Chief Executive's Review
It has been a privilege to work alongside our strengthened global leadership team, with a number of
strategic appointments in marketing, product and operations demonstrating our growing reach and level
of ambition.
Overview
I am pleased with the strength of our underlying performance during the period and our execution
against strategic priorities following the transformation our business underwent in 2024. This can be
seen within our financials on a constant currency basis where notwithstanding the significant
strengthening of the pound against the dollar during the period, we continued to deliver underlying
growth. We maintained a robust balance sheet to enable long-term investment, and notwithstanding FX
movements, expect to deliver revenue and adjusted EBITDA for the full year in line with expectations.
As we look to further solidify our position of market leadership, we took the decision to
significantly invest in service user marketing to ensure acceleration of reach and ultimately
sustainable usage in California in the period. This investment is now largely complete and the Company
expects marketing costs in the second half to be significantly lower. The benefits of this investment
will continue to be felt in H2 2025 and beyond and are best highlighted by the significant growth in
user numbers in California during the period, well exceeding our user registration targets and now
standing at over 130,000 youth in the State. We remain on track to exceed the California Department of
Health and Care Services’ (DHCS) targets for 2025.
Evolution of our strategy
To sustain our market-leading position and leverage the successes we achieved in 2024, we have taken
our unparalleled experience of the sector and the learnings from our material US expansion to further
evolve our strategy for the years ahead.
Designed to address and capitalise on the changes we are seeing in the sector, this evolved approach
will expand the services we provide within our platform, including access to more targeted tools to
help users back into work or education and support users at different stages, opening up new funding
opportunities and embedding us further with both our customers and users.
Funders are increasingly looking for solutions that not only increase access, but can also deliver
measurable and comparable outcomes, aligned to standardised metrics of clinical, social or economic
benefit. With our proven ability to reach populations at scale, and deliver high-quality care, Kooth
is well placed to support this shift and we will continue to evolve Soluna with new tools, guided
programmes and more structured touchpoints such as CBT therapy as we look to engage ever more
stakeholders and funders as part of our “State alliance” model.
Our market-leading position has been built on providing whole-population access to evidence-based
support, connecting users with self-guided, peer and professional support when they need it. In
California alone, we have reached over 130,000 youth, in all 58 counties, in just 18 months. By
providing a universal, trusted ‘digital front door’, we can connect users to behaviour
health services within Soluna and provide a trusted route into other support, whether through their
health plan, school district or college.
By embedding Soluna across the state, within public and private sector services, we can deliver value
beyond our immediate funders to ensure sustainability for the long-term.
This approach underpins the evolution of our strategy - our ‘State Alliance’ model -
which will build on our proven ability to reach whole populations, expanding the scope of our services
to more closely align to the requirements of a wider set of customers.
The achievement of this vision, in which Government funding unlocks population-wide access to our
core Soluna provision and then other partners can fund more targeted support for the populations they
serve, requires the development of a ‘networked continuum of care’, with personalised care
journeys embedded into our platform. The development of this ‘care continuum’ will be at
the forefront of our in-house work across clinical, product, tech and operational teams as we shift
into H2 2025 and beyond.
California
Our services continue to reach and support young people in improving their emotional wellbeing and
achieving their goals. Our landmark Soluna service in California is making a significant impact in
reaching and supporting California youth, and is now well-valued by its users, their communities and
State leaders. The DHCS recent Impact Report
described the programme as ‘reimagining behavioural health care delivery for children and
youth’ and emphasised Soluna’s key role in providing timely and effective care.
To ensure sustainable growth, we have made significant investments into our State-wide advocacy,
partnerships and integration programme in parallel with focused digital marketing. We have built
relationships with nearly 300 key supporters across California’s state, healthcare, education
and community-based organisations, activity based on our experience in the UK, where we have
demonstrated that local advocates are essential to building trust and embedding services within the
populations we serve. This activity supports our shift from digitally-driven growth to more organic
reach and local brand recognition over the term of the contract, thereby driving down the cost of user
acquisition.
New Jersey
Similarly, we have made strong inroads into advocacy building in New Jersey, resulting in steady
growth in user registrations and positive feedback from State leaders, with local advocacy targets
exceeded in the first half of 2025.
Examples of this essential work include our partnerships with the Social Emotional Learning Alliance
for New Jersey's Youth Mental Health Advisory Collaborative and NJ Institute for Community Schools,
which enables us to connect to approximately 150 school districts. Our team has also built strong
relationships with the New Jersey Statewide Student Support Services network, a state-wide system that
connects youth and their parents and caregivers with resources to support their mental health and
Soluna is now recommended via the network.
Wider US
State leaders remain concerned about the real-world impact of poor youth mental health, and are
seeking solutions to address this nationwide issue. In the context of reduced federal funding for
Medicaid, a renewed focus on cost effectiveness has generated greater focus on earlier intervention
and digital interventions - evidenced by recent moves to standardise reimbursement codes for digital
mental health technologies.
Our evolved strategy, as outlined above and which also takes learnings from our recently concluded
one-year partnership with Aetna in Illinois, unparalleled insights from our experience in the UK and
US, and significant stakeholder engagement, is designed to ensure we are well-positioned for success
in this growing market.
UK
In spite of sustained pressure on public sector spending, we remain the largest provider of digital
mental health services to under 18s. As in the US, increased policy focus on the relationship between
good mental health and improved social and economic outcomes, and support for digital interventions -
as evidenced by the Government’s 10-year plan (Fit for the Future) - further reinforces the need
for our services. With Soluna on track to launch in the UK in 2026, we are well-positioned to
translate these policy shifts into opportunities for growth.
Looking ahead
After a period of transformational growth, the first half of 2025 has seen significant investment as
we focused on solidifying our market position, consolidation of our strengths and embedding
ever-deeper connections with our customers. With this investment largely complete, Kooth is
well-placed to achieve our objectives for the remainder of 2025 and beyond.
We have a robust balance sheet, an undrawn working-capital facility and clear policy tailwinds in our
core markets, and our ability to flex product, partnerships and our go-to-market approach while
maintaining clinical quality and outcomes mean we are in a stronger position than ever before.
The need is greater than ever
As ever, I return frequently to the voices of our users, who remind everyone at Kooth of the
importance of our mission every day. Research undertaken by our team this year has underlined the
essential role that Kooth services have played in supporting our service users to connect with their
friends and family, get back to school, re-enter the workforce, and build the skills we all need to
live more fulfilling, healthier lives, whether in Newcastle or Newark, San Diego or Sunderland, London
or Los Angeles.
Kate Newhouse
Chief Executive Officer