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Digital [mental] health: Healthcare’s new found superpower

Tuesday, October 13, 2015

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Editor’s note: This post by Dr. Ravi Hariprasad (head of clinical programs at Ginger.io) originally appeared on the HealthTech Conference blog, as part of a series highlighting speakers in the 2015 HealthTech Conference. Dr. Hariprasad will be speaking at the conference on October 28th in Santa Clara, CA. 

There is currently much debate surrounding the role that technology should play in the healthcare system, specifically as it applies to the delivery of mental health care.

And for good reason. As a country, we’re underserving people suffering from mental health conditions on a massive scale. The system passed the “unethical” boundary miles back, and we’ve now entered into the realm of the absurd, bordering Kafkaesque in my opinion.

Some people involved in argument believe we need to invest more heavily in human resources to “hire our way out of the problem.” Others look to the promise of technology as a panacea that solves all problems and heals all wounds. As with most things in life, the truth lies somewhere in between.

Let’s start addressing the problem by looking at the facts: 1-in-5 Americans suffers from a mental health condition, the vast majority of which have depression or anxiety as a primary diagnosis or co-morbidity. Nearly 80% of those suffering do not get the treatment they desperately need-whether that’s because of where they live, their ability to pay, the stigma surrounding mental health, or a number of other systemic conditions.

To make matters worse, the U.S. mental health system couldn’t treat all these people even if it wanted to. We’re suffering from a drastic scarcity of mental health providers with wait times ranging from 24 days (national average) to eight months or more in rural areas.

Ten percent of patients consume 63% of the health care dollar (Hussain and Seitz, 2014). These “high utilizers” are often complex patients with comorbid chronic medical and mental illness.

So what do we do? We know the human connection is critical for addressing mental health conditions. Study after study demonstrates how the relationship formed between patient and therapist and the number and frequency of their interactions are key factors in improving outcomes for people with severe symptoms.

But we also know there are simple steps many people can take to address their condition long before walking into a psychiatrist’s office. Things like sleep hygiene, physical activity, and simple CBT and mindfulness practices can serve as preventive mechanisms and provide targeted improvements in populations with less severe conditions. What’s more, these categories of self-help interventions are well-suited for digitization and mass distribution via channels like smartphone apps and web-based services.

The challenge (and the opportunity) is finding the right combination of human services and technological supplements. It’s not an either/or scenario. Empowering higher-functioning clients to take a more central role in their health through education and self-management tools enables a better patient/member/employee experience while also freeing up clinician time and resources to focus on their acute populations and deliver better care across the board.

Following this human-centered/technology-leveraged approach, more people can get the care they need when they need it, and the system as a whole can become exponentially more flexible, responsive and accessible. As a clinician and an advocate for mental health, that’s all I could ever want to achieve.

Payers, employers and providers have to consider these inputs when weighing out what’s right for their populations. There’s no question that technology needs to play a central role in the design of clinical, prevention and wellness offerings. We can’t solve the access issue without it.  For what purposes and to what extent we use technology are the issues we need to address to measurably improve upon the status quo and provide help for those who need it.