Depending on your age, sex, and medical history, you’ve most likely had a screening test at some point during a GP visit — whether it’s a cholesterol test to detect early signs of heart disease, a Pap test for cervical cancer, a prostate specific antigen (PSA) test for prostate cancer, and so on.
Screening tests have been one of the great successes of modern healthcare — enabling the identification of diseases long before any externally visible symptoms show up, and thus allowing for timely intervention. Pap tests alone have been associated with a reduction of up to 492,000 cases of cervical cancer in the US over the past three decades.
Yet while we embrace routine screening when it comes to physical diseases, it remains hugely underutilized when it comes to mental health. In fact, depression screening rates fall below 5% in primary care settings — and far lower for minority populations. This is despite the fact that more than 50 million Americans suffer from mental illness and almost one in twenty experience suicidal thoughts, with over half (54.7%) of individuals not receiving treatment for their mental health conditions.
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On top of the risk of death by suicide and severely reduced quality of life, untreated mental illness can directly lead to poorer physical health outcomes. A recent meta-analysis found that depression significantly increases mortality risks in patients with chronic illnesses: by 184% in diabetes, 44% in heart attack, and 41% in kidney failure. It also raises the risk of major cardiac events by 52% in those with heart conditions and doubles the risk of dementia in diabetes patients. Additionally, poor mental health often leads to poor self-care — missing medications, engaging in unhealthy behaviors, and skipping medical appointments — escalating the risk of hospitalization and the overall cost of care.
These statistics highlight a critical gap in our healthcare system. If screening is core to the detection, prevention and early treatment of countless physical health conditions, why isn’t it the same for mental health?
Hidden blockers preventing mental health screening
Experts have long advocated for routine depression and anxiety screening for all adults in the US, but this is still far from being the case. One reason is feasibility concerns among physicians, who already have to manage a packed checklist during brief patient consultations. The average GP visit lasts 17 minutes, with just 5 minutes of patient speaking time. When the patient is dealing with multiple physical health challenges, mental health often gets sidelined.
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Medical training is also still lagging behind when it comes to recognizing mental health comorbidities. While doctors are often on the lookout for common physical health comorbidities (for example, congestive heart failure as a complication of renal disease), depression as a comorbidity of chronic illness isn’t commonly taught or paid attention to.
Furthermore, unlike screening tests for physical health conditions, which present objective signs of disease, mental health screening remains highly subjective, relying on a self-reporting model that assumes that individuals have the awareness, language skills and emotional readiness to discuss their mental health issues openly. Mental health stigma is still sadly a reality — even in healthcare settings — and prevents countless patients from seeking care.
How technology is enabling a paradigm shift
To make mental health screening a routine part of primary care, we need innovative solutions. Emerging technologies, particularly artificial intelligence (AI), are paving the way. AI can detect signs of mental health conditions by analyzing short voice clips, offering an objective and scalable method for screening. Scientific literature has long shown that the voice can reveal hidden mental health struggles, just as blood tests can indicate physical diseases. AI can process these vocal biomarkers, enabling early detection without disrupting clinical workflows or relying solely on patients to flag their struggles.
It is difficult to truly estimate the number of lives that have been saved thanks to screening tests for physical health conditions. AI could be the missing piece of the puzzle to bring the same level of preventative care to mental health. The need for this is especially critical right now, given that mental health resources across the country are being stretched thinner than ever. Nearly half of Americans live in areas that have a shortage of mental health professionals. Nationwide, 56% of psychologists say they have no openings for new patients and when they do, patients have to wait at least three months on average to see a therapist.
Emergency psychiatric care as well as therapy for moderate to severe mental health conditions are and always will be essential, but if we screen all primary care patients for mental health conditions, we can intervene early and prevent many severe cases from developing in the first place. Just as abnormal Pap test results can prevent a person from becoming a cervical cancer patient, early detection of signs of depression and anxiety has the potential to prevent mental health emergencies down the line and relieve the strain on providers. With tech-enabled routine screening, we don’t need to wait until a disease reaches an advanced stage before taking action.
Voice biomarker technology can bring a true paradigm shift in mental health care, paving the way towards a more proactive, responsive and inclusive health care system. This technology holds the potential to bridge gaps in care, ensuring that individuals who struggle to articulate their feelings are still seen, heard and supported. By integrating mental health screenings into routine care with the help of AI, we can create a healthcare system that truly addresses the full spectrum of human health — both physical and mental.
Photo: eakrin rasadonyindee, Getty Images
Prentice Tom, MD is Chief Medical Officer at Kintsugi, the AI-based mental health platform that helps clinicians detect depression and anxiety in patients using just 20 seconds of free-form speech.
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