A severe onset of obsessive-compulsive disorder (OCD) took Stephen Smith from starting quarterback at his Texas university to housebound in six months. He saw provider after provider, cycling through incorrect diagnoses, before learning the root of his struggle.
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After his diagnosis, Smith faced another obstacle: The only therapist in his city trained in exposure and response prevention (ERP) — the gold-standard treatment for OCD — charged $350 per session and had a seven-month waitlist.
With family support, Smith eventually received effective treatment, returned to college, graduated, and resumed his football career.
His struggle was not unusual.
Research suggests that about 4% of people have OCD, yet the American Psychological Association reports that many wait 13 years to receive treatment. Even when their OCD was recognized, they faced high costs and long wait times, and once therapy began — if it began — they were left alone to manage their symptoms between sessions. These were devastating barriers to care for a condition linked to high rates of suicide and premature death.
Smith attributed these challenges to a broken system and founded NOCD while still in college. It began as a mobile app with therapeutic exercises, progress tracking, and support between sessions.
As the app gained traction and proved there was an opportunity to revamp OCD treatment, Smith partnered with co-founders Anil Vaitla, Ilyas Patanam, and Larry Trusky, along with Chicago-based investor 7wire Ventures. Together, they added peer communities to the NOCD app and studied its effectiveness with Columbia University researchers.
But users needed more.
“People loved the app, but they told us they couldn’t find an OCD specialist to help them use it — even when they could, wait times and high costs kept them from accessing care,” Smith recalls.
NOCD responded by building a clinical leadership team and hiring, training, and managing therapists to specialize in OCD. After thousands of meetings with payers, leading insurers began covering NOCD Therapy, often reducing out-of-pocket costs for covered members to just a copay.
Specialty access, at scale
Today, NOCD is the world’s leading specialty mental healthcare company. 1,500+ fully employed, rigorously trained, and thoroughly evaluated NOCD Therapists deliver millions of sessions annually, 147 million Americans can access NOCD Therapy using insurance, and most members start within seven days.
This growth was enabled by Noto, the operating system that powers NOCD. “Delivering treatment for 10 members is different than 100,000,” remarked Anil Vaitla, NOCD’s chief technology officer.
A Journal of Medical Internet Research study — the largest of its kind to date — found NOCD Members saw substantial results in under half the therapy time of traditional OCD treatment. A later study, also the largest of its kind to date, demonstrated similar findings with pediatric patients.
NOCD’s treatment has a profound impact on the overall healthcare landscape. An Optum Advisory study found NOCD Therapy saved $3,430 in healthcare costs per member per year, and studies from Cigna, HCSC, and NovaOne showed similar results.
“When people with OCD get specialized care, the whole person gets better, leading to fewer unnecessary medical expenses and downstream health problems,” said Ilyas Patanam, NOCD’s chief growth officer. “We’ve never seen growth at this scale that directly saves lives.”
A new model for mental healthcare
NOCD has built a new specialty mental healthcare system, offering accessible, affordable, and convenient treatment with support between sessions. When people need other forms of care, NOCD coordinates with external providers for medication management or more intensive treatment.
“Every day our members show us that conquering OCD is possible,” said President Larry Trusky. “It’s our job to get them the right care, at the right time, in the right setting.”
In 2023, NOCD launched #KnowOCD with Howie Mandel, a national awareness campaign challenging misconceptions about OCD and encouraging earlier treatment, that has reached tens of millions of people worldwide.
“We’re just scratching the surface of the impact we can make,” Smith said. “We’re not stopping here.”
