ShockTalk

For centuries, Native American and Alaska Native (NA/AN) communities have accumulated immeasurable amounts of historical and intergenerational trauma in the U.S. The historical exposure to loss of land and life through cultural destruction, catastrophic disease, warfare and violence, coupled with ongoing experiences of poverty and discrimination has subjected native people to substantial difficulties. Indian Health Service (IHS) is severely underfunded (funded at 51% capacity), which contributes to understaffing and long wait times to access mental health services, and although IHS is tasked with implementing culturally appropriate care to NA/AN, often providers are non-native and do not have experience with the NA/AN communities that they serve. ShockTalk seeks to decrease adverse mental health effects in NA/AN by connecting users to Native therapists trained and experienced in cultural humility through a telebehavioral and wellbeing app focused on healing unresolved historical and intergenerational trauma.

Research indicates that Native American and Alaska Native (NA/AN) populations have disproportionately higher rates of mental health problems than the rest of the US population. High rates of substance use disorders (SUDs), post traumatic stress disorder (PTSD), suicide, and attachment disorders in many NA/AN communities have been directly linked to the intergenerational historical trauma forced upon them, such as forced removal off their land and government-operated boarding schools which separated NA/AN children from their parents, spiritual practices, and culture. ShockTalk aims to solve this problem by delivering culturally tailored and sustainable mental health services to the NA/AN population. To do this, we will be employing Indigenous therapists and clinicians that are trained and experienced in cultural humility.

Due to the combination of historical, intergenerational, and contemporary social traumas experienced by Native Individuals, it is regular and common for people to have their sympathetic nervous system highly stimulated by social media platforms. The hyperstimulation of the sympathetic nervous system produces a fight-or-flight response in active users and results in the reactions and aggressive behavior seen on platforms like Facebook. When this happens to a sufficient extent, Native users respond by withdrawing from the platform in question as part of a broader fight-or-flight response that is activated by the nervous system. ShockTalk represents that space that they can go to to get the tools they need while still maintaining connection to community. ShockTalk’s support section will include tools to stimulate the parasympathetic nervous system’s calming response while also connecting them to an Indigenous therapist. While they take a break from the type of direct engagement offered on Facebook, they can come back to ShockTalk to share and enjoy Indigenous content in a format similar to instagram in the sense that it is not a place for status updates and public commentary but content driven. It is not a microblogging platform, it is a content platform with social features.

ShockTalk was founded at the heart of NYC, which is home to the largest population of Urban Natives in the country. However, ShockTalk has no borders and will benefit all NA/AN communities with mental health needs by making culturally tailored mental health services more readily available through a mobile and online application. Our solution has the potential to function as a safety net for Native’s who are unable to access or access appropriate care via Indian Health Service, Tribally run clinics or Urban Indian Health Programs. Our solution is specifically for NA/AN who are seeking to connect with Native or Indigenous therapists in a timely manner to support their mental health and wellbeing.  

We didn’t come into development with a product-based focus, we came in with a needs-based focus. Overall, our guiding focus has been the need to mitigate the crisis our communities face, so we haven’t hesitated to seek out as much feedback as we could get from our community to show us what the tool should look like. More specifically, on-going customer exploration is key to our development. We listened to understand, not to reply, as Indigenous peoples see ongoing consultation and co-creation as protocol. The overlap of Indigenous protocol and the Agile Customer Discovery process has been key to making ShockTalk the most robust solution it can be. To date, we've reached out across Indian Country and held 66 interviews with both native clients and clinicians to develop both a deep and broad understanding of the problem at hand. Through this process, we quickly learned that we needed to pivot our initial product idea of an Indigenous social media network to address the true need of our people, effective healthcare.

The NA/AN community has disproportionately higher rates of mental health issues compared to other communities, and the aim of ShockTalk is to make mental health services more readily available to the community by facilitating native patient-provider relationships. Our community experiences various barriers to accessing appropriate mental health services such as availability, quality of services, location, and stigma. ShockTalk has the ability to facilitate sustainable patient-provider relationships through a matching algorithm that mitigates those barriers by supplying the resources for a long-term patient-provider relationship. ShockTalk will create a virtual safe space that promotes social and emotional wellbeing as protective factors.

Our solution is fundamentally innovative as it was built from the ground up with an Indigenous interpretation of Agile methodology. There are a variety of areas in the Agile process whose names can be “code-switched” to have a deeper meaning when interpreted through both shared Indigenous protocols and cultures. We used our innovative approach to Agile methodology to tackle the race and class barriers that existing services such as TalkSpace, Calm, or MyWellbeing overlook.

The core technology that will power our solution will be the synergy between our matching algorithm to create culturally appropriate relationships, our billing software to easily process Medicaid or other forms of payment, and leveraging an API such as VSEE or Amazon Chime with a custom React Native interface to facilitate telemedicine.

The technology behind ShockTalk has been used before, however it has not been used in the way we will be using it. Apps such as Talkspace, Calm, MyWellbeing, and ZocDoc all have similar purposes - to provide online counseling. These apps have demonstrated the ability to successfully facilitate a virtual patient-provider relationship and are successful, with all but MyWellbeing (which does not yet have an app) in the top 200 on the Apple App Store. Research demonstrates that culturally tailored services increase protective risk factors that decrease the likelihood of engaging in harmful behaviors and coping mechanisms.

ShockTalk 

Activities 

Facilitating a Native patient-provider relationship through the matching algorithm

Connecting Native users to Native or Indigenous providers through  chat, audio and/or video calls for telebehavioral support. 

Outputs 

A sustainable patient-provider relationship is developed and culturally tailored mental health services are accessed 

Short Term Outcomes 

Native patients demonstrate the ability to use positive and healthy coping mechanisms to support mental health and decrease adverse mental health effects. 

Long Term Outcomes 

Increase protective risk factors such as: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. By increasing protective risk factors our solution will decrease adverse mental health effects such as self harm and suicidal ideation and attempts. 

ShockShare 

Activities 

Create a trigger free and culturally tailored social space to promote social and emotional wellbeing for Indigenous Peoples. 

ShockShare will connect Native users with friends or other Indigenous peoples digitally through chat, audio, and video calls.

Outputs 

ShockShare, a space for Indigenous peoples to share culturally relevant content without fear of intimidation, hate speech, or other forms of harassment. 

Short Term Outcomes 

Native users will be connected with content which will  enhance cultural knowledge, while building community.

Long Term Outcomes 

Increase protective risk factors such as: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. By increasing protective risk factors our solution will decrease adverse mental health effects such as self harm and suicidal ideation and attempts. 

We currently have a rapid-prototype and are in the process of developing our web concierge before we begin serving our customers. In one year, we hope to be initially serving the 32,887 Urban Natives of the NYC Metro before expanding outwards into the greater tri-state area. By year five, we hope to be serving a large portion of the 5.2 million Indigenous peoples here on Turtle Island.

Within the next year ShockTalk will have launched into the market existing both online and via the app store. We envision ShockTalk being implemented within the tri-state area first, which serves approximately 17 tribes. After successfully piloting within the tri-state we will begin developing a strategic plan of implementation to scale up and provide services within other states through the United States. Our goal within five years is to be serving NA/AN communities within all 50 states. Moreover, we are striving to secure contracts with single payer healthcare systems such as Indian Health Service and Veterans Affairs who serve NA/AN communities.

Some of our main barriers include financial barriers, technology barriers, and legal barriers. Our major financial barrier is funding - just over 1% of start-up venture capital funding goes to entrepreneurs of color. Technologically, we may hit a barrier as well. Not everyone in the market for ShockTalk may have access to the proper technology, such as WiFi, needed to access the app. Finally, since ShockTalk will eventually be employing therapists and counselors across the nation, there may be legal barriers to service. Currently, we don’t have much of an understanding of cross-jurisdictional borders and therapist licensure.

To overcome the potential financial, technological, and legal barriers ShockTalk may face, there are a few solutions. First, to combat the barrier of proper funding, we plan to increase the visibility of NA/AN issues globally to bring more awareness to what our community faces on a daily basis. Second, to combat the technological barrier, we will offer diverse ways for patients and providers to connect with one another. More specifically, we plan to cache critical data and media for offline usage, and including text-based chat-only options alongside the ability to call in from a traditional phone number. And finally, to combat legal barriers, we plan to meet and consult with legal teams to learn the ins and outs of licensure and jurisdictions.

Full-time staff

• Sutton King, MPH (Menominee/Oneida) 
• Austin Serio (Chicoran Shakori)

Part-time 

• Darby Gallagher (MPH candidate) (Miami tribe of Oklahoma) 
• Ariel Richer, LMSW (Indigenous of Venezuela) 
• Jarrad Packard (LMSW candidate) (Yankton Sioux/Oglala Lokota) 

ShockTalk was founded by a diverse group of Indigenous, Native, and Afro-Indigenous individuals. We all aim to embody the values we believe our ancestors would want to see us have - resilience, strength, respect, protection, survival, and sovereignty. Our team has a wealth of experience invested in the vision of ShockTalk. Austin, Co-Founder, worked for Apple at one of their HQ locations while pursuing his degree at NYU Gallatin, and observed the structural changes presently roiling the global economy firsthand. Austin’s focus on the intersections between Indigenous communities, Sustainability, and Product Design are a key reason why our Indigenous-led team is well positioned to deliver this solution.Sutton King, MPH, Co-founder,  holds a bachelors in Psychology and a Masters in Public Health from NYU School of Global Public Health. She is passionate about developing innovative solutions to improve Indigenous health. She has led the development of the first ever culturally tailored simulation “Trauma-Informed Policing with Tribal Youth” which trained law enforcement how to engage with Tribal youth without retraumatizing them. Additionally, she’s implemented sucide technology within 80+ tribes. Sutton is a leader with 5+ years experience in local, state, federal and tribal affairs. She is experienced in the management of federal grants and the development, implementation, and evaluation of health programs in Native American and Alaska Native communities within rural and urban areas.

UIC has developed partnerships with key Indigenous organizations and programs to develop a pipeline of future Indigenous leaders as well as to begin the work of decolonizing and indigenizing New York City infrastructure. We are currently working with Safe Harbors Indigenous Collective, a Native theater company that has strong ties to the community, to meet the Native community and introduce our program. We are also partnering with The New School to work with students in Indigenous-focused classes and provide them with the opportunity to intern with us as we develop our programing and begin important community-led projects. They have also provided us with space to host our first community forum, despite it being cancelled due to Coronavirus. We continued to work with their students remotely and have been working with them to develop an intern program for the 2020-2021 school year. We have also partnered with Sovereign Bodies Institute, a Native-owned organization that provides advocacy and holds the database for Murdered and Missing Indigenous Women and Girls and we are working with them to develop their East Coast database. This is a major partnership that elaborates on this major issue in Indian Country, and further advocates for Indigenous women and girls and the local and state level. This is part of our work to decolonize and indigenize infrastructure to include data about Native American/Alaska Native/Indigenous people so that we are accurately represented and included in data and future programming. 

We plan to pursue a pathway to financial sustainability by first leveraging a combination of grants and investment capital as we continue through product development and craft iterations of our Minimum Viable Product. We plan to use our funding to code the prototypes we’ve developed from our research and customer discovery processes. After completing the first pass of product development and operationalizing our solution, we plan to continue our financial sustainability by processing Medicaid payments, and augmenting the reimbursements we receive with additional grant funding for trauma interventions. By making Medicaid reimbursement rates more attractive, we will be able to expand the amount of Native providers within the Medicaid network. A focus on robust Medicaid support is key to us as we focus on the class barrier to access, alongside the cultural barriers to access. We also plan to accept out of network benefits and are exploring the possibility of accepting private insurance. We plan to offer a form of co-pay or sliding-scale payment as a final fallback option to ensure all self-identified Indigenous peoples have access to culturally appropriate care. Finally, we plan to sell ad space to Indigenous businesses as a way for Indigenous users to connect with needed cultural goods for cultural and spiritual wellbeing. We expect to use a blend of these funds to both offset the price of healthcare for our communities as well as to maintain organizational sustainability.

There are two main reasons why we are applying to Solve - to increase the visibility of NA/AN issues and financial support of the project. The issues that the NA/AN community face are widely known throughout the community, but get significantly less attention outside of the community. Solve will be able to support us in several ways. If we were to be selected, the funding would be an immense help. However, our other main reason for applying to Solve is to raise awareness of NA/AN issues. Solve’s wide cross-sectional community, as well as connections we would make with other Solvers and members of the Solve community, and even the overarching MIT community, would broaden our own networks, and provide other opportunities to bring notice to the issues in the NA/AN community.

Connecting with Solve and MIT as partners would provide us with a broad network that we would love the opportunity to be a part of. As a start-up, we realize the most important value is generated through conversation and interpersonal connection. Furthermore, additional funding and marketing make a world of difference due to the lack of visibility on NA/AN issues. If we were to be selected, the resources that Solve could offer ShockTalk would elevate us to heights we may not be able to achieve on our own. 

One of the main organizations would like to partner with is Urban Indigenous Collective (UIC). UIC is a native-led team in New York City that is dedicated to the advocacy and support of affordable health and wellness services for self identified NA/AN peoples. UIC would make a good partner because their mission aligns with the goals of ShockTalk. We would also like to partner with MIT. As we explore the intersections between Indigeneity and Agile, partnering with MIT would help us advance our solution in several ways - it would increase our visibility, we would be able to connect with the massive MIT community, and MIT has resources we may not have access to ourselves. 

The Experian Prize has the opportunity to make a large impact if ShockTalk is chosen to participate. ShockTalk has the capacity to create new jobs that are accessible to tribal nations, a community that has been ignored for too long. Co-Founder Sutton is an Afro-Indigenous woman from the Menominee and Oneida nations of Wisconsin. She is the grand daughter of the last chiefs of the Menominee nation, who fought for their tribe to stay in their ancestral lands during forced removal. Her African ancestry traces back to the historic Africatown of Mobile Alabama, where the last slave ship arrived into America. Co-Founder Austin's family were Indigenous participants in the Great Migration to the North for “the good union jobs”. We see ShockTalk as the opportunity to invest in tribal communities by creating well paying jobs in tribal communities, so Indigenous peoples can stay close to their families and homelands. These jobs will be created by Indigenous peoples, for Indigenous peoples