Google’s new life sciences division made an important steal this week: It hired away Thomas Insel, the lauded and longtime director of the National Institutes of Mental Health.
Insel spoke with MedCity News about the promise – and challenges – of making digital tools effective in treating mental illness. He addressed Silicon Valley idealism in using technology for the greater good – but added that it’s important to consider the privacy concerns of using technology to manage mental illness. Insel explained the rationale for shifting to Google:
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“We need a major paradigm shift in mental health,” Insel said. “If we want to see an impact on morbidity and mortality for mental health, we have to do it in a different way. And that could be through digital technology.”
Here is the interview with Insel, edited for clarity:
What impact could digital health tools have on treating mental illness?
It’s still early days. But from my perspective, when I look across a lot of areas of medicine, what strikes me is that technology has revolutionized communication and entertainment and information – but it hasn’t really had much of an impact on healthcare. When you look across all areas – diabetes, cancer, respiratory diseases – the place where it might actually have the greatest impact of all is mental health.
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What’s some low-hanging fruit in terms of digital health applications for mental health?
We could use digital health tools to step in what’s often missing in psychiatric treatment – psychosocial interventions like psychotherapy, cognitive training, and even skills training in the form of video games.
Voice and speech analytics might be a good way to start with diagnostics – they’re passive and don’t require collecting a lot of data. You could collect maybe a minute, or 30 seconds, of unstructured speech, and use that as a window into the earliest stages of disorganized thought. A very early indicator of mania is that speech gets fast and chaotic. With depression, speech begins to slow down.
Any companies in particular pique your interest?
- Ginger.io, based up in San Francisco, has created a whole suite of tools for people to measure depression online. They have 800,000 people using their set of apps as a way to manage depression or anxiety.
- Mood Gym in Australia provides cognitive behavioral therapy, online.
- Big White Wall in the U.S. brings people together with depression, PTSD or other mental illnesses – to not only support each other, but to find a therapist any time, anywhere, 24/7.
Let’s talk privacy – because in mental health, this is obviously a priority.
Privacy is a sensitive issue – we want to be very thoughtful about what data gets used. When you think about Google and data, people begin to wonder – is my search information going to be used as a mental health biomarker? Or to make a diagnosis? I don’t think that’s ever likely going to happen.
What’s more likely is that providers, or a third party entity, will use the metadata of people in treatment. But it’ll always be through some sort of informed consent which you could pull back at any moment. Privacy is a huge issue here, in mental healthcare.
Remember, right now – everything you do now is being collected by someone online. But they’re using it to sell you shoes and clothes. It’s being used for marketing, but not to manage your own health.
I think this is a really important conversation people will have: Are we going to get to a point where we would use your online information to let others know when you’re suicidal? Or homicidal? Or severely depressed and need emergency care?
It’s a tough area, and I don’t know where we’ll end up there.
You’ve mentioned before that you used to assume that big tech companies’ interest in mental health was purely financial – but you’ve changed your mind. Why?
Maybe I’m being too naive, and the big corporations really are just trying to figure out how to make mental health a business. But I think there are companies that can afford to do things for the public good.
Apple’s ResearchKit, for instance – I don’t see any way that’s being set up as a commercial entity. It’s really meant to support getting more and more people involved in Parkinson’s and breast cancer research. It’s a wonderful thing to do. I don’t see the commercial side to that.
Part of what you see in Silicon Valley is people who have been incredibly successful commercially, and now want to do something to change the world – and are trying to find a way to invest their resources.
That may be a terribly naive thing for me to say, but I hope as a public servant moving into this sector, there’s an opportunity to keep some vision of public service in the private sector.
So, what is your new role at Alphabet?
It’s so undefined. Mental health is something they’ve decided will be their next area of focus in the life sciences – they’ve already done exciting work in cancer, heart disease and diabetes. As I said before, I think this technology will have an enormous impact on people with mental illness.
But what I’ll do specifically? I don’t know. We’ll explore that when I arrive in January.
[IMAGE: Courtesy of NIMH]
