Can mental health care be made more accessible?

The COVID-19 pandemic brought to light the growing mental health crisis. This renewed attention stems from social isolation, which induced a sense of fear, worry, and concern—both real and perceived—among the population. 

Mental health issues are a global concern. Some of the common disorders—stress, anxiety, depression, and substance abuse—need professional intervention. But traditional treatments are reactive and expensive. Virtual interventions are fast replacing in-person clinic visits, thus accelerating the curve on access and quality.

Today, sensors, artificial intelligence (AI), and digital technologies offer numerous possibilities and ways to diagnose and treat mental disorders. This paper comprises a healthcare ecosystem that leverages emerging technologies and enables service accessibility by using a platform-based approach to transform care for patients afflicted with mental disorders.

Technology as a catalyst of change in mental health

Although it is a global problem, mental health is neglected even in developing countries. Disruption of routine care and mental health services has further deteriorated the situation. Amid these challenges, technology leads the way in improving quality of care and enabling active user involvement across every segment of the mental health IT market, that includes providers, payors, and patients. Each segment’s growth is linked to an increased usage of mental health mobile apps. 

Mental health management has improved with early mental health intervention. Increased availability of mobile apps for patients and providers has made this possible. Smartphones, tablets, wearables, and other tools have become instrumental in data collection. These tools enable researchers to advance their understanding of the diseases. Payors such as Medicaid promote early mental health intervention to reduce the impact of mental illness on the physical health of members, thereby containing the associated costs of treating comorbidities like hypertension, obesity or cardiovascular disease, that result from neglect of mental health.

Research proves that technology and digital therapeutics (DTx) can positively influence cognitive, behavioral, and emotional aspects of mental health. Mental health and mental disorder, however, as products of complex systems, need concerted efforts within an ecosystem. The implications of the pandemic for mental health present a rare opportunity to translate and substantiate these findings in the real world. 

Predicting, monitoring, and measuring mental health conditions with digital biomarkers

Digital biomarkers—sensing changes in a patient’s physiological and biological systems—are revolutionizing mental health. The ability to check health status, track onset and progress of diseases, and monitor health conditions using non-invasive approaches is promoting an uptake in digital biomarkers’ usage. Moreover, the low cost and improved scalability of app-based digital biomarkers allow the collection of social, behavioral, psychological, and environmental data that were previously inaccessible. Given these capabilities, the global digital biomarkers market size is expected to reach $10.38 billion by 2027 at a CAGR of 39.2%.

Rise of the mental health apps, tools, and technologies

Emerging technology trends that are gaining traction in the treatment of mental disorders, include prescribed DTx through digital apps, FDA-approved apps for opioid use disorder (OUD), post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD). Healthcare providers also leverage surgical, ingestible, and non-invasive interventional tools to observe and affect brain and body function. Digital phenotyping in the form of deep brain simulation implantation of tiny electrodes is proving to be beneficial in managing addiction and behavioral self-control. 

Technologies such as AI, are a potent way forward in treating mental illness. AI chatbots as virtual assistants and digital health coaches are valuable in providing personalized services for psychological support, while ensuring care associated with social stigma, confidentiality, and data privacy of the end user. Personalization in mental health has evolved with the prevalence of wearables and the internet of things (IoT) devices that drive customized treatment, monitoring, and clinical decisions to deliver new interventions in real time.

For psychological intervention, augmented reality (AR), virtual reality (VR), and extended reality (XR) are paving the way for real-world robot companions to deliver experiential treatment sessions. Metaverse and digital twin could further hyper-personalize experiences.

Figure 1: Technologies that can improve care accessibility for patients afflicted with mental disorders

A platform approach to solving the mental health crisis

The ubiquity of digital devices has enabled the healthcare community to provide treatment through various channels, including digital platforms. A platform approach to mental wellbeing enables the healthcare ecosystem to equip stakeholders with the means to provide mental health services in a single, integrated application. Such platforms can assist healthcare professionals in scaling while making specialists accessible and available through virtually. 

Platforms can optimize the usage of trained resources and the combined data to provide evidence-based methods and install nudge-based interventions to measure and improve patient outcomes. Moreover, they can also empower patients with data privacy through unified, secure channels. This approach opens new avenues to leverage 5G, AI, AR, and VR for assessment, monitoring, interventions, and treatment procedures.

Proposing a mental wellness platform approach

The healthcare ecosystem players can build a DTx platform for mental wellness. This would follow the proposed functional architecture with critical elements, as shown in figure 1.

Figure 2: Functional architecture for a mental wellness platform 

The functional architecture of a mental health platform comprises three primary layers:

1. Channel layer facilitates a unified experience for the end user for availing secure services through alternate channels like web portal, mobile, interactive voice response system (IVRS), wearables, and chatbots. 

2. Interface layer enables integration of the core applications and the channel layer with external systems via an application programming interface (API) gateway. Some of the external systems include healthcare partner systems, social media sites, IoT integration, and the inter-channel communication layer.

3. Core layer is the heart of the platform, which enables core minimum viable product (MVP) services like member onboarding, master management, self-assessment, medication reminder, diary notes or journaling, and virtual consultation with counselors or medical professionals. Apart from these services, the platform drives specific programs for end consumers to handle burnout, stress, anxiety, depression, and substance abuse through the member services module. Managed services, on the other hand, can facilitate the care coordination module to bring in efficiencies.  

The platform must include a simple plug-and-play functionality for adding or eliminating services. Powered by an AI-based analytics layer, the platform can offer a dashboard view for real-time decision-making, that senses the end user’s abnormal behavior patterns. The core layer can facilitate horizontal services like billing, compliance reporting and audit trails, security, and standards to the platform to ensure better hygiene. The core layer can facilitate horizontal services like billing, compliance reporting and audit trails, security, and standards to ensure better hygiene on the platform.

Accelerating platform adoption and the key success factors

Championing mental health initiatives with a platform-based approach demands a strong network of service providers. The platform must provide personalized experiences through continual non-intrusive monitoring with appropriate nudges and interventions, while promoting adherence to mental wellness regime through value-added features and enhancing user experience. In addition, building actionable insights for various stakeholders and faster response to alerts will improve the confidence in the system. Beyond all the right privacy features, security provisions and alignment to the regulatory policies and procedures will ensure increased adoption.  

Moving forward, the evolution of the platform hinges on the expansion of the ecosystem from treatment to wellness. In essence, a platform-based approach backed by the right technology can be a gamechanger in transforming mental health care.