Yana : You Are Not Alone

Yana is a Chatbot that helps people achieve emotional wellbeing through strategies based on Cognitive-Behavioral Therapy. It works as an anonymous, secure and non-judgemental space in which you can work through different tools and techniques to tackle negative thoughts and behaviors any day, at any time. Yana is not only for those who have Depression or Anxiety, it is meant to help anyone to improve their mental health state.  

Yana is designed to help people overcome the obstacles in their lives and becoming better versions of themselves. For many this can lead to them seeking out therapy sooner, drastically reducing the current average of 10 years and preventing them from suicide.For others it can help them to take more control of their lives, go to the gym, get a job, or pursue a passion.

Although Yana is meant to help people achieve emotional wellbeing in general, we’ve decided to try and solve the problem of depression first. Specifically, the lack of access to preventive and active treatment, and the amount of time people take to receive it. 

According to the WHO, depression is the number one cause of disability worldwide, with more than 350 million people diagnosed, which is equivalent to 4,4% of the world’s population (an increase of more than 18% between 2005 and 2015), and is a major contributor to the overall global burden of disease. Most importantly, the number of people diagnosed with depression keeps rising. 

More than 50% of those affected and up to more than 90% in some countries don’t receive adequate treatment. Limited amount of mental health professionals, along with stigma, discrimination, and neglect prevent care and treatment from reaching people with mental disorders.

We’ve started to work in Mexico, where there are more than 5 million people clinically diagnosed with depression and the average treatment takes 14 years to receive.

It’s important to keep in mind that Yana is meant to help people achieve emotional wellbeing in general. With that in mind, we can serve basically anyone who has a Facebook account (and is over 13 years old) and speaks Spanish. Since anyone can improve their emotional state, we could serve over 250 Million people to do so (Spanish speaking people with a Facebook account). 

Because we also have a focus on depression, we estimate that we can help over 10 Million people (Spanish speaking people with a Facebook account who have a depression diagnosis). 

Although depression can and does affect people of all ages, from all walks of life, the risk of becoming depressed is increased by low income, unemployment, life events such as the death of a loved one or a relationship break-up, physical illness and problems caused by alcohol and drug use. 

We understand user’s needs through the data provided to Yana (we can analyze which tools are more useful, which sections are helpful or not, etc) and we also interview and ask for feedback daily to improve Yana and adapt it to their needs.

Yana is an automated conversational agent (chatbot) that helps people achieve emotional wellbeing through strategies based on Cognitive-Behavioral Therapy. It works as an anonymous, secure and non-judgemental space in which you can work through different tools and techniques to tackle negative thoughts and behaviors any day, at any time. 

Although Yana is meant to help people achieve emotional wellbeing in general, we’ve started to put a strong focus on depression. 

Yana’s Versión 1.0 is divided into four sections: (1) Mood journal, (2) Toolbox, (3) Emotional Health and (4) Crisis management. 

Mood Journal: daily check-in to evaluate your mood to better understand your day to day life and the factors associated to the mood (eg. feeling nervous, level 9, factor: school), daily conversations related to that mood and factor (eg. why it's normal to feel nervous and why you shouldn't feel nervous about it), and three recommended tools specific to that mood and factor (eg. dealing with stress, professional motivation and social anxiety tools).

Toolbox: more than 90 tools available to choose from to improve your life: tools for self-esteem, for better social interactions, for better sleep, for energy, for productivity, etc. 

Emotional Health: provides assessments every 2 weeks to understand if you are dealing with depression -and how severe it might be- and how is it changing overtime, along with recommendations of professionals available to book a session in case of need.

Crisis Management: helplines and guidelines to cope with suicide ideation, panic attacks and anger management. 

Yana's Alpha Version 1.0 will be released on the 2nd of August this year; Beta version will be released on the 23rd of August and the Public version will be available through Facebook Messenger the 30th of September. This version is powered by NLP and AI basics. 

While Yana DOES NOT replace therapy, we do use Cognitive Behavioral strategies that are usually delivered in therapy and give them to hundreds of people so they can benefit themselves from it, any day, at any time, in the commodity of their own phone. Since Yana is automated, it can talk to 1 person or 1 million people at the same time, without the need of human intervention (unless necessary). 

Cognitive behavioral therapy, or CBT, is the most evidence based and widely used therapeutic approach today; It helps people feel better by challenging negative thoughts and behavioral patterns. Yana does this by creating a space where you can challenge your thoughts again and again through a mood journal until you find healthier ways of thinking, and delivers over 90 tools and techniques you can apply to change your behaviors. 

It is important to say that, while there are studies that report the positive effects of CBT delivered through online platforms, we know there are limitations. And, when this is not enough for the user, Yana helps them realize that they need professional help and connect them in the least amount of time possible.

Regarding the competition, there are competitors (Woebot, Wysa, Youper, Replika) that base their intervention in only some aspects of CBT tools, such as Behavioral Activation (Volume), expressive writing (Kintsugihello), or only the cognitive side. We seek an integral approach, using behavioral, cognitive, writing, movement tools, among others, and other non-CBT that promote a good emotional state.

Yana is offered through a Chatbot in Facebook Messenger powered with Natural Language Processing and Machine Learning to better understand our users’ language, which will allow us to analyze their problems, feelings and thoughts profoundly. 

This analysis will bring more power to the user because they will be able to understand themselves better and, on our side, we will be able to understand the human mind in a more profound way, particularly, the vast amount of components associated to depression and anxiety, so we can deliver better products in the future.

We released a Minimum Viable Product last year in which ~650 people participated. We measured the state they got in through a Depression test (PHQ-9), and checked their improvements every week for 4 weeks, which is the amount of time the MVP lasted. 

From the people who finished the whole program, we saw an 85% improvement on test scores, and the other 15% remained the same.

We interviewed all of them and saw the most impressive effects: some realized they felt better when they exercised, so they enrolled at a gym. Others realized they felt worse only during work, so they changed jobs. Others realized that their body image had a huge impact on their depression, so they decided to see a nutritionist. Others started to wake up earlier, others listen to music more often, others created reminders to talk to loved ones so they wouldn’t forget, others walk to their job instead of using their cars. 

Let’s remember the problem we are solving: lack of access to preventive and active treatment, and the amount of time people take to receive it. 

Regarding the amount of time people take to receive therapy, we saw a huge change in people who would have never considered therapy before and regarding the access to preventive and active treatment, we helped people who had Minimal, Mild, Moderate, and, in some cases, Moderately Severe Depression, to prevent more severe emotional states by making changes in their everyday lives through a technological platform in Facebook Messenger. 

We have had ~650 users who’ve received help from Yana. We are aware that this is a small number, but all of them have come through word of mouth. We made a closed Beta with 8 people, and those 8 brought us more than 600 people. Considering that depression is still taboo, we think this is a pretty good number. 

We haven’t done marketing nor spread the mouth in general because we are working on reaching Product Market Fit and a certain percentage of retention before making noise.

We are working to release the official Version 1.0 in 13 days and planning on reaching more than 1 million people in less than a year. 

In five, 10 million.

We have to address the whole Mexican market before thinking about other Spanish speaking countries. 

Inside Mexico, we are planning on aligning efforts with crisis hot-lines so we can offer a text-based solution for our users, apart from the phone-based. We also want to collaborate with some pharmaceutical companies and depression/anxiety research centers to further the research and development of therapy and treatment. On the other hand, we want to develop and give a license to government or public institutions so they can hand it over to vulnerable groups for free, among other efforts.

We believe that 2 years will be enough to fully understand and serve our country, and then we plan on releasing it in every Spanish speaking country in the world (by year 2).

After that, we want to translate Yana to serve Nigeria, China and Russia (by year 5).

One of the most important barriers we have today is to understand the way in which we can create a viable business model, because this is the only way to truly create a sustainable business that serves every single being on the planet. 

In order to scale outside of Mexico, we would need to overcome the social and cultural aspects of other Spanish-speaking countries. The reason behind this is that most of the way Yana interacts with the user has to be relatable. What kind of problems do they face? How do they express themselves? What words do they use? What are their most important needs? 

Another aspect to scale would be the legal and regulatory barriers for the use of Yana in other countries. We need to understand the requirements and standards of every country in order to adapt it and make sure we are not violating any of them.

Lastly, another barrier is the development of new and specific tools to attend a broader mental health spectrum. Tools that would help people with problems like eating disorders or addiction, for example. We would need to hire professionals with those specialties because our current team only specializes on Depression and Anxiety; this new hires could include evidence based tools that are already in use, and innovate with new techniques as well. 

Regarding the business model, we already have financial experts and marketing strategists that are evaluating our possible paths, although we are looking for a Business Developer.

To scale outside of Mexico, we would need to hire teams in each place that can understand each market (socially and legally speaking), hire teams with different mental health specialists to attend a broader population, and create partnerships with international Mental Health institutions, research centers, pharmaceutical companies and universities that want to expand their research.

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• Full time - 5: Chief Clinical Officer, Chief Growth Officer, Chief Financial Officer, Chief Executive Officer, Junior Developer and Graphic Designer.
• Part time - 4: Senior Developer (consultant) and Editor.
• Contractors - 3: Crowdbotics (technology), legal department and accountants.

First and foremost, we are a human driven team focused on helping people becoming a better version of themselves. 

Our Mexico City-based team is composed of 8 members: 

• Andrea Mañon: expert in the field of Psychology and Psychotherapy; She is a fully dedicated and disciplined therapist, graduated from Anahuac University in Mexico and with a masters degree in Clinical Psychology and Cognitive Behavioral Therapy from the ISEP in Madrid. 

• Dr. Diego Garfias: general practitioner, graduated from UDEM. Diego is passionate for solving mental health related problems beyond a hospital environment.

• Fernando Rios: developer with vast experience handling and creating Chatbots. He is a skilled and relentless programmer who is always looking to improve his knowledge. 

• Bernardo Cassina: Senior developer who is always researching new technologies to make the hardest decisions in order to make sure that Yana can always scale.

• Jorge Torre: financial expert graduated from ITESM and a retired Wall Street banker with a passion for social entrepreneurship. 

• Regina Desentis: a talented graphic designer who translates all of our ideas into beautiful work.

• Luis Arriola: Spanish teacher who is in charge of checking all the content so that it can always have impeccable spelling and writing. 

• Myself: self-taught programmer with a huge passion for mental health. Through my own personal struggle, I’ve dedicated my life to give people the right helping hand I wish I had.

What makes our team unique is our ability to apply our professional expertise with our first-hand experience with depression and/or anxiety.

We do have a lot of potential partnerships, but nothing formal yet. We have potential Universities, Pharmaceutical companies and Institutions that support mental health in one way or another.

Yana provides value to its customers by being a mental health platform that can be accessed at any time, by focusing on personalized problems of each user and by having a diverse array of tools from which to choose how to manage your wellbeing. Yana does this by using strategies based on Cognitive-Behavioral Therapy through Facebook Messenger.

Yana’s key customers and beneficiaries are anyone who want to manage their emotional wellbeing (specially those with depression and anxiety), a Facebook account (and is over 13 years old) and speaks Spanish. Although depression can and does affect people of all ages, from all walks of life, the risk of becoming depressed is increased by low income, unemployment, life events such as the death of a loved one or a relationship break-up, physical illness and problems caused by alcohol and drug use.

Business Model Hypotheses:

1. (B2C) Charge the final user a monthly subscription of $2-4 USD to receive the whole program.

2. (B2B) Charge high schools, universities and companies to cover their alumni/employees subscription and get metrics on their mental health, alerts on those who need immediate help (crisis cases), see which areas or careers are more vulnerable, etc. $2,500-3,000 USD a month, for campus. 

3. (B2B) Charge health professionals in order to be recommended by Yana when needed. (We've been asked for psychologists, psychiatrists, nutritionists, etc). Which later on the road can evolve in a spinoff of our product for psychologist to manage and monitor their patients progress in an automated procedure. 

4. (B2B) Charge businesses in order to be recommended by Yana. Only places that promote wellbeing. Gyms, restaurants, meditation centers, etc. 

5. (B2B) Big data.

The great thing about this, is that we can have all of those models at the same time.

The most important thing we could do thanks to Solve is to find a viable business model in order to scale. The value provided by mentors, health and mental health leaders, investors and/or experts in the industry in general would allow us to create a sustainable business model so that everyone who needs it can benefit from Yana. We do not want to depend on charity or funds in order to make this work, we want to make it work on its own.

Although we do not NEED the money from the prize, it would certainly allow us to do things way faster by hiring a bigger team, particularly, a Business Developer, another Cognitive-Behavioral Therapist and a Machine Learning expert.

We would also gain exposure which will allow us to close the potential partnerships we have in mind.

Finally, but not less important, we currently have very few researches on Depression, CBT, Technology and AI in Mexico, and having access to all of this from people at MIT would be a huge game changer. 

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• MIT or a University from your network; so we can have an institutional backup, where academics and researchers within the university approve and support the quality and efficiency of Yana. 

• Beck Institute for Cognitive Behavioral Therapy; so we can have the approval of one of the most (if not THE most) important institute for CBT. They could check all our CBT content and somehow approve the quality and functionality of our work. We would also like to carry out randomised controlled trials to further our research and figure out the exact efficacy of Yana. 

• Mental Health Institutions in general; so we can collaborate together in awareness and/or stigma campaigns.

We want to utilize AI to create a safe and trustworthy environment between the user and Yana, so that he/she can open up and be honest when expressing his thoughts and feelings (they need to feel as safe as they do they are talking to their best friend). This environment can only be created through Machine Learning and Natural Language Processing; although we are currently using Dialog Flow, we are definitely not using it to its full potential. We are using a lot of pre-defined decision trees, instead of training Yana to do it naturally. 

With the prize money, we would be able to hire a Licensed Cognitive-Behavioral Therapist who can analyze the user’s responses word by word and a full time Developer who can train the “intents”, and little by little, model and create our own engine.

This will allow the user to interact easier and more naturally with Yana, as they would with a person. This, in turn, will allow users to get better, faster.  

We would use the prize to hire a bigger team, particularly, a Business Developer, another Cognitive-Behavioral Therapist and a Machine Learning expert. 

The Business Developer would help us find a viable business model in order to scale and help as many people as possible. 

The Cognitive-Behavioral Therapist would help us analyze the user’s responses word by word and the Machine Learning expert would train the “intents” in order model and create our own technological engine. This will allow the user to interact easier and more naturally with Yana, as they would with a person. This, in turn, will allow users to get better, faster.