Chances are that you or someone near you is holding a smartphone. That phone is a profoundly useful tool for managing our lives, helping us communicate and guiding our way through a city. Now UW Medicine researchers are exploring how a smartphone might help someone manage a severe mental illness such as schizophrenia or bipolar disorder.
Psychiatry professor Dror Ben-Zeev recently authored a study that found that for patients with a mental health concern, a special app on a phone can sometimes be as effective as a human counselor. In fact, the app was shown to have a better rate of patient engagement. While no app can replace a human therapist, a phone is available 24 hours a day.
“The app allows us to distill therapies to their most potent aspects and make them available to someone who might not want to go to a clinic or who might live 200 miles from the local clinic,” Ben-Zeev says.
First, the app asks the user to press a button indicating whether his or her issue might be related to voices in their head, medicine, mood, social issues or sleep. Then the tool leads the user to videos or text with tips for coping with a specific concern using cognitive therapy techniques.
Participants in the study gave high satisfaction ratings for both the app and the therapist, saying both were approachable, enjoyable and helped them feel better. One of the patients, a Chicago woman diagnosed with bipolar and post-traumatic stress disorders, says she used the app to help get through the day: “The app keeps you aware of how you’re feeling and what you might do to calm down, to reboot, to get back on the right track.”
The study looked at 163 clients with long-term serious mental illnesses including schizophrenia spectrum disorders, bipolar disorder and major depressive disorder. Ninety percent of those using the software, called Focus, turned to it at least once, while just 58 percent of those assigned to the clinic treatment went to at least one group therapy session. The study found that significantly more participants fully completed eight weeks of treatment or more using the mobile app (56 percent) than the clinic-based program (40 percent).
There are tens of thousands of apps in the world that address mental health, but this one is different, says Jürgen Unützer, chairman of the Psychiatry and Behavioral Sciences Department. “There are a lot of apps for people who have less severe mental disorders. What Dror does that is unusual is that he dares to use technology to help people who have the most serious and most entrenched mental health problems,” Unützer says. “Most people who do technology and mental health don’t have the guts to take on such a challenge.”
The concept of using technology to reach people recognizes that most people with a mental illness don’t see a therapist. Statistics say that only one in five Washingtonians with a mental illness will see a trained professional in any given year, Unützer says. So the UW has a responsibility to explore how technology, which can be available to someone in a way that a human therapist cannot, can be used to help people.
“Dror is giving them something they can keep in their pocket to help them track their symptoms and give advice. It can help them stay connected with their health care team. These are early days, but I am 100 percent sure that this is a fabulous opportunity to reach more people and to help more people,” Unützer says.
Ben-Zeev was recruited to the UW in 2017 to help explore how technology can help people with mental illness as well as those who treat them. He leads the mHealth for Mental Health program in the School of Medicine and co-directs the Behavioral Research in Technology and Engineering Center. The findings around the software called Focus are encouraging, and the researchers hope that illness self-management apps like it might soon be put into use.
“The idea is to create energy and capabilities around leveraging technology to support the study, assessment, treatment—and, ideally, the prevention—of mental illness and behavioral health problems,” Ben-Zeev says. “We ask questions such as: Can we leverage technologies that already exist like texting and other approaches? Can we create new technologies in collaboration with technologists to try to address major public health problems in a novel way?”