Sophia the Robot, Alexa and Tesla are just the tip of the iceberg when it comes to the evolving relationship between artificial intelligence (AI) and human beings. For the field of mind health, AI appears to be a positive disruptor. Engineers have partnered with data scientists and physicians to curate and inform AI platforms on how to appropriately and readily manage symptoms and the treatment of anxiety, depression and irregular sleep. AI has the potential to be preventive tool in reducing the probability of crises or relapses when mental health and addiction symptoms are flagged early.
I spoke with Gina DiGiulio, Director of Psychology at Medcan, to hear her take on the opportunities and risks of three technology products targeting mind health: Woebot, Ginger.io and Mind Me.
Woebot is a free therapy chatbot that launched as a stand-alone iOS app in January 2018. It was created by a clinical psychologist at Stanford University and uses cognitive behavioural therapy to treat depression by offering scripted and meaningful responses to users (Source: Business Insider, January 2018)
Ginger.io began in 2011 as a free tool that patients could set up to monitor symptoms and send alerts of escalation of mental health symptoms and episodes of crisis to their circle of care, which included their doctors, friends, and family members. Today, Ginger.io offers in-the-moment emotional support to all users via coaching, therapy, and psychiatry services, such as medication management (Source: Ginger.io, Fast Company 2016)
mind.me uses a “set it and forget it” approach for users to manage mental health concerns. Personal data feeds into the application, which allows mind.me to ambiently monitor behaviour. When mind.me predicts the early symptoms of depression, notifications will be sent to the user’s predetermined circle of trust (Source: mind.me)
Advantages of AI
“These apps offer value and support when incorporated into therapy,” says Dr. DiGiulio. “Meeting with a psychologist, psychotherapist or a family physician can help with the categorization of a mental health condition, which leads to the best treatment strategy. Following that, these apps can help with staying the course and also send the clinician updates and indicators of concern if they arise, so we can offer timely care.”
Other advantages include:
24/7 access to care
offer economic efficiency solutions
can reach people in under-served areas, or in geographically challenging areas to access help
are portable, can travel with you wherever you are
can help reduce stigma associated with mental illness (e.g., if more people accept that depression, for example, is a global epidemic that has not yet been proportionally recognized, funded, or treated — perhaps more people will start getting the help they deserve)
some of the products monitor symptom changes in real time, so clinicians can reach out to their clients when they need it the most, which can result in early intervention, relapse prevention, and streamlined aftercare solutions
Approach with caution
“Many or most of the apps are not currently regulated, so there is no real way to know how if the marketing promises match the actual outcomes. And, we don’t know if the strategies or approaches are based on empirically-sound science,” says Dr. DiGiulio.
Other risks and areas of concern with robot therapists:
there is not enough long-term data on their effectiveness
managing expectations when it comes to adherence: how long will people be willing to stick with an app as opposed to seeing a professional with whom they develop a productive and supportive rapport with?
there may be valid privacy issues; users need to be aware of how their data is being collected, stored and possibly used
Final say … for now
“With mental health, as it is with most aspects of health, there are usually no cure-alls or magic pills. The best approaches are personalized and consider the evidence-based medicine as well as psycho-social and emotional health, lifestyle choices, as well as genetic history.
“The app advantage is the wider net of support to people in a timely and easy way, and doing so, break down the stigma of mental illness. Through regular symptom monitoring, they can help detect symptoms of depression, anxiety, irregular sleep much more quickly, thus facilitating earlier intervention, which we know improves treatment outcomes. They can also be a great complement to therapy ‘homework’ and can help make inter-session time more effective by having clients track their mood and work on thought records,” says Dr. DiGiulio.
“These apps can certainly open the door to someone being introduced to therapy but the relationship component is missing, and sometimes you need that live connection with a person in order to really make an impact. We know that the therapeutic alliance is a vehicle through which progress in therapy can occur – an app can’t replace that human connection. And sometimes that human connection is the most therapeutic aspect of the live therapy session.”
Gina Di Giulio obtained her doctorate in psychology at the University of Ottawa and earned a masters in law with a health specialization from Osgoode Hall. In her clinical practice, she sees clients for a wide range of conditions including stress and anxiety, depression and relationships counselling. She is often consulted on individual counselling, organizational psychology as well as corporate wellness programs.