Mental illness is not uncommon: One in five Americans suffers from a mental-health issue in any given year. And if left untreated, it can be deadly. Suicide is now the second-leading cause of death among 10- to 34-year-olds and the 10th leading cause of death overall.
Yet for many, help remains elusive. According to the National Alliance on Mental Illness (NAMI), some 60 percent of adults struggling with mental illness did not receive treatment in the past year. Many Americans can’t easily access a mental-health provider because of insurance-coverage limitations, geography (there’s a shortage of providers in rural areas), or scheduling availability. Others may hesitate to seek professional help because of the stigma still surrounding mental illness.
Fortunately, technology is closing that gap. From digital spins on familiar formats to cutting-edge tools pushing mental health into new frontiers, a range of services are improving access while helping people monitor symptoms and stay accountable to goals.
Here’s a look at some of the latest innovations — as well as the limitations — at the burgeoning intersection between tech and mental-health care.
Expert Access From Anywhere
Simply getting to a provider’s office remains one of the biggest barriers to mental-health care.
One emerging solution is telehealth — ultra-secure videoconferencing that essentially transposes in-person psychiatry or therapy sessions onto a computer screen. Telehealth is a game-changer in rural areas, where residents may live hours from a mental-health professional.
Insurance coverage varies, however, from plan to plan, state to state, and even service to service (some insurers will cover only psychiatric services, whereas psychotherapy remains bound to the in-person model). Although this may change in time, if you’re seeking video-enabled mental-health services, check with your plan first.
Acute support services are also getting a digital makeover. While crisis hotlines are nothing new — the National Suicide Prevention Lifeline turns 15 in 2020 — digital iterations of the model are emerging. Crisis Text Line enables individuals in crisis (which the line defines as “any painful emotion for which you need support”) to text a trained counselor at any time. Many of its counselors are volunteers rather than professionals, which means users get practical support rather than full-blown psychotherapy.
For those who aren’t in crisis but still need off-hours support, services like Text4Mood help bridge the gap. Subscribers receive daily “text support” messages from mental-health professionals. The messages offer general guidance rather than personalized solutions (a sample text: “Anger can be empowering when it’s properly channeled; use it as an ally in your recovery”), but the advice is effective nonetheless: In a survey of subscribers, 83 percent reported that the service boosted their overall mental well-being. Though Text4Mood is currently available only in Canada, the continued rise of text-based treatment options suggests we may soon see a similar service in the United States.
It Takes a (Digital) Village
Support groups have long been a popular form of treatment largely because they promote what’s known as universality: the recognition that we are not alone in our struggles.
Digital support groups not only facilitate that sense of connection and community; the newest iterations also offer anywhere, anytime features as well as expert advice — all from a computer or phone screen.
Meru Health’s digital clinic is designed to address depression, anxiety, and other common mental-health concerns. It marries peer support — members can elicit feedback, swap tips, and offer guidance to other members, all anonymously — with evidence-based mental-health protocols such as cognitive-behavioral therapy (or CBT) and mindfulness. Experts are also available for more intensive, individualized support: Throughout the program, participants have telephone access to licensed mental-health professionals.
Billed as “The World’s Most Popular Mobile Sober Community,” the Sober Grid app not only connects users with others in recovery, it features a range of advanced tools including geosocial networking capabilities that enable them to meet up with other abstainers wherever they go. Sober Grid even features a Burning Desire button that connects members with immediate support when they’re feeling overwhelmed by the urge to use.
Wearable Support
Wearable technologies designed to help fitness-minded folks track their calorie intake or step count have boomed in the past decade. A growing number of wearable tools are empowering those with mental-health concerns to follow suit.
After all, mental illness manifests throughout the whole body: When we’re anxious, our heart rate increases; when we’re depressed, we often sleep too much or not enough. While plenty of devices track biomarkers like sleep and heart rate, the newest crop go a step further by translating biometric data into real-time advice.
The Feel wristband uses biosensors to capture variability in heart rate and breathing patterns as well as skin temperature and conductance — all key indicators of emotional distress. Proprietary algorithms synthesize the data, generating insights into the wearer’s emotional well-being. The tool then sends real-time, cognitive-behavioral-theory–based recommendations via a mobile app.
Spire Health offers a thumb-size “health tag” users attach to their clothes. The tag’s sensory technology collects data on sleep, respiration, heart rate, and physical activity. It then notifies wearers when their biometrics indicate a need to slow down (“You seem tense right now; try relaxing your shoulders”), ramp up (“Poor sleep last night; how about a workout today to get better sleep tonight?”) — or simply take a few deep breaths.
Other innovations provide a more literal form of relief. Touchpoints for Calm, a wearable wristband, emits microcurrents purported to relieve stress within seconds. Unlike other wearables, Touchpoints doesn’t track any biometrics or alert the user when stress markers are elevated; instead, the individual activates the device in moments of need.
A Digital Future?
In a field still struggling to deliver affordable and accessible services, digital mental-health solutions may literally save lives.
There are also pragmatic perks in the “anytime access” model. Sustaining improvements in mental health requires actually applying skills in daily life. Online and mobile mental-health tools can help individuals keep track of their progress and remain accountable to their goals outside of the therapist’s office.
Yet it seems doubtful that we will ever fully outsource our psychological well-being to a website. Human problems still benefit from human support, which explains why studies consistently show that the relationship between therapist and client, known as the therapeutic alliance, can have as much of an impact on outcomes as a therapist’s specific skills or techniques — or even more impact. After all, many people seek help for problems that are relational in nature. Skilled mental-health professionals use the therapeutic alliance to better understand (and in time, point out) how the client relates with others, using in-session behaviors as evidence.
Quality control is also a concern. A 2015 review of apps designed to address bipolar disorder concluded that few followed industry best-practice guidelines or cited sources of information used in their psychoeducation material. Moreover, fewer than a quarter of the apps included a privacy policy — and not surprisingly, the question of how user data will be stored and protected looms large over the mental-health-technologies sector.
For now, the intersection of technology and mental health may be best understood as an opportunity to augment rather than replace in-person support. We may never feel completely comfortable spilling our guts to an AI therapist, but integrating digital tools into the panorama of mental-health treatments could be key to ensuring that everyone can access help when times get tough.
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