Virtual counseling business provides vital support for new mothers

How an entrepreneur used her own experience to build a company that increases access to maternal mental health services

While the typical view of newborn parenting is of a blissful experience for mother and child, the reality can be quite different for millions of women who suffer from postpartum depression. University of Michigan data shows that in the last two years, 30% of new mothers in the U.S. who were screened showed symptoms of depression, nearly triple pre-pandemic levels. Kirthika Parmeswaran’s experience after the birth of her daughter and subsequent insight into how the right support can help prompted her to look for a way to provide easily accessible help for women in need.

“I lived through postpartum depression and then later in my career saw definitive data about the efficacy of mental health support for this condition, when women can get it,” says Parmeswaran, CEO and co-founder of Philadelphia-based Vital Start. “These experiences showed me that there’s a huge need for easy-to-access, effective maternal mental healthcare, both during pregnancy and postpartum.”

Parmeswaran’s company provides multilingual support both in-person and via telehealth. Vital Start uses virtual reality (VR) headsets to guide pregnant and postpartum women struggling with depression through simulations, calming exercises and counseling sessions. By using VR to deliver its services, the company plans to encourage use by women who might be reluctant to take medication or seek help due to the stigma surrounding mental health treatment. It also hopes that using technology to deliver treatment will increase access for women in areas with few treatment options. VR has been proven to be a powerful tool for increasing patient engagement. Ninety-three percent of doctors surveyed in a Thomas Jefferson University study cited better patient engagement as a key benefit of using VR.

Parmeswaran left a career in corporate research and development to start her business when she realized that she wanted to devote her time to increasing access for all women to maternal mental healthcare. Vital Start is a winner of a 2022 Citizens Small Business Community Champion Award, which recognizes entrepreneurs striving to improve their community.

The company is currently completing a pilot test of its platform with patients, coaches and psychologists and plans to roll out its services nationally.

Read Parmeswaran’s advice below on how entrepreneurs can find inspiration to start and grow their own businesses.

Tip: Be prepared to evolve

Your initial business plan may need to shift once you launch your company and learn more about market needs. In 2017, Parmeswaran started working on the original concept for Vital Start with the Penn Center for Innovation (PCI), a business incubator program through the University of Pennsylvania. At that point, the company was focused on developing medication management systems for babies exposed to drugs in the womb.

As she learned more about women’s struggles, it became clear that a better opportunity was to focus on treating women’s mental health, the crux of many substance abuse problems. Through PCI she met and formed a business partnership with Dr. John Chuo, an attending neonatologist, and Medical Director of Telemedicine at the Children's Hospital of Philadelphia. Dr. Chuo had experience with telemedicine, including the use of VR to deliver therapeutic benefits. From her own postpartum depression experience, Parmeswaran recognized that technology could help provide support to nursing mothers reluctant to take medication to treat depression. She also believed that VR could provide an alternative to women concerned about stigma surrounding mental health treatment.

The COVID-19 pandemic contributed to Vital Start’s decision to offer a telehealth model using VR technology and an inexpensive VR headset that works with clients’ own smartphones. The system uses analytics with machine learning and artificial intelligence (AI) to predict and recommend effective courses of treatment. In addition to a self-guided tier via an online portal and coaching sessions, clients may also use the services in conjunction with a licensed therapist in their home state. The length of treatment varies from client to client.

The telehealth model made it possible for pregnant women and new mothers to get care during the pandemic and provides ongoing access for women in areas where mental health services are scarce.

“We realized that by going virtual, we could help women wherever they are,” Parmeswaran says. “Many new mothers are not getting adequate perinatal care because they don’t have easy access to services — we can make it easier for them to get help online.”

Bottom line: Be open to deviating from your initial business concept if that’s what’s needed to offer the best product or service to your customers. “We realized that by focusing on mental health with a telehealth approach, we could reach a wider audience with a targeted product across the maternity spectrum that was also more commercially viable,” Parmeswaran explains.

Tip: Talk to your customers

The best people to provide insight about customer priorities are your customers themselves. Vital Start has used marketing campaigns to raise its visibility and learn what its target client is most interested in.

For example, near Valentine’s Day and Mother’s Day, Vital Start promoted raffles for free services on Facebook and Instagram. This spring, the company started an introductory offer for five coaching sessions and a three-month subscription to the Vital Start platform.

By asking respondents to their promotions to register on their website, Vital Start was able to collect research on its customer base. Through these efforts, Parmeswaran uncovered that women aged 25-36 were the most likely to be interested in Vital Start’s services and stay the longest on the site. Through other promotions, Vital Start learned that lower income visitors were also not converting, potentially because they may not have adequate insurance coverage.

Bottom line: Establish channels of communication that enable you to learn about your customers. This customer research can provide critical information on what you offer, where you market, and how you price and deliver. In Vital Start’s case, customer research revealed that a lack of insurance coverage for mental health services meant the company needed to offer a payment plan for out-of-pocket expenses. It also learned that customers wanted treatment plans mapped to the trimesters of pregnancy as well as postpartum.

Tip: Find financing as early as possible

No matter what kind of financial support you need, advance planning is important. Research the different types of financing that may be available to you. Outside advisors such as your business banker can help you determine what source of funding makes sense.

Parmeswaran says that she wishes she had started looking for financial support sooner, to give Vital Start adequate cash flow in its early days. Coming out of academia and research, she initially thought focusing on government grants was the best approach, rather than looking for investors. The lack of funding slowed company progress.

“I hadn’t done this before and I was hesitant — I didn’t want to feel like I was taking people’s hard-earned money for something new and untested,” she says. “At the same time we were applying for grants that can take months to get approved for and receive, we should have gone after private investors to help us grow faster.”

So far, Vital Start has raised $300,000 through grants and private investors and hopes to raise another $2 million by fall 2022. “It’s difficult at first, but once you line up your first investor that will give you confidence to go after others,” she says.

Bottom line: Financial support is needed for a business to thrive and grow. Start early and cast a wide net when you pursue financial support. Consider a variety of funding sources, including bank loans, a line of credit, grants and private investors. Parmeswaran suggests practicing your pitch with family and friends to be sure you are doing a good job of explaining the value of your company and how you will generate enough revenue to succeed. “They’ll be a good audience to help you figure out how to explain clearly and succinctly how your company solves a pressing need,” she says.

Tip: Look for mentors

Parmeswaran advises entrepreneurs to look for support and not go it alone. Business accelerators and resources such as University Science Center, Microsoft for Startups, Plug & Play, Newchip, Village Capital, F6S, the National Science Foundation (NSF) Innovation Corps and the U.S. Economic Development Association (EDA) have helped Vital Start in several ways, such as gaining access to investors and advice on practical things, such as tax advice, regulatory requirements and how to engage customers.

“Many resources are free and help you get access to professionals who can aid you in looking analytically at your business plan, to discover what you can do better,” she says. “It’s great to have someone to talk to — I’ve been a mentor through NSF myself as well.”

Bottom line: Build a circle of advisors for decision-making and expertise. This could be a network of individuals and organizations that can provide insight into ways to make your business a success. One valuable piece of advice Parmeswaran got from an accelerator was to not just focus on developing a product or service, but on creating something commercially viable. “It’s easy to get into the trenches of building your company and lose sight of making sure you’re creating something people actually want to buy or use,” she says. “Advisors ask tough questions you need to hear and provide ideas that can keep you on track.”

Tip: Maintain your optimism

Parmeswaran notes that in the beginning, she realized it was important to become thick skinned and not get discouraged when someone wasn’t open to listening to her idea.

“As a woman in technology, I’ve heard so many ‘no’s’,” she says. “When I was first pitching Vital Start, many men simply didn’t understand the complexity of postpartum depression. They’d say, ‘it’s just baby blues, this isn’t a real problem.’ But things are changing.”

Vital Start has a goal of impacting a million women by 2030. To reach as many women as possible, the company plans to partner with group practices and large health systems. Vital Start has also pledged to use 5% of its proceeds to offer counseling to women in underrepresented and underserved communities.

Later this year, Vital Start plans to begin an influencer marketing campaign with mommy bloggers and caregivers such as doulas and will expand the amount of information it offers via its website for self-guided care both in English and Spanish. And, the 10-person team will expand, hiring additional talent and moving current consultants to full-time employees such as a chief technology officer, care coordinators, a head of product marketing and additional coaches.

Bottom line: Remember that if people don’t respond positively to your business idea, it may not mean there is an issue with your business. While repeated questioning of your concept should prompt you to examine your plans, most entrepreneurs experience a lot of naysaying and push back. Maintaining your commitment and momentum in the face of these reactions is essential to success. Absorb constructive criticism, refine your idea as you learn more about your market, and continually hone the way you communicate company value. “If someone says no, that’s okay. Keep trying,” says Parmeswaran. “Eventually, you’ll find the right business case and people who say yes.”