Over the last few months, our hopes and expectations for 2020 have certainly been halted. There was an air of optimism globally as we entered the New Year and a new decade, but now we have been plunged into a world of uncertainty with the spreading COVID-19 pandemic. Future unknowns, both from a human well-being perspective and an economic standpoint are starting to take a toll on many people’s mental health.
Understandably, the situation we find ourselves in is creating concern and worry and many of us will feel anxious and on edge with the significant disruption to our daily lives and normal routines. For those with a history of mental health issues, these feelings will likely be more extreme. In order to try and support the situation, the World Health Organization has released some good advice on protecting mental health psychological well-being during the Coronavirus outbreak, and it seems at every turn companies and individuals are offering suggestions on how to cope. However, there are many people who will need more support than an online article can offer, so where do they turn?
The Role of Digital Mental Healthcare
With many people currently restricted to the confines of their own home, and with health care priorities changing to focus only on those with critical conditions or COVID-19, how have healthcare systems and providers been dealing with the potentially rising number of people who have mental health challenges during this difficult time?
The answer is digital mental healthcare. Never before has remote access to healthcare been more critical than it is today. For example, for those with anxiety and depression, online cognitive behavioral therapy (CBT), maybe the lifesaver that people need, providing people with access to any time, anywhere therapy all from a device and from the comfort and safety of their own home. Pressure needs to be taken off healthcare systems and with a greater move towards ‘at home’ access, digital delivery means more people can self-serve.
Delivered through a secure, real-time messaging platform, patients are assigned a therapist and receive confidential one-on-one treatment. As people struggle to cope with their changing circumstance this can provide the reprieve they need to get through each day. This works well in countries with modern healthcare systems like those found across Europe and North America. In the UK, for example, online mental health care services like our cognitive behavioral therapy service can be scaled up to meet demand. However, in parts of the world where there is a clear historical lack of mental healthcare support and scarcity of therapists, the growing mental health problem will only exacerbate, particularly in uncertain times like these.
Over half of all countries, today have 4 or fewer psychiatrists to every 100,000 people, and in low-income countries, the ratio is 0.1 to every 100,000 [1]. The therapist shortage exists in high-income countries too, with the American Journal of Preventive Medicine reporting that 65% of non-metropolitan US counties do not have a psychiatrist and almost half of the non-metropolitan counties (47%) do not have a psychologist [2]. The scarcity of therapists and available treatment, particularly when mental health challenges are on the rise, is very real.
The move from in-person to remote health care only solves a portion of the puzzle by removing geographic and travel barriers – it does not address the shortage of therapists or the stigma of seeking out traditional human-delivered mental healthcare.
What is next in digital health care delivery?
Over the past decade, the way the healthcare industry has used and analyzed data have changed dramatically with the development of new techniques in areas of artificial intelligence (AI). For the first time, data scientists are now applying deep learning and natural language processing to large pools of data to extract clinical insights from real-world healthcare delivery in a way that could fundamentally change our understanding of how treatments work, and allow us to bring new automated therapies to market that really work for people – including in the area of mental health.
What may be uncovered could change the dynamics of digital in mental healthcare, as we can start to decode what works and doesn’t work for each patient. For the first time, we can begin to apply new knowledge and context to future mental health therapy to derive improvements in today’s treatments, increasing engagement and personalization to help people face the challenges of the current world we live in.
This paves the way for a ‘new wave’ of digital healthcare services, which are highly personalized and nuanced, combining people, process and technology to deliver easier access to the highest-quality, evidence-based therapies anytime and anywhere. This, alongside the intelligence we can draw from real-world patient data, can transform the therapist/patient relationship, and deliver treatments that are more effective and accessed by the patient when they need it most.
A further iteration could be a virtual therapist, able to reach parts of the world without modern mental healthcare and remove barriers to accessing mental healthcare globally. Accessed remotely and trained to emulate the very best in human clinical practice, these services would be intuitive enough to meet the needs of each individual. They would also need to be backed by science, rooted in real-world evidence, and proven via clinical trials, delivering the much-needed therapy to those with diagnosable mental health conditions.
For patients unable to leave the house, this could mean anytime access to therapy all from an app on a mobile device. For those highly connected to technology, wearables and virtual assistants can be key technologies for delivering real-time support. Patients could trigger their virtual therapist by voice and get the help and treatment they need. Alternatively, a change in heart rate detected by a smartwatch, or changes in behavior detected by a mobile phone, could indicate a change in mood and the need for an on-demand Intervention.
A digital mental healthcare service like this could help people manage depression and anxiety, improve or even save lives, but also take the pressure off the healthcare systems, not only in difficult times but all the time. Ieso Digital Health is not only increasing capacity to its online therapy offered to NHS patients in the UK during this difficult time but is working to bring these new types of digital services to life with the development of automated, digital healthcare services that deliver the essential ingredients of therapy.
These new treatments are being developed in partnership with patients and clinicians in a way that recognizes the differences between each individual’s experiences of mental illness and will be validated on real-world populations in addition to traditional tightly-controlled clinical trials. Based on this real-world evidence, we know they will work in the real world.
About Valentin Tablan, Chief AI Officer at Ieso Digital Health
Valentin has spent 20 years in the field of Natural Language Processing, Knowledge Representation, and Artificial Intelligence. As SVP AI, at Ieso, Valentin and his team are responsible for applying advanced deep learning techniques to Ieso’s vast data set to determine which evidence-based therapy interventions are most effective. Under his leadership, Ieso has created the industry’s first AI-enabled tools that augment real-world data to increase quality and improve clinical outcomes.
[1] Global Health Observatory data repository https://www.who.int/gho/mental_health/human_resources/psychiatrists_nurses/e/
[2] American Journal of Preventative Medicine https://www.ajpmonline.org/article/S0749-3797(18)30005-9/fulltex
