What Building a Mental Health Startup Taught Me About My Own Mind

What Building a Mental Health Startup Taught Me About My Own Mind

There's a particular kind of cognitive dissonance that comes with building mental health technology. You spend your days immersed in clinical research, talking to therapists about therapeutic alliance, studying dropout rates and treatment adherence. You design systems meant to help people understand and manage their emotional lives.

And then you close your laptop and realize you haven't checked in with your own emotional state in weeks.

I'm Francisco, co-founder of Mena.ai, a digital mental health platform that helps psychologists manage their clinical practice and supports patients between therapy sessions. Over the past few years, this work has taught me more about myself than any self-help book, meditation retreat, or productivity hack ever did.

These are the lessons I didn't expect.

The Gap Between Knowledge and Practice Is Enormous

One of the first things I learned working closely with clinical psychologists is that knowing what helps and actually doing it are fundamentally different skills. This isn't news to anyone in therapy, therapists call it the "insight-action gap." But experiencing it firsthand, while building a product designed to close that exact gap for others, was humbling.

I knew that journaling improves emotional regulation. A 2018 study published in JMIR Mental Health found that online positive affect journaling was associated with decreased mental distress and increased well-being in medical patients after just one month. I'd read the research. I'd even built mood-tracking features into our patient app.

Was I journaling? No.

Was I tracking my own mood? Absolutely not.

The lesson wasn't that I needed to become my own patient. It was that building tools for emotional awareness doesn't automatically make you emotionally aware. You still have to do the work, awkwardly, imperfectly, on days when you'd rather not.

Working With Human Suffering Changes You, Whether You Want It or Not

When you build financial software, you think about numbers. When you build a social platform, you think about engagement. When you build mental health tools, you think about pain.

Not in an abstract sense. In a very concrete, "this is what a PHQ-9 score of 22 actually feels like for a real person" sense.

Our platform integrates clinical scales like the PHQ-9 (for depression) and GAD-7 (for anxiety). These are standardized questionnaires that therapists use to track symptom severity over time. The numbers range from minimal to severe.

Early in our development, I was testing the PHQ-9 integration and answered the questions honestly for myself. The result wasn't alarming, I was somewhere in the mild range, but the act of sitting with those questions ("How often have you been bothered by feeling down, depressed, or hopeless?") forced a level of self-honesty I'd been avoiding.

This is something therapists deal with constantly. A 2025 burnout survey by Tebra found that therapists reported the highest rates of mental health fatigue (77%) among all medical specialties. Over 52% experienced burnout in the past year. The people we ask to hold space for suffering are themselves suffering.

Building for this population means you can't look away from that reality. And it bleeds into how you see everything, your own stress, your team's wellbeing, the emotional cost of the work itself.

The Dropout Problem Is Personal

One statistic has shaped our entire product direction more than any other: therapy dropout rates among young people range from 20% to over 50%, depending on the study and how "dropout" is defined.

A meta-analysis by Swift and Greenberg (2012) in the Journal of Consulting and Clinical Psychology found that approximately 20% of psychotherapy patients prematurely terminate treatment. But among younger clients, the numbers are significantly higher. A study published in Frontiers in Psychology found that 37% of adolescents with depression dropped out when defined as ending treatment without therapist agreement.

These aren't just numbers for me. We started Mena.ai partly because of them. Our pilot project targets 1,000 young people with the goal of reducing therapy dropout by 30%.

But working on this problem also made me examine my own history of dropping out, not of therapy specifically, but of things that required sustained emotional effort. Relationships where I pulled back when things got hard. Habits I started and abandoned. Conversations I avoided.

The patterns are the same. Discomfort triggers disengagement. The things that matter most are often the things we quit first.

Understanding this at a clinical level has made me more patient with myself and others. Dropout isn't laziness or lack of motivation. It's usually a signal that something in the process isn't working, the fit, the timing, the level of support between touchpoints. That's exactly the gap our patient app tries to fill: keeping people connected to their therapeutic process even when they're not sitting in a session.

Founders and Therapists Have More in Common Than You'd Think

This was the most unexpected lesson. Startup founders and mental health professionals share a surprising number of occupational hazards.

Both roles involve:

• Absorbing other people's emotions and problems as part of the job
• Making high-stakes decisions under uncertainty
• Working in isolation more than outsiders realize
• Feeling pressure to appear calm and in control regardless of internal state
• A culture that rewards overwork and undervalues rest

Research shows that 72% of startup founders face mental health challenges, and only 7% of startups have any formal mental health support (A2D Ventures, 2024). Among therapists, over 60% report burnout symptoms, and nearly 40% have considered leaving the profession entirely.

The difference? Therapists at least have the clinical vocabulary to name what they're experiencing. Most founders don't. We just call it "grinding" or "hustle" and wear it as a badge of honor.

Building a mental health platform taught me to stop treating my own stress as a character feature and start treating it as data worth paying attention to.

What I Do Differently Now

I'm not going to pretend I've cracked some code. I haven't. But here's what has shifted for me since starting this work:

I track how I feel. Not every day, and not perfectly. But regularly enough that I notice patterns. Mondays are hard. Post-fundraising weeks are harder. Knowing this helps me plan instead of react.

I talk about hard days out loud. With my co-founder, with our team, sometimes publicly. Not for sympathy, for normalization. If we're building something that's supposed to reduce stigma around mental health, we can't pretend we're immune to it.

I separate productivity from worth. This is still a work in progress. The startup world tells you that your value is your output. Working with therapists has taught me that your value is inherent, and rest isn't the opposite of ambition.

I take the between-sessions seriously. In therapy, what happens between sessions often matters more than what happens during them. The same is true for founders. The reflection, the rest, the conversations with people who care about you, that's where the real processing happens.

What This Means for You

You don't need to build a mental health startup to benefit from these lessons. Here's what I'd suggest to anyone reading this:

Pay attention to your patterns. Not with judgment, but with curiosity. When do you withdraw? What triggers your worst days? What helps, even slightly?

Close the insight-action gap. If you know that exercise helps your mood, or that isolation makes things worse, or that you sleep better when you journal, do the thing. Imperfectly is fine. The research supports consistency over perfection.

Treat mental health like physical health. You don't wait until you break a bone to think about fitness. Don't wait until you're in crisis to think about your emotional wellbeing.

And if you're currently in therapy and thinking about quitting, talk to your therapist about it first. The discomfort might be a sign that you're doing exactly the right thing.

If you're in crisis, please reach out to the 988 Suicide & Crisis Lifeline (call or text 988) or your local crisis line.

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Building something at the intersection of technology and mental health? Mena.ai partners with clinicians and institutions to support therapists and patients. See how it works →

Frequently Asked Questions

Are founders really at higher risk for mental health challenges?

Yes. Research consistently shows 72% of startup founders report mental health impacts from entrepreneurship, and 54% experienced burnout in the past twelve months. Yet only 7% of founders facing challenges seek professional support, largely because startup culture rewards endurance over self-awareness. The pressure to perform, the isolation of leadership, and the identity fusion between founder and company all compound in ways most professional roles don't.

How can a founder begin to address their mental health without losing momentum?

Start small. Track how you feel regularly (even imperfectly). Talk about hard days openly with at least one trusted person. Separate productivity from self-worth as a deliberate practice. Consider therapy as maintenance, not crisis intervention — the most valuable sessions are usually about patterns, not emergencies. The goal isn't to become a different person; it's to build a sustainable relationship with the intensity that comes with building something meaningful.

Does building a mental health startup make you immune to mental health struggles?

No, often the opposite. Working with clinical research and therapists daily gives you the vocabulary to recognize problems but doesn't automatically make you address them. The "third-person effect" — believing data applies to others, not yourself — is especially strong among founders. Knowing that burnout is real doesn't prevent it. Knowing what helps doesn't mean you'll do it. Awareness is the starting point, not the finish line.

What's the difference between knowledge and self-awareness in mental health?

Knowing what helps and actually doing it are fundamentally different skills. Therapists call this the "insight-action gap." You can read about journaling, mood tracking, or CBT techniques, but until you practice them — awkwardly, imperfectly, on days when you'd rather not — they remain abstract. Self-awareness isn't a fixed state you achieve; it's a practice you return to. The founders I most respect aren't those who have it figured out, but those who keep showing up to that practice anyway.

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References:

• Swift, J. K., & Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 80(4), 547–559.
• Smyth, J. M., et al. (2018). Online positive affect journaling in the improvement of mental distress and well-being. JMIR Mental Health, 5(1), e11.
• O'Keeffe, S., et al. (2019). "I Just Stopped Going": A mixed methods investigation into types of therapy dropout in adolescents with depression. Frontiers in Psychology, 10, 75.
• Tebra (2025). Physician Burnout Survey, therapists reported 77% mental health fatigue rate.
• SimplePractice (2025). Therapist Burnout Report, 52% of therapists experienced burnout in past 12 months.
• A2D Ventures (2024). Startup Founder Mental Health: 72% face challenges, yet only 7% get support.
• Victoria Lewis (2024). Mental Health: The Silent Battle of 72% of Startup Founders.