Mental health affects all aspects of our life. ​Yet, it’s the most neglected area

Mental health affects all aspects of our life. ​Yet, it’s the most neglected area

Mental health affects all aspects of our life. ​Yet, it’s the most neglected area of public health, driving higher risk of comorbid disorders and mortality. 

​’Mental health’ as a term refers to cognitive, behavioral, and emotional well-being. It is all about how we think, feel, and behave. The state of your mental health determines how you handle stress, how you relate to others, and how you make healthy choices. As such, mental health affects all aspects of daily living, relationships, and physical health. For some people, “mental health” means the absence of a mental disorder. For others, it equals a life with daily stressors, mood disorders, affecting their ability to function.

Close to 1 billion people globally are living with a mental disorder[1]. In fact, mental disorder affects one in four families – a number which is expected to rise significantly over the next 20 years [2]. As measured by ’years of life lived with disability’, mental illness is the biggest disease burden in society today[3].

Without doubt, mental health is an important topic. Yet, the magnitude and burden of mental disorders remain unmet by the response. Countries across the globe have long overlooked the issue of mental health and mental illness. As such, more than 33% of countries allocate less than 1% of the total health budgets to mental health, with another 33% of countries spending just 1% of their budgets on mental health[4]. Consequently, relatively few people around the world have access to quality mental health services. In low- and middle-income countries, more than 75% of people with mental, neurological and substance use disorders receive no treatment for their condition at all [5].

If left untreated, mental illness can lead to other commodity disorders, such as depression, substance abuse and even early mortality. Substance abuse is common among people who are battling a depressive disorder, which can lead to further exacerbation of the symptoms related to depression, impairing mental functioning, and further damaging overall spirit, quality of life. Likewise, many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa. As such, mental health disorder patients accounts of 44% of cocaine and 38% of alcohol consumption​ [6,7]. ​

The magnitude, suffering and burden in terms of disability and costs for individuals, families and societies are staggering. Every year, the harmful use of alcohol results in millions of deaths, including hundreds of thousands of young lives lost. Illicit drug use disorders is – directly and indirectly – responsible for over 750,000 deaths per year. ​Not to mention, the 1 million people, whom commit suicide every year across the world [8].

Mental health has been hidden behind a curtain of stigma and discrimination for too long. It is time to bring it out into the open. Help us raise awareness, by sharing our post.

To learn more about how Monsenso mhealth solution can be used to increase treatment outcome, see our video below:

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Sources:

[1]WHO -2020

[2] WHO -2001

[3] WHO – 2012

[4] WHO – 2019 

[5] WHO – The Mental health Gab Action Programme (mhGAP)

[6] Drugabuse.org, The national Bureau of Economic research – 2020

[7] The National bureau of economic research. Mental health and substance abuse. 2020.

[8] WHO – Investigating in mental health

The use of digital health technologies in clinical trials

The use of digital health technologies in clinical trials

The use of digital health technologies in clinical trials has increased considerably during the last few years, partly to the popularity of wearables such as Apple watches and Fitbit devices, in addition to the many over-the-counter devices and sensors.

In 2000, only eight clinical trials used digital health technologies to assist the trial; however, by 2017, the numbers had increased to 1,100 trials[1]. It has been estimated that by 2025, 70% of clinical trials will incorporate digital sensors[2].

In 2020, the COVID-19 pandemic has further forced adoption of digital health technologies in the healthcare and pharmaceutical industries to protect participant safety and enable clinical trial continuity[3]. 

Modernising clinical trials

According to a study conducted by the Deloitte Centre for Health Solutions the return of investment for R&D in the pharma industry has decreased from 10% in 2010 to 1.8% in 2019[4]. This drives a need for biotech and pharmaceutical companies to transform their R&D models to improve productivity and stay competitive[5]. Already, many have started to shift from traditional trial models to more agile, patient-centric processes by adopting digital health technologies to improve patient engagement during clinical trials and to capture a more rich set of data by incorporating real-world data collection[5]. 

Real-world data is information captured as a “by-product of everyday patient care”, and it can be collected from different sources, such as electronic health records, patient registries, wearables, and the sensors in smartphones[6]. 

Some of the most common digital health technologies adopted by pharmaceutical companies for clinical trials fall into several categories[3]:

  • Telemedicine
  • Electronic informed consent (eConsent)
  • Digital data collection tools
  • Remote site monitoring
  • Direct to patient shipping (DtP)
  • Medication reminders

Besides accelerating and simplifying the clinical trial process, these tools help automate the quantity, quality, and frequency of data collection. 

When implemented together, digital solutions have the potential to do the following[3]:

  • Recruit a more geographically diverse participant population.
  • Ensure trial product availability for participants.
  • Reduce the burden of clinical trial participation.
  • Reduce the number of essential personnel needed at the study site.
  • Automate the collection of data while maintaining levels of quality for submission to health authorities.
  • Improve the efficiency of clinical trials leading to better decisions and reduced timelines.
  • Further advance the concept of risk-based approaches, focusing on the critical study elements that have been stated via health authorities and the International Council for Harmonisation (ICH) of Technical Requirements for Pharmaceuticals for Human Use’s Good Clinical Practice standards.
  • Synthesise real-world evidence (RWE) and digital biomarkers which could be more responsive to change, increasing the possibility of real-time decision-making and benefiting patients enrolled in trials.

There is also an opportunity for greater efficiency by establishing interoperability of EDC systems, electronic health records (EHRs), and digital data collection tools to reduce the amount of source data verification (SDV) required by study monitors. This would mean that a more significant portion of the data could be accessed and reviewed without human transcription and a minimum risk of misinterpretation[3].

Incorporating these technologies into clinical research at every phase opens the possibility for reduced timelines and cost savings. Consequently, it is expected that companies willing to invest in digital technologies may win market share, while those who fall behind may find themselves at a disadvantage[5]. 

consumer readiness 

Digital technologies are embraced by people of all ages, in fact, a 2019 report conducted by Provision Living, a senior living community in the U.S.,  revealed that on average, Baby Boomers (born between 1946 and 1964) and millennials (born between 1981 and 1995) spend on average, five hours a day on their smartphones.

A survey conducted by Rock Health revealed that:

  • 44% of the respondents tracked a health indicator using a digital tool in 2019, an increase from only 33% in 2017.
  • 56% of the respondents shared health tracking data with their physicians in 2019, in comparison to only 46% in 2017.

Monsenso as a companion device, that supports medical compliance

Monsenso is a digital health technology that enables secure real-world data collection and behavioural data tracking via a smartphone app for users/patients and a web portal for clinicians/investigators. The solution is technically and clinically validated, and it can help improve outcomes on clinical trials. 

To learn more about the different clinical studies and clinical trials that have included the Monsenso mHealth solution, visit our Resource Library.

 

References:

    1. Marra, C., Chen, J.L., Coravos, A. et al. Quantifying the use of connected digital products in clinical research. npj Digit. Med. 3, 50 (2020).
    2. Jansen, Y. and Thornton, G. (2020) Wearables & Big Data In Clinical Trials — Where Do We Stand? Clinical Leader 
    3. Beyond COVID-19: Modernizing Clinical Trial Conduct
    4. Steedman, Mark, et al. (2020). Ten years on: Measuring the return from pharmaceutical innovation 2109. Deloitte Centre for Health Solutions.
    5. Digital endpoints whitepaper. Navigating the shift from traditional trial models to agile, patient-centric processes driven by digital health technologies.
    6. Real-world data: how can it improve clinical trial outcomes?

 

A smartphone app that supports online therapy

A smartphone app that supports online therapy

Monsenso offers a smartphone app that supports online therapy by enabling users to share valuable health data with their therapists in real-time.

What is online therapy used for?

Online therapy, also called e-therapy or teletherapy has many advantages and it gives users access to therapy services offered by mental healthcare providers from the comfort of their home. Therapists can use one of the many secure platforms available to connect with their patients through video conference, phone calls or chat functionality.  It also helps reach people who have very busy schedules and can’t spare the commute, or those are not too comfortable with face to face appointments.

Online therapy can be effective to treat many mood and behavioural disorders such as depression, anxiety, bipolar disorder and borderline personality disorder.  In fact, according to research led by McMaster University online therapy can be more effective than in person.

Just as in traditional therapy, it is important that the goals of online therapy are created by both, the therapist and the client.

Online Cognitive Behavioural Therapy

Cognitive behavioral therapy (CBT) is a tool used to treat a number of mental and physical health issues, and due to its flexibility, CBT online offers many of the benefits found in the face-to-face model. CBT is widely available online, so people experiencing unwanted symptoms linked to anxiety, depression, and other conditions should view it as a viable option to treat their overall well-being.

Online Dialectical Behavioural Therapy

Dialectical Behavioural Therapy (DBT)  is a type of therapy that primarily involves skills training such as mindfulness, emotional regulation, and distress tolerance to assist individuals to better manage emotional distress. It also provides problem-solving strategies to identify and alter harmful behaviors and replace them with constructive ones.

An app that supports online treatment

Before using the Monsenso smartphone app to support his therapy, Peter Hagelund, followed the typical therapeutic setting. His psychiatrist would schedule an appointment every two-three weeks, and they would discuss Peter’s previous weeks.  On most occasions, Peter would say that he had been doing fine, but sometimes he forgot important details that he wanted to discuss.

Now, instead of relying on Peter’s memory during the consultation, his psychiatrist can access his data and see how he has been doing, as it happened. He can view how much he has sleept, how much he exercises, how much he drinks, the levels of anxiety he has, and other relevant aspects to his treatment and his disorder.

Mads Trier-Blom, another Monsenso user, said that the app helps him to be more connected with his clinician, Bente, who intervenes when she can see that he is not feeling well, to help him avoid having an episode.

Psychiatrist Kristoffer Södersten from PsykiatriResurs in Sweden says that the accuracy from a diagnosis obtained can very much depend on many factors such as cultural background and how comfortable the patient is in the conversation. Therefore, it can be very arbitrary the diagnosis a patient receives.

The information gathered from the Monsenso smartphone app helps him get a consistent and clearer view of an individual’s mental health. He finds the Monsenso mHealth solution to be particularly helpful in capturing relevant objective data. The solution provides a comprehensive and easily accessible overview of relevant patient data, such as the individual’s overall day score, his mood, the number of hours he slept, and if he took his medication.  The smartphone app also collects sensor data, such as physical activity, social activity, phone usage and voice features which helps to supplement the subjective data provided.

The Monsenso mHealth solution has helped mental healthcare providers to get an overview of an individual’s historical data and correlation analysis. It also helps them identify the triggers and early warning signs everyone has, enabling them to intervene at an early stage before they have an episode, such as in the case of Mads.

Besides, the smartphone app helps users to be more aware of their mood, their symptoms and the reason why these symptoms appear. It also provides them with useful skill-training content to help them deal with stressful situations.

A smartphone app that can help psychiatrists diagnose mental illness

A smartphone app that can help psychiatrists diagnose mental illness

“A smartphone app that can help psychiatrists diagnose mental illness” –  Peter Hagelund, a Monsenso user, speaks about his experience using the Monsenso mobile health solution to support his treatment, and how it has helped  him improve the communication with his psychiatrist.

Prior to using the Monsenso smartphone app, Peter and his psychiatrist followed the typical therapeutic setting, they would schedule an appointment every two-three weeks, and they would have a conversation to discuss Peter’s previous weeks.  Peter would usually say that he had been doing fine for each appointment, but sometimes he forgot important details that he wanted to discuss.

“It can be pretty tricky to remember, two weeks later [between appointments] how you actually felt that day. With the app it’s really easy to go back and see if your mood has been pretty stable over the last two months, or if you had had some ups and downs over a period,” says Peter Hagelund.

Now, instead of relying on Peter’s memory during the appointment, his psychiatrist can access his data and see how he has been doing, as it happened. He can view how much he has been sleeping, how much he exercises, how much he drinks, how much anxiety he has, and other relevant aspects to his treatment and his disorder.

“My psychiatrist now says things like You say you’ve been doing fine, but I can actually see that you’ve had a few ups and downs. I think the app helps him get a real view of how I have been doing,” says Peter Hagelund.

In his Danish documentary series “Jeg savner min sygdom” (which translates to “I miss my illness”), Peter Hagelund talks about his experience of getting the wrong diagnosis and how finally after six years he got the right diagnosis and treatment. 

In 2014, he was diagnosed with Bipolar Disorder Type 2.

During his whole life, he knew there was something different about him. He always struggled with depression and anxiety, and what eventually turned out to be hypomania. When he was 22, he had his first big episode of depression and began taking antidepressants. However, it took six more years before he was officially diagnosed with Bipolar Disorder Type 2.

He says that one of the trickiest things about having this diagnosis is that he does not experience the typical manic episode where a person feels over-energetic and nearly psychotic. Instead, he feels hypomanic, which means that he is socially well functioning. He is not psychotic. He just feels really well; the problem with this, was that he didn’t feel the need to inform his psychiatrist the fact that he was feeling too well

His psychiatrist found out that he had Bipolar Disorder was because he couldn’t come out of his depression. At first, he was diagnosed with depression and ADD. But these diagnoses didn’t seem to fit because he still had strong mood swings and a lot of anxiety. When he was diagnosed with Bipolar Disorder Type 2, it actually made sense to him. Suddenly, he could see why he had felt the way he had most of his life.

“I really believe that the Monsenso smartphone app could have helped my psychiatrist give me the right diagnosis at an earlier stage because the app helps me to keep track of my mood and to become more aware of how I feel. With the app, I have to pause and take a moment to think about how I’ve actually been doing before entering my answers. Keeping track of all this information has helped my treatment. My psychiatrist and I can plan better on how to avoid my future depressive or hypomanic episodes because we can clearly identify when I am having mood swings”. says Peter Hagelund.  

In August 2018, his documentary about living with Bipolar Disorder aired on national Danish television and the response was overwhelming. Many people contacted him, to thank him for talking about his illness. He made the documentary so other people who have this illness, do not feel ashamed of it.

“My hope is that in the future people are diagnosed at an earlier stage than I was and I truly believe the Monsenso app is one of the things that can help. I really hope that other psychiatrists and their patients will start using the app,” he added.

Click here to read this story in Danish.

Online therapy can be more effective than in person, according to research

Online therapy can be more effective than in person, according to research

Online therapy can be more effective than in person, according to research led by McMaster University.

Based on randomized control trials, the systematic review and analysis revealed that cognitive behavioural therapy that connected therapists and patients through such modes as web-based applications, video-conferencing, email and texting, improved patients’ symptoms better than face to face when measured using standardized mood symptoms scales. As well, there was no difference in the level of satisfaction or function between the two methods of delivery.

The details were published in EClinicalMedicine, published by The Lancet.

“Although this study started before the current COVID-19 pandemic, it is timely and assuring that treatment delivered electronically works as well if not better than face to face and there is no compromise on the quality of care that patients are receiving during this stressful time,” said corresponding author Zena Samaan, associate professor of psychiatry and behavioural neurosciences at McMaster and a psychiatrist at St. Joseph’s Healthcare Hamilton.

Using online therapy to treat patients with geographical limitations

Cognitive behavioural therapy is a type of psychotherapy widely used to treat depression. However, limited resource availability poses several barriers to patients seeking access to care, including lengthy wait times and geographical limitations.

In this evidence review, researchers identified 17 randomized control trials comparing therapist-supported cognitive behavioural therapy delivered electronically to face to face cognitive behavioural therapy. The studies were conducted between 2003 and 2018 in the United States, Australia, Netherlands, Switzerland, Sweden and the United Kingdom.

Samaan said the findings of the meta-analysis debunk widely-held perceptions about psychotherapy.

“The common understanding was that face to face psychotherapy has the advantage of the connection with the therapist and this connection is in part what makes the difference in treatment,” she said.

“However, it is not surprising that electronic interventions are helpful in that they offer flexibility, privacy and no travel time, time off work, transport or parking costs. It makes sense that people access care, especially mental health care, when they need it from their own comfort space.”

Samaan noted that the findings support advocacy and widespread implementation of electronic cognitive behavioural therapy.

“Electronic options should be considered to be implemented for delivering therapy to patients,” she said. “This can potentially vastly improve access for patients, especially those in rural or under-served areas, and during pandemics.”

This article was published originally by Science Daily, click here to view it.

Getting started with mHealth technology for mental health

Getting started with mHealth technology for mental health

Getting started with mHealth technology for mental health can seem like a daunting process even though it has proven to bring many benefits to medical practice such as improving medication adherence, increase patient engagement and improve health outcomes in a cost-efficient way.  Therefore, the sooner healthcare providers embrace this technology, the better.

Luckily, mHealth technology does not only offer benefits for patients, but it also solves many of today’s healthcare challenges, since it provides healthcare providers with the scalability to treat more patients with fewer resources.

In spite of the clear benefits, many healthcare providers, have not yet fully embraced mHealth technology due to several reasons:

  • Lack of budget
  • Uncertainty about choosing the right tool
  • Uncertainty about the ease-of-use
  • Uncertainty if it will, in fact, make a difference

Luckily, Monsenso is committed to helping healthcare providers overcome these obstacles.

Lack of Budget: A lack of budget may seem like the largest impediment to acquiring digital health tools. However, this type of tool should be considered as a valuable investment, since it enables providers to treat and monitor more patients with fewer resources. Besides, all healthcare professionals may have access to the same patient data even when their main practitioner is not available.

Uncertainty about choosing the right tool: Choosing the right tool may be confusing because the functionality greatly varies among the different suppliers. One thing is certain, providers need to choose an mHealth solution rather than a health app since the later does not allow information-sharing between patients and providers. Other criteria should include looking for a solution that is technically and clinically validated, is well-established in the market, and it holds relevant certifications such as the one given to the medical device companies, CE Mark and other ISO certifications.

Uncertainty about the ease-of-use: UI and UX have evolved considerably during the last few years, therefore the product development team of any serious company offering an mHealth solution, will take into consideration these principles to ensure the product provides a meaningful and relevant experience to users in terms of design, usability and function. It is as simple as booking a product demo or requesting a free trial to ensure that the desired solution is intuitive and easy to use for doctors and patients alike.

Uncertainty if it will, in fact, make a difference: Perhaps, this may seem the hardest obstacle to overcome. Would this thing actually work? Although no one can guaranty if a tool will work for a specific medical practice, there is a precedent that this technology actually works. According to a recent study conducted by McMaster University, online therapy can be more effective than in person. You can also read third-party validations to give you confidence in your choice.