Healthcare Technology Featured Article

December 15, 2017

How Digital Technology Could Close Mental Health Gaps

According to World Health Organization, globally, more than 300m of people are affected by depression, 60m suffer from bipolar disorder, 47.5m people have dementia and about 21m are fighting with severe mental disorder - Schizophrenia.

Yet, these appalling numbers are aggravated by more horrible statistics. Health organizations around the world fail to address the burden of mental disorders. Only 35-50% of people in need receive at least some basic treatment. This is in high-income countries. Low and middle-income states record the shocking gap of 76-85%.

The reasons of this unbalance vary from limited access to diagnostics and treatment to inability to identify the problem in the first place. For example, in Chad, Liberia, and Rwanda only a couple of psychiatrists are available for the entire country.

The results of this scarcity, however, bring up another extreme statistics. Mental health disorders are the leading cause of disability worldwide, accounting for nearly 8 million deaths annually.

Fortunately, major healthcare associations, researchers and technology companies are alarmed and today put serious investment and efforts to combat the problems of mental health. In this context, digital technology often appears in the center of this initiative. Thanks to productive eHealth, telemedicine and the perspectives of IoT, AI and other innovative technologies, focus on digital becomes common in the healthcare in general.

Machine learning and AI-enabled digital tools

The power of machine learning is widely applied across industries starting from predictive advertising to automation in manufacturing and energy sector.

Healthcare is not an exception, however, mental health has always been dragging behind. Not until recently, when IBM took a stand as one of the leading technology giants addressing the issues of mental healthcare.

The game-changer in cognitive computing and NLP technology, IBM claims to revolutionize mental health diagnostics and treatment with machine learning capabilities. Today at IBM, the scientists already use audio and transcripts of psychiatric interviews to effectively predict and monitor an array of mental disorders, including psychosis, schizophrenia, autism, mania and depression.

Advanced speech and text recognition, machine learning with pattern identification coupled with the analysis of the data coming from image diagnostics (MRI) and wearables create a full picture of every individual and allow clinicians carefully predict the probability of psychosis in a user by, attention, only 300 words.

Despite seeming remoteness of this promising technology, some applications are already available to the users of smartphones. For example, Eliza powered by IBM Watson analyzes speech to determine mental state. The other AI-enabled mobile tool from Apple, Autism & Beyond, applies facial recognition technology and enables early stage autism screening.

In other words, application of machine learning will be able to significantly increase mental health diagnostic and monitoring capabilities and scale. It may close the gap for underrepresented areas enabling doctors with digital tools to perform fast and efficient diagnostics.

Moreover, AI-powered solutions will be able to identify mental disorders in the infancy. It implies less overlooked patients, more timely diagnostics, wider range of treatment opportunities at the early stage of illness, and most importantly, less neglected cases of effectively curable states such as depression or anxiety.

AI-powered mobile technology

AI-enabled technology is powerful on both sides. It can both augment the capabilities of clinicians and medical facilities and get into the toolkit of every mental health patient. Thanks to the availability of smartphones across the world, including distant and rural areas and low-income countries, access to this technology is no longer exceptional.

Thus, many startups, mental health research organizations and even individual clinics already apply AI-powered technology to help people with possible mental disorders, those suffering from emotional traumas and patients diagnosed with mental illnesses of varying complexity.

One of such available mobile solutions is Woebot - AI-backed chatbot therapist that operates on Facebook Messenger. It helps people with depression and anxiety using an emphatic dialog based on cognitive behavioral therapy techniques. Or Mindstrong app that applies digital phenotyping assessment. It “passively, objectively and continuously” measures smartphone use to identify patterns in mood, cognition and behavior and determine the symptoms of neuropsychiatric disorders.

Another app How do I, NESTA prize winner, supports people with learning difficulties - those with special needs, autism, dementia, brain injury, etc. This educational app applies NFC recognition technology and shows contextual instructional videos on how to implement simple tasks with everyday objects, such as making a cup of tea or folding clothes.

Despite evident benefits, application of mobile technology has been receiving controversial opinions. Many mental health apps that flood the stores nowadays lack of scientific credibility and limited clinical effectiveness, according to various researchers. Due to time-consuming and relatively expensive procedures of clinical trials, apps often fail to prove their effectiveness, to say the least.

Unfortunately, the users of mental health apps often get into the risk group. The study by the University of Liverpool suggests, that many mental health apps can lead to over-reliance and anxiety around self-diagnosis. For people with possible or diagnosed mental disorders who tend to stay in isolation, digital solutions that lack social responsibility and clinical reliability can pose a real danger.

For this reason, it’s important that easily available mobile solutions with powerful technology behind also have sound security, strong evidence base and clinical reliability - CE certification, HIPAA compliance, related association accredit.

IoT,  wearables and virtual reality

Digital technology brings both availability and efficiency in mental health diagnostics, treatment and monitoring thanks to telepsychiatry, mobile apps for self-management and innovative screening solutions. Moreover, high-end technology discovers brand new ways to tackle the issues in mental health.

Application of wearables already has a relatively long history in healthcare. Combined with the infinite capabilities of IoT technology for remote monitoring and real-time data management, wearables bring up basically new way for treatment adherence and disease development tracking.

Recently, IBM and NESTA innovation foundation brought up the challenge for young inventors to find the application of high-end technology across various fields. Not surprisingly, the initiative ended up with a number of successful projects for mental health issues - remote monitoring for doctors and researchers, adherence solutions for patients. Further, some of these truly novel projects will be funded and implemented with the help of IBM’s cutting-edge cognitive computing tools and intelligent platforms.

For example, Breath Watch wristband monitors the symptoms of panic attack and can alert dedicated persons or turn on calm-down program on phone or tablet. ASDE motion Badge for people with autism spectrum disorder changes color depending on the wearer’s emotional state and facilitates communication with people around. Or IoT-based solution, The Home Sensor for people with dementia that tracks daily motions and routines, identifies patterns and sends alerts in case of unusual activity.

These digital tools backed up by high-end technology demonstrate infinite opportunities for tackling major problems in mental health - insufficient clinic and social care resources, low quality of life for people suffering from severe mental diseases, continuous tracking and monitoring for people with long-term mental disabilities, and collection of relevant data on illness development and treatment results.

Moreover, new technology enables building innovative environment for clinical studying of mental diseases. Virtual reality, for example, is the key tool for computational psychiatry that conducts large-scale studies for diagnosing and treating mental disorders. Virtual environment makes an ideal space with limitless modification capabilities. It enables long-term continuous studying impossible in traditional context-limited environment. In practice, it means more relevant data, better understanding of mental diseases and new solutions to both cure and prevent disorders in the future.

Clearly, the focus on mental health matters in the context of the reality we face today. More people around the world get traumatized due to large-scale conflicts, refugee crisis, political, economical and ecological problems. Today, more than 90% of the youth - most vulnerable target groups - live in low and middle-income countries with little access to quality mental health.

This is why digital technology that forms the basis for highly available and efficient mental health solutions should become the key resource to support the efforts and build healthier environment for the future generations.

Edited by Mandi Nowitz
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