A digital revolution is coming to mental health, having already established a foothold in business, education, and healthcare. This revolution is, however, not led by angry citizens, but is fueled by the rapid emergence of Exponential technologies. Exponential technologies are those that are growing swiftly in power and availability, and they are opening up entirely novel fields, such as 3-D printing of body organs. These technologies have immense potential to disruptively change how we live our lives, and how we manage our health. Exponential technologies include “wearable” sensors, artificial intelligence (AI), robotics (including drones), synthetic biology, 3-D printing (including the printing of body parts), and human-computer interfaces.
We may already have “exponential” technology in our pockets, as even basic smartphones contain considerable computing power, and integrate the functionality of many other historically separate devices. We are on the cusp of an explosion in the number of people using “wearables”, interactive digital devices that can monitor our behavior and/or physiology. There are many examples of wearables, including smartwatches (e.g Apple watch), smartglasses (e.g Google Glass), and activity trackers (e.g Fitbit).
When we assess a child’s mental health, we often consider their sleep, appetite, activity levels, and relationship with others. These are all areas where wearable sensor-rich devices can collect data, and in some cases potentially offer some type of intervention. In order for the data to be useful, it must lead to actionable change. The data must give us insights into a child’s functioning, and must therefore undergo an analytic process. Historically, data analysis was largely a human process, but the development of predictive algorithms in many industries has largely automated data analytics. These analytic algorithms are not based on a single person, but are based on subtle associations that are discovered from the analysis of thousands of individuals.
In the U.S, these wearable devices, in addition to other exponential technologies, are already transforming people from passive health seeking patients to actively engaged healthcare consumers. These consumers use technology to generate data, monitor their chronic health conditions, and shape the healthcare systems of the future. There is immense potential for these technologies to create mental health solutions that can overcome geographic boundaries, and create global solutions.
How Can Wearable Technologies Transform Pediatric Mental Health?
1. Quantitative Data
Most of our information about a child comes from a combination of parental report, clinician observation, and collateral information. Most of this information is subjective, and the reliability of the history may vary a great deal. We often ask parents to give us feedback regarding how a child has been doing for the preceding month or more. Clearly, this is by no means an easy task, and we are asking a parent to be a human data collector, complier, analyzer, and reporter. We should therefore not be surprised if the regency effect (people recall more recent events best) leads to bias. Wearable technologies can quantitatively monitor many aspects of a child’s behavior, and also assess their sleep patterns, arousal levels, and other physiologic markers. The data that these devices collect can be used to inform the clinician, and with the development of appropriate analytic tools, help monitor and guide treatment.
2. Scalable and Affordable Solutions
Worldwide, we face considerable mental health challenges, and many communities are highly under-resourced. Child’s mental health reflects an area of extreme need, with a substantial lack of clinicians. Technology has the potential to be highly scalable solution, allowing for a digital means of not only communication, but help with assessment, treatment, and ongoing monitoring. New technology almost always comes at a premium, putting it out of the reach of many potential users. Of the common attributes of exponential technology is however it’s rapidly falling price point, especially the price point per unit of performance/power. Training a mental health clinician may take months or years, while learning to use a wearable may only take a few hours, and downloading a software app may only take a few minutes. There are already a number of companies who are leveraging technological solutions to deliver healthcare and education to the most disadvantaged parts of the world.
3. Monitoring in Normative Environments
Children often spend considerable amounts of time at home, or in educational settings. Many healthcare systems assess the mental health needs of children outside of these settings, and only see children during “snapshot” assessments. Clinicians often utilize collateral history sources, e.g parental and teacher report, to further understand the broader picture. Wearable devices can by virtue of their portability, quantitatively and continuously monitor children 24 hours a day. Such data can form reports that may include activity monitoring, physiologic markers of stress, sleep quality and quantity, and also some measurements that relate to attention and concentration. These reports may offer a supplemental, yet powerful, means of understanding how the child is functioning in different environmental settings.
The Future
We are a number of years away from this vision of a digitally-guided mental health future, but it is coming. A number of barriers exist, firstly our understanding of the physiologic/behavioral correlates of children’s mental health remains poor, and secondly the cost of these technologies will, at present, be prohibitive to large numbers of people. The globalization of such technology can only happen if the price point for use and maintenance is affordable across geographic boundaries. Another barrier is the lack of children’s mental health content experts to help build the foundations of such tools. Additionally, the mental health needs of children are rarely prioritized for innovative projects compare to other parts of healthcare. We need politicians, healthcare leaders, and businesses, including technology companies, to realize the enormous amount of benefit to be gain by investing in children’s mental health.
Originally published in the IACAPAP Bulletin (http://iacapap.org/wp-content/uploads/BULLETIN-JUNE-20152.pdf)
Image courtesy of tungphoto at FreeDigitalPhotos.net
Recent Comments