Digital mental health

The Norwegian Board of Technology explores in a new project how the health services and citizens can make use of digital tools to detect, treat and prevent mental illness in Norway.

“We know that many people are struggling with mental illness without getting help in time. Digital solutions can give better services, help more people and lower the threshold for seeking help.”, says the director Tore Tennøe.

“At the same time, mental health data is very sensitive, and data protection and privacy are key concerns”, he continues.

Mental illness is a major societal challenge

About half of the Norwegian population suffers a mental illness or distress during their lifetime. Many of those with mental health problems have not been in contact with the health service, and even young people often do not seek help. Mental difficulties and disorders result in considerable costs for the individual, the family and society.

The government aims to include mental health as an equal part of public health work. The goal is to reduce risk factors and enhance preventive measures for the entire population. However, it is a challenge to achieve equal access to services and to increase the use of evidence-based treatment in the municipal and specialist health services.

Mental health becomes digital

New technology means new ways to guide and treat people with various mental disorders. Artificial intelligence also makes it possible to detect signs of risk and aggravation of disease earlier so that measures can be initiated sooner.

“Digital solutions for mental health are scalable and can reach more people, something that the traditional mental health care does not currently have the capacity for”, says project manager Adele Flakke Johannessen.

“The ongoing Corona pandemic has shown that there is great potential for digital solutions and that changes can happen quickly” she continues.

Self-help solutions

There are currently several digital solutions that provide good guidance for patients with anxiety or depression, between meetings with their psychologist. One study showed that symptoms of depression went down after 14 days of use, and that such apps appear to be an engaging and effective way to deliver cognitive behavioural therapy. E-meistring is a Norwegian therapist‐supported internet program for mental disorders which has shown good results.

During the Corona crisis, there has also been an increase in the use of self-help apps such as Headspace, Woebot and Thrive. These are apps you can download without going through a therapist. They provide information on what to do if you feel down and can provide various tasks to cope with mild mental health problems.

Some of these apps also offer social chat bots, which can guide users. An example is Woebot which helps people with mild anxiety and depression. It daily sends short messages asking how the users feel, and gives them customized tasks, videos and games.

Self-service solutions can assess the risk and need for help, thus lowering the threshold for contact.

Better guidance and training with virtual reality

The treatment of mental disorders often implies practicing new ways of thinking and new habits. With digital simulations, both healthcare professionals, patients and relatives can safely practice demanding situations and tasks.

One opportunity, for example, is to help individuals who have isolated themselves and need to practice social skills in everyday life so that they can improve their social functioning.

Detecting risks early

It is important to quickly identify signs of mental disorders and initiate preventive measures. New technology can detect signs of risk and aggravation of disease early.
Research is now being done on how machines can be trained to detect signs of mental problems in new ways. For example, an algorithm may learn to diagnose from smartphone usage data, such as changes in typing speed, voice tone pitch, or word selection. Facebook Suicide Watch can detect people struggling with suicidal thoughts by analysing their users’ activity on social media.

Ethical challenges

Digitalisation will make mental health services cheaper and easier to access. However, the introduction of new technology also calls for a wider ethical assessment and public debate.

“The use of artificial intelligence can provide personal guidance and follow-up for many, but data on mental health is personal and very sensitive, which easily can be misused” says project manager Adele Flakke Johannessen.

Digital mental health services may be available around the clock, strengthening the individual’s autonomy and ability to self-help. However, it is difficult to predict how a patient will react to the use of the services without the presence of professionals to provide support. This raises questions about how the authorities can ensure proper use.