“Mental health problems don’t define who you are. They are something you experience. You walk in the rain and you feel the rain, but you are not the rain.”

Matt Haig, Author & Journalist

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In the United States, the Centers for Disease Control and Prevention (CDC) reported that in 2019, 4.7% of adults aged 18 years or older reported regular feelings of depression, and 11.2% reported frequent feelings of worry, nervousness, or anxiety. Forty percent of Americans with a 12-month history of severe mental disorders do not receive treatment. The ongoing COVID-19 pandemic has increased mental health care needs while simultaneously restricting access, with unknown long-term consequences. From August 2020 to February 2021, the CDC described an increase in the proportion of adults reporting recent symptoms of anxiety or depression from 36.4% to 41.5%, with the fraction saying unmet mental health care needs increasing from 9.2% to 11.7%. Among children and adolescents, the proportion of mental health-related emergency department visits for those aged 5 to 11 years and 12 to 17 years increased by 24% and 31%, respectively, compared with 2019.

Mental health issues have shed much of the stigma they carried three decades ago, and parents and adolescents are more at ease when discussing the subject among themselves and seeking help.

“We envision a world where technology understands when someone is going through a depressive phase or panic attack and provides support in their time of need.”

George Eleftheriou, Founder and CEO, Sentio Solutions

Mental health is moving far beyond the psychiatrist’s couch. Technological advancement has pushed digital therapeutics to the forefront of convenience—in people’s pockets, on their laptops, and even within Facebook messenger. And with that, the category expands to include a suite of wellness products and services. It’s a new ecosystem that sees individuals relying on a wide range of tools—chatbots, apps, and digital support groups—to combat modern-day issues such as burnout, loneliness, and anxiety. Combined with traditional medical models, it encompasses a holistic approach to psychological wellbeing. So, reviewing the current research, here are the major technologies that can support mental health and well-being.

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Telehealth and Virtual Therapy – Tech is redesigning traditional care by improving access and customizing the experience. Virtual therapy apps such as TalkSpace, BetterHelp, and Amwell give patients the ability to call, text, and video teleconference with professional counselors on their schedule and in the comfort of their own homes. These frictionless options, often a fraction of the price of clinic appointments, serve individuals with time constraints or those in rural areas who lack access to care. Online platforms such as Rethink My Therapy, which offers unlimited therapy for $60 a month, particularly appeal to millennials who want their medical appointments as easy as ordering in dinner. Millennials are far more likely to address their mental health than generations prior, with seven out of 10 saying they feel comfortable seeking help.

Other virtual therapy apps center on counselor matchmaking and addressing specific patient needs. Regain specializes in professional couples therapy, and Pride Counseling serves LGBTQ individuals, while Henry Health targets black men. The newly launched Ayana connects marginalized communities with therapists from their culture, background, and race. Other virtual therapy apps center on counselor matchmaking and addressing specific patient needs.

“I think we all want for there to be great ways to see our doctors remotely… but when you move to online, you have to think about the modality of treatment, and whether it’s going to be effective.”

Christina Farr, Omers Ventures

Wearables – Mental wellness wearables such as headsets and bracelets slowly see traction, though many are still in the early stages of clinical trials. The Muse brain-sensing headband helps you get the most out of your meditation practice by giving you real-time biofeedback about what is going on in your mind. The Muse is not some dystopian headset trying to alter your brain. Instead, its makers, InteraXon, want to train you to modify it yourself. The routine is simple. You put the Muse headset on, and you complete the breathing exercises to the sound of waves (neutral), storms (bad), and tweeting birds (good) which indicate how focused and calm you are. If your mind is too active, the Muse gives you feedback to help you clear your thoughts.

Korean startup YBRAIN has raised $4.1 million to develop hardware for brainwave monitoring and brain stimulation for mental health professionals. The startup’s MINDD SCAN headset is a wireless EEG system that screens visualizes, and processes brain activity in real-time. Traditional EEG scans typically take an hour, while MINDD SCAN takes care of the examination and ensuing analysis in five minutes. YBRAIN’s second product, the MINDD STIM headband, helps activate communication between neurons in the cerebral cortex using electrical stimulation, which is beneficial for conditions like depression, anxiety, and insomnia.

Sweden startup Flow Neuroscience has raised $1.1 million to develop a brain stimulation headset that can treat depression without medication. Similar to the YBRAIN device we discussed earlier, the Flow Neuroscience device sends gentle electrical signals to the brain’s frontal cortex, which activates brain cells. Early results appear promising. In a trial, 23% of users overcame depression entirely, and 41% felt significantly better after six weeks of using the headset alone. Flow provides a CBT app that helps introduce positive lifestyle changes as well to maximize patients’ chances of recovery.

Feel has raised $1.8 million to develop a wristband that assists CBT therapy by identifying emotions. Feel’s technology monitors skin electricity conductance, heart rate, and temperature throughout the day and relays this data to machine learning algorithms that translate it into emotional patterns. The connected mobile app provides personalized recommendations based on users’ emotional states. For example, if you’re feeling anxious and agitated, your heart rate increases, and skin conductance changes suddenly. Feel’s wristband relays this information to the app, which suggests a calming breathing exercise. By doing the exercise, your body will feel calmer, promoting a clear emotional response as well. Feel has created a mental health program combining this feedback mechanism with remote therapist sessions and homework tutorials that help practice self-help techniques. The startup offers its programs through health plans and employers.

Fitbit and Apple Watch – Fitbit has a Relax app on its Blaze and Ionic models. The app is a breathing exercise that can last for 3 or 5 minutes and is designed to help the user slow down breathing and heart rate. It’s a quick yet still efficient exercise to find a few minutes of calmness every day. It also shows the progress you have made over time and how much you could reduce your heart rate during the exercise, which guarantees that you come back to it day after day. While you can’t quite track mental health on Apple Watch, that doesn’t mean that there aren’t features that can help with anxiety. For example, Apple has the Breathe app onboard. Deep breathing is one of the most straightforward tools to lower your body’s stress levels. In layman’s terms, when you breathe deeply and slowly, it sends a message to your brain that everything is OK, and the brain doesn’t need to release epinephrine (adrenaline) to fuel your fight or flight response. In other words, it helps relax you.

Founded in 2015, startup Somatix has raised $7.5 million to develop real-time gesture detection technology that helps in the behavioral and physical monitoring of patients. The startup’s platform uses sensors in commercial off-the-shelf smartwatches, smart bands, and IoT connected devices to track gestures in real-time and recognize physical and emotional indicators. Gesture data is sent to the cloud, combined with user-specific information like calendar appointments, contacts, and social media posts, and analyzed by machine learning algorithms to find significant behavior patterns.

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The mental health and wellness app environment – Mindfulness and meditation apps such as Headspace, Calm, and female-focused Sanity & Self offer audio tracks to relax listeners and strengthen mental resilience. Frequently, they’re paired with breathing exercises, visual aids, and journaling guides. Israeli social network Wisdo connects individuals struggling with mental conditions, as well as those overcoming difficult emotional situations. Some apps take their cues from entirely different genres, evidenced by the ever-growing anti-anxiety gaming space. Nearly a million people have played SuperBetter, an app that gamifies mental health upkeep. Players accrue points by persevering through stressful situations, completing breathing exercises, and breaking bad habits. Mindstrong is an app that analyzes how users interact with their phones—how they type or scroll—to identify mood states. Its machine learning can reportedly detect a range of potential mental health patterns. It is now being tested on California patients through the state’s public mental health system. Then there’s U.K. Startup Thymia, which has developed a simple set of mobile video games that might, with the help of AI, pick up on depression signals and any office examination, according to the founders. When clinical trials begin later this spring, Thymia will try to improve and even save lives as it alerts doctors to warning signs they might otherwise miss. The Thymia games, downloadable free from its site, are minimalist. They involve simple tasks in whimsical natural settings; in one, a player tries to track bees buzzing around sets of flowers. But the machine is gathering critical information. Mental health advocates also generally worry that cheaper app-based approaches to mental health could deter insurance companies from paying for human doctors. Thymia founders say that this is one of the reasons patients will not be allowed to use the service themselves and instead must go through their clinician. The company says Thymia does not share data with third parties, including insurers.

Mindaps.org is a terrific site that reviews over 600 behavioral health apps. It was created by researchers at Boston’s Beth Israel Deaconess Medical Center Health System. What I like best about the site is the ability to use various filters to examine the apps’ privacy policies. John Moore of Chilmark Research looked at those. And of the 600+ apps, only 458 had a privacy policy. Of those, only 426 declared a data use and purpose. Of those, only 251 let you delete data. And of those 251, only 22 meet HIPAA requirements. Bottom line: be careful with your personal information on these apps. Mental health apps have worse privacy protections for users than most other types of apps, according to a new analysis from researchers at Mozilla. The apps with the worst practices, according to Mozilla, are Better Help, Youper, Woebot, Better Stop Suicide, Pray.com, and Talkspace. The AI chatbot Woebot, for example, says it collects information about users from third parties and shares user information for advertising purposes. Therapy provider Talkspace collects user chat transcripts.

“It’s just really been there for me during a lot of my recovery. When you go to therapy, everyone’s kind of looking at the clock… Through the day, if I needed to talk to her, I could just text her.”

Tiffanie Mouzoon, TalkSpace user, Axios interview 5/2/2022

Chatbots – Chatbots are also on the rise. Woebot is an AI-enabled “robot friend” who looks like Wall-E and engages users through uplifting or sympathetic conversations. The adorable digital therapist is now available in 120 countries, serving more than half a million people. Woebot is a “fully automated conversational agent” developed by Woebot Labs in San Francisco. The app’s daily check-ins began with a question about where you are and what you’re doing but didn’t push with open-ended questions. Instead, it asked you to choose a quick emoji that describes your feelings. Over time, Woebot charts those emoji responses to help visualize trends and then shares that chart with the user. Next is Wysa, a playful artificial intelligence penguin that operates on iPhone and Android platforms.

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“[Digital mental health] is a $500 billion category over the next decade.”

Sandeep Acharya, Founder, Octave Health

Where we’re going – Mental health tech will move into the mainstream as cultural norms continue to shift. The widespread use of smartphones means that every person carries a supercomputer that can be used for personalized mental health care. Millennials’ embrace of convenient treatment, as well as interest in self-care, will transform how employers, universities, and local governments offer subsidized care. The ongoing public conversation on toxic workplaces and burnout is already pushing big companies to take action and realize that prevention is more affordable than treatment. In the coming years, expect more well-being tools that work in conjunction with medical care. The new consumer might find themselves weekly teleconferencing with a therapist, then relying on a meditation app during moments of stress. Or maybe they’ll wear a bracelet that will warn them when a panic attack is forthcoming. The future will be full of intrusive and feel-better tech readily available at an individual’s fingertips.