Changing the Conversation Around Brain Healthcare

Tens of millions of Americans are suffering. And it doesn’t have to be this way. 

Depression is the leading cause of disability in the U.S., resulting in massive societal costs through reduced work productivity and increased healthcare expenses. For the more than 20 million people struggling with major depression, the individual toll from unrealized potential and difficulty maintaining relationships or building social networks — to say nothing of the burden on their loved ones — is incalculable. Tragically, many either consider or take actions to end their lives.

Compounding this tragedy is the reality that effective therapies are available, but fail to reach the majority of sufferers. “Fully half of individuals experiencing depression, anxiety and other brain health disorders don’t seek treatment, for reasons related to both the stigma that shrouds mental health and the difficulty accessing providers for affordable care,” notes Brandon Bentzley, M.D., Ph.D., chief medical officer and cofounder of Salma Health. “And although many individuals who do seek care for major depression can ultimately benefit from medication, talk therapy, or a combination of the two, the road to recovery is littered with obstacles.” He explains that too many patients run through a gauntlet of months-long drug regimens, enduring both unpleasant side effects and serial disappointments, with each failed response rendering the next attempt less likely to succeed — perpetuating the cycle of hopelessness that plagues individuals with depression. 

Upwards of 30% are deemed to have treatment-resistant depression, generally defined as a lack of response to at least two appropriately administered antidepressants. “Yet, we have shown that 99% of individuals who could benefit from transcranial magnetic stimulation (TMS) — a non-invasive, drug-free interventional treatment shown to dramatically improve lives — either don’t know about it or don’t realize it could bring them relief,” Dr. Bentzley says.

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The current system is broken

All of this needless suffering demands fundamental changes in both the way we talk about brain health and how we treat it. “The current system is not helping the majority of people who suffer from depression,” Dr. Bentzley says. Among the maladies:

• Poor Access. Approximately half of psychiatrists don’t accept insurance, and few Americans can afford out-of-pocket payment for their treatment. Moreover, even if everyone who wanted and could afford it sought care, we don’t have close to enough brain-health providers to meet the demand.
• Fragmented Care. Effectively navigating the current system is extremely challenging for anyone, and even more so for someone struggling with their mental health. Across all levels of acuity, many people in need of care have no idea who to call. Too often, they get connected with multiple providers who aren’t in communication with each other. Too often, they must grapple with multiple insurers with disparate policies and varying levels of accessibility.
• Lagging Use of Evidence. For decades, healthcare systems have focused on the same antidepressant medications without incorporating the latest data-supported therapies or working toward treatment plans tailored to the specifics of the patient’s brain dysfunction.

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Salma Health’s coordinated, evidence-based alternative

Salma Health offers an entirely new system — one that breaks the cycle of fragmentation and trial-and-error approaches that result in delayed diagnoses, ineffective treatments and poor patient outcomes. Our solution is a comprehensive, end-to-end brain health system featuring advanced diagnostics, evidence-based rapid-acting interventions, crisis management and care coordination, all under one roof. Our vision is simple: Deliver the right treatment for the right person at the right time. Every time.  

For someone struggling with a brain illness such as depression, connecting with a system of care should be both easy and the last navigational step they will have to take. That single call should initiate a process of rapid, affordable access to care through an automatic navigation system, with a team of providers working together to ensure that the person receives the optimal treatment for their level of acuity, then continuing to support that individual on their healing journey for the rest of their life. 

That journey encompasses not just the acute treatment phase, but also the process of rebuilding what was lost during the months or years of suffering. This means connecting individuals with the evidence-based treatments they need in order to overcome whatever stands in the way of their ability to fully thrive.

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Brain emergencies without a system

One of the starkest examples of how the system falls short appears during moments of crisis. If someone experiences chest pain at 3:00 AM and fears they may be having a heart attack, they know exactly what to do: go to the emergency room. Once there, a well-defined protocol begins immediately. Physicians run tests, perform imaging and deliver targeted treatments designed specifically for that life-threatening condition.

But when someone experiences suicidal thoughts at 3:00 AM, what clinicians increasingly recognize as a brain emergency, the response is very different. Instead of entering a system equipped with specialized tools and treatments, many individuals encounter long waits, crowded emergency departments and limited options for rapid, targeted care.

In most areas of medicine, treatment options increase as the severity of illness increases. Hospitals are equipped with advanced technologies and specialized teams ready to intervene. Yet, for people experiencing an acute psychiatric crisis, those same systems often lack the precision diagnostics and rapid-acting treatments that could stabilize the brain and address the underlying biological drivers of the crisis.

The result is a troubling gap in care. Moments that should trigger the most sophisticated medical response often lead instead to delayed treatment, fragmented care, or no effective intervention at all.

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"Our message to anyone in that position is that there is almost always something you haven’t tried, and we won’t rest until we find the right treatment for you.”
-Dr. Bentzley

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Moving brain healthcare into the era of precision medicine

Determining the optimal therapy for an individual patient suffering from depression requires bringing mental health into the era of precision treatments. In almost all other areas of medicine, a revolution is underway, wherein technologies such as genomics, bioinformatics, artificial intelligence, and machine learning have ushered in a shift from standardized, one-size-fits-all therapies to personalized care. 

Unfortunately, this shift hasn’t occurred in brain health. In emergency departments across the country, patients with urgent needs related to a stroke, seizure, heart attack, and other acute conditions are monitored with the latest technologies. They undergo advanced imaging and metabolic testing to determine the cause of their event so that doctors can intervene in a targeted way. Meanwhile, patients with severe psychiatric emergencies are often found in the hallways, because the same precision approaches are lacking for mental health.

This shortcoming was a driving factor in the advent of SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy), an accelerated form of TMS developed by a team of researchers at Stanford University’s Brain Stimulation Lab that included Salma Health’s cofounders, Dr. Bentzley and the late Nolan Williams, M.D. SAINT employs advanced neuroimaging to locate the region of the brain’s prefrontal cortex associated with a person’s depression, then delivers an accelerated, high dose of magnetic pulses to that region over a five-day period. In the latest randomized controlled trial of individuals with treatment-resistant depression, half of the 24 participants in the treatment group were in remission one month after receiving SAINT, vs. 21% in the placebo group. 

The promise of SAINT and other precision medicine approaches for brain health isn’t just better treatment outcomes; they could also go a long way toward removing the stigma that increases social isolation and discourages people with depression and other brain illnesses from seeking help. “Historically, disorders that are not well understood become stigmatized,” Dr. Bentzley says. “Because of the complexity and mystery surrounding depression, suffering individuals continue to hear that they should just ‘cheer up’ or ‘muscle through it.’ ” Pinpointing the association between certain types of brain activity and function will help drive home the reality for Americans that depression is a chronic illness, he explains — and one that, like cancer, cardiovascular disease, or any other condition, requires evidence-based care. 

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Comprehensive, holistic, patient-centered care

Right treatment. Right person. Right time. Every time. There is no single panacea for a brain illness such as depression. The care must be comprehensive, holistic and evolving with the needs of the individual. Precision in brain health means treatment that takes into account not only measurements of changes in the patient’s brain, but also all aspects of their lives that bear on their mental well-being. Our goal is to ensure that everyone who walks into a Salma Health clinic can reach their full potential as healthy, productive, and fulfilled individuals at home, at work and at play.

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_References

_{1. https://www.psychiatrist.com/jcp/economic-burden-adults-major-depressive-disorder-united/}

_{2. https://www.nimh.nih.gov/health/statistics/major-depression}

_{3. https://pmc.ncbi.nlm.nih.gov/articles/PMC6191880/}

_{4. https://pmc.ncbi.nlm.nih.gov/articles/PMC3363299/}

_{5. Taylor,J.J., Mannet, A.J., Feyder, M. & Bentzley, B.S. Resource utilization and economic outcomes following repetitive transcranial magnetic stimulation for treatment-resistant depression: a retrospective observational analysis. J. Comp. Eff. Res e250019 (2025) doi:10.57264/cer-2025-0019. https://pubmed.ncbi.nlm.nih.gov/40491267/}

_{6. https://pmc.ncbi.nlm.nih.gov/articles/PMC11014756/}

_{7. https://www.aamc.org/about-us/mission-areas/clinical-care/exploring-barriers-mental-health-care-us}

_{8. https://stanfordhealthcare.org/medical-treatments/s/stanford-accelerated-intelligent-neuromodulation-therapy.html}

_{9. https://onlinelibrary.wiley.com/doi/10.1002/wps.70032?prg140729=28f6580a-43e3-4fd9-a37b-064d7b43be46}