Digital Mental HealthDavid C. Mohr, Ph.D.Northwestern UniversityFeinberg School of Medicine

www.cbits.northwestern.edu

DisclosuresHonoraria/Consulting fees

Otsuka PharmaceuticalsOptum Behavioral Health

Ownership InterestActualize Health

FundingNational Institute of Mental Health

P20 MH090318

R01 MH100482

R01 MH095753

R01 MH109496

R34 MH095907

Verizon Foundation

Mental Health12 Month Prevalence:

• >61 million (20-25%) American adults will meet criteria for a mental health disorder in any given year.• 24 million (9.5%) Mood Disorders

• 44 million (18%) Anxiety Disorders

Workforce is Inadequate:

• 21% receive “minimally adequate” care in any given year.

• 350,000+ mental health professionals needed (>twice what we have).

Geography:

• 90 million Americans live in federally-designated Mental Health Professional Shortage Areas (55 million for primary care, 45 million for dentistry)

What is Digital Mental Health:CBT delivered via different platforms

Didactic Content Homework Exercises

Human Support

Research and Practice

~100 RCTs show that

• Self-directed digital treatment are at best minimally helpful.

• Coach-supported web-based interventions

• Appear to be as effective as standard treatments (ds=.56 – 1.08)

• Coaches do not have to be mental health professionals

Lots of Validation

Richards D, et al. Clin Psychol Rev 2012;32:329-342.

Alvarez-Jimenez M, et al. Schizophr Res. 2014;156:96-106. Mohr, et al., Psychiatric Services, in press.

Real World

Implementation

Research-to-Practice GapDigital mental health technologies are poorly designed

IntelliCare Platformwww.intellicare.northwestern.edu

Apps in

www.cbits.northwestern.eduR01 MH100482

Diagnostic Status at End of Treatment

14.00%

22.00%

45.00%

40.00%

42.00%

37.00%

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00% 50.00%

ANXIETY

DEPRESSION

Full Remission Recovery Symptomatic

Mohr, et al. J Med Internet Res. 2017;19(1):e10.

Average App Launches over 8 weeks: 195Average time: 1.1 min (Median = 17 seconds)

2123

2527 28 29

26 26

0

5

10

15

20

25

30

35

1 2 3 4 5 6 7 8

Average # of App Launches Per Week

Week www.cbits.northwestern.eduAve

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Ap

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r W

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New Directions in Digital Mental HealthValue-Burden Ratio

Personal SensingReview: Mohr, et al.. Annu Rev Clin Psychol. 2017;13:23-47.

www.cbits.northwestern.edu

Challenges• Lack of reproducability

• Variability

Thanks to our funders and team!Some of our Team

Stephen Schueller, PhDKonrad Kording, PhDKen Weingardt, PhDMadhu Reddy, PhDEvan Goulding, MD

Bernice Ruo, MDKate Tomasino, PhD

Emily Lattie, PhDColleen Stiles-Shields, MS

Chris Karr, MASusan Kaiser, MPHSohrob Saeb, PhD

Darren Gergle, PhDEric Carty-Fickes, MS

Chris Brenner, MSand many more…

Funding:National Institute of

Mental HealthP20 MH090318 R01 MH100482 R01 MH095753R01 MH109496R34 MH095907

Verizon Foundation