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Using tech to tackle mental health
“The opportunity to talk to an anonymised source works for the majority of people,” says Alan Payne, Chief Information Officer, Aetna International as he explains one of the first hurdles in the race to tackle mental health issues with technology: stigma.
“Technology is about the best vehicle for the individual. It’s a level of personalisation to approach how you feel about your condition — rather than the societal stigma.”
According to the World Health Organisation (WHO) one in four of us will experience a mental health issue at some point in our lives. The spectrum of mental health conditions ranges from the neurotic, such as stress, anxiety and depression, to the psychotic, such as bipolar disorder and schizophrenia.
Symptoms can vary from person to person. Individuals with a mild form of neuroses are generally able to function on a day-to-day basis, while those with more severe disorders can experience significant disruptions in their daily life, even losing touch with a sense of reality.
In many countries, there is a disparity in the way physical and mental health conditions are viewed and treated. While the West is keen to lead the charge with de-stigmatisation of mental health, stigma remains prevalent in a range of cultures and regions, including Hong Kong.
Sources: Nami.org and SCMP.com
“Some countries endorse and embrace; some consider you a pariah if you even mention it,” states Alan of the global status quo. “Any mental health solution needs to be secure and about them — the patient. Talking to an anonymised source rather than visiting and sitting with a person could be a way to get care and treatment into places where there is stigma. Hopefully, with time, that stigma will dissipate.”
Depending on the severity of the condition, technology has enabled those experiencing mental health issues to self-manage their condition through:
- apps, such as mood trackers
- depression tests
- mindfulness and calming sessions, like Elefriends
- online platforms like MDLIVE or MentalHealthOnline.
These enable the individual to take control, and then share with a mental health clinician.
“Trust is incredibly important — particularly with mental health,” adds Alan. “You trust your doctor to prescribe a digital health care journey as well as a physical pathway. And people need to trust the technology.”
Although there have been many campaigns and movements to reduce the stigma around mental health, the path to treatment for clinical depression is still very long. It's not yet given the same consideration and gravity as a physical injury. The WHO states: “Currently, more than 40% of countries have no mental health policy and over 30% have no mental health programme. Around 25% of countries have no mental health legislation.”
“Although a phone cannot replace the role of a professional, it may also go some way in helping to avoid unnecessary contact with a clinician”
Governments and academia
For Alan, also an Honorary Professor at University College London (UCL), “technology in relation to health care” is a key area of his research.
“Sadly, governments play a minor role. The academic world is leading the way. Academia is building outcome-based approaches to explore the use of digital technology to support mental health programs.”
As Alan explains, it’s extremely difficult to measure outcomes on mental health, with the industry invariably struggling with consistent and standardised measurement methodologies.
“UCL is doing great work on addiction with the Center for Behaviour Change, particularly around smoking cessation techniques that are not drug-based.” He adds that tests of a ‘quit smoking’ app have produced amazing results, with subjects having a 25% chance of being smoke-free after a year of using it.
The instruments of revolution
One potential leveller across countries is our growing use and dependency on technology, with the prediction that 90% of the world's population will have a mobile phone by 2020. Whether it’s a smartphone, laptop or even fitness tracker, the potential role in tackling mental health issues cannot be ignored.
“Two things have revolutionised health care in the last 10 years,” Alan states. “The first is the mobile phone. By 2007, Apple had shown that personalised delivery for almost anything could be achieved — services as well as products.
“The second key thing is ubiquitous access to the internet.
“In combination, these two things have allowed service-based health care models to proliferate and drive access to consumers and their interests, rather than a statistical view of what someone needs. Personalisation of naming a need and finding a resolution — from ‘Doctor Google’ to an APP for diabetes management.”
Listen to Dr Sneh Khemka discuss digital mental health care in our Fit for Duty podcast episode below.
It’s not all about the gadgets
New technology seems to occupy more and more of the news agenda, with innovations in genetic medicine and robotic operations receiving airtime in the media. But, as Alan explains, as far as mental health is concerned, it isn’t the gadgets that will solve the problem, it’s what they allow us to do: “Technology by itself is not as important as the concept of data and customer experience. The personalised nature of data is driving ever increasing opportunities to identify where behaviours — particularly modifiable — can be diagnosed and intervention strategies created.”
There are clear winners in this space and mental health is one of them. Tech has shown notable successes with mindfulness and sentiment attachment simply by tracking how patients respond in communications.
For example, email communication style can indicate your level of stress in the work place. It’s an opt-in service that can privately assess the way you’re responding to emails and give you a stress level rating based on the language you use and the speed at which you respond amongst other metrics. As a result, patients can start to build interventions and preventative measures — take a break, go outside.
Alan continues, “With behaviour-modifying tech your return-on-investment is a ‘return on happiness’.”
Using technology, doctors could prescribe digital as well as physical care pathways, recommending and monitoring lifestyle changes as well as prescribing medication.
“What if for type 2 diabetes, you could prescribe lifestyle changes that can be monitored and adhered to and tracked? What if we could build in the ability for biometric feedback as well as sentiment for how you’re feeling as you’re going through the treatment?” Says Alan.
Who is using tech to tackle mental health?
- Consumers
The individual, subjective and personal nature of many mental health issues means people want something that is relevant, bespoke, reactive and, often, private. - Business
Businesses looking for techniques to reduce absenteeism and increase productivity, let alone as a retention tool. - Health services
Using technology to reach more people in a cost effective and personalised manner, leveraging personalisation, Cognitive Computing and bio-feedback
The hurdles
But are there drawbacks of technology being used for mental health prevention and treatment? Stigma around mental health is a recognised hurdle, but what about the technology itself? What are the costs? Could there be logistic issues around connectivity and access? What about data, privacy and compliance?
“Technology isn’t a panacea for every person,” says Alan. “Some people will respond to social and physical intervention, others will respond to a bot. Our task is to find the best avenue for the customer in an omni-channel way.
Regulations and compliance are regionally specific. That’s why Aetna International have a regional specific cloud-based system that allows us to meet stringent country regulatory requirements, while giving patients a seamless customer service wherever they are in the world.”
Expat mental health
For those moving or travelling abroad mental health issues can be exacerbated. Those away from their homeland are more likely to suffer poor mental health. A lack of support and exposure to a different environment can lead to mental health issues.
A different language in another country may also be a barrier for accessing counselling, or there may even be more of a stigma in a country not as accepting of mental health issues. For example, in Zambia, mental health problems are commonly seen as a form of punishment from God. Technology could be very useful here for support networks or using apps to help those with existing or new conditions cope.
Research indicates that apps can be helpful for providing an essential support network to those experiencing issues. The anonymity offered can enable individuals to share, read or view content on where to find help or ask questions that they may feel ashamed or embarrassed to ask someone close to them, or even their medical professional. Being able to self-manage mild conditions is useful, but there is also research that says it depends on the app you choose and whether it’s peer reviewed.
Technology is a fundamental part of our lives, and has a place in all our experiences, including mental health conditions. It can play a great part in helping to manage or treat certain conditions, whether that is alongside professional help, or individually.
Listen to Dr Anushka Patchava, Proposition & Strategy Lead, vHealth discuss mental health as part of a holistic approach to health care in the Fit For Duty podcast episode below.
Learn more about international relocation and how it affects emotional health in Aetna International’s white paper: Expatriate mental health: breaking the silence and ending the stigma.
For more information on getting international health care for you and your family, contact one of our expert sales consultants.
“Trust is incredibly important — particularly with mental health,” adds Alan. “You trust your doctor to prescribe a digital health care journey as well as a physical pathway. And people need to trust the technology.”
