Digitalization could help tackle the issue of lacking resources in mental health services

Digitalization could help tackle the issue of lacking resources in mental health services

Did you know that over 500.000 Danish citizens currently live with one or multiple mental health disorders [1] and that approximately half of the Danish population will suffer from a mental illness at least once in their lifetime [2]?

Mental health is declining in Denmark [2]. However, treatments and services offered to people with mental disorders often lack quality compared to those offered to people with physical disorders [2]. One of the reasons is a clear shortage of resources. 

Lack of resources as a challenge in Danish mental health services
Recruiting and retaining mental health professionals, in social psychiatry, regional psychiatry, and specialised social services focusing on children and youths [2] has been a significant struggle in recent years.

In Region South, for example, only 8 out of 21 open job positions for psychologists could be filled at the beginning of the year. In Region Zealand, it was even less: 11 applicants for 22 advertised positions, and 6 suitable candidates hired [3].

There are several assumptions for why it is so challenging to recruit mental health professionals. One of them is that we are currently experiencing a generational shift, with many healthcare professionals retiring at the same time [3].

The insufficient capacity and availability led many individuals suffering from mental illness to not receive the right treatment at the right time [2]. The average waiting time to see a psychologist in Denmark is around 16 weeks – but in many cases, patients easily wait up to 20 weeks before their first treatment [4]. 

This limited capacity also reduces the possibility of early detection and interventions. Insufficient preventive measures are a major cause of high mortality rates amongst individuals suffering from severe mental illnesses in Denmark [2].

Approaches to improve mental health services in Denmark
In order to make the quality and availability of mental health services a top priority, the Danish government decided to initiate working on a 10-year plan for the development of psychiatry in 2020, setting aside 600 million Danish Kroner annually for the improvement of mental health care in Denmark. [2].

Recommendations for the long-term plan include the expansion of easily accessible offers for mental health services in Danish municipalities (including improved offers for children and young adolescents), increased country-wide mental health promotion, and better early detection of mental illness [2]. 

None of these goals will be properly implemented if Denmark is still facing a lack of resources. But while the need to hire more trained professionals is undoubtedly critical to improve mental health services, this may also be an opportunity for scalable technologies to improve the reach of the current workforce to serve the needs of patients waiting to receive care.

Digitalization as the key to improved mental health services?
A large study by Elsevier Health (2022) shows that 77% of international clinicians expect tech companies to become “key stakeholders in managing healthcare systems in 10 years”, and that the majority of clinicians (70%) believe an increased use of digital technologies will transform healthcare positively [5].

Many healthcare professionals therefore expect that digital technologies and remote monitoring tools could help them to handle the growing patient data volumes they are currently feeling overwhelmed with [5]. 

The current recommendations for the psychiatric 10-year plan acknowledge that digital solutions can facilitate making better use of resources available in the future, and ensure the capacity meets the growing demand for mental health services. The use of digital technology offers the potential to address challenges in Danish mental health services. In particular, the use of digital platforms for remote patient monitoring and health assessment could improve access and speed to care, and real-time patient analytics could enable personalised treatment and improved quality of care [5]. 

Everyone deserves access to mental healthcare. The integration of digital solutions in healthcare bears huge potential, and it needs to happen timely. There is never a better time to act.
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About Monsenso
Monsenso is a digital health company that enables better outcomes for patients and clinicians through data-driven decisions. We are focused on mental health and user-centred in designing our solutions for patients and clinicians. At Monsenso, we focus on ensuring that the right service can be offered to the right patient at the right time by enabling stepped- and blended care. Our digital health solution can thus be a support to clinicians where resources are scarce and additionally ease healthcare professionals’ workload by providing them with a better overview of their patients’ data and conditions. The Monsenso solution also offers clinicians the possibility of early data collection for better diagnosis and treatment, as well as enabling early intervention by e.g., giving patients access to psychoeducation. Our cloud-based platform is a CE-marked medical device (Class 1, pending Class 2a and MDR certification) that is HIPAA compliant, with certifications in ISO 13485, ISO 27001, Cyber Essentials, and TGA. Our solution has been clinically and scientifically validated by over 70+ peer-reviewed studies and can be configured for applications across mental health conditions. We work with healthcare systems, life sciences, and research organisations globally. Book a demo to learn more.

References:

[1] EN AF OS (n.d.). About EN AF OS. Sundhedsstyrelsen.
http://www.en-af-os.dk/da/English/About-us#:~:text=Statistically%2C%201%20in%205%20Danes,they%20will%20get%20well%20again.

[2] Sundhedsstyrelsen (2022). Fagligt oplæg til en 10-årsplan.
https://www.sst.dk/da/Udgivelser/2022/Fagligt-oplaeg-til-en-10-aarsplan

[3] Kofoed (2022). Der er mangel på psykologer over hele landet – og det kan især gå ud over unge. DR.
https://www.dr.dk/nyheder/indland/der-er-mangel-paa-psykologer-over-hele-landet-og-det-kan-isaer-gaa-ud-over-unge

[4] Kofoed et al. (2022). Millioner til psykologhjælp forbliver ubrugte trods rekordlange ventetider. DR.
https://www.dr.dk/nyheder/politik/kommunalvalg/millioner-til-psykologhjaelp-forbliver-ubrugte-trods-rekordlange

[5] Elsevier Health (2022). Clinician of the Future Report 2022.
https://www.elsevier.com/connect/clinician-of-the-future

Top pain points in the delivery of mental healthcare and how digital technology can help

Top pain points in the delivery of mental healthcare and how digital technology can help

Close to 1 in 7 people suffer from a mental health condition [1], a leading cause of disability globally [2].
However, 75% of people with mental illnesses do not receive any treatment [3], highlighting the issue of access to mental healthcare, which has only been exacerbated by Covid.

The shortage of trained professionals in mental healthcare is a key contributor to the issue of access [4]. Patients are faced with long waiting queues to receive care [5], with no promise of quality care, given clinicians’ heavy caseload [4]. It is not uncommon that patients only receive 5 mins of clinicians’ time after months of waiting for the appointment [6]. Indeed, a large study by Elsevier Health (2022), involving over 2800 clinicians and nurses from 111 markets, found that almost 1 in 2 of clinicians globally (69% in Europe) admit that time they are able to devote to each individual patient is insufficient “to give them good care” [4].

Clearly, there are plenty of opportunities to improve patients’ access, speed to, and quality of care globally. Promisingly, the same study found that over half of the clinicians (56%) state that patients have become more empowered to manage their own conditions, and that clinicians (62%) expect a change in role towards being more in partnership with patients over the next decade. Given that mental health costs a whopping $16 trillion to the global economy by 2030 [7] and growing, there is an urgent need for solutions that are designed to tackle these issues in a scalable and cost-effective way.

The use of digital technology offers the potential to address this matter. In particular, the use of digital platforms for remote patient monitoring and health assessment could improve access and speed to care, and real-time patient analytics could enable personalised treatment and improved quality of care [4]. Ultimately, to fully benefit from such technology, patient data needs to be managed securely, the design of the solution should focus on the needs of its users, and it should be continually assessed on its ability to deliver value to patients and clinicians.

About Monsenso:
Monsenso is a digital health company that enables better outcomes for patients and clinicians through data-driven decisions. We are focused on mental health and user-centred in designing our solutions for patients and clinicians. Our cloud-based platform is a CE-marked medical device (Class 1, pending Class 2a and MDR certification) that is HIPAA compliant, with certifications in ISO 13485, ISO 27001, Cyber Essentials, and TGA. Our solution has been clinically and scientifically validated by over 70+ peer-reviewed studies and can be configured for applications across mental health conditions. We work with healthcare systems, life sciences, and research organisations globally. To learn more, visit www.monsenso.com

References:
[1] World Health Organization (2020). World Mental Health Day: an opportunity to kick-start a massive scale-up in investment in mental health.
https://www.who.int/news/item/27-08-2020-world-mental-health-day-an-opportunity-to-kick-start-a-massive-scale-up-in-investment-in-mental-health#:~:text=Mental%20health%20is%20one%20of,every%2040%20seconds%20by%20suicide.

[2] Wainberg, M. L., Scorza, P., Shultz, J. M., Helpman, L., Mootz, J. J., Johnson, K. A., Neria, Y., Bradford, J. E., Oquendo, M. A., & Arbuckle, M. R. (2017). Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective. Current psychiatry reports 19(5): 28. https://doi.org/10.1007/s11920-017-0780-z.

[3] Marchildon, J. (2020). 4 Barriers to Accessing Mental Health Services Around the World.
https://www.globalcitizen.org/en/content/barriers-to-mental-health-around-the-world/.

[4] Elsevier Health (2022). Clinician of the Future Report 2022.
https://www.elsevier.com/connect/clinician-of-the-future.

[5] Royal College of Psychiatrist (2020). Two-fifths of patients waiting for mental health treatment forced to resort to emergency or crisis services.
https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2020/10/06/two-fifths-of-patients-waiting-for-mental-health-treatment-forced-to-resort-to-emergency-or-crisis-services.

[6]. Becker, G., Kempf, D.E., Xander, C.J. et al. (2010). Four minutes for a patient, twenty seconds for a relative – an observational study at a university hospital. BMC Health Serv Res 10(94).
https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-10-94.

[7] Lancet Commission. (2018). Report: Mental illness will cost the world $16 trillion (USD) by 2030. Mental Health Weekly 28(39): 1–8. https://doi.org/10.1002/mhw.31630.

Mental health in an unequal world. World Mental Health Day 2021

Mental health in an unequal world. World Mental Health Day 2021

Mental illness, why bother if all goes well? Because the day it hits you or your loved ones, you may be faced with the harsh reality of “Mental Health in an unequal world”. Close to 1 billion people globally are living with a mental disorder. Yet, countries spend on avg. 2% of their national health budgets on mental health leaving a disproportionate gap between demand for mental health services and supply. Each year, October 10th marks the “World Mental Health Day”. This year the theme is “Mental Health in an Unequal World”. 

Originally chosen by the World Federation for Mental Health, the theme Mental Health in an Unequal World” refers to the inequality in access to health services in low- and middle-income countries, where between 75% and 95% of patients with mental disorders have no access to mental health services at all. Despite the universal nature and the magnitude of mental illness, the gap between demand for mental health services and supply remains substantial.

The global pandemic along with the climate crisis and social disarrangement lead the world to a difficult place. To date, the pandemic is impacting people of all ages and backgrounds: Illness, economic impact, job insecurity, and most importantly, physical distancing leading to social isolation and millions of people facing mental health issues.

  • Close to one billion people have a mental disorder and anyone can be affected.
  • Depression is a leading cause of disability worldwide and a major contributor to the global burden of disease. Globally, an estimated 5% of adults suffer from depression.
  • Globally, one in seven 10-19-year-olds suffers from a mental disorder. Half of all such disorders begin by the age of 14, but most go undiagnosed and untreated.
  • People with severe mental disorders like schizophrenia typically die 10-20 years earlier than the general population.
  • One in 100 deaths is by suicide. It is the fourth leading cause of death among young people aged 15-29.
  • The COVID -19 pandemic has had a significant impact on people’s mental health.

The World Federation for Mental Health also addresses the disparity between mental health investment and overall health. On average, countries spend only 2% of their national health budgets on mental health. This has changed little in recent years. Despite the scale of mental illness, the gap between demand for mental health services and supply remains substantial. Unaddressed mental health issues are now a leading global cause of disability and suffering. Yet only 10% receive “adequate” treatment – 75% receive no treatment at all.

The limited global availability of effective mental health treatments and a lack of objective measures of response to treatment, are some of the barriers in advancing patient outcomes. To reduce burden, it is critical to diagnose and monitor mood disorders using widely accessible, less costly, and scalable methods, which can enable a higher degree of specificity in mental health diagnoses and timely detection of clinical deterioration.

Building on the widespread adoption of smartphones, mobile health (mhealth) has gained significant interest as a means for capturing continuous, objectively observable and measurable data of patients’ behaviour and mental state. The data collected on smartphones and sensors represent a new approach aimed at measuring human behaviour and mental health, and thus an opportunity of detecting, assessing, and monitoring psychiatric disorders in a less costly and less burdensome way for the clinician.

The data collected on the smartphone are also referred to as digital biomarkers. These can be collected both passively through inbuilt sensors on the smartphone (physical activity and geolocation, social activity, text messages usage, phone usage, voice and speech pattern or wearables (sleep and activity), and actively via user engagement through self-monitored data/self-assessment data (mood, sleep, stress, medicine adherence).

By collecting this data between physician visits, clinicians can see fluctuations in patients’ mental states, providing a more holistic representation of the patient’s functioning over time. The data hereby offer the opportunity for clinicians to predict relevant outcomes in mood disorders and can thus serve as a tool of triage enabling to provide timely and preventative support to the individuals in critical need.

This approach, also known as digital-enabled psychiatry, has gained considerable interest and been extensively researched over the past decade to offer more people access to high-quality health and social care.

To learn more, visit our Research section here or watch a video on the opportunity of digital-enabled psychiatry from the Week of Health and Innovation conference 2021 in Denmark.

References:

https://wfmh.global/2021-world-mental-health-global-awareness-campaign-world-mental-health-day-theme/

https://www.who.int/publications/i/item/9789240031029

https://www.who.int/campaigns/world-mental-health-day/2021

https://www.who.int/key-messages

[1] https://www.who.int/gho/publications/world_health_statistics/EN_WHS2012_Full.pdf

[2] The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011

[3] OECD – 2015

[4] Economist Intelligence Unit – 2015

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.

The top cause of insurance claims is mental illness

The top cause of insurance claims is mental illness

The top cause of insurance claims is mental illness. According to a new study conducted in the UK, two-thirds of British adults said they have experienced mental ill-health at some point in their lives. The survey revealed that on average 70% of people between the ages of 18 and 54 have experienced a mental health problem. In all, 65% of all the people surveyed, said they had experienced some form of mental health problem. [1]

Britain’s high stress, long-hours work culture has led to a higher level of people out of work with mental health problems than any other country in the developed world. [2]

Furthermore, a different study has shown that approximately 53% of NHS patients displayed clinical symptoms of depression and anxiety within a year after completing psychological treatments. Over half of these were found to have suffered a relapse event, with up to 79% of events occurring within the first six months after treatment.[3]


The economic cost

According to an OECD report, people unable to work because of mental health issues cost the UK economy £70 billion each year with 40% of all people claiming disability benefits is due to psychological issues.[2]

Top cause of insurance claims

The top cause of insurance claims are mental health issues, which have remained at the top of the list since 1999, far above other claims such as back injury or stroke.[4]

According to an analysis by the Institute for Fiscal Studies, nearly half of all people claiming disability benefit are doing so because they have a mental illness rather than a physical condition. [5]

The analysis reveals that the proportion of disability claims which are related to mental illness has risen from 27 per cent to 41 per cent since 1999. [5]

In fact, six in ten claims by those aged between 25 and 34 are now related to mental illness, up from half in 1999. [5]

In a recent interview, Vanessa Sallows, Benefits and Governance Director at Legal & General’s Group Protection, said: “Mental health continues to be the main reason for absences on our group income protection. [4]

mHealth technology is here to help

Smartphones and wearables
In the UK alone, there are over 40 million smartphone users over 3 million people utilise some type of wearable device.

Mobile health technology
mHealth technology uses connected devices to help prevent illness, improve compliance and get people back to health.

Customer centricity
mHealth technology puts customers at the centre, where they want to be, and helps them to live the lives they want.

The Monsenso mHealth solution for mental health can be used by insurance companies to offer a preventive, mental wellness programme.

Policyholders can use the Monsenso smartphone app to enter their daily levels of stress, anxiety, irritability, physical activity and number of hours they slept. This information is gathered and stored electronically so it can be accessed by a coach or telehealth consultant, anytime, anywhere.

In this way, the coach or telehealth consultant can remotely monitor policyholders and follow up with those users who present any triggers or warning signs. For example, the the coach or telehealth consultant will be notified when a policyholder indicates a high level of stress, anxiety and irritability for more than five consecutive days or when someone sleeps less than six hours for more than three consecutive days. These two actions would be considered indicators that the individual needs to be contacted for a “wellness check” and implement the necessary measures to prevent the person from going on long-term leave, or become affected by other physical conditions such as heart disease.

References:

[1] Two-thirds of Britons have had mental health problems. The Guardian. Haroon Siddiqi. (2017, May 8)
https://www.theguardian.com/society/2017/may/08/two-thirds-of-britons-have-had-mental-health-problems-survey?CMP=share_btn_tw

[2] British workers among the most stressed in the world. The Telegraph. Georgia Graham. (2014, Feb 14)
http://www.telegraph.co.uk/news/health/10629374/Over-a-million-people-with-mental-health-issues-are-out-of-work-and-claiming-benefits.html

[3] More than half of NHS patients display symptoms of relapse after depression treatments, study finds. News Medical Life Science. (2017 May 3)
http://www.news-medical.net/news/20170503/More-than-half-of-NHS-patients-display-symptoms-of-relapse-after-depression-treatments-study-finds.aspx?showform=printpdf

[4] Legal & General group protection payouts rise. FT Adviser. Simoney Kyriakou. (2017, May 2).
https://www.ftadviser.com/protection/2017/05/02/legal-general-group-claim-payouts-rise/

[5] Nearly half disability benefit claimants have a mental illness. The Telegraph. (2015, May 21)
http://www.telegraph.co.uk/news/health/11622166/Nearly-half-disability-benefit-claimants-have-a-mental-illness.html

Clinicians to monitor cardiovascular disease markers for teens suffering from mental illness

Clinicians to monitor cardiovascular disease markers for teens suffering from mental illness

According to a recent statement by the new American Heart Association (AHA),  major depressive disorder and bipolar disorder should be recognized as moderate risk factors for atherosclerosis and early cardiovascular disease.  [1]

In 2011, the National Heart, Lung and Blood Institute identified four conditions (chronic inflammatory disease, human immunodeficiency virus, Kawasaki disease, and nephritic syndrome) that lead youths to a mild risk of developing cardiovascular disease before they reach 30. [2]

The statement released a few days ago, reveals that depression and bipolar disorder meet the same criteria as these conditions. Moreover, these two behavioural disorders are more widespread than the previous mentioned conditions combined.

These studies showed evidence of a link between paediatric depression and bipolar disorder with premature cardiovascular mortality. Cardiovascular risk factors for these teens include obesity, insulin resistance and diabetes, dyslipidemia, and hypertension.[1]   According to the statement, depression and bipolar disorder are the first- and fourth-most disabling conditions, among adolescents worldwide.

After the report had been unveiled, researchers from schools around the U.S. and Canada looked at existing studies on mood disorders in people under the age of 30. Researchers looked specifically into youths suffering from depression or bipolar disorder with cardiovascular markers such as high pressure and cholesterol. They found a significant connection between having depression or bipolar disorder and increased odds of high blood pressure, high cholesterol, obesity (especially belly fat), type 2 diabetes, and hardening of the arteries. [3]

This discovery denotes that healthcare providers should track physical activity levels and food intake as well as metabolic monitoring is crucial for these young patients as a preventive measure.

However, to monitor cardiovascular markers, physical activity and food intake, of thousands of young patients who also suffer from mental illness is not an easy task. Although, there are hundreds of smartphone applications tracking physical activity and counting calories, these apps are personal, and clinicians do not have access to an individual’s data. Nevertheless, with the Monsenso mobile health (mHealth) solution, this cumbersome task becomes easy and achievable.

The Monsenso mHealth solution enables clinicians to access a patient’s data on a daily basis. Every day, youths would be reminded to fill in a self-assessment with important information that could include the number of hours they slept, the amount of unhealthy food they have eaten, and if they realized any physical activity throughout their day. Additionally, the smartphone can also collect physical activity and mobility data, based on the smartphone’s inbuilt accelerometer and GPS locator.

The Monsenso mHealth solution, especially designed to monitor behavioural data of patients suffering from mental illness, can in this way help clinicians monitor any unhealthy habits of patients with risk of developing cardiovascular disease.

Further, with the customisable action plans, each youth could follow “contingency plans” if they experience some symptoms related to their mental illness or if they have engaged in unhealthy activities. For example, a special trigger could set up if a youth has indulged in unhealthy food for several days in a row, or has had a low level of physical activity. The action plan listed for this trigger could then encourage individuals to engage in physical activities and and to try to avoid sugar and fat during the upcoming week.

References:

[1] Browser,D Medscape. Depression, Bipolar Disorder in Teens are CVD Risk Factors: AHA (2015, August 10)  http://www.medscape.com/viewarticle/849312

[2] American Heart Association. Young people with mood disorders have increased risk of developing early cardiovascular disease (2015, August 11)

http://blog.heart.org/young-people-with-mood-disorders-have-increased-risk-of-developing-early-cardiovascular-disease/

[3] Walton, A Forbes. Teens with depression, bipolar disorder, should be screened for heart disease, experts say. (2015, August 11) http://www.forbes.com/sites/alicegwalton/2015/08/11/depressed-teens-may-be-at-higher-risk-for-heart-disease/

Goldstein BI, Carnethon MR, Matthews KA, et al. Major depressive disorder and bipolar disorder predispose youth to accelerated atherosclerosis and early cardiovascular disease. Circulation 2015.