Study: Majority of mental health patients would consider giving clinicians access to phone behaviors, locations

A small study published in JMIR Mental Health found that 84 percent of surveyed patients living with mental illness were willing to use apps that would collect and share biomarkers.
By Laura Lovett
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With the percentage of smartphone ownership skyrocketing to around 77 percent in America, smartphones have become constant companions. Recently, mental health professionals have kickstarted the conversation about how smartphone usage can help gauge a patient's wellness and behavior. 

Several apps have begun to emerge that will track a patient’s phone habits, behaviors, and even location through GPS. However, often these apps do not have access to a users content. For example, an app may be able to report if a user answered a text message, but wouldn’t have access to the content of the message. 

In a small study published by JMIR Mental Health, researchers from Canadian academic institutions found that 84 percent of participants living with a mental illness said they were completely willing or potentially willing to install such an app.

“The patients surveyed had a high incidence of ownership of internet-connected mobile phones, which suggests some plausibility for the general approach of mental health state inference through mobile phone data,” the researchers wrote in the study. 

Traditionally, patients with a mood or anxiety disorder self report their symptoms to a doctor. This can lead to missing information or even bias. 

“Patients may be unwilling or unable to answer accurately due to inaccuracy of recollection, psychopathology and/or biases, ambiguity in the questions, or lack of comfort with their clinician, among other factors,” authors of the study wrote. 

Researchers set out to see if patients would be open to an app that would passively be able to retrieve these smartphone-based data points. 

“Mobile data-based assessment is possible because of the large amounts of diverse information available from a modern mobile phone, including geolocation, screen activity, physical motion, and communication activity,” researchers wrote. “This data may offer much more fine-grained insight into mental state than traditional methods, and so we are motivated to pursue research in this direction. However, passive data retrieval could be an unwelcome invasion of privacy, and some may not consent to such observation.”

Researchers surveyed 82 participants that were new patients referred to a tertiary care mood and anxiety disorder clinic. Participants were asked to answer 13 questions.  First researchers asked if participants owned a smartphone, which showed that 89 percent or 73 of the survey takers owned a smartphone. 

Participants were asked about phone usage and also about their potential willingness to share specific data. Researchers then asked specifics — for example, would a participant be willing to give clinicians access to their phone metadata which would not include content. Another question asked if the participant would be willing to have the contents of their phone messages analyzed for clinically relevant words. 

Researchers found that 41 percent of responders said they would be willing to install an app that would help doctors better diagnose mental health problems and provide treatment. An additional 43 percent said that they “may be willing to use such an app, provided they were given more information about how the app functioned." Sixteen percent said they were not willing to use such an app. 

“This finding shows that there is a general positive interest in using mobile phone apps to aid in mental health assessment,” the authors of the study wrote. “Considering that the questionnaire expresses that such an app is believed to help both clinicians and patients but makes no claims about proven effectiveness nor does it quantify said effectiveness in any way, it is plausible that if such apps are to be developed and proved to be effective that rates of adoption may be higher than reported in this study once patients are presented with these findings.”

Both developers and clinicians have turned their attention to this type of technology. 

In June, Mindstrong, a company that uses phone activity to measure mental health and behavior closed a $15 million Series B funding round, bringing the company to a total of $29 million in financing. Mindstrong has been around since 2014, but really started grabbing public attention last year after former NIMH director Dr. Thomas Insel left Verily in order to work at the startup. It was cofounded by Insel and Dr. Paul Dagum, who patented the first digital measure of the central nervous system.

The digital psychiatry program Beth Israel Deaconess Medical Center has also been working on two apps to help monitor people living with mental illness. One of the apps uses the survey method, while the other will use digital biomarkers. 

“Now we can measure with self-report surveys, can measure behavior on the phone, with GPS how active you are, with calls and texts messages how social you are,” Dr. John Torous, co-director of digital psychiatry at Beth Israel and Editor in Chief of JMIR Mental Health, said at Mad*Pow’s Health Experience Design Conference in June. “Can we redefine what the lived experience of mental illness is and then can we match it up to all this biological data? … In some ways, we are looking to treat mental illness but are we going to have to redefine mental illnesses with these technologies.”