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

Monsenso is ISO 13485 certified

Monsenso is ISO 13485 certified

Quality Policy and Standards

As a technology leader in mobile health (mHealth) solutions for mental health, Monsenso is ISO 13485 certified.

ISO 13485 is the gold standard for medical device companies to ensure the quality, safety and efficacy of products in the medical device field. This certification ensures that the product in question, consistently meets customer requirements and regulatory requirements applicable to medical devices and other related services.

Monsenso adheres to the highest security standards. Beyond, being ISO 13485, Monsenso holds the ISO 27001 certifications, a TGA certification and class 1 CE mark.” says Thomas Lethenborg, CEO at Monsenso.

You can download this article as PDF in English.

For additional information contact:
Bettina van Wylich
Chief Marketing Officer
Monsenso
+45 22704724
wylich-muxoll@monsenso.com

Monsenso is ISO 13485 certified

Monsenso is ISO 13485 certified

Quality Policy and Standards

As a technology leader in mobile health (mHealth) solutions for mental health, Monsenso is ISO 13485 certified. ISO 13485 is the gold standard for medical device companies to ensure the quality, safety and efficacy of products in the medical device field. This certification ensures that the product in question, consistently meets customer requirements and regulatory requirements applicable to medical devices and other related services.

Monsenso adheres to the highest security standards. Beyond, being ISO 13485 certified, Monsenso holds the ISO 27001 certification and class 1 CE mark.” says Thomas Lethenborg, CEO at Monsenso.

For additional information contact:
Jennifer Highland
Marketing and Communications Manager
Monsenso
+45 81 71 7713
highland@monsenso.com

Monsenso will begin clinical trials for anxiety

Monsenso will begin clinical trials for anxiety

Monsenso will begin clinical trials to support the treatment of anxiety disorder in collaboration with The Mental Health Services in the Region of Southern Denmark (MHS).


The Anxiety Monitoring Study

The objective of the study is to implement and validate the Monsenso mHealth solution to support the treatment of anxiety disorders.

The Monsenso mHealth platform uses a double-loop treatment model to connect care providers and individuals. Currently, it is being used to collect patients’ self-rated status and sensor-based behavioural data on a daily basis.

Recent advances in mobile technologies have created more opportunities for assessments and treatments to be available to people in situations where they are most needed. Personal health technologies can collect patients’ self-rated status and sensor-based behavioural data (e.g., physical activity, phone usage, social activity) on a daily basis.

The information gathered this way provides feedback on treatment progress to both care providers and individuals. Moreover, it also supplies ecological momentary interventions (EMI), for instance, by prompting individuals to do assignments depending on the context and patients’ current status.

Regarding anxiety disorders, mobile health solutions can be useful in assisting patients to use skills learned during treatment in real life situations, as well as to monitor and give feedback on progress or lack of progress during therapy. This feedback leads to better outcomes for patients not responding well to treatment.

Pilot study: The feasibility of the solution will be evaluated using a qualitative and quantitative study without a control group involving 30 patients for three months examining usability and usefulness of the solution for both patients and clinicians.

Participants: Anxiety Patients in Routine and Special Care Settings in Southern Denmark.

Expected results: The study will result in the development of a solution based on user needs. The platform will be a feasible, usable and useful intervention.

Implementation: If the results of the feasibility study are promising, the study results will be used to improve the mHealth solution and develop version 2. Afterwards, a randomised controlled trial (RCT) will be conducted to examine outcome related effects of the solution, such as rate of recovery. If the feasibility and outcome of the RCT studies are positive, it is expected that there will be interest in implementing the mHealth solution in routine and specialized care settings around the world.

To read the press release, click here.

Improving the treatment of bipolar disorder with mobile health technology

Improving the treatment of bipolar disorder with mobile health technology

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. [1]

People suffering from bipolar disorder will have periods or episodes of depression – where they feel very low and lethargic mania – where they feel high and overactive. [2]

Unlike simple mood swings, each episode of bipolar disorder can last for several weeks and some people may not experience a “normal” mood very often. [2]

Getting an accurate diagnosis is the first step in bipolar disorder treatment. However, this isn’t always easy. The mood swings of bipolar disorder can be difficult to distinguish from other problems such as major depression, ADHD, and borderline personality disorder. For many people suffering from bipolar disorder, it takes years and numerous doctor visits before the problem is correctly identified and treated. [3]

Indicators of bipolar disorder:

  • Repeated episodes of major depression
  • First episode of major depression was experienced before age 25
  • First-degree relative suffering from bipolar disorder
  • Mood and energy levels are higher than most people’s when not depressed
  • Oversleeping and overeating when depressed
  • Episodes of major depression are shorter than 3 months
  • Lost contact with reality while depressed
  • Suffered from postpartum depression in the past
  • Developed mania or hypomania while taking antidepressants
  • Antidepressants stopped working after several months
  • Tried three or more antidepressants without success [3]

If a person is not treated, episodes of bipolar-related mania can last for between three to six months. Episodes of depression tend to last longer, for between six and twelve months. However, with effective treatment, episodes usually improve within about three months. [2]

Most people with bipolar disorder can be treated using a combination of different treatments that can include:

  • Medication such as mood stabilisers and antidepressants
  • Learning to recognize triggers and early warning signs of an episode of depression or mania
  • Psychotherapy to deal with depression and provide advice on how to improve relationships
  • Lifestyle advice such as doing regular exercise, planning activities you enjoy that give you a sense of achievement, and advice on improving your diet and getting more sleep [2]

Mobile health technology

The Monsenso mHealth platform is based on The MONARCA Research Project, aimed at developing and validating a solution for multi-parametric, long-term monitoring of behavioral and physiological information relevant to bipolar disorder.

The Monsenso solution can help predict and prevent episodes by training patients to recognize their early warning signs, which are symptoms that indicate an oncoming episode [4].

In particular, during the research project, it was discovered that these three parameters are crucial in keeping a bipolar patient stable:

  • Adherence to prescribed medication: Taking all medications on a daily basis, exactly as prescribed.
  • Stable sleep patterns: Sleeping eight hours every night and maintaining a consistent routine of going to bed, waking up.
  • Staying active both physically and socially: Getting out of the house every day, going to work, and engaging in social interaction.

Therefore, the Monsenso solution includes five core features that support a patient’s self-management:

  • Self-assessments – Reminded by an alarm, patients enter subjective data directly into the system through their smartphones. This data includes mood, sleep, level of activity, and medication. Some items can be customized to accommodate a patient’s specific needs, while others are consistent to provide statistical analysis.
  • Activity monitoring – Through a GPS and accelerometer, objective data is collected to monitor a patient’s level of engagement in daily activities. The system can also measure the amount of social activity based on phone calls and text messages.
  • Historical overview of data – On the web portal, patients and clinicians can obtain a two-week snapshot of a patient’s basic data for immediate feedback. The portal also gives them access to a detailed historical overview of the data, enabling them to explore it in depth by going back in time, and focusing on specific variables.
  • Coaching and self-treatment – The MONARCA systems supported psychotherapy in two ways. Firstly, through customizable triggers that notify the patient and clinician when the data potentially indicates a warning sign. Second, since the patients have access to their own Early Warning Signs, it empowers them to learn more about them.
  • Data sharing – To strengthen the relationship between patients and clinicians, important information and treatment decisions are shared.

Resources:

[1] What is bipolar disorder? National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

[2] Bipolar disorder.
National Health Service (NHS) UK. http://www.nhs.uk/Conditions/Bipolar-disorder/Pages/Introduction.aspx

[3] Bipolar disorder treatment. HelpGuide.org http://www.helpguide.org/articles/bipolar-disorder/bipolar-disorder-treatment.htm