Sherry Rais is co-founder and CEO of Enthea, a benefit plan administrator that provides health plan benefit riders and single case agreement services for psychedelic healthcare. She is also the executive director of the Boston Psychedelic Research Group and the grants manager for the California Institute of Integral Studies (CIIS).
Rais recently described how Enthea’s health plans work, the positive impact they’re having on employers and employees alike, and the critical role such programs play in expanding access to psychedelic therapy to larger populations.
How did you get involved in this line of work?
I think it goes all the way back to my upbringing and my roots, which were very much based around service.
I grew up in Toronto, I’m the daughter of immigrants, and my family really emphasized what in our culture is called “seva,” which means a selfless kind of service.
This idea had a huge role in my childhood. It was like my north star. When I began my career, I was interested in international development and spent about 10 years consulting to the UN and the World Bank specifically on poverty reduction.
I helped build programs that are called cash transfer programs, which is the idea of just giving money to the poor with no strings attached.
I did that at the national level in 37 countries, and I was so fortunate that I got to be involved in every part of the process, from designing programs from econometrics and creating distribution formulas, to working directly with other governments to train staff and collect information that would help shape policy.
During those 10 years, it became very clear to me that you can’t effectively reduce poverty without addressing the mental health issues that people suffer from.
We could improve their lives temporarily with economic measures, but we weren’t addressing their mental health problems, which are one of the major reasons why people get left behind.
Then around 2018, I saw what was happening in the psychedelics space, and a light bulb went off in my head. I thought, this is exactly the missing piece we need!
I saw all this information about positive outcomes from clinical trials addressing a variety of mental health conditions and got excited.
I tried to bring this information to the work I was doing — predominantly in Africa — and I talked to my bosses about how we should include the training of psychedelic therapists in the budget, which was just unheard of at the time.
Mostly they just laughed at the idea. I tried to escalate it up the chain of command, but it didn’t go anywhere.
So, I started talking to people within the psychedelics space itself. I got involved as a consultant with CIIS, which was one of the only accredited universities that was training therapists at the time. I helped them with grants and funding and strategic initiatives. And from there my career just pivoted completely into psychedelics.
I joined the Boston Psychedelic Research Group, which is a nonprofit community that focuses on disseminating information about what’s happening in the space. There I met so many like-minded people, and ultimately that led to meeting my other co-founders of Enthea.
What was the idea behind Enthea?
The initial thinking was – these medicines are powerful, but inaccessible for many people, mostly due to cost. Our idea was to create employer-based benefit programs that would provide access to safe and affordable psychedelic healthcare for anyone who can benefit from it.
We realized we needed to operate as a TPA (third-party administrator) of health plan benefits, so we could work with employers so they could in turn offer this to their employees as an added benefit.
We launched as a nonprofit in the United States and have since transitioned to a public benefit corporation.
What is a third-party administrator? And how do your benefit programs work?
So, depending on their size, most U.S. companies have to offer health benefits to their employees, like medical and dental insurance programs. Some go further and offer vision and fertility plans.
These are considered add-on benefits that go beyond traditional coverage, and they are often managed by a third-party administrator.
So what we offer at Enthea is psychedelic therapy as an add-on benefit that employers can offer. How much the company wants to fund this benefit determines what the out-of-pocket costs are to the employee.
It might be a co-pay, or a co-insurance, or sometimes the company covers all the costs. Then the employee chooses a psychedelic therapist within our provider network and gets the treatment.
I assume this covers ketamine-assisted therapy, because it’s the only psychedelic treatment legal nationally. Are you able to cover psilocybin or other treatments in states where they are now regulated like Oregon and Colorado?
We are actively looking at that now: how we can offer psilocybin-assisted therapy in those states.
It’s complicated because these medicines are still not FDA-approved, and many companies have out-of-state employees, and so we obviously have to make sure that we can legally offer such services.
But we’re working out the details now because as different states adopt different policies, our goal is to be able to offer cost-effective and safe access to all approved psychedelic treatments.
Also, the FDA is expected to approve MDMA soon and perhaps psilocybin after that. When they do so, we’ll make sure those therapies are also covered in our plans.
Is your sales pitch to employers that this is a benefit worth offering because they’ll have better mental health across their company?
Well, it’s really interesting you ask that. And it makes me so happy to say that we haven’t had to do as much selling as I thought we would have.
Companies of all sizes and across numerous industries are coming to us. In most cases there’s a psychedelic evangelist at the top of the organization, someone who’s either experienced the medicine themselves or who really understands its healing potential.
I mean dozens of companies — some of them Fortune 100 companies — are approaching us usually because someone in the C-suite is a believer. The mainstream media does a lot of the selling for us. That’s how much the world has shifted in just the last two years with its thinking around psychedelic therapy.
Of course, when we meet with them, we share all the data we have about how better mental health leads to better productivity.
For example, employees who experience mental health issues are on average unproductive 35% of the day. So, that’s an obvious area that makes economic sense. Then we share data about cost-savings they can expect from traditional medical expenses, which will go down because employees are taking care of their mental health.
Also, there’s data that shows Millennials and Gen Z-ers are leaving their jobs in record numbers due to mental health reasons. Most companies know this, and that’s why the demand is already huge for psychedelic therapy as an employer benefit.
How do you build you provider networks?
I’m so grateful for my team. We have two people, Andrew and Baker, who are building the provider network so efficiently that it’s very soon going to be nationwide.
We’ve seen a huge growth in the amount of providers that are out there, and many of them want to join our network because obviously it gives them new sources of clients.
We are working with the big clinics well as independent therapists. Because of this, employees have a choice whether they want to do their treatment in person at a bricks-and-mortar clinic, or at-home and online with a therapist trained in that method.
Among your existing client employers, can you talk about a specific success story or case study? Or is it too early for that?
We definitely have a success story with Dr. Bronner’s. They were our first major company and our proof of concept.
I’ve talked to several of their employees since we launched the program and I’ve heard about so many positive experiences and outcomes. One employee shared her experience in a blog and it’s a really beautiful story. She said she never would have tried psychedelic therapy if she hadn’t worked for a company like Dr. Bronner’s, which is a well-known supporter of the psychedelic movement.
And it wasn’t just because it was expensive. She said psychedelics didn’t seem like legitimate healthcare until it became something covered by insurance.
Like many people, it had this big stigma for her. And yet the treatment had this profound impact on her life.
That’s great. So, in her case, do you know how much she had to pay for ketamine-assisted therapy? How much did she save?
That’s the amazing thing. She didn’t have to pay anything because Dr. Bronner’s covers the benefit 100% for all employees.
Not only that, they also cover it for employees’ partners and spouses. There is incentive for employers to do this. I mentioned earlier that when an employee has a mental health issue, they are on average unproductive 35% of the time.
Well, that holds true even if their partner or spouse is the one suffering. They can’t focus at work if if they’re constantly worrying about their partner or spouse at home.
It sounds like Enthea has really pioneered a way to reduce costs and increase access to psychedelic therapy. Who’s your competition? Do you know anyone else doing what you’re doing?
Thank you for saying that. To my knowledge there are no other licensed TPAs of psychedelic health plan benefits. I know that there are some companies that are offering telehealth ketamine therapy sort of like a gym membership where employees opt-in and pay a subscription fee, but that is a different model.
I will say that I would love competition, because even if we had even had twice as many staff members and twice as much time, we couldn’t realistically onboard more than 100 employers by the end of this year, and maybe 300 by the end of next year. This is very small piece of the pie in terms of the American workforce.
So I would love competition, because I don’t even see it as competition! People are suffering from mental health problems all around the country and the world. We can’t get to everyone. To help them get the treatment they need, we need as many companies as possible to offer this as a benefit.