The Zeera Effect: How our Innovative Care Model Drives Measurable Mental Health Outcomes

By Dr. Rachel Hoffman, Chief Clinical Officer, Zeera

Key finding #1: After 60 days of using Zeera, on average, a member’s depression decreases by 4.57 points (PHQ-9); stress decreases by 6.78 points (PSS-10); loneliness decreases by 7.11 points (UCLA-20).

Key finding #2: After 60 days of using Zeera, 56% of participants improved from one severity level of depression to a healthier severity level of depression (e.g. from “severe” to “moderate”, as measured by the PHQ-9), 46% of participants improved by at least one severity level in loneliness (as measured by the UCLA-20), and 51% of participants improved by at least one severity level in perceived stress (as measured by the the PSS-10).

Key finding #3: 85% of participants report feeling either satisfied or very satisfied with their experience using Zeera.

Key finding #4: Zeera’s impact was attributed to the diversity of topics available in-app, eclectic modalities of care, practical tools and educational content, presented in a relatable, non-judgmental way. Personalized recommendations and a user-friendly design enhanced Zeera’s efficacy, while audio content of member stories within a friendly tone fostered a sense of community.

The Challenge: Addressing the Rising Mental Health Crisis

TW: suicide

The first client I ever welcomed into my office arrived, settled onto the couch, and shared something that struck me deeply: he had attempted suicide twice before, and was currently grappling with suicidal ideation again. What struck me even more was that I was the first therapist he had ever reached out to.

It made me pause and wonder: how does this happen? When we feel chest pain, we don’t wait until a heart attack strikes before seeking medical attention. So why is mental health care different? What sets it apart is that often, people delay seeking mental health help, even when they need it. Tragically, even when people do seek help, the help they receive often falls short of what they truly need.

Not only do we need a better mental health care system — in other words, a better mental health care product — but we need people to engage with care sooner. This means we need a care model that people want to engage with earlier and more frequently.

Today, mental health challenges pose a significant challenge, with 76% of working adults having a symptom of mental illness (source). What may come as a surprise is the alarming impact it’s having on the workplace.

  • Depression left untreated costs $51 billion annually in the US alone in absenteeism and lower productivity at work (source).
  • Stress and loneliness left untreated costs employers $154 billion annually in the US alone (source).
  • 76% of working adults had a symptom of mental illness last year alone, thereby requiring mental health support, though we only have enough therapists in America to offer weekly therapy to 7% of Americans (source).

We need Innovative Solutions: The Zeera Approach

Traditional care models, like 1:1 therapy, prove effective for individuals with access, affordability, and the ability to find a suitable therapist who meets their needs. However, due to a scarcity of clinicians and poor diversity within our country’s therapist population, the majority of Americans remain unable to benefit from these high-touch solutions. Measurably speaking, 93% of Americans will never have weekly therapy, due to our therapist shortage. We have to increase the number of mental health specialists in the US by 15 times in order for every American to have access to 12 weekly therapy sessions per year — and this doesn’t yet cover the racial inequities across therapists. Due to this massive gap, the challenge lies in constructing an innovative, scalable care model that upholds a stringent standard of clinical efficacy. In other words, we need to build a new model of care that effectively treats mental illness, without relying on 1:1 therapy.

Zeera is transforming how we incorporate mental wellness into our daily routine with a new mental health care model that members engage with anonymously. Inspired by the principles behind group therapy, Zeera combines therapist-tools, therapist lessons, and real-member stories about lived experience facing mental health concerns, in an audio content model, delivering clinically effective mental health care in an easy-to-use, lightweight product.

Now, mental health content models have existed before — we have meditation apps, we have CBT-manuals online. The problem, however, is that until Zeera, we have yet to build a mental health content model that is clinically effective. And thus, we have yet to build a content model that can actually solve for our therapist shortage. It is paramount that our mental healthcare offering at Zeera demonstrates tangible clinical outcomes, thereby bringing to life a solution that is engaging, affordable and clinically effective.

We’re dedicated to this at Zeera, and are proud to announce the outcomes of our most recent IRB study, validating our care model’s clinical efficacy.

Zeera’s Proven Clinical Outcomes

At Zeera, we are dedicated to continuously improving the clinical results of our care model, most recently conducting and completing a successful IRB-study capturing our outsized clinical outcomes. The IRB study examined Zeera’s impact on depression, loneliness, perceived stress, and resilience across 50 working adults, while also tracking engagement, after a 30-day single-arm intervention of using the Zeera mobile application, and also after 60 days of use. Participants were selected across various races, geographic locations, and workforce industries, ensuring fair representation across the board. Participants were also invited to participate in a live, follow-up interview.

Our findings demonstrate decreases in depression scores within 60 days of Zeera usage. Notably, 56% of participants improved from one severity level of depression to a healthier severity level of depression (e.g. from “severe” to “moderate” or from “moderate” to “mild”, as measured by the PHQ-9); 46% of participants improved by at least one severity level in loneliness (as measured by the UCLA-20); and 51% of participants improved by at least one severity level in perceived stress (as measured by the the PSS-10).

When accounting for industry, deskless workers experienced a 20.77% reduction in perceived stress (measured by PSS-10) and a 6.25-point reduction in depressive symptoms (measured by PHQ-9). For context, a 5-point reduction in PHQ-9 score is considered to be clinically significant.

We found strong positive correlations for perceived stress with depressive symptoms and loneliness, meaning those who reported greater decreases in perceived stress scores were highly likely to also report greater decreases in depressive symptoms (PHQ-9) and loneliness (UCLA-20). This relationship held true at both the 30 day and 60 day mark. There were also strong negative correlations for resilience with both loneliness and perceived stress at 60 days, meaning higher resilience scores at 60 days were associated with higher decreases in loneliness and perceived stress. In other words, as members experienced decreased feelings of loneliness and stress through their interactions with Zeera, they reported an increase in resilience.

After adjusting for race, gender, baseline severity therapy status, and prior depression diagnosis we found that the changes over time remained significant for depressive symptoms, stress, and loneliness.

Real Stories, Real Impact: Understanding the Human Element

At the core of Zeera’s impact lies the essence of real people sharing real stories. This is the very beauty of traditional group therapy — people clinically benefit from learning how issues show up in others’ lives. The problem Zeera solves is many people aren’t comfortable attending group therapy and “showing” others they, too are struggling. Our audio content model solves for this — delivering the benefits of group therapy, allowing members to hear from other people struggling with comparable issues, while still remaining anonymous and confidential.

While numbers and statistics offer a glimpse of our impact, it is the personal narratives of each participant’s experience that truly illuminate Zeera’s effect on our members. Through qualitative interviews that complemented our robust quantitative data, the nuanced ways in which Zeera transforms lives came to light.

Zeera Enhances Emotional Understanding:

Participants emphasized that Zeera deepened their understanding of their emotional states such as anxiety, stress, and worry. Engaging with the platform expanded their mental health vocabulary, fostering greater self-awareness. Participants noted that Zeera helped them identify their triggers and articulate their experiences and emotions more effectively. Furthermore, participants reported learning practical strategies tailored to their needs, aiding in stress management in various life situations such as parenting and work.

“I think that the workplace has a major influence on your mental health because we spend most of our awake time there. So there’s a piece that’s called ‘Reduce Workload,’ a three-minute piece by the therapist that gives you a technique, like a to-do list that will help you through the day. So I feel that specific piece, that’s the session that helped me manage my stress at work.” — Hispanic Latino or Spanish origin, Man, 32

Zeera Alleviates Loneliness and Fosters Connection:

For individuals with limited social support, Zeera played a pivotal role in alleviating feelings of loneliness. Participants expressed how the app, despite its virtual nature, provided a sense of companionship. One participant shared a personal account of turning to Zeera during a particularly challenging time when their usual support system was unavailable.

“[Zeera] definitely made me feel less alone. I was definitely surprised to play one of the sessions and it be as similar to something that I was dealing with….that definitely, you know, eased any feeling of loneliness that I had… it eased my stress.” — White, Man, 27

Zeera Builds Resilience:

Our qualitative analysis delves into the subjective development of resilience among participants. For some, resilience manifests as motivation, while for others, it signifies the courage to seek support during adversities. Many participants associated resilience with enhancing self-awareness and acquiring skills to navigate challenges independently. Interestingly, many participants viewed resilience not merely as a goal but as a necessity for survival, especially for those confronting continuous adversity.

“That was what made me feel resilient…[Zeera] just constantly reminded me that like I have control over the situation and just helped me calm down and come back and ground myself..almost like somebody telling you like, come on, get up. Let’s go do this…try this coping mechanism, like stuff you didn’t even think about” — Asian, Woman, 23

Zeera Supports Members in Moments of Crisis:

Zeera’s impact on resilience was particularly evident in moments of crisis, providing accessible support when participants needed support most. One participant shared their experience of turning to Zeera while caring for their significant other in the hospital:

“I was working from my husband’s hospital bed dealing with insurance companies and lawyers and still taking care of him. This app was literally like what helped me know I’m okay it’s okay it’s gonna be okay…The app definitely gave me an outlet to listen to other people and how they got through it. It just gave me a moment to stop thinking with my own brain and listen.” — Woman, American Indian or Alaska Native, 41

Moving Forward: Zeera’s Commitment to Mental Wellness

As we navigate the complexities of modern life, the need for accessible, effective mental health care has never been more critical. Zeera stands at the forefront of this paradigm shift, offering not just a platform, but a community of support and empowerment.

Our journey thus far has been marked by profound insights from our members and impactful clinical outcomes. The data presents a compelling narrative: engaging with Zeera drives a clinically significant reduction in depressive symptoms, a decrease in stress levels, a decline in loneliness, and a notable increase in resilience. Yet, beyond the numbers, it is the individual stories of strength and growth that truly embody Zeera’s mission.

Looking ahead, Zeera remains steadfast in its commitment to mental wellness for all. We continue to innovate, refine, and expand our offerings, ensuring that every member finds the tools they need to thrive.

So, whether it’s rediscovering a sense of calm amidst chaos, learning new coping strategies, or finding a community of like-minded individuals, Zeera is here. Join us as we embark on this journey towards holistic, preventative mental wellness.

Welcome to Zeera. Your mental health journey starts here.

*Thank you to Dr. Onisha Etkins for her leadership in conducting this clinical study.