As a founder, a visionary, and a parent, April Koh often looks to the future. To the world her kids will inherit.
So what does mental healthcare look like in a decade?
“You notice something’s off, you get help within days. It’s personalized from the first step, and support is continuous, not just crisis-driven or bound to biweekly sessions.”
It’s a long way from where we are today, and almost incomprehensible from the place where April Koh started over 10 years ago. It was a world that silently suffered in the grips of a mental health crisis, where conversations simmered but were swept under the rug, and where struggles were swiftly dismissed as ‘moods’ and ‘phases’.
April’s upbringing was no different in that respect. “I grew up with my own mental health struggles and watched people I love get bounced around a broken system.” Many recognized the scale of the challenge, but few could draw the dots together to build the solution.
At Yale, the dots started to connect. It was a research paper by Adam Chekroud, who would later become her co-founder, that suddenly implanted the thought, “This is it – this could actually fix what I’ve seen my whole life.” It would take time, patience, and immense amounts of energy, but it was solvable.
This is the story of Spring Health, and of April Koh’s life’s work to tackle one of the biggest public health crises of a generation, putting mental health firmly in the mainstream of healthcare.
Going against the grain
Starting her own business has always been a prospect for April. When she was younger, her dad left a stable corporate job to start his own business: “I grew up watching someone trade security for possibility.” The challenge wasn’t her risk appetite; it was finding a problem big enough to solve and to dedicate her whole career to.
Mental health was like no other challenge she had found before, and was something that sat very close to home. For one, stigma was everywhere. April has spoken previously about the challenges of growing up in an Evangelical church. “You were supposed to just ‘be strong’ or ‘pray harder.”
For a long time, this meant mental health wasn’t treated the same as physical health, even in clinical settings. “Long waits, trial-and-error meds, no outcomes tracking.” It became glaringly obvious to April that these diagnoses and therapies would never work unless they were tailored to the individual.
“Everyone acted like that was normal. I decided it wasn’t.”
Like many great businesses, Spring Health started with a chance encounter. In April and her co-founder Adam’s case, this was her discovery of a research paper that Adam had written as part of his PhD at Yale.
His thesis outlined the first machine learning model that outperformed the average psychiatrist at matching people to meaningful treatment. There it was. That breakthrough that April had visualized was on the page in front of her. A proven, empirical, data-driven approach that wasn’t focused on making care available, but rather on connecting people to the right care.
She didn’t hesitate, almost instantly cold-emailing Adam to discuss more. In no uncertain terms, she typed out her thoughts: “Your paper represents the future of mental healthcare.”
Stop selling algorithms, start selling outcomes
From the outset, Spring Health’s mission has barely shifted. The foundational belief that AI provides the best tool for matching individuals to the best possible mental health care remains as true today as it was then.
But while it may be hard to comprehend today, in the early days of Spring Health, people weren’t as interested in AI. Buyers—whether that’s clinics, employers, or patients—cared less about the technology and more about whether the tool was actually making people better.
“So we stopped selling the algorithm and started selling outcomes,” April remembers. Crucially, this helped them land on the real value they were offering. In a sector where wasted time can be a real killer, they provided the fastest path to the right care.
For April, this reminds her of one of the best pieces of advice she received. “You need stubborn conviction about the mission and product vision, and extreme humility about almost everything else.” They didn’t need to change what they were selling; they just needed to change how they were selling it.
The early days of Spring Health also led to significant discoveries around their target buyers. The original product was designed to sell into health systems, helping them better diagnose their patients. The response was underwhelming, to say the least. Their product was falling on deaf ears, and meetings were drying up.
But one meeting with a large health provider proved instrumental: not in terms of the results of the meeting, but in the advice they received. They suggested speaking to their HR department about offering it to their burnt-out employees. Offering Spring Health as a health benefit to employers opened a world of possibilities and generated strong momentum at a pivotal moment for the business.
“Selling to clinics was a dead end. If we hadn’t pivoted to employers when we did, Spring probably would’ve died,” April remembers.
COVID proved to be a powerful inflection point in this regard. Impacts of the pandemic on people’s mental health ballooned globally, and companies felt overwhelming pressure to support their employees’ health holistically. “Mental health became a board-level issue overnight,” April explains.
After COVID, the company saw a massive increase in users, started working with some of the US’s biggest corporations, and surged to a $3.3 billion valuation in 2024. Spring Health has made several acquisitions in the past few years: they recently acquired Alma, a software platform to help independent mental-health providers accept insurance, build their practices, and connect with patients. Post-close, their combined valuation will be estimated to be $6 to $7 billion. “Seeing our long-term bet on precision, data-driven care validated was deeply satisfying.”
Spring Health: A snapshot
Year founded: 2016
Number of employees: ~1500
Amount raised: $400M+
Total covered lives: ~50M
Balancing high growth with high responsibility
Many founders struggle to keep up with the pace of high velocity scaling. Not April—it suits her ambitious nature as a founder. In her own words, she’s a “mission-obsessed, high-conviction, high-accountability founder”.
Like the best co-founder relationships, April’s personality dovetails perfectly with that of co-founder Adam. “He’s the scientist and evangelist; I’m the builder and operator. He’s more measured and data-first; I’m more instinct- and momentum-driven. That tension, plus deep trust and shared values, is what’s kept us balanced.”
And yet this high growth is always tempered by a hard reality check, especially in healthcare. “You don’t get to move fast and break things with people’s health.” While April’s always had one eye on pushing the boundaries of possibility, she’s always kept the other eye firmly on safety and wellbeing.
That applies just as much to internal practice as to external mission. April would be the first to admit that it has not been easy harmonizing hyper growth with mental health. Monitoring the natural tension between high growth and culture is one thing; stepping in when the two collide is what really makes the difference.
“Our culture nearly broke under hypergrowth and burnout: if we hadn’t owned that publicly and changed how we work, we would have lost our soul and our talent.”
In response, the company has built a clear people philosophy, introduced initiatives such as Focus Weeks and company mental health days, and offers ongoing coaching and therapy to its employees. April’s own role has even evolved, from “Chief Everything Officer” to “steward of vision, culture, and senior talent”.
Writing the future
Given how far the conversation around mental health has progressed over the past decade, it would be easy to think that Spring Health has simply ridden the wave of a changing healthcare paradigm. But Spring Health’s role in transforming mental health is not incidental. What April and Adam have achieved is immeasurably greater, uncovering a genuinely impactful solution to healthcare that doesn’t rely on gut instinct or trial-and-error, but on effective, measurable outcomes.
In many ways, their impact has been measurable too. Their platform is now accessible to 20 million people globally, provided by over 400 employers from Fortune 500 companies to tech startups. For those using the platform, 92.3%report reliable improvement or recovery from symptoms of depression and anxiety.
“We helped move mental health from ‘nice-to-have perk’ to core infrastructure.”
As an AI-native company, their focus remains on continually pushing the boundaries of what AI can achieve. One of her key focuses is currently on their specialty care programs for higher-acuity conditions (“the hard parts of mental health, not just light-touch wellness”). She’s equally sensitive to the gray areas of AI, insisting they would never ship models that haven’t first been clinically vetted.
There’s always room to grow. More dots to join up. Further conditions to focus on, geographies to expand to, and individuals to support. On a personal level, April is constantly pushing herself to grow, especially given ambitious plans on the horizon. “As a founder, I’m still leveling up from ‘great startup CEO’ to ‘great long-term, possibly public-company CEO.’ ”
Her focus remains fixed on the future. But like any visionary, she never leaves the future up to chance.
“My superpower is holding a very long-term, ambitious picture of where mental health should go, and then relentlessly turning that into product, strategy, and standards.”
