Americans spent more than $140 billion on behavioral health and substance use treatments last year, up from $40.9 billion in 2000. That’s a 3.4x increase in 25 years, against a backdrop of mental health outcomes that have not improved. Half of all Americans will experience a behavioral health disorder in their lifetime. Veterans more.
The reason isn’t a shortage of interventions. SSRIs, ketamine, psilocybin, neuromodulation, digital therapeutics, microbiome modulation — the pipeline is busier than it’s been in a generation. The problem is that mental health care still depends on what ARPA-H Director Alicia Jackson called “subjective scales, delayed feedback, and trial-and-error.” We don’t know what’s working until weeks or months in, and even then the signal is filtered through patient self-report. We’ve been spending more to guess better.
ARPA-H’s EVIDENT initiative is a $139.4 million bet on changing that. Announced in April, EVIDENT funds the first generation of objective, measurable, predictive endpoints for behavioral health — biological signals that can tell a clinician whether a therapy is working for an individual patient before subjective change shows up. The initiative also commits at least $50 million to psychedelic research for serious mental illness under the Administration’s mental health executive order.
The first cohort of EVIDENT performers was named last month. Two of them are in our portfolio.
Holobiome received funding to launch a 6,000-person placebo-controlled interventional trial targeting the gut-brain axis with prebiotics to reduce stress and anxiety. The bet rests on a platform few microbiome companies can match: a database of microbiome data from over 100,000 people, a world-class strain bank, an in-house human gut simulator, and a partnership with Radicle Science to run the trial at scale. CEO Phil Strandwitz frames the goal as building “a foundation model of the microbiome” — the longitudinal, multi-modal, interventional human dataset the field has never had.
The commercial validation arrived in parallel. In March, Ingredion announced a partnership with Holobiome to use the same platform to screen food ingredients — sweeteners, plant proteins, texture solutions — for their effects on the gut-brain axis before they enter human trials. The point isn’t that fiber is good for you. The point is that for the first time, an ingredient company can ask “what does this do to mood, sleep, or stress at the biological level” with predictive resolution.
Alden Scientific, based in Cambridge, MA, sits on the other side of the same problem. Where Holobiome generates intervention data, Alden generates the measurement infrastructure to make sense of it. Their EVIDENT mandate is multi-omics analysis — proteomics, genomics — to detect physiological changes that indicate mental health state and change. In a program structured around the question “what should we use for objective measurement,” Alden is part of the answer.
We invested in Holobiome and Alden Scientific for the breadth of what their platforms can do, not because of behavioral health specifically. EVIDENT is one manifestation of that potential.
This is what the move from trial-and-error psychiatry to precise, biological, patient-specific mental health care actually looks like in capital terms. The drugs and devices get the headlines. The measurement layer underneath is where the long-run defensibility sits. For us, this is the Food Is Health thesis arriving in behavioral health: precision tools, biological endpoints, food and microbes treated as inputs to mental health rather than afterthoughts.
