Although management consulting was still a male-dominated industry in the 1990s, Malekeh says she was inspired by how committed BCG was to building a diverse team. “That commitment has inspired many of the decisions I have made at my own company,” she says. “Our small US-based leadership team is majority female and represents nine countries. We deliberately celebrate that diversity and all of our differences.”
Malekeh cites two BCGers in particular as influential mentors. The first was Clay Christensen, who was also one of her professors at Harvard Business School. “He was a life mentor who taught me about staying true to one’s values,” reflects Malekeh. “I learned from him that remaining 100% committed to one’s core values makes it so much easier and simpler to make important life decisions.”
Another BCGer who had a big influence on Malekeh is managing director and senior partner Debbie Lovich. “She combines this amazing brainpower with so much humility and kindness,” says Malekeh. “Any time that Debbie walked past my office, she would stop to ask how I was doing and whether she could do anything to help me. I admire her compassion and her faith-based values.”
After leaving BCG, Malekeh worked in several different consulting roles, focusing mainly on health care and education. When one of her sons experienced a series of neurological issues with psychiatric and nonpsychiatric comorbidities, Malekeh was immersed in the struggles of navigating the complex—and inequitable—US mental health care system.
“As a parent, it was extremely difficult to understand whether a symptom was a medication side-effect or a new set of challenges,” she says. “I didn’t know which clinician I needed to call to get that information, and when I did call, I was unable to get the provider. Ultimately, I was forced to go to the ER to get answers and treatments.”
Malekeh’s own journey as a parent of someone with behavioral health care needs inspired her to take a hands-on role in building an impact enterprise that could address the inequities around access to mental health care.
“In my research, I found out that my son’s situation was the norm,” says Malekeh. “All patients in this category have complex disorders and require a more comprehensive and multifactorial approach to their assessment and treatment. I was also a privileged parent. I was, at the time, on the board of Baylor College of Medicine, with extensive access to care and knowledge. The clinic that ended up diagnosing my son within three days had a 2,000-patient waitlist.”
Recognizing a need for better and more equitable behavioral health care, Malekeh cofounded Trayt Health. The company’s mission is to transform mental health care by using data and algorithms to enable more accurate diagnosis and treatment and improve outcomes across populations.
“The data on inequities in the current system speaks for itself—as of last year, there were over 570 counties in the US that were considered mental health deserts, meaning that there were no behavioral health services available to anyone within a 90-minute travel radius,” Malekeh says. “That is a big part of the reason why 50 million US adults and 60% of children with mental health illnesses are not receiving the care they need. It’s a crisis, and these disparities are much higher for certain racial and ethnic groups.”
According to the Kaiser Family Foundation, roughly half of white adults accessed needed mental health services in 2021. In the same year, only 39% of Black adults, 36% of Hispanic adults, and 25% of Asian adults accessed such needed services. “Mental health deserts are typically located in lower-income communities with significant challenges in accessing food, transportation, and other basic resources,” says Malekeh. “This is true across the entire spectrum of health care, where your ZIP code defines your health outcomes. In behavioral health, the problem is especially severe due to shortages in specialty providers and reimbursement challenges.”
To help reduce these disparities, Trayt has built a technology that uses collaborative care models, remote patient monitoring, and virtual observations to increase equitable access to mental health services. In April 2023, Trayt received a US patent for its methodology of collecting, synthesizing, and analyzing multifactorial data including symptoms, environmental, and social factors.
Trayt’s methods are getting traction. In the three years since programs launched, Trayt has enrolled almost 13,000 clinicians and served 65,000 patients. In one state, a significant majority of students with severe depression whose providers were supported by Trayt’s service saw significant improvements in their depression scores. “We looked at the data and found that many of the patients who benefitted were those who lived in mental health deserts and would otherwise never have been able to access the care they needed,” says Malekeh. “Seeing these outcomes was incredibly rewarding and energizing.”
Malekeh will be donating her prize from the North America DEI Alumni Award to One Mind, a leading brain-health nonprofit. “They exemplify a data-driven and multidimensional approach to improving mental health diagnosis and treatment models, especially for children and adolescents,” says Malekeh.
As for the future, Malekeh believes progress on equitable access to behavioral health care depends on collaboration among multiple stakeholders.
“The mental health crisis in the United States today is similar to the COVID crisis, which means we need a coordinated public- and private-sector response to save human lives,” she says. “Governments have allocated a lot of funds to address the issue, but these programs are so scattered that it’s difficult to know if they are having any impact. We have the case studies and the data to show that if you take a strategic, data-driven, and coordinated approach to behavioral health, you can make progress on achieving both equitable access to mental health care and improvements in mental health outcomes.”