Rethinking Technology for Mental Health and Wellbeing Workshop

The recent pandemic has put mental health and wellbeing at the forefront of everyone’s minds. There is an increased interest in the role of technologies, technology designers and technology companies in supporting mental health. Consumer and enterprise technology solutions have become so pervasive in our daily lives and critical to our daily functioning that we cannot ignore the role of everyday technologies.  

This workshop invited interdisciplinary researchers, academics, advocates, designers, developers, clinicians, and people with lived experiences from public and private sectors to discuss the future of mental health technology research. Topics of discussion included:    

• Implications for technology design, deployment, and evaluation for community, accessibility, and accountability for individuals and clinical care    
• Implications for technology equity, policy and implementation for societal change    
• Privacy and security first perspective on technology design and development    
• Responsible and culturally competent AI and technology design practices and guidelines    
• Integrating mental health needs in product design and development    

The goal of this workshop was to set a collaborative agenda at the intersection of technology and mental health to understand where we can complement each other’s efforts, how we can better align our efforts, and where we should make further investments. As a tangible outcome of the workshop, we invited the speakers and the attendees to co-author and publish a report on comprehensive strategies and future directions discussed during the workshop.

Speakers

Junaid Bajwa

Chief Medical Scientist, Physician
Microsoft Research, NHS

Munmun De Choudhury

Associate Professor, School of Interactive Computing Georgia Tech

Piers Gooding

Senior Research Fellow, Melbourne Law School
University of Melbourne

Thomas Insel, MD

Author, Co-Founder & Executive Chair
Vanna Health

Terika McCall, PhD, MPH, MBA

Assistant Professor of Biostatistics (Health Informatics)
Yale University

Shri Narayanan

Professor, Niki & Max Nikias Chair in Engineering
University of Southern California

Theresa Nguyen

Chief Program Officer, Vice President of Research & Innovation
MHA

Jason Owen, PhD, MPH

Clinical Psychologist, Mobile Apps Team Lead
National Center for PTSD

Jessica L. Schleider, PhD

Director, Lab for Scalable Mental Health; Assistant Professor
Stony Brook University

Cal Thompson

VP of User Experience
Headspace / Headspace Health

Agenda

Session Details

• Panel 1: Community, Accessibility, and Accountability: Implications for Design

  Panel Abstract: Research on designing technology that supports mental health and wellbeing should consider the unique challenges and needs of individuals and communities in order to identify problem areas for which technology is an appropriate solution and to ensure that the design and deployment of the technology is rendered accountable to its promises. This panel brings diverse perspectives on the implications for designing technology that supports mental health and wellbeing, including a perspective from interfacing with the community at scale, a perspective from designing mindful user experiences, a perspective from leveraging technology as a tool to understand people, and a perspective from working across institutions to empower research on the whole-person context. What unique challenges and needs exist for different individuals and communities for which technology is or is not an appropriate solution? How do we design such technology solutions to be accessible and inclusive? How do we engage the community to have agency over the end-to-end design, usage, and evaluation of such technology? How can technology be leveraged to better inform our strategies around biopsychosocial interventions? How do we design technology tools and solutions responsibly and mindfully such that they do not pose additional harm to the mental health and wellbeing of their target populations?

  Theresa Nguyen  

  Youth are increasingly turning to the internet to seek advice about how to manage their mental health issues. Using data from over 5 million screeners a year at MHA Screening (www.mhascreening.org), MHA will share insights about the complexity of mental health challenges faced by youth and young adults. Our data and research explore what mental health conditions are most prescient among youth from diverse backgrounds along with their concerns, barriers and needs in thinking about support and access to care during the earliest stages of developing mental illnesses. We’ll share lessons on strategies including how crowdsourcing, participatory research, machine learning, and lived experiences are incorporated in the design of tools to overcome barriers, increase engagement, and meet the needs among youth. 

  Jessica Schleider  

  The discrepancy between need and access to mental health support is incontestable. This gap is particularly stark among adolescents: Up to 80% of youths with mental health needs go without services each year. Online single-session interventions (SSIs) are well-positioned to rapidly increase access to evidence-based supports, precisely at moments of need. Online SSIs mitigate key treatment access-barriers: they are self-guided (requiring no therapist); web-based (completable from any location); and 8-25 minutes in length, eliminating premature treatment dropout. SSIs are also effective. To date, >70 randomized trials have shown their capacity to reduce mental health problems, with sustained positive impacts up to 9 months later. In this talk, I will overview how my research lab, the Lab for Scalable Mental Health, has developed and evaluated free, anonymous, evidence-based SSIs for adolescents with depression—and how we have leveraged social media to disseminate our SSIs to >30,000 young people to date. In particular, I will highlight our approaches to promoting autonomy and agency, affirming identity, and overcoming access barriers to deliver SSIs to teens who are least likely to access traditional mental health care (e.g., LGBTQ+ and racial/ethnic minority young people). 

  Callie Thompson 

  In a data-driven product world of personalization based on preferences, and rapid experimentation to measure in-product human behaviors, it is our duty as designers and innovators to build whole-health, inclusive, accessible experiences that introduce new and healthy behaviors in our users’ lives, and make personal health gains achievable. Technology has an outsized role to play in supporting healthy behaviors in humans, and expanding users’ ideas about others, themselves, and what is possible. 

  Munmun

  A Decade Later: What We Have Learned from Utilizing Social Media to Improve Mental Health  

  Over the last decade, a growing body of work has witnessed social media data being used to computationally learn about and infer the mental health states of individuals and populations. There have been stories of many successes. And yet, questions about the theoretical, domain, and psychometric validity of this novel information source, or its underlying biases, when appropriated to augment conventionally gathered data, such as surveys and verbal self-reports continue to feature in contemporary discussions. This talk reflects on the speaker’s and her collaborators’ decade-long research in this space to both highlight the potential of social media in mental health, as well as to recognize its many pitfalls. As a path forward, the talk will present a few collaborative, multi-disciplinary, and multi-institutional initiatives as examples, where machine learning algorithms to glean mental health insights from social media are being developed in a context-sensitive and human-centered way, in collaboration with domain experts and stakeholders. The speaker will conclude with some speculations on what the next decade could bring to this line of research, both from the perspective of those who develop the technologies for mental health support as well as those who stand to be impacted by them. 

  Ebele Okoli 

  As we strive to define a collaborative agenda for supporting mental health, conducting research and driving digital mental health innovation, physical and digital accessibility are key. In addition, considerations for the diversity of the human experience (i.e., intersectionality) should be backed into all aspects of research to intervention design.  Establishing best practices for how to ensure your products are accessible and inclusive for mental health is paramount. The risk far outweighs any value we stand to gain should any players in the mental health technology space fail to do so. The wins lie in the consistent application of inclusive practices. 

  Junaid Bajwa  

  There is no health without good mental health”. As a community of innovators, aspiring to make transform healthcare for the most vulnerable in society, it is becoming increasingly critical for us to have a better understanding of the truly holistic nature of healthcare. Our understanding, and any impact we are able to make, will be enabled by access to relevant data/information across both traditional datasets, plus broader social determinant datasets as they become available. However, within the extensive domain of “Mental Health” related conditions, there appears to be a general paucity of accessible curated data upon which to undertake translational research and related innovation. How might we, as communities across tech companies, government, healthcare systems raise the importance of Mental Health, transform this space and ultimately drive better outcomes for those who may be amongst the most vulnerable in our society? 

• Panel 2: Digital Mental Health Equity, Policy, and Implementation: Implications for Social Change

  Panel Abstract: Technology has the potential to reach billions of lives. As mental health and wellbeing solutions become digitized, we need to consider whether the promises of such technology are being met for those who need it the most and they are not inadvertently introducing further disparities. This panel brings diverse perspectives on the implications for digital mental health technologies to bring lasting social change through appropriate policy and implementation practices, including a perspective on human-centered and inclusive design, a perspective on affective computing and challenges of engineering systems, a perspective from national dissemination of digital mental health solutions, a socio-legal perspective on digital mental health beyond liability, and a perspective on the future of digital mental health. How do we leverage technology to provide mental health resources to underserved communities? What is the role of engineering in mental health and how do we scaffold the process for open discussions around ethics, security, and privacy? What quality, safety, access, power, or policy issues should we be mindful of in designing such technologies to make progress towards closing the disparities gap? What challenges lie ahead of us in implementing such digital mental health solutions?

  Terika McCall

  For Us By Us: Inclusive Design and Considerations for Developing Digital Mental Health Technologies

  There is great potential to leverage digital mental health technologies to advance health equity. However, communities that are underserved have been historically underrepresented in the design process for digital health tools, creating intervention-generated inequalities. The importance of employing a user-centered design approach and co-designing with communities will be highlighted. Principles will then be illustrated by a case example: mobile app to support self-management of anxiety and depression among Black American women. Ethical considerations will be shared on the fallacy of creating something for us without us.

  Shri Narayanan

  Multimodal machine intelligence possibilities for mental health research and care

  Developments across the machine intelligence ecosystem, from sensing and computing to data sciences, are enabling new possibilities both in advancing science and in the creation of technologies supporting mental health research and its translation to practice. This talk will focus on some of our efforts in behavioral machine intelligence — algorithms and technologies for quantitatively and objectively understanding human behavior — with a specific focus on multimodal communicative, affective and social behavior. Examples spanning applications in screening, diagnostics, and treatment will be drawn from varied domains such as relationship issues, depression, autism spectrum disorder, addiction counseling and workplace wellbeing. It will also discuss the challenges and opportunities in creating trustworthy machine intelligence approaches that are inclusive, equitable, robust, safe and secure.

  Jason Owen

  Perspectives from building and disseminating self-management and treatment companion apps at scale for Veterans & trauma survivors

  The U.S. Department of Veterans Affairs (VA) is the largest integrated healthcare system in the United States, and digital health is a key component of the VA’s strategic vision to best meet the needs of U.S. Veterans and those that care for them. The National Center for PTSD (NCPTSD), chartered by Congress in 1989, has led the way in providing evidence-informed digital health tools for Veterans and others who have experienced trauma. PTSD Coach the first mobile app released by the VA in 2011, and NCPTSD now offers a core suite of 16 public-facing mobile mental health apps targeting PTSD, insomnia, anger and irritability, depression, alcohol abuse, relationship challenges, and more. In the past decade, the Mobile Mental Health Program at NCPTSD has done extensive provider and public-facing assessments, interviews, and user experience testing with Veterans and clinical providers. We know that there is strong demand, from both patients and providers, for digital health resources that can supplement face-to-face care or provide evidence-informed guidance and strategies to those who have not yet been able to connect with care. Providers and Veterans are looking for digital health solutions that have clear privacy standards, are readily available at the point of care, and provide up-to-date and evidence-informed information, features, and resources. Providers face myriad challenges in implementing digital care, including limited or changing access to private sector products, region-by-region approaches to implementing digital health, electronic records integration, and strict privacy and safety standards maintained by the VA. To respond to these needs and challenges, we have 3 teams dedicated to supporting digital health dissemination, implementation, and innovation: Public Digital Health Innovation Program (PDHIP), Center for Mobile Apps Research, Resources, and Support (CMARRS), and Technology into Care (TIC).

  Piers Gooding

  What are the main legal issues relevant to digital mental health products and practices? Which issues should developers, users and mental health practitioners be aware of? This presentation will go beyond health law and regulation, to outline issues arising in consumer law, data protection law, labor and employment law, and discrimination law. It will also consider international human rights law, asking what role digital mental health technologies might play in enhancing or, in some cases, threatening people’s human rights.

  Thomas Insel

  We are in the early phases of a revolution in mental health care. This revolution began with the simple shift from brick-and-mortar care to telehealth, increasing access for millions of people. Some of the largest providers of mental health care in 2022 are digital mental health companies that did not exist in 2012. While these companies have democratized care and could serve global needs, it is not clear that these providers have moved the needle on population health. That change will require tackling three challenges. First, we will need to improve the quality of care. An ambitious project (IAPT) in the UK has demonstrated that the quality of psychological care can be improved in traditional treatment settings at scale, but digital mental health innovators are just beginning to commit to performance improvement of their workforce. Better measurement, better training, and value-based payments will help. Second, we need to solve the engagement problem. Less than 50% of people who could and should benefit from care receive it. Why? Low engagement is usually attributed to stigma or lack of access, but the inconvenient truth is that these illnesses preempt their treatment. The wizardry of UX design and smart engineering can help, but we should not underestimate the challenge: depression confers hopelessness, anxiety involves avoidance, and many people with psychosis deny having an illness. Finally, to improve population health we will need to innovate for people with serious mental illness (including psychotic illnesses like schizophrenia and bipolar disorder). The 14.2M people with serious mental illness have been neglected not only by our health care system (and often relegated to the criminal justice system), but by entrepreneurs. These are the most expensive patients, yet they have the worst outcomes – a perfect storm for innovation. If we create the tools for recovery (both high tech and high touch) and ensure those tools are financed by public and private insurance, we can transform outcomes for people with serious mental illness. There are, of course, ethical concerns about digital innovations, but I will argue that these potential risks are less urgent than the profound injustice of our current marginalization and criminalization of those with serious mental illness. For them, a revolution in care cannot come quickly enough

Workshop organizers

Ali Benter (opens in new tab), Microsoft
Amanda Durkee (opens in new tab). Microsoft
Ebele Okoli (opens in new tab), Microsoft
Daniel McManus (opens in new tab), Microsoft
Jina Suh, Microsoft Research Redmond
Judith Amores, Microsoft Research New England
Jenna Butler, Microsoft Research Redmond
Kate Nowak, Microsoft Research Redmond
Kathy Dixon, Microsoft
Koustuv Saha, Microsoft Research Montréal
Mary Czerwinski, Microsoft Research Redmond
Robert Lewis, MIT
Sachin Pendse (opens in new tab), Georgia Tech
Sameer Segal, Microsoft Research India
Tracy Zhang, Microsoft

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