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How the American Psychiatric Association wants to transform mental health care

Inaugural 'Innovation Lab' encourages new ways to improve access, diagnosis, and treatment

As technology advances, accessing mental health care is getting easier. Apps, for example, can help with everything from anxiety to providing support from bullying to managing symptoms of post-traumatic stress disorder. But innovators in psychiatry say they want to see much more creative problem solving in their field. It's an area with the potential to help large numbers of people; one in five adults experiences diagnosable mental illness each year.

"We're really failing to treat patients adequately, and many patients can't get access to the care that they need," said Donovan Wong, the medical director of behavioral health for Doctor on Demand, a smartphone app that quickly connects people with health care providers. "The upside is I think there is a lot of opportunity to do things in a different way."

That's where the American Psychiatric Association's inaugural Innovation Lab comes in. The event, where Wong will serve as a judge, is set for May 15, during the group's annual conference. The goal is to bring together seven teams of finalists, chosen from an open call for submissions, to work on their ideas for improving mental health care, with the winners receiving $2,500 at the end of the three-hour session.

The association is looking for a broad range of ideas, including ones that address access to care, disease prevention, diagnosis, and treatment, said Nina Vasan, a Stanford psychiatry resident and the event's chair. So far, she's seen submissions that propose teaching users mindfulness through an app, using a smartphone to detect psychosis early, and using cultural media to improve access to care.

"Every day clinicians, patients, and their loved ones are coming up with ideas on how to improve mental health care," Vasan said. "The Innovation Lab will teach people these principles so they can turn their ideas into sustainable solutions."

Vasan is assembling a panel of judges and 40 innovation leaders from a variety of backgrounds to work with the teams of finalists. Beyond psychiatry, they hail from areas like business, technology, nonprofits, and government.

"We're going to objectively pick a winner, but I think a big part of this is about the process — bringing people together to think about this and gain different perspectives," Wong said.

A crucial part of finding solutions to issues in mental health care is involving people who have firsthand experience with mental illness and substance abuse. Tristan Gorrindo, the association's director of education, argued that patients have never been as involved in their own care as they are now, especially as ways of self-monitoring health — including through trackers like FitBits and Apple Watches — continues to grow.

People with lived experience and caregivers are also encouraged to apply for the lab's innovation leadership positions so that their voices can be heard. (Applications are due April 29.)

"How do we partner with our patients in this innovative space and develop new ideas or new technologies that help the patient and bring them along, but help them inform clinical care in a meaningful way?" Gorrindo said.

Innovation, for the purposes of the upcoming lab, isn't limited to high-tech solutions. What's more important than the flashiness or complexity of a given idea is its potential to be evaluated scientifically, so experts can determine its effectiveness.

As an example, Vasan points to the Luminosity app, which claimed to boost users' memory and help stave off Alzheimer's. The Federal Trade Commission ended up fining the company $2 million, because the lofty claims couldn't be proven.

"I think the interest and excitement is there, but in terms of the data and proof that we know these are sustainable solutions," Vasan said, "I don't know that we have that yet."

Innovators in psychiatry face another challenge, one that's more unique to the field: stigma. Many people are reluctant to seek treatment for mental illness and substance abuse due to pervasive negative attitudes held by the public.

Technology, such as apps that connect people with doctors or target minority communities, can help by lowering the barriers to treatment and allowing people to get the help they need more discreetly, with less in-person interaction. But that won't solve everything.

"If you create an app aimed at combating stress versus combating depression, people are much more willing to admit to themselves or even recommend to others that they try out something for stress over something for depression," Vasan said. "The content of the app could very well be the same thing, but the way in which it's presented, one in a less stigmatized way, can really make a difference in terms of whether or not people use it."

Ultimately, the association's hope for the Innovation Lab is that whatever people come up with has life beyond the meeting. Rather than leaving with polished ideas, participants will theoretically use the time as a jumping off point for collaborating with colleagues and, from there, move forward to iron out challenges that arise.

"I don't think this experience is a one-off. It's new to psychiatry," Gorrindo said. "We'll see how well people gravitate toward the idea. It's exciting to be a part of that first wave."

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