How your phone habits could reveal signs of depression
A new field of mental health research has opened up that's looking at how we use our smartphones as a way to gain insight into a person's mental state.
"There's a truism in medicine that we don't do very well if we get there at stage four," said Tom Insel, co-founder of Mindstrong Health, a health tech company based in Silicon Valley.
For more than a decade, Insel was the director of the National Institute of Mental Health in the United States, before joining Mindstrong Health.
He's seen the mental healthcare system struggle to help patients, who typically approach them in a crisis situation.
"[The system] would love to be able to find a way to pre-empt the crises and reduce emergency rooms and hospitalizations, which are expensive and traumatic," says Insel.
Enter digital phenotyping
A novel solution to this problem is digital phenotyping, a new field of research that looks at how we use our phones — from how often we text to how often we open apps — to obtain clues about our mental health.
A growing number of companies including Mindstrong Health are trying to implement this technique to build new screening tools for mental health issues.
But the research is still in its early stages, and as you might imagine, there are privacy and ethical concerns to be worked out.
[The mental healthcare system] would love to be able to find a way to pre-empt the crises and reduce emergency rooms and hospitalizations, which are expensive and traumatic.- Tom Insel
Despite all this, digital phenotyping still holds tremendous potential to transform the current mental healthcare system by catching distressed individuals much sooner than traditional methods.
Instead of using questionnaires to diagnose a patient, your smartphone can collect continuous data of your digital activities and offer a more comprehensive and objective report of your behaviour, according to Insel.
"Things like the words we use [in a text message] change pretty dramatically when someone becomes depressed or manic," Insel explains, referring to the broad capabilities of digital phenotyping. (Mindstrong Health does not collect any user text).
"You can think of [digital phenotyping] as a smoke alarm — the first signal that somebody who might have had a history of mental illness is having difficulties again."
Pre-screening mental health through phone use
His company is working on using the technique to pre-screen for depression, post-traumatic stress disorder, schizophrenia and bipolar disorder.
Their initial studies were able to link the digital features from participants' phones to how well they did on neural cognitive tests.
I think it's critical that any participant in the study fully consent and have full knowledge that they're participating in the study.- Sean Hill
"It was the first sign that there's something here that's informative and worth doing more research on," says Insel.
Mindstrong Health is now embarking on more testing with scientists to further validate their digital diagnostic features.
Protecting device users' data
Sean Hill is the director of the Krembil Centre for Neuroinformatics at the Centre for Addiction and Mental Health in Toronto. Like Insel, he finds digital phenotyping appealing as a screening tool for mental illnesses, but says health tech companies must consider the ethics of their work.
He especially wants them to pay attention to users' data privacy when creating new products and services, and alludes to the 2014 Facebook mood experiment in which the company manipulated the newsfeed of more than half a million of its users without notifying them.
When the public found out, people were outraged. In response, the company formed an institutional review board, typically used in academia, to review their ethics.
"I think it's critical that any participant in the study fully consent and have full knowledge that they're participating in the study," says Hill.
It's important that tech companies also follow the example of academia and put together strong research ethics boards (as they're known in Canada), says Hill.
These boards will look in depth at the privacy issues and make sure that the standards are upheld by the company.
Beyond ethical and privacy concerns, it's also important for tech companies to work closely with clinicians.
"The only way these things can be effective is to be linked in to professional, clinical care, where the appropriate expertise is present to understand the real situation," says Hill.