What’s Up Doc?: Leveraging technology to improve mental health care for youth



There is a crucial need to improve mental health care for youth. While we need long term solutions and systemic changes, leveraging technology can help us provide better mental health care in the short term.

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We need to do more for youth mental health, and technology could be a solution.

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Mental disorders often manifest for the first time before 24 years of age, according to research. There is a tremendous opportunity cost when we don’t address youth mental health early. Poor mental health is associated with health and development concerns, such as substance use. Mental disorders also tend to persist into adulthood.

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Unfortunately, we are not doing enough for our youth and we need to fix it. A 2013 survey of Canadian students showed that stress, anxiety, sleep difficulties, and depression were among the top five factors affecting academic performance in students. The same study also showed that a large percentage of Canadian students felt overwhelmed (89.3 per cent), lonely (63.9 per cent), overwhelming anxiety (56.5 per cent), and very sad (68.5 per cent) within a one-year period. 9.5 per cent of students thought seriously about suicide and 1.3 per cent reported attempted suicide within a one-year period. As a society, we have an ethical responsibility, especially to the most vulnerable youth, to help them reach their full potential.

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We need to find better ways to provide early intervention for youth struggling with mental health.

The Potential Role of Technology

In Major Depressive Disorder, Cognitive Behavioural Therapy (CBT) is the first-line treatment for mild severity. Combination treatment with Selective Serotonin Reuptake Inhibitors (SSRI) is recommended for moderate to severe cases. Since psychosocial intervention is generally the first-line treatment for mild cases, technology can complement psychotherapy provided by trained professionals and increase the number of psychotherapy sessions people receive.

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Technology may also help young people to get help sooner. Youth are generally physically healthy and do not have regular visits with their primary care physician, so it becomes easy for mental health concerns to slip through the cracks. Making online or app-based psychotherapy readily available for students may prompt students to see their health care professionals earlier.

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Luckily, we already have the technology to provide effective psychotherapy. Artificial Intelligence (AI) has been used to provide CBT. Conversation agents (think Apple’s Siri or Amazon’s Alexa) have the potential to deliver therapeutic content.

An example is Woebot, a full automated conversational agent developed by Dr. Alison Darcy at Stanford University. Woebot was modelled on human clinical decision making. It delivers psychoeducational content and includes features of the therapeutic process such as empathic response, tailoring, goal setting, accountability, motivation and engagement and reflection. In a peer-reviewed paper, university students that used Woebot for two weeks experienced significant reduction in depression and anxiety.

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Envisioning the Future of Mental Health Care

The long-term solutions for youth mental health will require changes in government policy, funding, and increases in mental health professionals. As a society, we also need to continue health promotion efforts to improve mental wellbeing, but until we can achieve these long-term solutions, technology should be used to help the youth of today.

What if schools and employers could provide free access to technology-based CBT to all students and employees? While it is hard to know the long-term benefits of technological intervention and whether or not the gains will be sustained, it never hurts to have an additional pair of listening ears when the time gets tough.

Dr. Amy Li is the Executive Director and Co-Founder of the not-for-profit organization Outrun the Stigma, which is focused on reducing mental health stigma and youth empowerment. She received her MD from the Cumming School of Medicine and will be pursuing Community Health and Prevention Research as a Knight-Hennessey Scholar at Stanford University.

What’s Up, Doc? is a medical column that covers the most interesting doctors, health researchers, and health-care issues or innovations in Canada and in our wider global community. If you’d like to contact us about a topic of interest, please e-mail info@snapdx.co

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