principle, or I don't know if it's mental health care, religion, whatever it might be, but the human condition is like everything we feel sits with us if we don't let it out. And I think what's so dangerous is when you let something stay inside of you for so long without acting on

it, you'll act on it, right? And it might be physical, harm on someone else. It might be physical harm on yourself. It might be substance use, but the underlying human need is like, you have to get this out of your system. And I don't know what was the principle behind the confession booth, but I do think it served that purpose. I'm like, you can't hold this in. Like, trauma lives in us. Right. Yeah. I mean, and that's a lot like in substance abuse when I, like there's just word relapse and I, I want to curse. Like I hate this word because I feel like the word relapse keeps people drunk and high much longer than they need to because someone will start this process of trying to get sober and all of a sudden they'll

pick up a beer or they'll go out with friends and they'll quote unquote relapse and they they throw away in their mind this three six year long term of like this sobriety or this work that they did and they are so shameful around it and that relapse was probably generated from a feeling that they weren't certain if they wanted to be sober or not or they were insecure going out in social settings without drinking and then they go and they like to your point they get it out or they act on it and then they feel like a piece of shit

because they broke this contract with the world that was totally unnecessary when like hey you drank last night that's okay that doesn't discount the last three months of your sobriety and you can not drink today yeah but like we're not using that line would you put it what would you, is there a different language you recommend or you like for yourself? I mean, they use like they're saying return to use,

which again sounds just like totally over dramatic or clinical to me. Yeah. I mean, for me it's like, hey man, like I made a mistake last night or like I did something I didn't want to do. And I acknowledge that. And I'm going to do my best to not do that today. Yeah. I don't know if there's one word that says that.

No, I love the thinking. I think we have such an extremist point of view on all forms behavior change like it even happens in like weight loss that's just like I need to not do this like we're zero or a hundred and like I'm someone who's kind of zero a hundred so like I have that temptation often but we would all live healthier if we can understand like we're still humans right and like you haven't in the case of any form of substance use you haven't thrown away your past six years of sobriety because of this one moment like you still did that and you're still there and language is important we do need to find

that resonate with people that inspire them to be better versions of themselves. Yeah, and there's a lot of studies coming out just about confrontation and how it actually doesn't work. And, you know, after six years, someone does have a beer. And trust me, they feel bad enough about that themselves. We don't need to, like, hammer the point home to them. They just need love in that moment. You said zero to 100, so I'm going to change gears here.

Because then we're going to get into zero, but like you bike cross or you biked where to wear to raise, like there's some crazy zero to a hundred story you got on a bike and didn't stop. Oh, I biked across a few countries. Okay. I biked across the U.S., and I biked across Italy and I biked across Switzerland and I biked across France. You did U.S. like coast to coast?

Coast to coast, yeah. In one, like, what can break it down? Like, tell me. I biked from San Diego to Florida, St. Augustine, Florida, in 55 days. Oh, my God. The other countries were smaller. The U.S. was my first country. And what was the inspiration behind that?

And what did you learn doing that? I mean, I'm a endurance junkie. I'm a do cool things junkie. Yeah, yeah. So that I did when I left college. Okay. So it was 19 or 20, probably 20. honestly I mean I was so my second year of college just angry and fed up and I think it was a combination of so that was when I started throwing myself at mental health care and learning how broken it was and at the time you know I was I was at Stanford a school that boasts itself for innovation and my 19 year old brain thought like oh my god my peers are making up stupid clubs and

and making up stupid roles and definite job descriptions of those roles in clubs, and thinking they're changed in the world, they're doing nothing. And like the world has so many needs that I already can do something about. And so that's when I got in touch with David Kelly, who's a professor at Stanford. He's a founder of IDO and would give him a long, angry rant.

These are all the things that are wrong. And if you're the king of innovating and redesigning things, I get to redesign mental health care. And I was like, I need to, leave. I need to start something. Did he listen? Did he give you? Yeah. He was the one who would later say, you need to come back. Got it. Got it. Yeah.

But he was, he was so great. It's like, yeah, well, Stanford also has things that could help you get there, like make use of those things. And I'm like, well, I don't want to take these other classes that are mandatory. He's like, well, don't. See what they say. And it was the inspiration I needed. Like, all right,

I'm going to use how I would describe at the time is you know, I was fortunate to not have to pay to go to Stanford. He's like, I'm going to use this scholarship as a gift card. And in the same way that I would never let a store tell me how to use my gift card, I would buy what I want. I am going to buy what I want here.

And I will take the courses that support my goals. I will apply to grants that support my goals. And if there's a mandatory course, I don't want to take because it takes away from things I want to do, I'm going to say no and see what they say. What's your relationship like with Stanford today? I mean, the way I did school loved it. And I'm so lucky. I mean, I don't think they were always thrilled with the way I did it,

but I'm so lucky that I got to do that and gave me so much of the funding. I mean, how insane that a little 20-year-old was like, well, now I want to go interview a bunch of janitors at psych wards to see what's their experience, seeing patients here, and hear about the number of patients that are like. You did that. And what did they say?

I mean, they've seen patients tackled to the floor and, you know, share the real-life stories. And if anyone's seen an inpatient mental health facility, unfortunately, that is a reality that, and I say this all with, like, an understanding for how much patients it takes to work in those spaces and how unsafe they can feel to a nurse or an individual working there. So when you, like, paint a picture of what this looks like, you really see the realities of physical abuse against patients. and just how many patients go misunderstood and not heard in an environment where they're supposed to be taken care of. And janitors certainly had a clear point of view on that. And certainly could also say firsthand, like, and I'm scared sometimes too.

And spoke to a countless number of patients and ex-patients, predominantly ex-patients, like after they left those facilities, spoke to one person who checks himself into an inpatient mental health facility, like once every few years, when he needs a break from the world. He's like it's really the only place I can go to where just like the world stops asking me to do things which was a fascinating perspective. Yeah, it's interesting like when you, I mean I've been in my fair share never actually has a patient but visiting patients

in varying degrees. And there's something that's really jarring when you enter into those wards and the door locks behind you. And you don't have, I can't have, I can't. can't get out without someone else letting me out and that's it's so scary and I go back and forth between it being necessary because when someone is not in their right mind like sometimes they do need a certain level of structure but at the same time like does that model actually work totally when I first I saw a therapist at Stanford and

a friend of mine who, a different friend who had previously attempted suicide, told me, when I was like asking her, like, what is therapy? Like, what should I expect of this it's called caps, this counseling services location?

And she said, whatever you do, don't tell them anything related to suicidality, because if you do, they call the police, which is like 51-50ing, the police come and bring you to the inpatient mental health facility. But, like, how? insane like how powerful in the worst of ways is hearing like when someone reaches a point of

i need support i need help one of the like first pieces of like pro tips i got from someone else was whatever you don't tell them perhaps the very reason why you're going to them because the police will be called and to your point i understand why like we have limited services that can just make mental health care work and i like maybe get how we decided the police is who who's called, but at a moment where someone feels so vulnerable, so that vulnerability is fear. Like they feel so scared, so alone, so hopeless. The police are called. You feel like a criminal.

Yeah. Right? And you feel like a criminal for feeling these things, for telling someone you feel these things. It ends up being a system that lacks trust. And the very thing you need in that moment, brings me back to what I thought when I first visited my friends inpatient and rehab. like this lacks warmth I got in a moment where I feel the most in need of care and love and support I'm afraid you know I'm afraid of myself I'm afraid to tell anyone about myself like it's a really scary

system so yes I totally see to your point there are real times in the mental health care system where physical restraint might be supportive and again I can only imagine I imagine there are times where staff members do feel fear of themselves. But the reality is we lose so much humanity is lost when you rip someone of every clothing item on them that might possibly harm them. And again, to your point, I'm understanding the why behind many of these things,

but so many people in those facilities will tell you, like I was so dehumanized. I was an animal suddenly. Yeah, the trauma from that actually keeps them. Totally. Not well. Yeah, I mean, look, we see it all the time. Like at release, I mean, and I have this kind of amongst our team.

I think they would tell you that I have this willingness to take on some more, quote, unquote, challenging cases. And, you know, what I've, my philosophy that I've developed over the years is like, there's no two cases that come across my desk that are going to be the same. Yeah. And we can choose to use whatever words we want. Yeah. And we work some really actually good programs. We get referrals from pretty well-established hospitals and behavioral health care facilities, and we'll get phone calls from the therapist, and they'll say, I'm just, you know, it's a really tough case.

And I'm like, well, what does tough mean? Right. You know, like, explain that to me. Right, yeah. Well, they're a little manic and this, and they don't really participate often in group. And, you know, there was an attempt three months before they got to us, and they're not really, sounds like a perfect fit for us sounds like the person we want to work with send them over like we're going to give them a hug and and those people that we've taken quote

unquote chances are on like when my admissions team calls me and they need my approval to say bring them in you're not the one that they can just streamline through we've done so well with them just by doing exactly what you said like treating them like a human understanding that they're not Probably going to hear much the first couple weeks, but they're going to feel some stuff. Yeah. But that's the person you're designing this system for. Like, I get so angry, a good anger, but an anger thinking of, I remember the early days when I would just interview everyone related to mental health care. And I had clinicians who worked in these facilities tell me, like, I'd ask them, like, have you asked the patients how they feel?

And clinicians would say, no, they're not well. I can't ask them they're out of their mind but that is the person you're trying to take care of now so it doesn't matter how this resonates with anyone else like it does not matter how I

an outsider look in but oh does that look like good care your goal here is to make this person better whatever we call better and so actually what matters more than anything is their point of view on how this is going and the whole if that's everything breaks if you're not taking into consideration what they're saying right do they feel

safe right now secure heard protected taken care of and like the scary thing is like usually like five out of five that's a no and you do need and maybe it is because they're manic and maybe it is because like every maybe they can't participate group then we got to change this group yeah right like we have to be willing to change the care we're delivering in order to serve people to meet people who are there at not ask them to meet us where we're at right and it isn't they versus us we're all the same right so long story short what we're saying is that we have a lot of work to do and the other thing that we're saying i believe is that there's hope because in 2024 what i can tell you and i can give you this antidote and i've shared this a couple of times is i was down at old miss university

a few weeks ago and i am asked and i'm grateful to be asked to go out and speak on men's mental health to college campuses and over the years I've walked into rooms of 100 people 10 people 500 people you know like whatever it is and at Ole Miss they had almost a thousand guys men show up to hear this talk yeah and that tells me that we are starting to make progress and that the world is actually warming up a little bit to the idea that uh you know speaking about our mental health and caring about our mental health and not just doing therapy but really taking care of us and one another is starting to happen. So with Zira, the Spotify for, like, tell me. Tell me about Zira. Tell me we've heard kind of your experience and your story and what's gotten to this

moment. And I think this is what I'm really excited to talk about. Yeah. So, you know, we set out when we built this company, our point of view is mental illness is skyrocketing. But our mental health care system is not meeting the need and that's for a million and five reasons one it takes people on average of 11 years to reach care after symptoms of illness people sit in shame in silence they struggle alone two even if everyone wanted to get therapy sooner we don't have enough we only have enough therapists for 7% of the population like we just need to completely redesign this and just start from like what are the goals of a mental health care system starting from the goals how would we build this from scratch. And we actually started from a very different model of care. We took a huge

pivot to where we are today. And we started by delivering building a brick and mortar membership model. And the goal was you'll pay a membership model just like you might, a gym membership. And what you'll have access to are groups. And on top, you can pay for one-on-one. But the real goal is therapy. Therapy, yes. The real goal is how can we get more and more people to groups? How big can we make groups while maintaining clinical outcomes and build this membership models such that it's a part of every day. It's brushing our teeth and we can we can identify, we can prevent crisis, build practices and resilience before crisis.

And was the idea almost like soul cycle like you go on and you can say like there's a group at 630 and I'm going to book it, yeah, book it. But more not pay per group like it's included in membership. Yeah. Yeah. I love that. And then this was all set to open in April 2020. COVID hits, we aren't able to open the brick and mortar.

So we put up what was meant to be a one month offering of free care, one-on-one therapy and group therapy all for free. What we learned in that month completely pivoted our company. We learned that no one wanted one-on-one. Huge surprise. We were offering free therapy amidst a global pandemic. No one-on-one one-on-one. Like zero people showed up or like-

Not zero, like a minority of slots were filled. Everyone wanted groups. No questions asked free therapy, mid-COVID. Thousands of people went through the program. No one wants one on one. Everyone wants group. But groups were booking out. They weren't selling since it's free,

but they were booking out within minutes. And group therapy is not even a known concept outside of AA. We haven't normalized what is group therapy. But people wanted to join group therapy, those group sessions, with their video off and their name hidden. And this wasn't marketed to people. We didn't offer this as an option,

just on their own. Over the course of hundreds, not only thousands of people, did no video, no name, I just want to join a group. And when we would survey to capture like what are people, like why are all these people doing groups and they'd ask for recordings, we'd survey to capture like, what are you getting out of this with your video off, with your name hidden, why are you choosing this not one-on-one? Time and time again, people would share, I want to learn how this looks for other people more

than anything. I want to hear from other people. What are they going through? And two, then I want a therapist to give me active tools, actionable tools. and I just don't want anyone to know I'm here. I don't want to admit that I'm struggling with, you know, an eating disorder, that I'm struggling with, you know, intimacy issues, sexual issues. And I want a recording of this because I want to return to this when I'm struggling, right? Monday at 3 p.m. I'm fine. Catch me Friday at midnight and I have shit to talk about, right?

And so what we uncovered there is what people are looking for is a content experience, right? You're looking for you don't want to live speak in this session, but you want the benefits of group therapy and you want it available on demand. So people were showing up hiding their face, hide their name, and not saying anything. Correct. Just fly on the wall.

We'd build these anonymous forms of interaction, like polling, right? Like, submit in the poll and people would do that. So the idea was like, I just don't want anyone to know that I'm here struggling. But I want to learn how do other people engage with this? I want a therapist to give me tools to work on it. I want to return to these tools. And so at that point, we were like,

okay, this, how do we? we deliver the benefits of group therapy and content form and ended up spending what would be two years on research and development? What are various forms of group therapy via content? And, you know, tested video, tested audio, tested written, and would eventually land on this audio content model that offered you member stories, therapist tools, you know, an algorithm that is identifying your needs, much like, I mean, an Instagram algorithm identifies your interests, Instagram, just wants you to spend more time on Instagram, so their algorithm has a different goal than ours does.

But ultimately, what it's doing is saying, I'm using your content engagement to understand you and to feed you more entertaining experiences. We are utilizing your content engagement to understand your needs, your mental health needs, and to personalize care such that your needs are better served. And that research and development effort was largely powered by, like, is this clinically effective?

Do we reduce depression? Do we reduce anxiety through audio content? And then after years, we proved that we did under IRB study. And that's when we launched into workplaces and employers and scaling our platform. But it's an entirely new model. We still do have anonymous group therapy in our platform. So it still lives as a live component, though the novelty we bring to life is that our audio content model itself. It's not just able to scalably alleviate mental illness, but far more people are willing to engage with care in this model.

You know, it's not dissimilar from, like, what people are getting from TikTok therapists, where people are getting from hearing your stories on Instagram. People are, like, when we take a million steps back, we realize, like, people today are doing this with social media, right? They're going to social media to hear people share their stories, whether it's an influencer or an everyday person. People are just excitingly watching what are someone's real story. And then two, people are following TikTok therapists.

I think some recent research showed Gen Z trusts TikTok therapists. more than they trust in-person therapists like people are looking online to say what am i supposed to do with all these various issues the problem is instagram and tic-tok are not clinically safe places for that like again their algorithms aren't built to improve your mental health but they are delivering these key benefits and so when it comes to zira we're thinking how do we we know people are seeking this right we saw it in our own experiment if you will we're seeing it on social media how do we build this into a single platform or you can get the benefits of member stories or you can get the benefits of therapist tools in an environment and an algorithm that is clinically safe and

built to improve your mental health. And is there an opportunity if you want to share? So I guess if you show up, there's obviously, there are people there participating, right? And some people have their video? Like is that? You can share both in groups and you can share via content. So you can share your story, honestly, similar to Instagram, TikTok, and that, like, you can submit your story, but it goes through clinical safety for us. So first, it's assessed. Can this be just shared on a one-to-many platform? Or does it need to be, you know, should we have a trigger warning? Should a therapist speak over this and say, like, this is how you should understand the story? But a long-winded way of saying, yes, you also have the opportunity to share your

story, both in on-demand content form and in groups. And are you so the rebrand was recently from real to zero I'm going to shout out to your teen I love this sweatshirt I'm sure people will ask where I got it I got it from Ariela so you can take that up

with her what are you seeing what are the findings what's going to like tell me yeah I mean men are far more willing to engage with our platform than traditional therapy which is probably not surprising when you think of the anonymity component we also see people engage with much more frequently

with our platform so people when you think of therapy for the very few people have access to therapy they're going once a week and the setbacks of that is like you might have had a great therapy session or great therapy breakthrough like the learnings are out the door

right they're at the door tomorrow they're in six months whereas we're seeing people re-frequent the app on a regular basis even in the course of a week So they're really like building behavior changing patterns. And we're seeing workplaces sign up for Zira. You know, we have, they can't share most of their names, but some really major employer partners. Yeah, tell me about that because I feel like that's a big thing.

And obviously the workplaces where humans spend most of their lives. Yeah. We go to work. We work 40, 50, 60 hours a week. It's a huge part of our existence. So tell me the ground you're making there and why. I guess you chose to I think put a pretty big emphasis on employers um so we're from where I sit we're living in like a once-in-a-lifetime moment where employers

care about the mental health of their employees in that like employers were always responsible for funding your health care but mental health never really played a serious part in that story and over and that's really because what motivates an employer to pay for things if they're losing money off things like and that's not me being rude me and it's just what is an employer and what's come to light in the past few years is so many people are speaking up about their mental health trying to utilize services and making expensive decisions when their mental health is not served like they're leaving workplaces they're quitting they're showing up poorly they're late and employers have just gotten a lot better at measuring that

and saying like wow we're losing a lot from the fact that employees are mentally unwell and they're not using traditional services today. Why is that? And so I view this and we certainly view this as a very timely opportunity to support people by partnering with those workplaces and delivering mental health care through the workplace. And I've shared a bit about this with you, but we're able to learn things that workplaces didn't know. And like one of the things we're certainly uncovering in workplaces is how much more common substance use is amongst employees that employers know and the reasons why employers want to know that is they care about supporting their employees for the sake of their business transparently but if they don't have

access to that information they miss out on so much and what we find is one unfortunately like it takes you know this it takes people way too long to get to rehab right to get to traditional forms of yeah health care when it comes to substance use people will battle in silence for so long and we normalized drinking excessively, we socialize it. Yeah, I mean, I knew in college. I didn't go to treatment until 26, you know, so that's six years. And then I got out and took me another year to get back, you know, so it was a seven-year. And there needs to be more.

I mean, if the seven years could have been one year, how different life could have looked. And so we're finding that employers are stepping up. They care more. They're understanding that traditional health care is not going to land at their employees. I mean, nine times out of ten, when I talk to an employer, and they tell me, like, we're using, we use an EAP today, which is a common tool that employers use. I'll ask them, have you ever used it?

Nine times out of ten now. Like, are you shocked your employees haven't? You know, and it's not, no one's a bad, it's not coming from someone being a bad person. They have a ton on their plate. They're figuring out every health benefit. But when it comes to mental health, something so beautiful to me is that, like,

it's a human thing, right? Don't think clinical. Don't think healthcare. Just think you. Like, you've been, think of the past month. Think of the most anxious you ever been. Most stressed you were in that month. Most insecure.

Did you go to the EAP? What did you do? You sat in silence. You perhaps went to the bar. You, maybe if you have a good community, you called a friend, right? Like, you did not use that. Right. That's how you should be thinking.

And we're living in a moment where employers are listening. They hear that. Like, that makes sense. And I think these are, like, when we talk about, like, How do we change? Improving mental health requires a changing culture, right? How do we build the brushing your teeth of mental health care? How do we make people recognize those moments of insecurity,

those moments of anger, those lash outs? Like, that's a moment if you need care. What do you do it? How do we, we need to build care that you could mean in that moment. If you tried to call a therapist, they would say you have an, there's an eight-week wait list. We need to build care that can support you in that moment. And we have to normalize and socialize this notion of like,

this is something to be worked on. And that comes to life because people like you speak up about it. Right. Well, I've always said, you know, it's fascinating. And I think employee culture and company organizational psychology and all that stuff is just, it's fascinating. I mean, I'm fascinated by a lot. But the thing that I think my, and I don't know if this is a business idea that someone

wants to steal because I have just too much on my plate. If you want a partner on it, give me a call. But the thing that I've always thought about is drug testing in the workplace, right? historically I think about my friends at companies will be on the text chain and say oh I got drug tested you know and they pass their drug test whatever it is and my next my next question what I want to ask is like what happens if you fail and I'm sure it's you're fired or you know we need to talk to you yeah instead of hey man I saw you were like using some cocaine like what what's going on yeah can we help you 100% is there something else that you want and like really

drug testing with love so we're We're saying we're not drug testing you to catch you. This isn't punitive. This isn't, this is just like we understand that we're living in a world right now that's super stressful. Yep. And people use drugs and resort to drinking. So if you're exhibiting some of that behavior, we just want to say like we're here for you. Yep.

100%. And what change that might bring on. But, you know, so black and white to a lot of these folks. No, I completely. And that can be said about so much of mental health care that we have. like you're a criminal right like I'm I'm I you're a criminal I'm afraid of you you need to leave like it's stripped you of community which as we know just makes people worse right we suffer more and we're stripped of community when we think we're not worthy of a job or a

promotion and especially when it comes to employer sponsored mental health care so many people are afraid to use employer sponsored mental health care because they're thinking I don't want my employer to find out I'm struggling with this I love that one yeah it's like Am I less likely to be up for promotion? Or I have to go to rehab. I don't know how I'm going to tell my employer. You don't tell them anything. You have a medical condition that you're going away to take care of.

Period. End of story. And be proud that you're asking for out. 100%. And that's hard to hear when you're like actively abusing cocaine and, you know, staying up all night making bad decisions. The fear is someone's going to find out that this is who I really am. But the truth is most people know.

But we need to meet it. I mean, we can compare it to physical health and say when someone is diagnosed with cancer, when someone breaks a leg, right? When someone goes through any physical health condition, they know I can go to my workplace, I can communicate this. I'll be met with love and support. To be clear, many people who struggle with serious physical illness

will have some form of like, call it mental unrest. I won't call it mental illness, but like anger, frustration, panic. And like the world has sympathy or empathy for, I understand you're going through a lot like how can we be supportive we know how to do that with physical health what we need to do is like teach people how to do that for mental health

right and we just haven't built that education system we haven't normalized the notion of like what is mental health what do you do I mean so much of what we're deploying in workplaces is even training people managers people leaders all leadership how do we talk about mental health in the workplace

how do you identify the warning signs across your employees and your direct reports, what do you do when someone comes and talks to you about it? I mean, we've had so many employers say to us, like our people managers are getting direct, having conversations with their teams or their direct reports about their depression, their burnout, their anxiety, they don't know what to do.

They freeze up. Or sometimes they say the wrong thing, right? And so a lot of, I think a lot of the need, it's like we need to teach people, it's an education need that I think will have clinical impact on like, how do I, how do I mental health? And not just for myself,

but how do I do it for and with others? Yeah. And that's something we certainly care about doing at Zira. I love that. And I, you know, viewing the mind as a muscle as like cliches that sounds, we need to work it out, you know? We need to give it the ability to kind of like get stronger

and be able to handle and take on more. Two kind of getaway questions that I want to ask to try and give some real functional, actionable steps that people can take if they're if they're struggling one if someone comes to you and says they're feeling anxious or they're feeling depressed how do you respond to that like what is your go-to response to that like what are some things that you tell people when they feel like they are struggling with their mental health and then two on back of that which will help answer number one I'm sure is if someone is listening to this and they want to sign up for zero

or they want to get involved they want to utilize the resource how does one go about that so to the first question if someone tells me they're anxious or depressed my response is to say tell me more like i'm going to listen like far before i can give you advice um the very thing i think the best thing you can do is listen yeah ask them tell me your story what's what's making you feel this way when do you feel this way more when do you feel this way less when was the first time you felt this way um like you don't need to be a therapist to listen you don't need to be a therapist to be kind um and so often we kind of have a like i'm not a doctor um you could you have ears you know you can listen tell someone you care about them um and if there's anything you're saying or advising like share your story or someone

else's story I think like the first second and third feelings are loneliness when you're struggling right and it's like I'm lonely I'm weird I'm different and the more we can share the stories of others going through it and like you have them you do like we all know if you don't like call me I'll tell you all of mine but we we know people who have struggled we've struggled and what someone needs in that moment is to feel heard to feel cared for to feel not alone and all of us have the tools to deliver that to a person who's struggling. And on how do you sign up for Zira?

If you need help with stories, Zerra certainly has a lot of them. You can go to Zera.com and sign up to... Z-E-E-R-A dot com. Zera.com. Yes. And you can sign up directly in site. I'm sure I can...

Still membership. Is it still a membership? Yeah. Still a monthly membership model. Okay. And I'm happy to share a code too and make it easy for people to sign up. Though the first month is free anyway. So give it a shot free of charge.

And so you get on there and there's stories, there's testimony. There's still the groups. Yes. Okay. Yep. So try for a month. Join a group. Let me know what you think.

I love that. Ariel, you were brave today. You were smart today. You showed up. You gave hugs. You did it all. So I just want to say thank you. for coming. It was really nice. Zero.com. Look it up. Just another amazing resource. And

I hope you and your team are proud. Thank you. I'm so happy to be here.