Digital medicine: Solving the mental health crisis

Digital medicine: Solving the mental health crisis


The pandemic’s long-term impact on mental health unfortunately continues to grow. A May APA report revealed that the pandemic has impacted the mental health of 43 percent of adults, up from 37 percent in 2020.

The Virtual Care Gap

In response to the mounting mental health crisis, investors poured a record 1.5 billion dollars into the mental health industry in 2020, more than five and a half times the total amount of funding in 2016. Despite increased investment, longstanding mental health access issues persist. One in four Americans still don’t have access to in-network therapists and more than half of counties in the U.S. don’t have a single psychiatrist.

Increased funding for digital mental health solutions catalyzed a monumental shift in mental health care delivery when the pandemic reduced access to in-person care. A report from Cigna, shared that virtual behavioral health services were the most utilized specialty in 2020 and that the majority of Cigna’s behavioral health patients are still using teletherapy in 2021.

While virtual care can reduce administrative burdens and remove location barriers that inhibit access to care, these improved efficiencies are incremental, not transformational. Today, about 60 percent of people who seek mental health care still do not receive it. This discrepancy stems from the fact that our current supply of mental health professionals cannot fundamentally meet the growing demand for mental health services. The United States only has 30 licensed psychologists per 100,000 people. Even when you take improved efficiencies through virtual care into account, we still fall woefully short of filling this gap.

We Have a Drug Problem

I often say that we are looking the wrong way when it comes to mental health. Despite significant attention and investment in virtual mental health care, simply bringing therapy online cannot solve the mental health crisis alone.

Since we cannot meet demand for mental health care through our current approach, the majority of people with mental health conditions are left with one option to address mental health problems — drugs. In fact, over three-quarters of patients with mental health problems receive medication. Medication provides people with an accessible and affordable way to tackle their problem. Unlike therapy, you can easily produce more pills to reach those who need it.

Although medications are effective for some, they may not be suitable for all. The majority of people using the most common mental health medications experience moderately severe side effects, and fewer than half benefit sufficiently. Between 1996 and 2013, the number of adults who filled a benzodiazepine prescription, a common mental health medication, increased by 67 percent, and the quantity of benzodiazepines consumed more than tripled. It’s clear that, while medications are the most common mental health treatment, they are high-risk, and often ineffective for long-term recovery.

Making a fundamental shift to address the mental health crisis takes much more than just producing more drugs, and still hasn’t been solved by shifting therapy online. We must reimagine the way we deliver care to support the millions of people who are still searching for solutions.

Digital Medicine: A New Approach

According to the National Institute for Health and Care Excellence (NICE) and the American College of Physicians (ACP), non-drug therapies including behavioral medicine are the preferred first-line treatment for the most common mental health issues. For decades, treatment was primarily administered by human therapists, or through manual and time-consuming processes like books. Through extensive research, we can now deliver evidenced-based behavioral medicine digitally, in a way that is effective and engaging.

Software helps to close the gap by offering safe and effective non-drug alternatives for mental health. Consider the standard drug development model: A pharmaceutical company discovers a molecule, tests it, and eventually manufactures the molecule. Switch “molecule” with “algorithm” and the dynamics should fundamentally work the same. With pure algorithmic software, it’s possible to create near infinite copies without any reduction in quality.

This approach is possible today through the thoughtful development of digital therapeutics. Digital therapeutics deliver evidence-based, clinically evaluated software to manage, and prevent a broad spectrum of health challenges.

The future of mental health care – which I call Digital Medicine – must draw a distinction between therapist-delivered telehealth and digital therapeutics in order to access on-demand and personalized care that addresses the limited scalability of in-person or virtual therapy, due to the lack of highly trained providers. My company, Big Health, offers digital therapeutics for poor sleep and worry & anxiety. Through robust clinical evidence, including more than 60 clinical papers and 13 randomized controlled trials, we have shown the safety and effectiveness of digital therapeutics. Our solutions have helped 76 percent of patients obtain better sleep and 71 percent of patients move from clinical to non-clinical worry and anxiety levels.

Digital Medicine is about delivering consistent and measurable results at scale. In-person therapy, teletherapy, and drugs will always have a role in health care delivery, but over the last eighteen months it has become increasingly apparent that we cannot fundamentally solve the mental health crisis with these solutions alone. Through digital therapeutics, we have a once in a lifetime opportunity to reinvent how we develop and deliver medicine. Software that is backed by science, in compliance with FDA regulation, and verified through clinical research will provide the right kind of scalable, consistent, and affordable approach that addresses the mental health crisis once and for all.

Picture: Big Health