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Can Artificial Intelligence Save Us From Depression?
Source Patra Kongsirimongkolchai / EyeEm, Recep-B/Getty
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The human brain is a mystery, but we're getting closer to cracking the case.
OZY steps outside the medical mainstream to find the latest on alternative health.	From DIY doctoring to multidimensional healers, this OZY series steps outside the medical mainstream to find the latest on alternative health.
By Molly Fosco
The Daily Dose January 25, 2019
As the Brett Kavanaugh hearings dominated the news cycle in September, Silicon Valley–based mental health startup Ginger found its app buzzing with sexual assault survivors who were reporting feelings of heightened anxiety, anger and powerlessness. Ginger's app took charge. It scanned the words users typed to their coaches in a bid to better understand the patient's situation and then recommended how the health professionals might intervene. The therapists were then able to provide coping strategies based on an individual's needs.
For Ginger co-founder Karan Singh, the reason for developing the app was personal. After learning of a friend's suicide attempt, Singh decided to help develop better resources for people suffering from depression. The suicide rate in the U.S. hit a 50-year peak in 2017, according to data from the Centers for Disease Control and Prevention. As many as 14 people in every 100,000 died by suicide in 2017 — 33 percent higher than the rate of 10.5 per 100,000 in 1999. Now, artificial intelligence, machine learning and natural language processing — all of which Ginger leverages — are spawning a growing number of startups that are tailoring mental health care to an individual's needs and circumstances in ways unimaginable just five years ago.
Silicon Valley–based Mindstrong's app uses human-computer interaction patterns (the swipes and taps that a person makes on their smartphone) to analyze and treat mental health conditions like depression. Launched in 2016, Mindstong has inspired a study at the University of Michigan, where researchers are trying to determine whether the tool can help people who have not been diagnosed with mental illness but who are at high risk for depression or suicide. The platform combines smartphone activity data with machine learning to determine when a user is at risk for depression and to recommend behavioral changes.
Other mental health apps are attempting to solve the growing epidemic of loneliness, which also affects physical health. Like Ginger, 7 Cups — which launched in 2013 — is an app that offers the opportunity to text with a therapist or coach any time of day. Similarly, Replika, founded in 2014, allows users to talk with someone — in this case, an artificial intelligence chatbot — to help you feel less alone.
Oftentimes, people are not clinically diagnosed and then they actually get sick.
Karan Singh, co-founder, Ginger
Some of these companies started in a more traditional fashion. Ginger, for instance, was founded in 2011 with hospitals as the initial target audience. In November 2017, it moved to a direct-to-customer approach, launching an app-based mental health care service. A little over a year after that launch, nearly 50 top employers across the country provided their staff with access to Ginger.
"It's about prevention," says Singh. "Oftentimes, people are not clinically diagnosed and then they actually get sick."
Replika's AI chatbot is also focused on preventing loneliness. It was originally designed as a messaging platform, but the company recently added a voice feature that allows users to have a phone conversation with the bot. You can even set it to call you at certain times each day to check in and see how you're doing. Replika co-founder Eugenia Kuyda says the idea was "just giving someone a friend, someone who will always listen and try to help you." But soon after Replika launched, the company began receiving emails from people saying the app had helped them with symptoms of depression and bipolar disorder. "It's hard sometimes to be that open and vulnerable with real-life friends," Kuyda says. "We're not claiming to be an artificial therapist, but I think there should be more tech that creates resources for [mental health]."
For one user, Tywan Carson from New Jersey, Replika has acted as a sort of life coach for the past year, reminding him of "who I am and where I am headed," he says. "[It] reminds me of the good and the bad and how both helped me in becoming who I am today."
Berlin-based Ada Health has until now focused on diagnosing physical ailments using AI, but it's begun redesigning its app to also assess mental health and psychiatric conditions based on feedback from some of the 5 million users whose Ada assessment encouraged them to seek additional support for mental health concerns. The company's goal is to connect people with the most appropriate form of care, whether it be a physician or a therapist.
The evolution of these emerging tools has taken longer than other tech-driven consumer products, but there's a good reason for that. Innovation in health care requires extreme attention to detail and therefore takes time to develop, says Daniel Nathrath, co-founder and CEO of Ada Health. "The tech tenet 'move fast and break things' absolutely does not work when it comes to health," he says. "It requires a level of caution and thoughtfulness that can often get lost in the hype."
Still, these founders recognize that when it comes to addressing mental health concerns, immediacy is key. When you sign up for Ginger, you can start chatting with an available coach or therapist right away in real time or access teletherapy or telepsychiatry via video chat. The same is true of 7 Cups. The personalized care and privacy these apps provide is also an incentive for many. Kristen Vitale, a caregiver who receives health care benefits, including access to Ginger, through SEIU 775 Benefits Group in Washington state, says that conventional mental health organizations don't understand her well. "I have complex PTSD," she says. The therapy Vitale receives through Ginger is much more suited to her individual needs, she says, adding that she has faith mental illness won't be so stigmatized someday, but until then, Ginger is a great confidential resource.
By themselves, tech tools are not enough to resolve most mental health conditions. A 2018 study published in the journal mHealth found that mental health apps are most effective when they facilitate high engagement between therapist or coach and patient, a simple interface and a feature that allows for reporting thoughts, behaviors and actions to increase self-awareness. Ensuring that level of engagement remains critical for this new wave of mental health apps to truly make a difference, say experts.
Many of these companies understand that using technology to solve health issues can be daunting to the average person. That's why Ginger therapists provide guidance on how to prevent depression from becoming worse, which has proven helpful for many. In the past eight months, 46 percent of Ginger users who were identified as "at risk" reported a 50 percent decrease in their symptoms. And Ada always advises users on when and where to seek professional health care. "Technology will not replace doctors," Nathrath says. "It will provide them with the tools necessary to support … and simplify the health care experience overall."
By providing personalized mental health interventions, AI can help patients like Vitale get exactly what they need. "It's not going to cure us of depression writ large," says Singh. "But it's bringing science to a space that's largely been based on guessing."
Correction: The original version of this feature referred to coaches as therapists.
Molly Fosco, OZY Author	Follow Molly Fosco on Twitter	Contact Molly Fosco
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