Image credit Woebot Labs Inc.
Exploring therapeutic bots and other digital services to scale mental health support
It is estimated that one in four people worldwide will be affected by a mental or neurological disorder in their lifetime. Globally, nearly 300 million people suffer from depression, while close to 800,000 suicide deaths are attributed to the illness each year. Some segments of the population are disproportionality affected by the disease; this includes women and children who have experienced violence; soldiers returning from war; migrants and refugees displaced by conflict; the poor, and other vulnerable groups in society (i.e..: unemployed). Anxiety levels are also on the rise from job automation risk and the changing nature of work. Worldwide estimates suggest an annual economic output loss of US$2.5-8.5 trillion stemming from mental, neurological and substance use disorders, while this figure is projected to nearly double by 2030.
Though some progress is being made to improve access to mental health services at scale, key challenges remain: (i) a shortage of human professionals trained to provide quality mental health services; (ii) persistent stigma commonly associated with the ailment; and (iii) lack of integrated interventions that strengthen social, economic and mental health outcomes that are required to provide a strong foundation for improving livelihoods and the mental well-being of sufferers. Youth may benefit most from integrated interventions, as outlined in the Pathways for Peace report, given the rising levels of mental illness, social challenges, and stark unemployment afflicting them. A catalyzing force is therefore needed to achieve measurable impact, particularly when considering the magnitude of the challenge.
As mobile broadband infrastructure improves in developing countries, there is an opportunity to leverage emerging technologies to address different dimensions of the mental health challenge. Tools such as mobile learning platforms and artificial intelligence hold promise for enhancing access to quality treatments, harnessing data to derive insights, and scaling access to health promoting factors. A recent publication we’ve written on the topic, Harnessing Technology to Address the Global Mental Health Crisis: An Introductory Brief, outlines different technologies that could be utilized to garner new insights, build efficiencies, and scale support across an array of communities and contexts. The brief was financed by the Multi-Donor Trust Fund for the Middle East and North Africa Region. Below are a few examples of different technologies that could be used to improve access to mental health services.
Enhancing Access to Quality Treatments
New tools are empowering patients to access digital mental health services conveniently, cost-effectively and anonymously. In some cases, these interventions provide an alternative to long wait-times for receiving mental health support. Some tools also embed safeguards to alert human professionals of high-risk cases, though further testing is required as the technologies and applications evolve. One promising intervention is a therapeutic bot, intended to guide individuals to express their feelings and concerns about their mental well-being, and then offered tools and techniques to improve their mental health. Some applications are grounded in internet based cognitive behavioral therapy (ICBT). One example of this service is Woebot, a conversational agent developed by Stanford University researchers, which combines CBT, a guided self-help infrastructure, and natural language processing. An initial study illustrated that participants who conversed with Woebot via the text message interface “experienced a significant reduction in symptoms of depression” after two weeks, while those in the control group did not.
Scaling Capacity and Access to Health Promoting Factors
One approach to address the shortage of mental health professionals is to train non-specialist health workers on diagnostic, support and treatment strategies for mental illness. Digital learning platforms could be leveraged to fast track and scale the completion of mental health training by non-specialists and community volunteers. Quality content, including the World Health Organization’s Mental Health Gap Action Programme (mhGAP), could be delivered through digital learning environments, and partnerships with academic institutions could be integrated to facilitate accreditation (e.g., micro-credentials). Additionally, the ability to earn a living, engage in purposeful work, and attain good education can serve as strong protective factors against mental illness. Digital platforms can also enable access to these opportunities through skill building, certification, and career programs.
Embracing technology will be key to addressing the global mental health challenge. The innovations featured may catalyze and amplify positive outcomes in resource constrained environments, though these are predicated on having the underlying technological infrastructure in place. Though these innovations are not a panacea, they can be a driving force to scale the capacities of non-specialist providers and offer new forms of mental health support. Looking ahead, a cultural shift may be needed to enable the adoption of these new tools among wider populations. Despite the varied challenges expected, the application of these technologies holds promise, with the hope of achieving timely, low-cost and quality treatments for the millions of individuals afflicted by mental illness, globally.