Transforming Mental Health Treatment with Erin Sivyer Lee

In this episode of Leadership Bites, Guy Bloom interviews Erin Lee, the CEO of Flow Neuroscience, a company that has developed a wearable headset designed to treat depression through mild electrical stimulation of the brain. 

Erin shares her journey into the healthcare sector, the science behind the headset, and the promising results from clinical trials. The conversation explores the integration of Flow's technology with traditional treatments, the challenges faced in the medical community, and the potential future applications of this innovative approach to mental health. 

Erin emphasizes the importance of accessibility and affordability in mental health treatments, and the episode concludes with a call to action for listeners to explore Flow Neuroscience's offerings.

Takeaways

• Erin Lee runs a neuroscience company that treats depression with electricity.
• The Flow headset is a wearable device that stimulates the brain.
• Clinical trials have shown a 75% drop in suicidal ideation.
• Erin's background includes experience in healthcare and tech companies.
• The headset works for 50-70% of users in treating depression.
• Flow can be used alongside traditional antidepressants.
• The technology aims to be accessible and affordable for all.
• Primary care clinicians are increasingly open to using Flow.
• The future of mental health treatment may include more personalized approaches.
• Flow is exploring applications for conditions like autism and ADHD.

Sound Bites

• "We saw a 75% drop in suicidal ideation."
• "We can fit into a treatment for you that works."
• "We’re not anti-drug, we’re anti-depression."

Chapters

00:00 Introduction to Flow Neuroscience
02:55 The Science Behind the Headset
06:05 Erin's Journey to Flow Neuroscience
08:48 The Founders and Their Vision
12:03 Understanding the Technology
14:49 Integration with Traditional Treatments
17:46 The Future of Mental Health Treatment
20:45 Educating Healthcare Professionals
24:09 Strategic Targeting and Clinician Response
26:53 Challenges in Primary Care vs Psychiatry
29:50 The Role of Data in Treatment Effectiveness
31:45 Exploring Applications in Autism and Neurodivergence
34:01 The Future of Technology in Mental Health
35:57 Understanding the Use of Flow for Well Individuals
38:46 Integrating EEG for Personalized Treatment
42:45 Concluding Thoughts and Future Directions

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Transcript

Guy Bloom (00:00)
So here we are looking as if we know what we're doing. Beautiful. And Erin, it is absolutely fabulous to have you on this episode of Leadership Bites. Welcome.

Erin Lee (00:11)
Thank you so much.

Guy Bloom (00:13)
Well, I always start every podcast with a process of just making sure that everybody knows who you are and making sure that you're at the right podcast. That's always a key component of it. So if somebody was to want to know, hey, Aaron Lee, the heck are you? So let's just say you're at a social gathering. You're being introduced by people. Everybody's doing introductions and somebody said, Aaron, what do you do? What would you say?

Erin Lee (00:43)
would say I run a neuroscience company that treats depression with electricity.

Guy Bloom (00:49)
course you do.

What a fantastic opening statement. I was somewhere the other day and this guy said, well I'm actually a jet fighter pilot. I went are you really really a jet fighter pilot? went yeah, somewhere you've kind of won then haven't you? So what you've just said wins the day so we'll get into that. Well let's jump into what that means right now and you know you have a, we'd say a product wouldn't we?

Erin Lee (01:06)
Thank you.

Guy Bloom (01:18)
product that is, I've seen it on the internet, it has come across my kind of streams in various places and spaces, which definitely tweets an interest. I think the world is full of, you know, everything from things that shift the paradigm through to things that are complete mumbo jumbo, but this isn't anything other than it feels something very, very potentially revolutionary. So it'd be good to understand that.

And maybe if people, if we say, what is the product? How would we describe it? I will put an image up of it, you for those that are watching on a clip and or who are watching on YouTube, because the full episode will be up there. But for somebody that went, what are we talking about here? A pill, a book, something, yeah, shove up your nostrils, what else? So what is air and bring it to life so people can imagine and visualize and keep come with the, come to the party.

Erin Lee (01:57)
Yes, of course, of course. ⁓

Yeah

Yes.

Yes, of course. So I work for a company called Sloan Neuroscience and we have a wearable headset. So it looks not all that different from a pair of headphones, although it's of oriented slightly differently. And you wear that headset for 30 minutes a day for anywhere from three to five times a week. ⁓ And the act of doing that directs a mild stimulation into the sort of part of your brain responsible for mood, memory, focus.

And via that mild stimulation, are treating depression, at least to start. And then there's a number of other diseases that we're very excited about. So very straightforward.

Guy Bloom (02:53)
like saying the car's straightforward isn't it but the internal combustion engine is actually quite complex so yeah I mean maybe let's keep it simple to start with because I'm not in any way technical but if I go to flowneuroscience.com one of the things that just jumps out at me is and I'm looking at it right now is crisis services Leicestershire

Erin Lee (02:55)
Yeah. Yeah. Fair enough. Fair enough.

Yeah.

Guy Bloom (03:18)
The Leicestershire NHS Partnership Trust Crisis Service has shown up to a 75 % drop in suicidal ideation across the trial with the Trust confirming that hospital admissions had been avoided. To be frank, if you said 7.5, I think it would be worth looking at, let alone 75. So when you start doing something like this and you have, I'd love to, ain't no,

almost the catalyst point for, you know, how did you get into this through to 75 %? Yeah, we saw that coming. Or is that surprising even you? So let's, I'd love to, I want to bounce around a little bit of that, but it'd be, it'd be great to maybe just to get us to 75 % on what that means. Maybe we start off with how did you come into this project? Um, yeah, what were the stepping stones to you?

Erin Lee (04:01)
Yeah. Okay. Okay.

Guy Bloom (04:15)
being intrigued by it, catalyzing it, getting involved in it, being the instigator or the joiner of. It'd be great just to get that and then we'll work our way up to where we are today.

Erin Lee (04:28)
Okay, so little bit about my journey to Flow then. Yeah. So let's see, I have joined Flow about four years ago from a company called Babylon Health, which many people may be familiar with. That was actually my first foray into healthcare and sort of the first time ⁓ because we were treating sort of a variety of folks across primary care that you see really the impact of mental health on physical health and overall wellbeing.

Guy Bloom (04:31)
Yeah, let's do that.

Erin Lee (04:56)
And that was sort of when I decided that healthcare was something that I wanted to continue to do even though it's very difficult.

Prior to Babylon, I actually spent the vast majority of my career, really the last almost two decades, in high growth consumer tech. So my first job out of college was at Google. I spent a number of years there. It's a great place to grow up. You learn a lot about what it's like to work in high tech. It's a very safe environment. They teach you a lot. I actually came overseas about 10 years ago with Uber. I ran our operations in Northern Europe and the Middle East.

I think what people don't realize about Uber is we didn't always do things. ⁓

by the book, but actually taxi cabs are an incredibly regulated industry. So that was actually my first foray into highly regulated, rapid growth companies. But what Google and Uber had in common is this obsession around customer experience and really delivering something delightful. And I think what I've looked for in my last couple of roles is the ability to bring that sort of customer experience obsession into health care, where it's so badly lacking.

to that, you know, my own personal experience, my family's experience with mental health issues, addiction, and I actually stumbled along a flow looking for solution for a family member. Started the conversation with the two co-founders, Daniel and Eric, and there's just this point where...

you get where you're like, if this works, I mean, it sounds like at the time, you know, we didn't have any of the trials, but at the time, it sounds like science fiction. But you sort of say if it works, it'll be transformational. And how am I not going to be a part of this?

Guy Bloom (06:38)
That's an interesting one, isn't We've got this thing. Now, if it works...

Erin Lee (06:42)
It works. Yeah. Yeah,

it was a gamble. was it was a gamble.

Guy Bloom (06:46)
Yeah, and that's a moment in... Well, I suppose it's like anything in life. You know, you can set up a hairdressers and you go, well, it's not that hairdressing clearly is a thing, but you know, it's not that this mind's got to work, right? So there's a combination of things here. You know, it's just like in some respects, maybe it's like an iPhone, you know, it can look pretty. And I look at the headset and I go, clearly well designed, looks fantastic. But so what if it's not...

Erin Lee (06:55)
Yeah.

Guy Bloom (07:15)
with evidence, it probably would have some headway until somebody went, there any trials? This thing clearly doesn't work. So, know, chicken before egg, but the two have to kind of land at same time. So the two originators, creators of this, of the headset, could you just give a sense of their background that, again, this is not for clinical people or for people with deep understanding they would want probably a different level of, but just for the...

me the layman who are they and how do they come to the party

Erin Lee (07:49)
Yeah, so our two co-founders are Daniel and Eric, ⁓ Swedish by background. Our company is based, one of our headquarters is in Malmo, Sweden. Daniel is a clinical psychologist. Eric's background is in AI, machine learning. He's also studied a lot of neuroscience and he's done a number of startups. They knew each other from before their paths had crossed. And, you know, Daniel was practicing in clinic.

treating patients. And I think what he saw every day was just sort of the limitations of the existing treatments, right? They work for some folks, but actually, you know, more than 70 % of people don't respond to drugs. And when people don't respond, we actually don't have very good options that are accessible and affordable. And they had both studied some form of neuroscience in school. So there was sort of this understanding of this technology, TDS, where, though it may seem very new,

to users who are sort of experiencing it for the first time. It's actually been around for a while. So the first studies of the technology were done in the 70s by the US government, military. They were training snipers, right? So not surprising. But there was never the ability to make it work for other indications. Now, whether that's because all of the investment money went into pharmaceuticals and also our understanding of the brain and our ability to sort of visualize it has changed. 10 years ago, they made the

the jump to try and develop something using the technology, but with one major differentiating goal, I would say, versus other technologies, which is, how do we make this in a way that can be accessible and affordable to as many people as possible? And that's very difficult with hardware. ⁓ And that's been the founding principle. ⁓ And you don't get to widespread adoption. You don't get what to widespread trust.

without clinical evidence. so almost from the gate, that was the goal, is let's get a trial and let's prove that it works and let's build from there.

Guy Bloom (09:53)
jump to one thing and then come back to something because I'm looking at by now and Automatically I have a fact I'm going to encourage the audience to go guess how much you think something like this would be right? Which is I think it's incredibly well priced because actually when something is offering Something that again if this was a something that was relevant to you then

Erin Lee (10:12)
Yeah.

Guy Bloom (10:22)
almost the prices and irrelevance because of what it can technically do for your life. So when I see £399 to buy, I just think, gosh, now you wouldn't like anything in life. You wouldn't want to take a punt on it with no evidence because that would be a lot of money. But actually, if things are exactly what they are, this becomes incredibly reasonable, ⁓ which I find quite

encouraging because actually it's not some offered miracle cure at a miracle price right it has an intention behind it that says well it may or may not be a miracle depending on how where your starting point is but we are trying to make it accessible and genuinely real for people yeah

Erin Lee (10:59)
No, no.

Yeah.

That's right.

And our goal has always been, you to try and make it not. I don't think, you know, I don't know if we should believe in miracles per se, but I think we can always say that this should be the baseline. Right. We work for anywhere from 50 to 70 percent of people with our first product. Our second product gets a lot closer to accessing more individuals. But we appreciate it's a leap of faith for some folks and.

⁓ It can be a stretch particularly in today's economy. And so what we also offer is always no questions asked, money back guarantee, try it it doesn't work for you, refund everything you spent, which again, like drugs won't do, other devices won't do. But we think that's really important, particularly for people who are suffering, right? We would love to be a solution for everyone. We're not quite there yet, but we're not gonna stop trying.

Guy Bloom (12:03)
So a couple of things just to work through. One is just exactly what is the headset doing? So let's just do that first. Technically, layman's serms, jack and jill, what's it doing?

Erin Lee (12:11)
Okay.

So ⁓ what does the headset do? When you, I'll take a step back and sort of talk about where we focus. So when you look at, I'll start with depressed brain. So when you look at a depressed brain, what you often see in the left or so lateral prefrontal cortex, this area of the brain, is lower activity. ⁓

So less neuron firing, just a lower amount of activity versus what you call a healthy brain or a non-depressed brain. And so what we're doing is with a very mild form of electrical current, about 2 milliamps. So that's less than you find in a 9-volt battery. What we're doing is stimulating that area, non-invasively, so externally, ⁓ very gently, and nudging activity back into that region. And so over time, what we see is

Improved activity reduction and depressive symptoms also improvement in things like sleep memory and focus because all of those things are also managed by that same region and that's sort of how it works. So it's a similar mechanism of action to much more expensive treatments things like TMS, which is done in clinics. That's a much harsher treatment. I think some people I hesitate to say it will be like, this like ECT? We sort of say that's, you know, our ugly stepsister.

By all accounts, ECT actually is fairly effective, but it can be quite damaging. It's very harsh. This is very mild and gentle, and that's why it's safe enough to use at home.

Guy Bloom (13:43)
Do you, I mean, again, there's a difference between maybe this is a clinical trial or this has been provided by the NHS or something along those lines versus I'm at home and I go, you know what, I'd really like to try it, man. And I do notice you can even rent it. It's gonna sound like I'm being paid to do this. I'm just sort of put absolutely out there. This is not, reached out and there's no benefits here for me. So.

Erin Lee (14:02)
Yeah, you can. Yeah, we... Yeah. No,

Guy Bloom (14:11)
Would this be run in conjunction with just for as in might somebody go yeah there will be a spectrum of maybe approaches for certain people where it might be no just do this as a standalone activity actually no ⁓ anything from your diet through to you know ⁓ aligned drug taking ⁓ would would would it be run no don't would you

run it as notes, it needs to run alone to prove itself or actually know it can work very well in alignment with. How does that generally play out?

Erin Lee (14:49)
Yeah, so look, no two people are depressed in the same way. And I think we are still the scientific community, the clinical communities. I think we're honestly still trying to figure out what depression really is. And it's some mix of physical, emotional lifestyle. Right. ⁓ And so from the start, what we really wanted to offer was an option and something that could integrate well into the sort of the treatment pathway. And so when we did our trial.

It had two arms or we had two different groups. The first flow was used on its own as a monotherapy and that the goal there was to show that yet it does work by itself ⁓ and over 50 % of people were in remission. So there's no depressive symptoms at 10 weeks. What we also wanted to show is there's a lot of folks that have been on drugs SSRIs for a while and may have helped moderate their system symptoms, but they may still feel depressed. And so for those folks, sometimes they need a boost and we added flow.

⁓ In that case, it's an adjunctive therapy. And then nearly 70 % of those users went into remission by adding flow. So there is an additive effect of flow plus antidepressants. And I think that's really important because I think there's a tendency to see us as like David and Goliath. We're not anti-drug, right? We're anti-depression. And for people who don't respond well, we can fit into a treatment for you that works. And our goal is always to get people better, healthier.

and then keep them healthy and then offer some improvements on sleep from there. So, yeah.

Guy Bloom (16:21)
There's a little part of my brain that goes, drug companies must hang it. Now you may not even want to comment on that, but in my instinct it would be, that's not necessarily me putting my tinfoil hat on, which is to say, in reality, within a couple of years, if the evidence keeps building up, this is gonna have an impact on a lot of people, A, the people with depression, which is a positive, but then also they make a

people make a bucket load of money from depression. And that's interesting.

Erin Lee (16:53)
Yeah, they do.

They do. ⁓ You know, it's been very interesting for me to go on this journey because as an American, I think we have sort of this tendency to say like better living through chemistry, right? No one has more drugs prescribed to them than the American community. I think. I mean, kudos to the drug companies for their advertising in their baseline, but we sort of just take for granted that everything works right. If you don't respond to a drug, it's your problem. not the drugs. It's not that the drug doesn't work, it's that you aren't

responding in the right way. And that's been very interesting. would say our drug companies are afraid of us. They're certainly aware of us. I think you go on that journey where they ignore you, then they laugh at you, and then when they fight you or they take you seriously. I think we're starting to get to that later point. Again, we really think we work very well with them. We can be a great adjunctive therapy. But.

But we also think that the science has changed. We understand a lot more about the brain. The brain runs on electricity. What we've been able to do in the last five years in terms of results, ⁓ the drug companies haven't been able to do with billions of dollars over decades. Now you can say, what an extraordinary company and what an extraordinary technology. And there's an element of that. Of course, I'm biased. But then you might also say, well,

Maybe it's because pharmaceuticals aren't necessarily the right way to tackle it. Like if you have to spend that much and try that hard to only get halfway there, maybe we're missing a trick. And so do I see the tide changing? Absolutely. Even in the last nine months, I think you see a lot more about some of the people who've been injured by SSRIs, have terrible side effects, don't respond, really just want to try something else. And I think we'll be there to help. Or we're certainly going to try and be there to help.

Guy Bloom (18:43)
And you don't necessarily have to comment if actually it's just healthier for you not to. I'm okay with that. You know, I'll say it because I do see a drug, even when it's a beautiful thing, to be invasive. You know, it's going into you. You know, I don't know if technically, you know, it's considered that. this isn't. No, of course not. I suppose, you know, we suppose that the thing's going, two amps is going into you, but whatever you said it was. it also wouldn't be...

Erin Lee (18:54)
Mm-hmm. That's right.

Guy Bloom (19:08)
addictive would mean I've got to keep doing it. maybe not addictive, I don't know. But so what's with the flow? If do you get to a point where actually

Erin Lee (19:10)
That's right.

Guy Bloom (19:20)
you then start to reduce or I mean, I don't know why you care if you didn't have to because again, you know, so what harm it's not actually, you know, a chemical going into your body, but actually is it? No, what happens is generally speaking, no, you might be on it for the rest of your life, just doing regular touch points or no, for some people it takes them to a good spot and off they go and it goes into the cupboard and it's there if they need it. What's the kind of the outputs of that?

Erin Lee (19:46)
Yeah,

it's a mix. So for about 50 % of people who are clinically depressed, depression is sort of a chronic illness for them, right? So that's something that they've generally been treating for many years, may treat for the rest of their life. What we do is we work to get those folks to remission with their clinicians. Many of them choose to continue using Flow even once they're no longer depressed, ⁓ because they don't

They don't want to go back to where they were, but also they see benefits, as I mentioned, sleep, focus, memory, overall performance. And so in that way, it's like from sickness to health and then optimizing sort of what you're able to achieve. I think for others, they do it for 10, 12 weeks. They get the results they want. They turn it off. They're good to go. And I think one of the benefits of flow and the technology or any sort of noninvasive stimulation is unlike drugs, you don't have this concern around tapering.

And when I first started, people were really hammering us. You've got to be so careful. People are going to use those. They're not drugs. And they're going to get off drugs. And I was like, well, I feel like a drug problem. And of course, be careful. They are serious pharmaceuticals. And they have very real consequences. But you can walk away from flow. You don't have to worry about sexual side effects, weight gain, worsening of symptoms. We don't have that. ⁓ And so it's really something you choose to use when you need it. And you can stop whenever you want.

Guy Bloom (21:12)
So if you were under some sort of medication, you would say to the doctor, hey listen, I'd like to try. And even if your doctor poo-pooed it, you go, well, hey listen, I'm gonna try it. So you need to know that I'm gonna try it. It's like I take testosterone replacement. So I'm 56 years old, I take TRT, very happy to say that. And X amount of years ago, I went to a doctor, did a blood test, NHS doctor, you're fine, nothing wrong here. Well, I know what good feels like and this isn't it.

Erin Lee (21:24)
Yeah.

Guy Bloom (21:43)
went, waited a year or two, just feeling dreadful for a whole load of things as a different podcast and just went back to another doctor. No, you're absolutely fine. Got private blood tests. I mean, you are far from fine, my friend. Yeah, this is the average. This is where you are. Try it for a little bit if you want to. Even if you trust right for a month, you should see a difference. Well, that first injection just was an incredible experience just in the first 24 hours. So.

Erin Lee (21:56)
Yeah.

Guy Bloom (22:12)
It is actually, I imagine, that there is a little bit here of...

education of doctors are phenomenal people in many many respects but I think this distribution curve just like there is for anything in life from they really get it they're on the ball they're up to date with modern thinking all the way through to them really learned anything in the last 20 years and actually the relationship for a certain with male health and testosterone is if you ask for HRT there it is TRT they don't want to

Erin Lee (22:35)
That's right.

Guy Bloom (22:46)
So I'm very interested in, doesn't matter even if that is the right thing, the educational process for getting a group of people that will have a confirmation bias and or are not being educated to take an interest in. what's your process with, even if this everybody acknowledged it's great actually, which I think it would be a TRT thing, which is I don't know anybody that doesn't go, yeah, if you need it, you need it.

Erin Lee (22:54)
Yeah.

Guy Bloom (23:16)
But actually, how would that, how does that then apply to educating a group of people who may not have learned that back in the day, but now it's a thing?

Erin Lee (23:17)
Yeah.

So what's interesting is, and I think this is probably true to an extent for any disruptive technology or treatment, think the early adopters were really powerful advocates for awareness for flow, right? So you had people who...

had been suffering for a while, had tried everything. A lot of them had been hospitalized, suicidal. And they were sort of told by their clinicians, there's nothing else I can do for you, right? Even the best-meaning clinicians were out of options. And so they do their own research. They found Flow, and this is very early days. We've had some extraordinary Flow users success stories. We've got some early coverage. Interestingly, ⁓ our first NHS partnerships, I'd love to be able to sit here and say,

We were very strategic about who we targeted. did all this research. We went out. But the reality is they found us. we saw, I've been following this technology for a while. Or I understand the limitations of drugs. I've been looking for something that finally had evidence. I want to try it in my trust. And I would say we've been so lucky. That ⁓ has been the most surprising thing to me is the response from primary care clinicians and the NHS. They don't have time.

but they understand the limitations that they're seeing in their practice every day and the seven minutes that they're given to treat a patient. so what we try and do is keep it simple. I think the other great thing about flow for clinicians is to your point around taking multiple other drugs or we don't have drug interactions. so, you I'm not sure if people are aware, but a lot of a clinician's time is actually managing all of the different drugs as do pharmacists, making sure that there aren't negative interactions between

And that can be very challenging for elderly, postpartum, comorbid patients who are on a drug cocktail. And this is an option where it's very low risk for them. But the fundamental switching point and sort of the six or seven trusts where we're active now is they've got to see, a patient use it? You know, there's that quietly. No one's going to wear a headset. Come on. And then they do actually. Over 90 % of people who are offered flow chose flow over drugs. Is it easy for the clinicians? Is it more work for them? Like right or wrong? They're time constrained.

And then do they see the results at the trust level? And I think the challenge for a technology, you have to do all three. Clinicians have to be willing to prescribe it or it to be easy for them. Don't make more work for me. Patients have to like it. They have to use it. You have to have results. You have to save them money. And I think we're able to do all of those things, which is we certainly don't take for granted. But I think what we've seen is then in that success, all of the subsequent trust came from the results of those early trusts. So it's one thing for me to go out and say,

flow works, look at all of our clinical trials, look at the eight NHS studies we've done. But the other trusts tend to trust their colleagues. And in fact, based on those early results, our first commission trust in the NHS was actually Practitioner Health, which is a trust that delivers care to NHS clinicians themselves. So I don't know ⁓ if that is any indication of perhaps the openness of clinicians to engage with the technology. ⁓

Now, that sounds wonderful, like why isn't it everywhere? I think there's definitely challenges around budgeting and access and proving for different populations. And again, I would say that's mostly primary care. We've definitely had a different experience with psychiatrists, with private psychiatrists. don't think that, I think they're much more skeptical. I know they're much more skeptical. So that will be a continued battle.

Guy Bloom (26:53)
And why would they be more skeptical? What's the difference between being primary care and being... Is it that actually that would end my income flow?

Erin Lee (27:04)
So there's definitely an element of that. And this is going to be contentious. ⁓ So in primary care, you're given seven minutes to see a patient. So you only have so many slots. And what you don't want to be spending time on is you don't want be sitting there with a patient that you can't actually help with the tools that you have. And so with Flow,

53 % fewer appointments for a couple of reasons. One, it's more effective. Two, you don't have drug interactions, so they're not coming back. You're not switching meds. Three, you can actually manage it remotely. So we provide insight to clinicians. They can see who's doing the treatment, how they're responding. They can be more resourceful. That's what we've seen with community mental health. So they really like that, right? So I'm not going to say that primary care is trying to get people out of the office. But that is sort of true.

Guy Bloom (27:55)
But it's more performance

focused. more data, not as data led, not so much evidential led, but it's data led. And they're looking at operating in a much more finite and kind of so what space in the immediacy. If you can do that, if you flick that domino and it releases those other three, I'm all in.

Erin Lee (28:04)
data line.

That's right.

Yes.

Well, and I think there's a recognition, right? We have a finite amount of resources. We have to allocate those resources to a population where there's a ton of need. Like, can we triage in a way? Or what is the best use of an in-person visit or in-person time? And that isn't always drug titration, right? And so think people underestimate how much time is spent just managing drugs. Now,

psychiatrists. And again, I will caveat this by saying we work with some tremendously forward thinking psychiatrists who are really pushing the indications right in terms of like autism and ADHD. And so there are certainly people out there, but fundamentally their incentive is to get people in office for visits. ⁓ And I hesitate to say I'm just going to say it like there was, you know, sort of the the American ⁓ psych

psychiatry associations annual conference and they were sort of interviewing people outside and they're like, you know, how many of your patients have recovered and universally or they also none right they all come back and so That's very pessimistic of me to say but but fundamentally, I don't think the incentives are aligned And there there tend to be a little bit less data driven and in fairness were a relatively new technology I think we'll get there as we have, know, we do work having said all of that. We do work with over

you know, 500 clinics across Europe. So it's certainly not like there aren't early adopters. But as with everything, I think the tale is long.

Guy Bloom (29:51)
Yeah, and I'm again, yeah, there's a lot that could be said there. But I think in all places and spaces, there are some that don't want the status quo to shift because actually that would mean they'd have to and it would shift their approach, their dynamic. And for some people, the validation of themselves, it's got, you and you know, that you're coming to me to be the wisdom and that's not just a...

Erin Lee (30:04)
That's right.

Guy Bloom (30:20)
That's in many bloody places, same with coaches. It's interesting about coaching, for example, which is where I specialize, which is I don't, for example, sell X amount of sessions. What I do is I go, we're outcome led, which means if we, in 25 minutes from now you go, do you know what, I'm exactly where I need to be, thanks very much. Okay, well that's it. You you're not paying for X amount of sessions, you're paying for an outcome. Now if in six sessions we're still there, actually we'll have to keep going and the chances are I'm not gonna come back to you for more money.

Erin Lee (30:21)
Yes, that's very true.

Yeah, that's great.

Guy Bloom (30:50)
you I'm working with you until this is done. And actually, of course, that shifts me. I'm not thinking about it working through to the next session. I'm actually trying to get you to a point where you go on where I need to be. And I think that's, there are people like that in all works of life. yeah, and it's getting that, yes, and then maybe, as you say, there's a weight of evidence that eventually it becomes, so why wouldn't you do this? And that may be that.

Erin Lee (30:52)
Yeah.

Yeah, we're sure more. That's great, right?

Guy Bloom (31:19)
tipping point comes at some point. So I just heard you, my little boy has autism. So I just heard you mention autism there in reference. we're talking about, you know, initially this has the headline for depression. So how, where is this manifesting in different places? I have a particular passion around autism. So if there's anything you can tell me, this may be my next big thing.

Erin Lee (31:45)
Yeah. And

again, it's I know our sort of in-house clinical psychiatrist, Hannah Nierney, Dr. Hannah Nierney, her passion area or her area of treatment is really around neurodivergence, autism, ADHD. And as with depression, as with all brain related illness, it's a complex illness, right? It affects people differently. ⁓ But she uses it in her practice. And again, there's

differentiate much like when we say we treat addiction. You can treat sort of the comorbidity of addiction with depression, right? Most people who are addicts do have some form of depression, depression, anxiety, either it's the result or the cause, depends on who you ask, right? And so there's very good evidence that we can treat like a comorbidity element of it. But there's increasing evidence that we can also treat the area of the brain that drives cravings for things.

like alcohol and opioids. And that's my obsession, right? As having seen the devastating impact of the opioid addiction on my own family, is looking for a solution there because you're really hamstrung for solutions. The same is true with autism. It's very much day zero for what we understand. And that's really more about personalized medicine. But I'd be happy to connect you two for a conversation. Yeah. Yeah, exactly. No. And it's...

Guy Bloom (33:07)
to do that because that might turn into its own podcast even if it is you know what we're here today

and who knows where we're going but that might be its own interest.

Erin Lee (33:13)
And again,

it's devastating because we have so many inbounds of so many, and to your point around clinicians, think we're in the age of AI and I think people are torn on whether that's a good thing or a bad thing. And time will tell what it means for humanity. But at a minimum, what it does is it makes an incredible amount of information accessible to the average.

individual and I think people can be better advocates for themselves and I am so hopeful that it means acceleration of adoption of new technologies because there are so many people we hear from every day who have met the end of what traditional medicine can do for their particular use case whether it's time resources whatever and it's heartbreaking because it doesn't have to be like that or I hope it's not like that for long and I'm hopeful that things will change.

Guy Bloom (34:01)
So when it comes to things, let's just, I'm going to use the word neurotypical and I'm going to use this word normal, which is hilarious because I don't even know what that means anymore. Yeah, exactly. So I use it in the vernacular to mean I don't think there's anything wrong. Okay. So at one end you've got somebody that goes, Houston, I have a problem. So this may be something that could really help me out. It's not invasive, know, blah, blah.

Erin Lee (34:08)
Okay.

Yeah. What does that mean? Yeah.

Okay.

Guy Bloom (34:31)
like CBD you know you know you can take it with other things it's not gonna probably give you a problem so why not blinking try it again don't have to comment so what happens if no what happens if if somebody is like taking vitamins there's nothing wrong I take them because I think it would add value so if somebody was inverted commas normal and we've you know we just indicated what we actually mean by that

Would I use this?

Erin Lee (34:58)
So it's funny, when I first started and I would tell people, our first indication is depression because it's the largest cause of disease morbidity. It's massive unmet need. ⁓ But the potential for autism, traumatic brain injury, it's huge. The first question for most people is, if I'm not depressed, will this make me extremely happy? Can I be the happiest person alive? Unfortunately, no.

Right. There's a ceiling or, you know, they would be flying off the shelves. Trust me. You know, like there's been some days where I've really reached for that. I hoping for exactly that. Yeah, exactly. Exactly. Can I, you know, can I wear it 24 7 and just be superhuman? And, you know, maybe in 10 years we'll find out. Yeah, you can. But I wouldn't recommend it today based on the evidence. We're not quite there, but, you know, we have 50,000 users across Europe and the UK.

Guy Bloom (35:29)
or we'll be selling a hell of a lot more of them.

If I put two on will it make it twice as powerful?

Bingo. We're not quite there yet.

Erin Lee (35:57)
And what we see when we look at the real world data, which was very surprising to us, is there's actually quite a large cohort of folks who are not clinically depressed, have never been clinically depressed. They're well. There's nothing wrong with them. They're normal.

Guy Bloom (36:09)
Yes, well actually is probably a better word than normal. I'll use the word well. Yes, yes.

Erin Lee (36:11)
Well, yeah, normal well, yes.

I think some people would probably call them biohackers. I think others would call them people who are health focused. ⁓ We've had, for example, concert pianists who swear that using flow helps their creativity. We've had surgeons who say it helps their fine motor skills. These early adopters are actually helping us identify new areas to target. And I think it aligns with what you see in

Society and and I'll say like kudos to Ali parset Babylon. This is really his fundamental belief Which is today we wait for people to get sick ⁓ to treat the root cause issue and then we get you back to health And I think people are just I'm not gonna wait to be sick either I want to live forever or I want to make the most of my life I want to prevent the onset of Alzheimer's. I want to prevent the onset of Dementia or depression and I think that's what we're seeing

Now, right? Healthy folks want to maintain their health, just like you work out, right? Just like you take hormone replacement therapy to maintain. You're really working out your brain for focus, memory, sleep, general well-being. That's right. That's exactly right. That's exactly right.

Guy Bloom (37:17)
maybe there's a calibration element here as well that ⁓ this

isn't about anything. not not well, why do I take that vitamin? Because I'm I don't know where I don't know if it's having a 1 % impact or a 10 % impact or whatever it might be who knows we're not that fine tuned. So why do you take it when you take it because what you're almost doing is like a leveling compound on a floor, right? The floor is still there.

Erin Lee (37:36)
Yeah. Yeah.

That's right.

Guy Bloom (37:46)
It's a perfectly good floor, but actually it won't be perfectly level everywhere. So you take something with that intention. So there might be something here around why would somebody who's well, much better word, utilise this. And it might be, well, why do you take vitamins? Because actually if you put it on and you go, I feel better for using it. Now, whatever the logic behind that is,

Erin Lee (37:52)
That's right. That's right.

Guy Bloom (38:17)
who in some respects who cares. Yeah, that's interesting. Yeah.

Erin Lee (38:21)
Yes,

and I think we're getting smarter about being able to identify that. our next device, which is coming out early next year, integrates sort of EEG. And so much like the accessibility of blood tests, right? Like now you can get them mailed to your home, you can mail them back. You can take advantage of really understanding how best to calibrate your own body. ⁓ We hope to do very similar things for the brain, right? So you can calibrate to your own needs.

Guy Bloom (38:46)
what would the

EEG element do?

Erin Lee (38:49)
So what we can see is what your individual brain waves look like. We can compare those for depressed patients. What we're able to say is like, are you someone who would respond to treatment based on what we know of other patients, right, of 50,000 other users? For a healthy individual, we might say, OK, here's where you come for baseline. Let's stimulate for a while. Let's see what your alpha waves look like. Are you seeing improvements to focus? Because for a healthy individual to your point of calibration,

the degree of change may be much more minor. So for super performers, whether that's athletes or professionals, gamers, interestingly, musicians, they're more tuned into those micro changes. And so that's our ability. Exactly, exactly. They're hyper calibrated. Yeah, that's right. That's right. But we can bring that to more people, right? Particularly, I think, in the space around focus and memory.

Guy Bloom (39:29)
F1 drivers and those people that are just at they are calibrating for the point zero zero

Erin Lee (39:46)
But my colleagues, Youth Flow, I'd like to say none of us are depressed. I think there's an element of stress at any startup, but they do it for focus and they swear by it. I don't have those results. Unfortunately, I've tried, but it absolutely helps my sleep. And we see about 60 % of users have massive improvements in sleep. Yeah.

Guy Bloom (40:03)
And that's not unusual is it, where

I take one paracetamol, I very rarely take anything, I take one paracetamol and I'm done. I know other people, if they don't take three it doesn't touch the sides. And that's just because you just, we're all different and there is no hard and fast, no hard and fast rule. So with the EEG one just coming out in due course, or next year, would that be you'd see it in real time or would it be that actually, no it'll go somewhere and then come back or you have to plug it in afterwards or?

Erin Lee (40:15)
doesn't touch it, exactly. We're different. We're all different. That's right. That's right.

No, you do it in home, real time,

real time. So you do it before treatment. And again, it depends on your profile, do it before treatment, we can see how did you respond to treatment, immediately following treatment, we can monitor over time. For some people, they may also use it as a preventative mechanism, you know, do a scan once a week.

Guy Bloom (40:33)
Yep.

Is it the EEG

can work without you activating the flow element?

Erin Lee (40:51)
And then they work, they can work independently, right, as a diagnostic or as a monitoring, right? But they also work synergistically. And without giving too much away, we have the ability to today, we sort of have a relatively standard protocol, right? A set number of simulations that can be adjusted with a clinician. ⁓

Guy Bloom (41:13)
be more customizable to your genuine. Yeah. Yeah, that would make sense.

Erin Lee (41:15)
That's right. So we can customize the actual wavelengths for your,

so you can imagine both the expanded accessibility and also probably improvements in performance.

Guy Bloom (41:27)
So I've done stuff in the past where, again when I'm running lead shift programs or things like that, where I've had somebody put on something and we purposely stress them out. But just with, you know, just by asking difficult, like putting a maths question up and going, what's that? And people, because they're in a public setting, they go, ooh, and you can see their heart rate shift or even those that have got the very good social veneer, they display no shift, but you go.

you ask them and they're going yes so you see it and then you teach them a breathing exercise and it's a beautiful thing okay so that's that's a beautiful thing could i use it like that i'm excited now you say

Erin Lee (41:59)
Yeah, that's right.

Yeah,

of course. I'll say there are also competitors out there that just do EEG. I think they focus on mindfulness or optimizing your ability to curl. So the way I think about it, again, coming back to what works for some folks, some, I think, folks have a strength of mind where they can train your brain, basically. I see how I'm performing. OK, let me do some breathing. Let me refocus. Let me do some mindfulness yoga, whatever. Others may need that physical boost, which they get from stimulation, to help get them in the zone. And maybe they can maintain that.

Guy Bloom (42:16)
Hmm.

Yeah.

Yeah.

Erin Lee (42:38)
So that's sort of how I think about it.

Guy Bloom (42:40)
Okay, okay, so listen,

this is you know this is this is good I'm I was interested and now I'm I'm I'm super interested which is which is a great thing and maybe that's indicative of other people listening so if people want to ⁓ get more information do they go to flow neuroscience.com

Erin Lee (42:54)
Yeah.

sorry, floeneuroscience.com. We've got all of our clinical trials, ⁓ studies, upcoming indications. I'm also always open if people have individual questions, Erin at floeneuroscience.com. ⁓ But yeah, those are probably the two best channels.

Guy Bloom (43:21)
So do know what? ⁓ I'm gonna just bring us to a natural end there because I think in terms of now I would start deep diving and nitpicking on certain things and we could be forever in a day. But I think that for me it's a great, I had a curiosity around it. It looked as if what you were going to say, I kind of was hoping you was going to talk like you did about what you've spoken about because my instinct was telling me one thing.

Erin Lee (43:29)
Yeah, Yeah, yeah. ⁓

Okay. Yeah, okay.

Guy Bloom (43:47)
It's also easy to see something on a website and then you meet the individual and you go, yeah, yeah, the individual doesn't really match the rhetoric on the website. So it's beautiful to see somebody holding space who clearly isn't doing a bait and switch or is being Machiavellian. It's clear that you are there with integrity and you have good intentions and the data and the evidence is absolutely backing you up and that's a beautiful thing.

Erin Lee (44:04)
No.

Guy Bloom (44:16)
So on that note, I'm gonna say ⁓ floaneuroscience.com, go there, of course that'll be in the link. Stay on just to make sure everything loads up just before you go. But for me and ⁓ the millions of people that are listening to this, I live in hope, ⁓ episode, Erin, thank you, thank you so very much.

Erin Lee (44:25)
Okay, sure.

Thank you. Thank

you so much. This was