By Dr. Will Osei, Ph.D.

The core idea:
Mental health care is in a strange economy: demand at an all-time high, revenue per clinician at an all-time low.
Platforms and private-equity models have scaled “access” by burning through clinicians. They treat therapy as a volume business — a subscription model built on human attention.
We’re building the counter-model.

1. The Economics of Exhaustion

Talkspace, BetterHelp, Headway, Alma — they solved distribution, not sustainability.
They monetized the gap between what clients can pay and what clinicians can endure. The industry rewards throughput because throughput scales; depth does not.

But depth is where outcomes live — and retention, referral, and brand value follow outcomes.
When you reduce therapy to messaging frequency or session count, you cut the one variable that actually drives results: the therapeutic relationship.

Meanwhile, reimbursement remains stagnant. A licensed clinician can hold thirty sessions a week and still out-earn an entry-level engineer by a slim margin. High demand, low margins — the classic setup for exploitation disguised as innovation.

2. The Productivity Fallacy

Community agencies once carried the caseload myth: 80, 100, 120 clients per clinician, justified by “access.”
Digital platforms revived it at scale. Their dashboards display “active clients,” not “effective work.”

A “full” therapist looks great to investors, but the cost is invisible: turnover, diminished empathy, clinical error, disillusionment.
The system’s brilliance is its deniability — every individual burnout looks personal, not structural.

3. Why Clinician-Led Models Matter

Therapists understand the product in a way finance never will: it’s time, trust, and focus — none of which compound.
Clinician-led organizations optimize for quality per hour, not hours per week.
That’s not idealism; it’s economics.

When you align the business model with how therapy actually works, three things happen:

1. Retention improves. Clients stay longer, refer more, and need fewer re-entries.
2. Clinician turnover drops. Stability lowers recruitment and onboarding costs.
3. Brand equity compounds. Credibility becomes your differentiator — not discount codes.

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This is how you outlast platforms chasing quarterly growth.

4. Redefining Scale

Scale in mental health shouldn’t mean “more sessions.” It should mean more sustainability per session.
We can scale through:

• Clinical infrastructure — shared supervision, AI-assisted documentation, outcome tracking that actually measures change.
• Operational design — technology that reduces admin load rather than extracts value from clinician labor.
• Revenue diversification — workshops, organizational partnerships, psychoeducational products — not more 1:1 hours.

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The next phase of this field isn’t telehealth at volume; it’s therapy at integrity.

5. What the Anti-Factory Model Looks Like

At OtherKind, our bet is simple:
Quality of care is the business strategy.

That means:

• Smaller caseloads, higher engagement. Clinicians practice at their optimal capacity, not maximum capacity.
• Transparent economics. Shared profit models, not top-down extraction.
• Clinical leadership. Business decisions filtered through ethical frameworks, not investor decks.
• Technology as support, not surveillance. Tools that extend thinking, not track productivity.

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We’re not anti-business. We’re anti-burnout economics.

6. The Industry Reckoning

If the field keeps chasing scale without structure, we’ll lose another generation of clinicians — and with them, trust.
Mental health care doesn’t need more apps; it needs better systems.

We don’t have to beat Talkspace at distribution.
We have to make their model obsolete.

The Takeaway

The caseload myth was always about scarcity — not of time, but of imagination.
Clinician-led organizations can rewrite that narrative by proving that depth scales differently:
through outcomes, reputation, and longevity.

That’s not a wellness ideal. It’s a market advantage.