Hi Bruce, great to reconnect here! Thank you for all your thoughtful comments. I really appreciate your perspectives. Here are my responses to your points.
Yes, we are primarily a "life-improving" intervention rather than a life-saving one. While we do track suicidal ideation and believe we may have prevented several suicides, proving this counterfactually is challenging. So, when calculating our impact, we consider lives saved as a "bonus" rather than our primary measure of impact. As such, we don't account for that in our cost-effectiveness estimates.
We are on track to improve our cost per person (but still not there). The $233 cost per person reported for 2023 included our total spending for the year, which involved significant consulting fees to Columbia University for their supervision in our first year. Excluding those fees, which are not recurring, our actual cost per person was $152 in 2023. We expect 2024 to be in that range.
Regarding your other notes:
The NBER paper was an incorrect reference—thank you for catching that. The link has been updated.
We don’t believe the Baird RCT is especially relevant to our work because 1) it focuses on adolescents, 2) it was delivered by non-specialist, age-peer providers (i.e., other adolescents), and 3) the "12-month follow-up surveys were conducted at the height of the pandemic." A hard moment for everyone.
We also saw that update from GiveWell, although they noted, "we will be using our historic benchmark until we have thought it through." So, we think it’s fair to continue using the historic benchmark until they switch.
So appreciate the thoughtful feedback, it helps us to refine our thinking and keep improving!
thanks so much, Nick!
thanks so much! Love having a creative team!
Hi Bruce, great to reconnect here! Thank you for all your thoughtful comments. I really appreciate your perspectives. Here are my responses to your points.
Yes, we are primarily a "life-improving" intervention rather than a life-saving one. While we do track suicidal ideation and believe we may have prevented several suicides, proving this counterfactually is challenging. So, when calculating our impact, we consider lives saved as a "bonus" rather than our primary measure of impact. As such, we don't account for that in our cost-effectiveness estimates.
We are on track to improve our cost per person (but still not there). The $233 cost per person reported for 2023 included our total spending for the year, which involved significant consulting fees to Columbia University for their supervision in our first year. Excluding those fees, which are not recurring, our actual cost per person was $152 in 2023. We expect 2024 to be in that range.
Regarding your other notes:
So appreciate the thoughtful feedback, it helps us to refine our thinking and keep improving!