Perspectives

Recently, 7wireVentures had the pleasure of sitting down with Stephen Smith, Founder and CEO of NOCD. Continue reading to learn how Stephen’s personal experience recovering from OCD inspired him to start NOCD and help the 140 million people with OCD around the world access high quality care.

When you were a child, what did you want to be when you grew up?

As a child who loved sports growing up, I wanted to be a professional athlete. First baseball, then football. Ultimately, I went to college and played quarterback and I realized that it was not what I wanted to do professionally. I studied a variety of different subjects like trading (my father was a trader) and law (my mother was an attorney). These practices seemed fairly structured, and I was never one who preferred too much structure. I thrived in environments with autonomy and being able to problem solve in a unique way. When something pretty traumatic happened to me personally, I had that same solution-focused mindset. With that, I ended up stumbling into the world of entrepreneurship and have really enjoyed it.

What was your first job?

My first job was in high school working for a sports drink company. My job was to set up a table in Whole Foods, provide samples to shoppers, and try to get them to purchase packages of the drink. I had to talk to people walking through the store and quickly communicate why they should buy the product. This was my first foray into sales.

I also worked at an AM/PM gas station and Subway sandwich shop. I worked behind the register and made sandwiches. It was a great learning experience – I was forced to learn how to work directly with people. I developed an appreciation for how hard people work. I had coworkers who worked every day, for 12 hour shifts, just to make ends meet. They’d get there at 7am and leave at 7pm. It opened my eyes to the hardships people face in life.

What experience was most formative in propelling you to start NOCD?

I have had personal experience suffering with OCD. When people hear the word OCD, they are typically thinking of OCPD – obsessive compulsive personality disorder – where people have different personality quirks or are particular about certain things. In reality, OCD is a condition that manifests with severe intrusive thoughts that are typically about the future. Often, that thought violates that person’s core values and characters.

I have this condition – I started having these severe intrusive thoughts in college. I saw a therapist who misdiagnosed me with anxiety. They told me to take a rubber band and snap it on my wrist every time I had an intrusive thought. That’s the worst thing to do for someone with OCD, by the way, it only makes the thoughts worse. I was misdiagnosed four times before I hit rock bottom. I had to leave school and stop playing football and was housebound with severe depression.

One day I finally found an online forum with others who were experiencing the exact same thing as me. They defined it as OCD. I searched for treatment for this, and learned that exposure and response prevention (ERP) was the gold standard treatment for OCD. There was one therapist in my area who specialized in it; she had a $300 out of pocket cost per session and seven-month waitlist. I was fortunate enough to have a family friend cover the cost of my treatment and ended up getting off the waitlist. I saw the therapist for one hour a week and then between sessions I would try to self-manage. I slowly but surely got back on my feet, went back to school, and finished my football career.

Accessing effective treatment is not a clinical issue – we know ERP is effective at treating OCD. It’s an operational issue. There are 1 in 40 people that have OCD. These individuals can get better but are not today because there’s no accessible OCD treatment. I wanted to figure out a way to make this highly effective treatment much more accessible – and this became NOCD.

“There are 1 in 40 people that have OCD. These individuals can get better but are not today because there’s no accessible OCD treatment. I wanted to figure out a way to make this highly effective treatment much more accessible – and this became NOCD.”

What do you think will be the long-term impact on the delivery of mental health care from this pandemic?

I think it’s going to be primarily telehealth in the future. You can conveniently get the same quality treatment at home. NOCD’s live video therapy sessions feel the same as live OCD therapy. COVID-19 has shown us that telehealth is just as effective. In some cases, telehealth is actually more effective because it allows the provider to see the patient’s home, or another place where the patient is most triggered, versus in an office setting where you have to try to replicate the environment. In addition to the effectiveness, it’s much more convenient for both patients and providers.

What are the greatest challenges that you faced in scaling a successful venture backed company?

Perfecting our market fit. There are a ton of intricacies at play that require us to test and to be patient. We have to be relentless in the way we work to understand our customers’ needs and thinking, and then adjust accordingly. Once you know that there is a solution that is effective, you have to ensure that it fits in with the broader healthcare ecosystem.

“We have to be relentless in the way we work to understand our customers’ needs and thinking, and then adjust accordingly.”

What has most contributed to the success of NOCD?

We have learned the importance of hiring strong teams to drive our vision forward using creative solutions. We look for people with a certain attitude towards problem solving. We have learned that by hiring the right people, we can build something that people love – something that helps people make a 180-degree turn around in their lives. Our dedicated team is the pillar of success that has driven us forward.

What is your superpower?

My superpower is probably my competitiveness – the desire to win keeps me going in many ways. I think about the business nearly 24-7. This strong sense of competitiveness has helped me push forward and do whatever it takes to drive the business.

What would you want to do if you could no longer be the CEO of NOCD?

I’m motivated by learning. So, if I could no longer be the CEO of NOCD, I would want to learn more about being on the other side of the table as an investor in early stage companies. On the operations side, I look at the growth of the company through a completely different lens. Looking at a financial model is one thing, but to actually make it come to life is a whole other story with so many intricacies and challenges to overcome. On paper things look one way, but in reality, there are so many curveballs thrown your way. I’d like to one day help others navigate those curveballs.

What book are you reading right now?

The Ride of a Lifetime by Robert Iger. It was recommended to me by Amazon – they’ve gotten to know me a little too well!

What is one piece of advice that you would give to our readers?

Stay open minded. Particularly in healthcare, there are so many biases that affect the way we think. We look at data for truths and design processes that we think will work, but things change direction all the time. Being open minded helps us to see opportunities more clearly. At NOCD in the beginning, we were growing and trying to figure it out. We were trying to survive – to get enough revenue to keep the lights on. We were open minded to new ideas because we didn’t have the biases of knowing how the healthcare system adopts a product like ours. We eventually developed a model to fit in with providers, payers, and life science companies. I think if we weren’t open minded, we probably wouldn’t have found some of those opportunities and be in the strong position we’re in today.