AsianScientist (Oct. 24, 2021) – Whenever we feel feverish, getting confirmation is often no more complicated than reaching for a thermometer. Backed by extensive clinical data, physical diseases often have distinguishable symptoms and known biomarkers, alongside lab tests for diagnosing and monitoring patient trajectories.
However, mental health disorders are not as clear-cut, with most lacking quantitative biomarkers. Varying from patient and clinician, subjective experiences are difficult to interpret, whether for diagnosis or evaluating treatment effectiveness.
Because of these gaps, mental disorders remain understudied, underdiagnosed and undertreated. Singapore is not spared from these challenges, despite steps to improve access such as through community-based programs and training for health professionals.
According to Professor Benjamin Seet, Deputy Group Chief Executive Officer for Education and Research at Singapore’s National Healthcare Group (NHG), mental illnesses should be treated like all other medical conditions—which would require a more robust evidence base.
Social factors, prescription histories, sleep patterns and physical activity are all data points that can provide additional insights into patients’ mental health. Such data can transform how care is provided—from treatment innovation to prevention to clinical and community care.
By leveraging digital innovations to create urgently needed mental health solutions, Singapore can pave the way to raise the standard of care for those in need.
Tackling data gaps
In many Asian societies including Singapore, the stigma associated with mental disorders often dissuades people from seeking help and fully divulging their sentiments and needs to clinicians. Lack of access due to high costs, limited numbers of specialists and geographic distance also barricade individuals from receiving the care they need.
When they do gain access to mental healthcare providers, diagnosis and management are limited to the clinic, reliant on brief consultations. Even with follow-up sessions, patients may only get to meet doctors once every few weeks or months, noted Seet.
Especially in psychiatry, unstructured clinical notes are challenging to interpret, compared to quantitative data from lab tests or scans. Besides potentially leading to inadequate or inappropriate care, these gaps also pose a challenge for mental health research and analytics.
“Clinical management today is based on snapshots of the patient’s medical condition,” Seet shared, with such fragmented accounts failing to capture the range of daily experiences that can impact patients’ mental health status.
As ups-and-downs are inevitably part of the patient journey, the data used to manage mental health conditions has to match the depth and diversity of these personal experiences and contexts. Real-world data can provide more comprehensive insights into each patient’s day-to-day lives, thus enabling better monitoring of their behavioral changes.
Through artificial intelligence (AI) tools like natural language processing models, free text clinician notes are translated into structured information and quantifiable indicators, such as symptoms or stressors.
Such enriched evidence can help mental health researchers and drug developers to better understand disease severity and changing conditions over a longer period. This can change how a medical condition is diagnosed, as well as lead to more accurate diagnoses, more effective interventions and a wider range of treatment options.
Translating evidence into practice
Diverse patient experiences call for appropriately diverse and personalized interventions. Through AI-powered analytics, clinicians can profile disease risk and gain a better grasp of individual contexts. With deeper interpretations of rich patient data, care choices are adapted to evolving personal needs.
“Through AI, we can provide personalized nudges to modify health behavior risks, as well as to sustain positive changes over an extended period,” Seet explained.
Besides analytics, doctors can prescribe software medical devices called digital therapeutics apps as part of the treatment plans for mental health disorders. Through these innovations, care is no longer limited to the hospital but extends into the home.
To help substance use disorder outpatients stay healthy beyond the clinic, Singapore’s Health Sciences Authority approved in 2020 US-based company Pear Therapeutics’ reSET app, which provides personalized therapy sessions to encourage treatment adherence and prevent relapses.
Transforming the entire system
For Seet, developing healthcare innovations to meet these needs will rely on close partnerships between hospitals and health tech companies.
“These partnerships would ensure a faster development cycle, so that we end up with a product that doctors need and are prepared to use,” he added.
Earlier this year, NHG and Institute of Mental Health (IMH) signed a Memorandum of Understanding with Holmusk, a leading global data science and digital health company building the largest Real-World Evidence (RWE) platform for behavioral health. Through this collaboration, Holmusk will work closely with NHG and IMH to co-develop new tools to improve mental healthcare in Singapore with digital technology, data and predictive analytics.
While companies like Holmusk take care of developing innovative technologies, hospitals can support these efforts with clinical feedback, in turn driving further innovation. Combine this with real-world insights, and communities will benefit from a more integrated and responsive mental health system.
“Digital phenotyping, digital biomarkers and digital therapeutics will be part of the future of psychiatry,” Seet highlighted. “Singapore has the right tech environment to roll out digital health at the community level, as well as extend the reach of our innovations into the region and beyond.”
With the right investment of support and resources, Singapore has the opportunity to become a leader in mental health innovations that bridge clinics and communities to ensure care—building the future of digital mental health as early as today.
Asian Scientist Magazine is a media partner of Holmusk.
Copyright: Asian Scientist Magazine; Photo: Oi Keat Lam/Asian Scientist Magazine.
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