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

Our future tech-savvy clinicians: What can we expect and how do we get there?

Our future tech-savvy clinicians: What can we expect and how do we get there?

It is no secret that our world is constantly changing towards becoming more digitized, and so is healthcare. Earlier, we discussed the top pain points in the delivery of mental healthcare and how digital technology can help. Now, we want to look at the clinicians of the future – how tech-savvy will they need to be, and what are the main benefits and challenges they expect to face in relation to digital solutions?

Where are we today?
The digital era has arrived in today’s healthcare settings. A large study by Elsevier Health (2022), involving over 2800 clinicians and nurses from 111 markets, found that 88% of clinicians acknowledge the significantly growing importance of being technologically literate compared to 10 years ago [1].

Today’s electronic medical records (EMRs) can store large amounts of patient information. However, they also cause frustrations among clinicians. Many healthcare professionals report that contemporary EMR systems are too time-consuming due to the need for frequent manual data inputting, significantly adding to their already heavy caseloads [1]. Additionally, it has been found that as many as 69% of clinicians record feeling overwhelmed with handling the “growing volume of patient data” [1].

What are the drivers of change?
Covid-19 has particularly shown the relevance and benefits of real-world data (RWD) collected in real-time. During the pandemic, “data took center stage”, and many patients became more comfortable with their data being utilized “in informing decisions” [1]. In addition, patients are becoming more empowered globally, and many are utilizing digital health applications to better manage their own health [1].

What can we expect in the future?
The Elsevier Health study (2022) shows that 77% of 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 [1].
Most clinicians (79%) therefore also expect future EMRs to integrate a variety of data sources, such as “patient consumer health app data” [1]. The integration of digital solutions in future EMRs is expected to be beneficial for its potential to help clinicians communicate with their patients more effectively and make more informed clinical decisions. Importantly, healthcare professionals believe digital technologies and remote monitoring tools could help them to handle the growing patient data volumes they are currently feeling overwhelmed with [1].

How do we get there?
67% of clinicians agree “they will need to become experts in the use of [digital technologies] in the future” [1]. However, many clinicians (83%) do not feel sufficiently tech-savvy currently. Thus, they will need the right access, support, and education. One of the key focus points, therefore, needs to be giving clinicians training and confidence in their ability to use digital technologies [1], as these will only be effective in healthcare if clinicians are adept at using them.

How Monsenso enables clinicians on the path to digitalization
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. Easing clinicians’ workloads by providing them with a better overview of their patients’ data and conditions is one of our priorities when working with healthcare professionals. When clinicians use our solution, they are not being left alone. In-depth workshops during the planning and implementation phase ensure clinicians will feel 100% comfortable and confident in using the Monsenso solution, and our friendly support team provides help whenever needed. 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] 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.

New research: Can smartphone data be a digital marker for discriminating bipolar disorder from unipolar disorder?

New research: Can smartphone data be a digital marker for discriminating bipolar disorder from unipolar disorder?

Unipolar disorder (UD) refers to individuals suffering from depression without experiencing mania, whereas individuals suffering from bipolar disorder (BD) usually face episodes of mania in addition to their depression [1]. Clinicians often encounter difficulties identifying whether depressed patients suffer from BD or UD. Given that the course of illness and related treatments vary for patients with BD and UD, the discrimination between these two disorders is critical [2].

A new research paper has just been published on “Differences in mobility patterns according to machine learning models in patients with bipolar disorder and patients with unipolar disorder” in the Journal of Affective Disorders [2].

This new research investigated whether using the information on activity and mobility of patients with BD and UD as supplementary objective measure could assist in the discrimination between the two conditions [2]. Data for this study has been collected as part of the RADMIS trials, two similarly composed randomized controlled trials (RCTs) that investigated the effect of daily smartphone-based monitoring including a clinical feedback loop in individuals suffering from BD and UD. The Monsenso digital health solution was used for the collection of smartphone-based patient data in the intervention group of the trials [3].

The present study included gathering both passively collected smartphone-based location data and patient-reported smartphone-based data on mood from 65 patients with BD and 75 patients with UD [2]. Smartphone-based self-assessments of mood were completed by all patients, and smartphone data on location reflecting mobility patterns, routine and location entropy (chaos) was collected passively from all patients on a continuous basis over the course of six months [2]. The data collection was followed by an extensive data analysis, comparing differences between the two groups.

Results of the study show patients suffering from BD have significantly lower mobility in, e.g., their total time of daily movement during depressive periods (eB 0.74, 95% CI 0.57; 0.97, p = 0.027). Additionally, the area under the curve (AUC) of location data was rather high in classifying patients with BD compared with patients with UD, although results of the study may be limited by relatively low symptom severity of the participating patients contributing to the dimension of the AUC [2].

The study results suggest alterations in location data may be a promising digital diagnostic marker in patients with BD and UD, and smartphone data on mobility patterns could hence help in discriminating between the two disorders. 

Mads Frost, PhD, Co-Founder & Chief Information Security Officer at Monsenso, who has contributed to the research says: “The work on comparing mobility patterns between patients with bipolar disorder and patients with unipolar disorder has been highly interesting, and we look forward to further explore our data looking for potential digital diagnostic markers”.

 “We are excited that Monsenso is a part of promising new research on digital diagnostic markers, and contributes to the research in and the treatment of mental health and neurological disorders”, says Thomas Lethenborg, CEO at Monsenso.

About Monsenso:
Monsenso is an innovative technology company offering a medical grade digital health solution. Our mission is to help provide better mental health to more people at lower costs. Our solution helps optimise the treatment of mental disorders and gives a detailed overview of an individual’s mental health through the collection of outcome, adherence, and behavioural data. It connects individuals, carers, and health care providers to enable personalised treatment, remote care, and early intervention. Based on continuous research and development, our team is committed to developing solutions that fit seamlessly into the lives of individuals, increase their quality of life and improve the efficacy of mental health treatment. To learn more, visit www.monsenso.com

Research publication:
You can find the research publication in the Journal of Affective disorders here.

References:
[1] Quilty, L., Pelletier, M., DeYoung, C.G. & Bagby, M. (2013). Hierarchical personality traits and the distinction between unipolar and bipolar disorders. Journal of Affective Disorders 147(1-3): 247-254. https://www.sciencedirect.com/science/article/pii/S0165032712007604#bib2

[2] Faurholt-Jepsen, M., Busk, J., Rohani D.A., Frost, M. Tønning, M.L., Bardram, J.E. & Kessing, L.V. (2022). Differences in mobility patterns according to machine learning models in patients with bipolar disorder and patients with unipolar disorder. Journal of Affective Disorders 306: 246-253. https://www.sciencedirect.com/science/article/pii/S0165032722003019?dgcid=author

[3] Faurholt-Jepsen, M., Tønning, M.L., Frost, M., Martiny, K., Tuxen, N., Rosenberg, N., Busk, J., Winther, O., Thaysen-Petersen, D., Aamund, K.A. & Tolderlund, L., Bardram, J.E. & Kessing, L.V. (2020). Reducing the rate of psychiatric re-admissions in bipolar disorder using smartphones—The RADMIS trial. Acta Psychiatrica Scandinavia, 143(5): 453-465. https://onlinelibrary.wiley.com/doi/10.1111/acps.13274

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.

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.