Meet Two Entrepreneurs Who Are Improving Access to Quality, Affordable Mental Health Services

Mental health affects how we think, feel and act. It’s critical at every stage of life, yet access to care and treatment remains out of reach for many. Tidal River talked to two founders who are hell-bent on changing the landscape.

Maggie Rose Macar, CEO and founder, zant

After losing a dear friend to suicide, Maggie Rose Macar knew she needed professional help to heal. Unfortunately, finding the support she needed proved challenging. “I encountered exorbitant fees and extensive waiting periods navigating the fragmented mental health system,” she told Tidal River.

The experience would dramatically alter the course of Macar’s life. “Becoming a CEO of a mental health startup was never a thought,” she said, yet after finding a therapist who was willing to work with her for a reduced fee and “transforming her pain into a driving force,” that’s exactly what she did. Macar’s company, zant, offers comprehensive, affordable mental health care via an app. Unlike other services that limit options to therapy, psychiatry or life coaching, zant offers a one-stop shop with specialists across multiple disciplines, so users have a better chance of finding the help they need. Zant is different in other ways too. For example, zant addresses challenges providers face, like marketing and practice management, which saves them time and money. To help eliminate high costs and paywalls, there is also no mandatory insurance participation.

What’s next for Macar and her team? “We’re in the process of raising an additional $500k from angel investors,” she says. “We eagerly anticipate introducing two new revenue streams with a particular focus on extending our services to college students nationwide, and forging partnerships with corporations to offer mental health support as part of employee benefits.” The team is also working on an advanced design concept that incorporates cutting-edge features and leverages components of artificial intelligence. “This innovation will enable us to continue making a profound impact on the lives of those in need, revolutionizing the way mental health support is sought and financed,” Macar says.

Eve Mamane, co-founder and chief revenue officer, Agave Health

When Eve Mamane met the man who would become her husband, she learned that, as an adult, he had been diagnosed with ADHD—a condition she knew very little about. Early in the relationship, she says she didn’t fully comprehend the complexity of the diagnosis and believed he could simply “try harder.” Things changed when they started living together. “I began to witness the extraordinary effort he had to exert to compete tasks that seemed simple to me. I saw how his racing mind could be both a source of distraction and a remarkable force, especially in his professional life. I also observed the impact of ADHD medication—how it could be helpful at times, but also fail him and push him to emotional limits that seemed neither healthy nor sustainable.”

Mamane, a marketing executive who had spent a decade working for and advising up-and-coming startups like Wix and Fiverr, got to work researching ADHD, which led her to the realization that there was “a striking lack” of behavioral care for adults.

“When it comes to managing ADHD, the options typically revolve around medication, traditional therapy and face-to-face coaching,” says Mamane. “Medication can be helpful, but it only provides relief for a limited number of hours and often has significant side effects. Traditional therapy, if provided by an ADHD specialist, can be beneficial, but tends to be expensive and infrequent—usually limited to weekly sessions. Face-to-face coaching specialized for ADHD offers practical guidance for day-to-day management but can be hard to find and comes with a hefty price tag.”

Recognizing an underserved community, Mamane built Agave Health, the first virtual clinic for adults with ADHD. “What sets Agave Health apart is our truly unique approach,” Mamane says. “Our therapy programs are rooted in cognitive behavioral therapy (CBT) methods developed by psychologists who specialize in ADHD. These programs are delivered digitally, making them easily accessible to all. Our coaching services are provided by ADHD coaches who collaborate with Agave. They offer the advantages of both one-on-one video sessions and the flexibility of chat-based coaching between visits.” Mamane stresses that technology is a real game changer. “By embracing digital delivery, we not only make high-quality care accessible to everyone, but also significantly reduce costs for our users. This makes Agave Health the most affordable option for receiving high-quality ADHD care today.”

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Tidal River: Was there anything that surprised you about becoming an entrepreneur?

Macar: Without a doubt. My journey has been a perpetual cycle of learning and unexpected surprises. These moments of astonishment primarily stem from navigating the ever-evolving landscape of entrepreneurship across various stages of growth. When initially launching a company that you’re intensely focused on and deeply passionate about, it’s only natural to assume multiple roles and become a “jack of all trades.” However, many fail to consider the second half of the adage: “master of none.” As I progressed as a leader, I realized that as we entered the second stage of our startup, my primary focus needed to shift toward recruiting an exceptional team. In the subsequent third stage, I had to empower that team to handle day-to-day operations while I directed my time and energy toward forging partnerships and securing investors. Now, our sights are set on scaling the business. This ongoing process keeps leadership incredibly captivating because it constantly presents new challenges that necessitate sharpening my skill set.

Mamane: I find that being an entrepreneur is like being in an endless intensive seminar. Not a day

goes by that you don’t encounter something new. Whether raising funds, building products, growing teams or developing the business’s strategy, the environment an entrepreneur evolves in is dynamic and fascinating. This motivates me in a way I never expected: While it may sound overwhelming to realize the large array of fields an entrepreneur dips their toes in on a daily basis, I was positively surprised that it makes me even more energized. I’ve never spent such a large part of my day outside my comfort zone, and I find it more curiosity-triggering than stressful and challenging, as I expected.

Tidal River: What do you look for in an investor?

Macar: We are actively seeking investors who bring a distinct skill set, expertise and mastery that complements our team’s existing capabilities. Specifically, we are looking for individuals with expertise in sales, marketing, scalability, nationwide contracts, higher education, negotiation and, naturally, those who have successfully exited previous ventures. The most crucial factor for us is finding investors that share our unwavering passion for making a difference in the lives of people who cannot access affordable support services as well as who comprehend and align with our vision of becoming the leading healthcare app nationwide.

Mamane: More than anything, I look for a strong belief that anything can be achieved with hard work and dedication, and a personal inclination toward making an impact. To be blunt, we’re not building a B2B SaaS product that will make your sales team more efficient—we’re in the business of impacting people’s lives in the deepest, most meaningful way. By succeeding, we will be able to help millions of adults hurt less, feel more at peace and fulfill their potential. This is a meaningful and important mission, and I seek investors who are eager to join such an important mission. Of course, we’re businesspeople too, and we’re building a business that’s advantageous to our shareholders and to ourselves, but we do so while deeply embracing the responsibility that comes with building health-focused technology, and we expect our investors to be on board with this approach.

Tidal River: Did you face any funding challenges, especially as a woman?

Macar: Absolutely! When I initially dedicated myself to building the company, I never anticipated the challenges I would face simply because I am a woman. I encountered an investor who dismissively referred to me as a “silly little girl with an idea.” On multiple occasions, I sat down with investors, only for them to direct their attention solely toward my male counterpart, disregarding my presence. I even had an investor proudly claim to mentor women but admit to not investing in them. These horrifying experiences are unfortunately just a few among many. In the face of such adversity, I made the unorthodox decision to document every interaction I had with investors. This serves as a source of encouragement for me along this arduous journey. Understanding that the odds of securing funding are typically between 1% and 2% at best, I keep my focus unwavering, like a horse with blinders. The right investors for us may be scarce, but they do exist, eagerly waiting to support a startup that seeks to disrupt a fragmented and flawed system. The moment we secure funding from such investors, we are immediately filled with the energy and momentum needed to propel us forward at an accelerated pace.

Mamane: I didn’t really face any challenges, for the very simple reason that both my co-founder Ori Fruhauf and I were aligned from the get-go: An investor who feels uncomfortable investing in a woman founder, let alone a pregnant one, is an investor we don’t want to have by our side. I’ve pitched late in my pregnancy and early in motherhood. I’ve entered investors’ offices with a nine-months-pregnant belly; I’ve pitched on Zoom with my newborn sleeping in my arms, well within the camera view. I’ve never apologized, nor have I let it become an issue. I believe that there is nothing abnormal about this, and the way we make this opinion mainstream is by acting accordingly. Perhaps some investors shied away from investing in us because of it without expressing it openly; if they did, it was for the best. Our investors are our partners; we want them to have similar values, not only about health technology and business, but also about the place of women and mothers in the workforce. We signed our first term sheet the day before my daughter was born, and closed our round when she was five weeks old. It required some logistical juggling, but it didn’t prevent us from building a team and launching our product in six short months.

Tidal River: What advice would you offer other females or minorities who want to start a business?

Macar: To begin, I want to emphasize that if you are a woman or belong to a minority group and are contemplating initiating a business venture, it is crucial for you to embrace it wholeheartedly. Numerous challenges lie ahead. If you genuinely believe that entrepreneurship is a fundamental part of your destiny, approach it with relentless determination and unwavering commitment. Devote yourself entirely to your vision until it materializes. Second, concentrate on assembling a passionate and skilled team. If financial constraints prevent you from hiring experienced personnel, consider recruiting interns. By offering enriching internships to college seniors, you can begin building and scouting potential future hires. Lastly, engage in networking events to establish connections. In addition to future partners, it is essential to connect with individuals who understand the challenges you face during the entrepreneurial journey.

Mamane: The fact that you’re a woman is only a parameter of your strength: We have been blessed by nature to have the privilege and abilities to do it all. The only thing that stands between you and your dreams are your own fears. Set them aside, look ahead and run forward. Anyone who stands in your way because of your womanhood only proves they aren’t the partner you’re looking for. Shake it off and move forward—women can do it all.

Tidal River: If you had to go back to the beginning, would you do anything differently?

Macar: It would be disingenuous to deny it. As the leader, founder and CEO of a startup, my journey is characterized by continuous learning and personal growth. Reflecting on our trajectory, I realize the importance of prioritizing the development of our internal team rather than relying solely on external agencies. Let me clarify that agencies do provide significant benefits to startups, and we currently collaborate with a few of them. However, I have come to recognize that startups often place excessive trust in agencies, resulting in unnecessary expenditures of time and money, especially during the early stages when such investments may not be entirely warranted.

Mamane: We’re still at an early stage, but so far, every setback has turned into an opportunity to push ourselves further and be more creative in the way we tackle challenges. We’ve most certainly made mistakes and will make more in the future. I can’t say any of these mistakes have been tremendously detrimental to our path, nor that any of them have been without a valuable lesson.

Tidal River: Any final thoughts you want to share?

Macar: First, while not everyone has mental illness, everyone has mental health. Whether you are an investor or a business owner, prioritizing your mental well-being is crucial. Make a conscious effort to engage in regular conversations with someone who exists outside of your immediate circle, be it in the context of a business or personal matter, like a performance or success coach. This individual should be genuinely invested in equipping you with the necessary tools to excel beyond your current circumstances. By doing so, you will undoubtedly witness a transformation in your leadership abilities, outcomes and overall achievements.

Mamane: Being part of a minority gifts us with learnings that folks in the majority don’t have access to. Harness those learnings and turn them into strengths.