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Mental Health Month Q&A on digital health research

One in five U.S. adults experiences mental illness. In honor of Mental Health Month, we sat down with data scientist Stefanie Nickels to learn about how digital tools can unlock better ways of managing mental health.

Why is it important to focus on mental health research, especially now with the impact of COVID-19?

Over the past 30 years, we've seen no improvement in mental health outcomes. Mental health disorders are the leading cause of disability in the United States, and anxiety and depression have only increased during the pandemic. Social isolation and worries around getting sick or losing loved ones can exacerbate existing mental health conditions. Not only is there a cost to the healthcare system, mental health issues have a profound impact on the sense of self, emotional and physical well-being, and the professional and personal relationships of the individual.

What are digital therapeutics and why are they interesting in the mental health space?

Digital therapeutics are technology tools used to prevent, treat, or manage a disease. We can deliver many types of therapies digitally. Telehealth allows you to speak to a mental healthcare provider via video chat, removing the barriers of needing to be in the same room if you';re physically distant or experience mobility challenges. There are also apps with built-in cognitive behavioral approaches – a common type of psychological treatment – that can teach valuable skills in a scalable way that's accessible to many people. You can go at your own pace, using an app that's always available and private.

What is a digital biomarker and what's an example in mental health?

A digital biomarker is something you can measure digitally that indicates mental health status. A simple one is how long you sleep. Sleep disturbances are associated with depression so changes in sleep can indicate a shift in mental health.

Smartphones contain sensors that can capture data relevant to health, and figuring out how to translate this information into useful insights is still a young field. One of the data points mental health researchers are interested in is location, because it helps us infer how much time people spent at home. Increased homestay is associated with depression, as is increased social media app usage and decreased physical activity, which are other things we can infer from smartphone use.

Can you describe some notable aspects of mental health research that Baseline has conducted?

Most clinical studies are conducted at a study site like a hospital. For the Baseline Mood Study I and II, we set out to make them completely remote, easy to access, and fun. The studies were self-guided using an app, and one of the notable aspects was the use of an engaging chatbot that led participants through daily activities. We also used a mix of clinically validated electronic questionnaires that are approved by a body of experts to accurately measure something related to health, and more novel research approaches like audio diaries.

What is next with mental health research and care, and what do you hope we can achieve?

On the research side, we have a lot of work to do in finding digital biomarkers and provide evidence that they are valid mental health measurements that can tell healthcare providers something meaningful about mental health outside the clinic. This in turn can enable better care.

Measurement-based care is routine in other fields, but not in mental health. For example, with diabetes we continuously monitor A1C levels to understand if the disease is being controlled. What this might look like for psychology and psychiatry could be completing a questionnaire every one to two weeks in order to quickly identify whether a treatment is working. One reason this isn't being done today is that it's burdensome to providers, but through an app, this type of data can be collected very quickly.

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