How Digital Tools Could Make Measurement-Based Behavioral Healthcare Possible
Founder and CEO at Ellipsis Health
Measurement-based care has transformed the identification and management of physical health diagnoses. By the 1950s, blood pressure cuffs became the standard of care for monitoring high blood pressure, contributing to the significant reduction of deaths due to heart disease. Glucose test strips, first introduced in the mid-1960s, were able to accurately assess blood sugar levels quickly and effectively. Both seemingly small inventions helped shift the health paradigm from intuition to quantification, changing healthcare dramatically.
However, there has been no equivalent of a blood pressure cuff or glucose meter, which are physiological measurements and not self-reported, to measure depression, anxiety and behavioral health conditions. These conditions often impact other chronic diseases that have been monitored for decades. Even though depression is the leading cause of disability globally, a patient will wait 11 years on average from the onset of their mental health conditions symptoms to receive proper treatment.
The Role Of Technology In Behavioral Healthcare
In his book, Reading our Minds, the Rise of Big Data Psychiatry, Dr. Daniel Barron discusses how the "structure of the psychiatric evaluation is essentially unchanged from the early 1900s." Data is needed to get the mental health epidemic under control, as people cannot effectively manage what they cannot measure. Like the blood pressure cuff, digital health tools can shift the standard for measurement-based mental health making screening, monitoring and alerting for depression and anxiety severity much easier, supporting time-strapped providers and enabling data-driven care.
Digital tools also have the potential to be used more widely to address the severe shortage of mental health providers in the U.S. Estimates project a shortage of between 14,280 and 31,091 psychiatrists by 2024. The imbalance between the supply and demand of mental health providers has created severe access problems for both insured and uninsured people.
Digital tools that are scalable solutions can meet people where they are (at the right time and place) and can provide the right intervention, due to their intelligence, in mental healthcare. While some of these technologies are available now, it's important that those in the behavioral healthcare industry use them correctly, ethically and effectively and that healthcare technology companies seek innovation in these areas.
Best Practices With Digital Health Tools
There is a multitude of digital tools available to mental health providers to aid in the diagnosis and treatment of patients. Effective digital solutions should offer accessible approaches and support positive behavioral change on a larger scale, allowing providers to have better insight into their patient’s habits outside of a traditional in-person appointment. In my opinion, they should also be available anytime and from anywhere, providing on-demand help without the long waits often needed for in-person care.
For example, mobile apps to support mental health, like Headspace and Calm, can provide guided meditation sessions and offer practical and easily accessible tools to manage stress and anxiety. Other mobile apps, like SonderMind, can help patients navigate their own care path in an interactive way. These helpful tools can assist patients in their mental health journey, but keep in mind that they do not provide measurable and actionable insights into patient behavior, which are crucial for clinicians. Remote one-on-one support allows patients the freedom to access care on their own time in a way that fits into their life.
Tools that rely on voice have emerged as an ideal vehicle for powering digital mental health tools to gauge someone’s emotional health. Using a person’s voice, providers can measure the severity of anxiety and depression at scale using patient speech. During my time as the founder and CEO of a company that offers these types of voice tools, I've come to understand that what someone says — and how they say it — has a direct correlation to physical and mental health, making speech an incredibly powerful tool for patient assessments and the monitoring of conditions and treatments. As with other digital health technology, these tools using patient speech should not be used to replace a patient's time with providers, but can provide actionable insights between appointments to better assess progress, which can impact future treatment plans.
Treating alcohol and substance abuse disorders typically requires a balance of physical and mental health support, unique to each patient. In order to best support someone during their recovery timeline, in-person therapy sessions, group counseling and detox support, providers can consider offering long-term digital health solutions to track and assist patients on their recovery journey. For example, platforms such as Help Near and Now (HeNN) offer prevention-based content and health resources, including facility lists for further in-patient treatment as well as local support groups. Users can set up notifications to encourage interaction with the platform, enabling individuals, treatment professionals and families to connect with the correct resources in near real-time.
Challenges The Industry Faces
The lack of objective, scalable measurements for mental health conditions is driving interest in digital technologies. As providers continue to face increasing documentation burdens, digital health tools could become a smarter, easier way to identify and measure mental health symptoms.
We need businesses to step forward and be innovators and demand evidence-based research and deliver the data to support it. Further, it’s going to take a collaborative effort across businesses to ensure a future where all overlooked and marginalized populations experience true agency and representation in research, especially in mental health.
The status quo is no longer sufficient when it comes to addressing the mental health tsunami that is ravaging our society. The introduction of objective, longitudinal behavioral health data means that the industry must rethink care and disease management. We need to adopt a new mindset when it comes to understanding population risk and how we interact with patients.