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Technology is ubiquitous. Children have smartphones, octogenarians are savvy iPad users, and nearly everyone tracks steps and calories with wearables. It is no surprise that the field of psychiatry is forging a path toward using technology to revolutionize the way mental illnesses are diagnosed and treated as well as how outcomes are measured.
That was the consensus that emerged from McLean’s inaugural Technology in Psychiatry Summit last November, a two-day meeting that brought together leaders in medicine, research, data science, technology, industry, and patient advocacy to share their work and insights. Topics included leveraging technology to enhance mental health assessment, expanding research beyond the laboratory, using technology in geriatric health, and ethics and privacy.
McLean President and Psychiatrist in Chief Scott L. Rauch, MD, opened the sold-out event, reminding the more than 200 attendees that psychiatric illness is the leading cause of disability. He acknowledged the field’s formidable challenges, such as access to care, early intervention, stigma, and cost, directing a call to action to an audience of great minds working at the juncture of technology and psychiatry. “Technology has opened new vistas...and digital psychiatry may well enable a genuine revolution in our field, and such a revolution is sorely needed,” said Rauch.
“Someone said recently that if you want to know where to innovate, look for the duct tape, and wherever there is duct tape, there is a design problem,” said keynote speaker Tom Insel, MD, former director of the National Institute of Mental Health and co-founder and president of Mindstrong Health, a firm that analyzes how people interact with smartphones to help diagnose brain function. “Our mental health system, to the extent that it is a system, is covered with duct tape.”
Summit participants discussed weaknesses in the system and the potential for technology to fix them: the lack of objective measures to diagnose and track psychiatric illnesses; the high rates of relapse; the upward trajectory of the suicide rate; the staggering—and growing—number of elderly patients struggling with dementia; and the lack of access to behavioral health care for people in under-resourced areas.
Although the challenges are significant, presenters shared ideas about potential collaborations and solutions.
“While each of you are individually thinking through many of these problems, in fact, there are great ways we can think through them and learn about them together,” said Lara Mangravite, president of Sage Bionetworks. “That will be more effective, move us faster, and get us even further.” Sage Bionetworks is playing a key role in the Precision Medicine Initiative, which seeks to understand how genetics, environment, and lifestyle can help determine the best approach to prevent or treat disease.
UC Davis Assistant Professor of Psychiatry Laura Tully, PhD, spoke about smartphones’ potential for monitoring illness, describing her research into tracking and preventing the return of psychotic symptoms, such as hallucinations and delusions. Like Tully, Ipsit Vahia, MD, medical director of McLean’s Institute for Technology in Psychiatry (ITP), is using technology to monitor patients’ movements when they are alone, thereby better understanding physical agitation and other symptoms of dementia.
Kerry J. Ressler, MD, PhD, McLean’s chief scientific officer, closed the summit by highlighting some of the event’s most significant moments. Ressler expressed both his confidence and his hope that problems can be solved using “the basic tenets of value, efficacy, engagement, and efficiency, which require trust, transparency, agency, and responsibility.”
Major summit sponsors:
The summit was organized by ITP Technical Director Laura Germine, PhD, with the help of Scientific Director Justin T. Baker, MD, PhD, and Vahia. It was the first major conference on this topic hosted by the hospital and brought McLean clinicians, researchers, and data scientists together with collaborators from outside the hospital to develop, test, and support innovative digital health technologies.
McLean is planning a second event for November 2018.
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