UK National Schizophrenia Awareness Day 2022 – A mental illness in need of destigmatization

UK National Schizophrenia Awareness Day 2022 – A mental illness in need of destigmatization

July 25th is National Schizophrenia Awareness Day in the UK, aiming at shining light on “what it means to live with this much misunderstood and often stigmatized mental health condition”, fighting prejudice surrounding it, as well as seeking to raise awareness of and support for its treatment [1].

What is schizophrenia?
Individuals with schizophrenia experience disruptions in their thought processes and perceptions, as well as in social interactions and emotional responsiveness. The mental illness, usually including psychotic symptoms such as delusions and hallucinations, can be highly disabling to people suffering from it [2].

Economic costs of schizophrenia
Worldwide, around 24 million people are currently diagnosed with schizophrenia [3] – in the UK it is over 685.000 people (approximately 1% of the population) [4].
Schizophrenia has a large economic cost. It accounts for approximately “30% of all spending on adult mental health in the NHS” [5], estimated at 11.8 million GBP in England alone in 2012 [6]. Generally, it costs around 6 times as much to treat an individual with schizophrenia over its lifetime than it costs to treat a heart disease patient [5].

Stigmatization of schizophrenia
Schizophrenia affects all genders and individuals from all social backgrounds, and onsets most often in the late teenage years or in the early twenties [5]. The mental illness severely impacts affected peoples’ quality of life. In the UK, only around 13% of individuals suffering from schizophrenia are working [5], and it has been found that affected people are “2 to 3 times more likely to die early than the general population” [3]. Schizophrenia is also a significant burden that impacts productivity of family caregivers, who on average spend 22 hours a week for 15 years of their life taking care of their relative with schizophrenia.
Additionally, stigma against people suffering from the condition is still “intense and widespread” today [3]. Individuals with schizophrenia oftentimes experience social exclusion, and/or discrimination due to the disease, and some even experience limited “access to general health care, education, housing, and employment” [3]. According to the World Health Organization (2022), these issues often only exacerbate the suffering peoples’ symptoms [3].

What needs to change?
Schizophrenia is not as rare as one might think, and prejudices surrounding the illness unfortunately only further increase the burden of the disease on people suffering from it. It is therefore important to raise awareness about schizophrenia, destigmatize the mental illness, and help to ensure that individuals with schizophrenia are not facing discrimination. Given the high economic costs of schizophrenia, it is also important to continuously work on improving the treatment support provided. This includes seeking for new ways to help individuals suffering from the mental health condition.

How digital solutions for mental health can help
The use of digital platforms for remote patient monitoring and health assessment, as well as real-time patient analytics, could enable personalised treatment and improved quality of care [7]. Digital solutions for mental health could therefore offer the potential to empower and engage individuals with schizophrenia to better manage their mental health, facilitating treatment for clinical professionals and empowering family caregivers to help drive down economic costs and increase productivity.
At Monsenso, we have worked with schizophrenia in both research and clinical settings. Our digital mental health solution has helped many individuals with schizophrenia to better understand their conditions and live a more independent life, as well as helped clinicians to better support their patients. We are proud to support the National Schizophrenia Awareness Day in the UK and will continue to spread knowledge about the mental health condition and offer our support to individuals affected and clinicians providing treatment for the mental illness.
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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. 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] Awareness Days (n.d.). National Schizophrenia Awareness Day 2022.
https://www.awarenessdays.com/awareness-days-calendar/national-schizophrenia-awareness-day-2022/#:~:text=National%20Schizophrenia%20Awareness%20Day%2C%20marked,with%20a%20diagnosis%20of%20schizophrenia.

[2] National Institute of Mental Health (n.d.). Schizophrenia.
https://www.nimh.nih.gov/health/statistics/schizophrenia#:~:text=Schizophrenia-,Definition,be%20both%20severe%20and%20disabling.

[3] World Health Organization (2022). Schizophrenia.
https://www.who.int/news-room/fact-sheets/detail/schizophrenia#:~:text=Schizophrenia%20affects%20approximately%2024%20million,%25

[4] Royal College of Psychiatrists (2015). Schizophrenia.
https://www.rcpsych.ac.uk/mental-health/problems-disorders/schizophrenia

[5] Living With Schizophrenia (2017). Facts and Figures.
https://livingwithschizophreniauk.org/facts-and-figures/

[6] Ride, J., Kasteridis, P., Gutacker, N., Aragon Aragon, MJ., Jacobs, R. (2020). Healthcare Costs for People with Serious Mental Illness in England: An Analysis of Costs Across Primary Care, Hospital Care, and Specialist Mental Healthcare. Appl Health Econ Health Policy 18(2):177-188.
doi: 10.1007/s40258-019-00530-2.

[7] 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

The importance of early intervention in the recovery process

The importance of early intervention in the recovery process

Early intervention is critical to treating mental illness before it can cause tragic results such as serious impairment, unemployment, homelessness, poverty, and suicide [1].

The identification of mental illness and its treatment, as early as possible, represents a high priority. The early detection and treatment of mental illness promote recovery, independence, and self-sufficiency, as well as facilitating social activities and employment opportunities [2].

It is estimated that 100,000 adolescents and young adults in the United States alone experience a first episode of psychosis every year. The early phase of psychotic illness is widely viewed as a critical opportunity for indicated prevention, and a chance to alter the downward trajectory and poor outcomes associated with serious mental disorders such as schizophrenia. The timing of treatment is critical; short and long-term outcomes are better when individuals begin treatment close to the onset of psychosis. Numerous studies find a substantial delay between the onset of psychotic symptoms and the initiation of treatment. In the U.S., treatment is typically delayed between one and three years, suggesting that many people experiencing first episodes of psychosis are missing a critical opportunity to benefit from early intervention [3].

Early identification and rapid referral are essential to shortening the duration of untreated psychosis and pre-empting functional deterioration. The World Health Organization advocates reducing the duration of untreated psychosis to three months or less by addressing “bottlenecks” in the pathway from early psychosis identification to initiation of specialty care [3].

To support early intervention, in 2009, the National Institute of Mental Health (NIMH), implemented a research project to change the prognosis of schizophrenia through aggressive treatment in the earliest stages of illness.Recovery After an Initial Schizophrenia Episode (RAISE) is designed to reduce the likelihood of long-term disability that people with schizophrenia often experience. It aims to help people with the disorder lead productive, independent lives. At the same time, it aims to reduce the financial impact on the public systems often tapped to pay for the care of people with schizophrenia [4].

In 2011, RAISE began conducting a full-scale, randomized controlled trial comparing two different ways of providing treatment to people experiencing the early stages of schizophrenia and related disorders. Both types of treatment emphasize early intervention but feature different approaches for initiating and coordinating care. Treatment may include personalized medication treatment, individual resiliency training, and supportive services, such as family psychoeducation and education or employment assistance [5]. The RAISE study, expected to be completed by August 2016, aims to emphasize the importance of early intervention.

The Monsenso mHealth solution can help healthcare providers to closely monitor patients who have experienced a first episode of mental illness.

After experiencing a first episode, the healthcare provider can encourage the patient to use the Monsenso mHealth solution. This will enable the clinician to monitor the individual on a continuous basis, and react if symptoms arise.

With the Monsenso user app, patients can fill in self-assessments on a daily basis. These self-assessments include information on the patient’s behaviour and symptoms related to his mental health. Furthermore, the solution collects sensor data through sensors in the patient’s smartphone, and this combined with the self-assessment will help the healthcare provider to continuously monitor the patient, and support intervention at a very early stage. Early warning signs and automatic triggers can be set to indicate to the health care provider that proactive intervention is needed, if for example a patient sleeps too little or feels too distressed.

Early intervention and continuous monitoring can maximize a person’s chances of a fast recovery, self-sufficiency, and living a high-quality life including the possibility to pursue and education and maintain a stable job.

References:

[1] Directors Blog: SAMHSA and NIMH partner to support early intervention for serious mental illness. P. Hyde and T. Insel. National Institute of Mental Health Blog (2014, June 17) http://www.nimh.nih.gov/about/director/2014/samhsa-and-nimh-partner-to-support-early-intervention-for-serious-mental-illness.shtml

[2] Early intervention and recovery for young people with early psychosis: consensus statement. J. Bertolote and P. McGorry. British Journal of Psychiatry (2005). http://bjp.rcpsych.org/content/bjprcpsych/187/48/s116.full.pdf

[3] Evidence based treatment for first episode of psychosis: Components of coordinated specialty care. PHD R. K. Heinssen. RAISE NIMH (2014, April 14). http://www.nimh.nih.gov/health/topics/schizophrenia/raise/nimh-white-paper-csc-for-fep_147096.pdf

[4] Raise Project Overview. National Institute of Mental Health. (2009)http://www.nimh.nih.gov/health/topics/schizophrenia/raise/index.shtml

[5] NIMH RAISE Project makes progress as team refines research approach. National Institute of Mental Health. (2011, August 9) http://www.nimh.nih.gov/news/science-news/2011/nimh-raise-project-makes-progress-as-teams-refine-research-approaches.shtml