The first time I met Marika Conomos, she took to the stage at the Spring25 Pitch Night in Sydney. Unlike the twenty founders before her, she didn’t stand beside the stage; she stepped up onto it. In an instant, she commanded the room - focused and completely in her element. There was a strength to the way she spoke, the kind that comes from years of seeing a problem up close and deciding “heck I’m going to fix this myself.”
That problem, for Marika, was the persistent drag in mental health care. As a psychologist and clinic owner, she’d spent years balancing therapy sessions with the operational grind of running large practices. “I built Ecko Health to solve the issues that were just persistent on the ground,” she told me. “Not just from a clinician’s point of view, but from the operational side of running a business.”
Ecko Health is the product of that lived frustration, an AI operating system for mental health care that brings clinical intelligence, patient engagement, documentation, telehealth and practice management together in one place. At its centre sits the Clinical Double™, an AI counterpart that learns how each clinician works, thinks, and speaks.
The concept came from something deeply personal. Marika is a twin, and her sister, also a psychologist, has always been her mirror in work and life. “We think the same, we work the same,” she said. “I’ve always trusted her completely.” The thought stuck: what if every clinician could have that kind of perfect counterpart?
The result is an AI system that doesn’t just automate admin or write reports, it studies each therapist’s tone, rhythm, and approach to care. Over time, it learns to sound like them, work like them, and help them deliver care in between sessions. “It learns about the clinician,” Marika explained. “Their style, their tone, the way they deliver therapy.”
This isn’t the same as the standard scribing software or admin tools already circulating in psychology. Ecko Health’s Clinical Doubles are personalised to each clinician, opening entirely new doors for how mental health professionals can work with patients more frequently.
So how does Ecko really work? The Clinical Double sits in on every appointment, securely retaining context and providing clinicians with session briefs before they even sit down. It retains full historical context and can engage with patients between sessions in a voice they recognise. It might check in about a goal discussed last week, or gently prompt them to practise a technique at the time of day they usually struggle most. “It’s not like they’re seeing someone different in between sessions,” Marika said. “It keeps them aligned and engaged.”
In early trials, Ecko Health ran with around 30 psychologists and 500 patients. In our conversation, Marika shared that the feedback was striking (and exciting). Patients felt more supported and clinicians said it deepened their connection with clients having received the context from the patient in between in-person appointments. As the double is always learning, it can also brief therapists before sessions with updates and insights. Think: what’s changed since the last session?, what patterns are emerging?, what’s worth focusing on this appointment? and what diagnostic profiles should i consider?. “Traditionally, you spend half the session playing catch-up,” Marika said. “Now it’s more of a hybrid model of care.”
The name Ecko reflects exactly that idea. “It’s meant to echo you,” she said. “Sound like you, talk like you, be like you.” The original spelling was taken, but the meaning stayed: a reflection of the human clinician, not a replacement.
Ecko Health has just entered open beta, welcoming psychologists, counsellors and mental health workers to join. Beta users get full system access to the Clinical Double™, the OS features, and direct support from Marika and her team.
“We’re quite close to our beta users,” she said. “We want them to feel supported and part of what we’re building.”
You can register at eckohealth.ai and connect with Markia on Linkedin.
That moment on stage, Marika stepping up while everyone else stayed on the floor, feels like the perfect metaphor for what she’s building. A reminder that sometimes progress is as simple as seeing the platform in front of you and taking a leap.
