Erin Smith

In 2019, the software company Cloudflare made its initial public offering. Two of its 3 co-founders celebrated, while its third co-founder lived with a difficult diagnosis: frontotemporal dementia. A 

 chronicles his heart-wrenching decline, from a superstar programmer to a shell of his former self.

It is tragic to lose a brain with incredible aptitude. Countless others have suffered and will suffer the same fate: a brain robbed of its full potential.

Disruptions to brain health, such as mental health conditions and neurodegenerative diseases, are becoming increasingly prevalent. These disorders, many of which are preventable or at least treatable, carry heavy tolls on families and communities. Additionally, they cost the global economy trillions of dollars per year in lost productivity; in 2010, it was estimated that brain health disorders cost $2.5 to $8.5 trillion.

 This cost is expected to double by 2030.

The COVID-19 pandemic has accelerated the global decline in brain health. Not only does the COVID virus directly attack the brain (leading to symptoms ranging from brain fog to seizures), but the pandemic has also generated excessive fear, 

anxieties, sleep disturbances, and forced social isolation

 In addition to the personal toll, there is a concrete economic cost: McKinsey & Company suggest that roughly 90% of employers have noted declines in employee behavioral health during the pandemic (along with concomitant losses in productivity).

How will the rise of artificial intelligence (AI) and big data influence these trends? Will they pose new dangers to brain health and the current economic order? Or could they be beneficial too?

The use of data is a double-edged sword; while AI can help us tackle tough problems in areas like climate change and healthcare, it also presents a risk to millions of individuals’ livelihoods. McKinsey estimates that automation threatens to displace “as many as 375 million workers—or roughly 14% of the global workforce” by 2030.

To manage this transition, business, civil society, and government leaders must initiate large-scale reskilling efforts. In these programs, brain skills will take center stage. Meta-cognition—that is, self-awareness of your own learning process—is central to this. Since any individual’s work skills will have a limited shelf life in a fast-changing world, the ability to understand and learn new things throughout one’s life is crucial.

Employees of the 21st century must continuously acquire knowledge, creativity, and flexibility to race with, and not against, machines. Doing so means re-imagining our brains and their value.

Brain Capital is a form of capital relevant to a complex, interconnected, and fragile global economy that puts a premium on brain skills and brain health.

 Brain skills include self-control, emotional intelligence, creativity, mindfulness, compassion, altruism, systems thinking, metacognition, critical thinking and cognitive flexibility; these skills are all dependent on brain health. Optimized Brain Capital creates flourishing, a state when people find fulfillment in their lives, social connectedness, and accomplishing meaningful and worthwhile tasks.

The growing role of artificial intelligence in the global economy has inspired the saying that “data is the new oil.”

 While the importance of data is hard to overstate, we believe that the convergence of several factors makes Brain Capital a resource essential for understanding and assessing the success of our modern economy and society.

The Brain Capital concept applies at the individual, organizational, national, and global levels. The individual certainly receives a massive payback from investing in Brain Capital. Similarly, organizations who can nurture and support Brain Capital will find performance and results significantly improving. At a national level, we believe that policymakers will increasingly recognize the importance of optimizing Brain Capital for national progress. If the nation takes care of Brain Capital, many things will then take care of themselves. At the global level, many of the immense challenges that can only be solved collectively—climate change, biodiversity loss, for example—require co-operative problem solving and associated skills emphasized by Brain Capital.

Improving Mental Toughness and Resilience

A focus on Brain Capital can help nurture key higher-level brain skills, like resilience, mindfulness, grit, adaptability, and confidence. Resilience is essential to navigating shocks of constant change, and the shocks of the 21st century are set to be of unprecedented magnitude. Climate change, nuclear weapons, biotechnology, cyber-terrorism, and advanced machine learning systems might all pose existential risks to humanity, as well as increasing stress at the individual level. To respond to the inevitable crises of this century, we must show extraordinary resilience, both collectively and individually. COVID-19 has shaken the global psyche and socio-economic systems. Renewed commitment to inventing new methods and approaches will be essential to help our economy and societies recover from the COVID-19 crisis and to transform it, hence enhancing its resilience to future shocks and crises. 

In recent years, misinformation and science denialism have played a large role in global politics and public opinion. Misinformation in the era of COVID-19 is directly harmful, encouraging unsafe practices based on false but popular beliefs (eg, masks can lead to oxygen deprivation).

 The President of the Red Cross even labeled the dissemination of fake news about vaccines a “second pandemic.”

 Strengthening brain skills can help people evaluate existing information, become better critical thinkers, and avoid the proliferation of dangerous fictions.

While we believe Brain Capital deserves to play a larger role in the global conversation and policy, the title of this piece does not intend to disparage the importance of data. On the contrary, we believe that the 2 resources are complementary and inextricably linked.

Data are needed to improve brain wellness: artificial intelligence is enabling automated mental health solutions and aiding in the early diagnosis of neurological diseases. Digitization of existing, proven techniques allows scaling of benefits (eg 

 with mindfulness meditation). The scaling of proven techniques is critical in low- and middle-income countries where there are not enough trained mental health care workers—hence e-health, m-health, and telemedicine are vital.

 More broadly, computational neuroscience is a burgeoning field. The 

 in the US, which seeks to map functional circuits in the brain, is leveraging the latest and greatest in computational techniques. In Europe, the 

 is using supercomputers to build a digital simulation of the brain. The 

 seeks to compile data on the connections between neurons in the brain. There is also growing interest in the development of brain-computer interfaces (such as Musk’s 

) which aim to further interweave minds with machines.

Similarly, Brain Capital is the key resource needed to improve the data ecosystem: investment in brain health and brain skills helps foster the growth of curious, intelligent, well-adjusted knowledge workers to extract and use data. Further, Brain Capital will help ensure that society can function at the intersection of intelligence and wisdom, instilling robust ethical frameworks into actions that ensure more equitable progress.

Despite the current planetary emergencies and challenges that await us, there are reasons to be hopeful. For instance, the economic importance of mental healthcare has inspired many business leaders to act. McKinsey & Company

 have both recently published reports on the importance of mental health in the workplace. The 

 (created in partnership between Thrive Global, SAP, Qualtrics, and Fortune) aims to quantify employee well-being and its impact on business goals. An article in the 

$4 is returned to the economy for every $1 spent caring for people with mental health issues

 As many have come to believe that mental healthcare is an important and underserved market, money has followed in suit. Venture capital funding for mental health startups has skyrocketed: a recent editorial in 

 notes that in 2019, VC firms “invested a record-breaking $637 million in more than 60 different mental health–oriented companies, which is more than 22.8 times the investment in 2013.”

All this initial evidence points to the immense benefits of optimizing Brain Capital at every level. We hypothesize that Brain Capital has enormous positive externalities and spillovers. If Brain Capital is optimized at the individual level, it has a strong positive effect on family, community, and co-workers. If my organization nurtures Brain Capital, it makes my work (and life) better, and contributes to the nation, including in reducing individual and economic losses from brain disorders. If the nation focuses on Brain Capital, individuals and organizations all benefit.

We also hypothesize that the constituent elements of Brain Health and Brain Skills are themselves highly synergistic. If my critical thinking improves, my creativity also goes up. If I emotional intelligence is strengthened, resilience, grit and confidence improve. If my mindfulness improves, the propensity for mental illness declines.

Overall, we believe that a focus on Brain Capital will set up a synergistic cycle resulting in a significantly better society and economy.

Based on these hypothesized benefits, a diverse group of global experts recently proposed a 

 aimed at building on the Brain Capital, and reorienting the global economy around optimizing for higher Brain Capital.6The group prescribes an in-all-policies approach, suggesting a role for Brain Capital in policy areas ranging from Foreign Affairs & Trade (where a “brain health diplomacy”

 approach is proposed) to Aerospace & Aviation (where, for instance, long-duration spaceflights may present unique mental health challenges).

 Additionally, they outline a Brain Capital Investment Plan, leveraging traditional (eg venture capital, government grants) and novel (eg new collaborations like the 

) sources of capital. Finally, the team of experts encourage the development of a Brain Capital Index to formalize and track Brain Capital over time.

Brain Capital is of the utmost importance. By focusing global efforts towards continually building brain skills, early detection of negative changes, and treating brain disorders, we can help meet the challenges of the 21st century. We must build a future that prioritizes people and gives individuals the resources necessary to develop their full potential and well-being.

is a machine learning researcher at Stanford University.

is an associate with the PRODEO Institute.

is the founding director of the Center for Brain Health at UT Dallas.

is SVP and Head of Technology Investing, GIC.

is a venture partner at Alsop Louie Partners.

is a partner and Chief Economist at PWC Nigeria

is a senior oil and gas executive and investor.

is head of the OECD New Approaches to Economic Challenges Unit.

is president of the Euro-Mediterranean Economists Association.

is a co-founder of the PRODEO Institute and adjunct associate professor with the Institute for Mental and Physical Health and Clinical Trials (IMPACT) at Deakin University.

1. Upson S. The devastating decline of a brilliant young coder. 

https://www.wired.com/story/lee-holloway-devastating-decline-brilliant-young-coder/

2. Harvard School of Public Health, World Economic Forum. The global economic burden of non-communicable diseases. September 2011. 

http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf

3. Carson J, Eyre H, Lavretsky H. Dear mental health innovators: the COVID-19 honeymoon is almost over. 

https://www.psychiatrictimes.com/view/dear-mental-health-innovators-covid-19-honeymoon-almost-over

4. Coe E, Enomoto K, Gupta A, Lewis R. National employer survey reveals behavioral health in a COVID-19 era as a major concern. 

https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/national-employer-survey-reveals-behavioral-health-in-a-covid-19-era-as-a-major-concern#

5. Illanes P, Lund S, Mourshed M, Rutherford S, et al. Retraining and reskilling workers in the age of automation. 

https://www.mckinsey.com/featured-insights/future-of-work/retraining-and-reskilling-workers-in-the-age-of-automation#

6. Smith E, Ali D, Wilkerson B, Dawson WD, et al. Brain Capital grand strategy: toward economic reimagination. 

https://www.nature.com/articles/s41380-020-00918-w

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University of Pennsylvania Authentic Happiness

https://www.authentichappiness.sas.upenn.edu/newsletters/flourishnewsletters/newtheory

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https://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00393-4

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Articles

What consequences will big data and artificial intelligence have on brain health and economics? 

Move Over Data, Brain Capital is the New Oil

Modern mental health problems are characterized by their complexity, multi-systemic nature, and broad societal impact, hence making them poorly suited to siloed approaches of thinking and innovation. The New England Journal of Medicine recently published an article that articulated the stark limitations of an increasingly siloed focus on biologic knowledge in psychiatry.

 The article describes how the biological revolution of the 1980s has failed to live up to its therapeutic or scientific promise, with a comprehensive biologic understanding of the causes or treatments of psychiatric disorders yet to be discovered. Further, the article argues that psychiatry faces a new set of challenges, such as a professional diagnosis being reduced to a “checklist-style amalgamations of symptoms,” and an alarming degree of “trial-and-error medication management” taking over practice.

Psychiatry is characterized by multiple complex interacting, biological, social, medical, psychological, and related systems. Consequently, it is important to note that these challenges are not nostalgic arguments for a return to the insular, often unscientific psychodynamic practice of psychiatry that marked the 20th century. Instead, they indicate the need to forge a new path, one with an approach ready to meet the unprecedented and complex systemic mental health challenges of the 21st century.

Indeed, the 21st century will be largely defined by our collective response to the global mental health crisis. According to a recent World Health Organization (WHO) report, around 450 million people currently suffer from mental health conditions, making brain disorders among the leading causes of ill health and disability worldwide. The world’s failure to respond to the mental health crisis has resulted in a “

 of human capabilities and avoidable suffering.”

 Many of these issues will be magnified by COVID-19 that will result in social and physical distancing, economic hardship, and challenges in accessing care (

A paradigm shift is needed in order to solve the unprecedented complexities and challenges associated with the current global mental health crisis. Indeed, scientific progress may be seen as “a series of peaceful interludes punctuated by intellectually violent revolutions.”

 A convergence science approach is needed to address the global mental health crisis, bringing about an urgently needed revolution in science and society.

Convergence science integrates knowledge, tools, and thought strategies from various fields for tackling challenges that exist at the interfaces of multiple fields.

 In the context of mental health, convergence involves the integration of scientists, clinicians, bioinformaticists, global health experts, engineers, technology entrepreneurs, medical educators, caregivers, and patients. Synergy between government, academia, and industry is also vital. Convergence mental health is the approach used for mental health (

Innovation and entrepreneurship with convergence science

COVID-19 can provide a framework for a convergence science approach to tackling the global mental health crisis. Akin to 

 efforts, solutions to the global mental health crisis will require the traditional sciences of chemistry, biology and virology, and the new sciences of big data and artificial intelligence, computer science and statistical models, and -omics medicine. Subsequently, solutions will need sociologists, psychologists, philosophers, ethicists, scientists, media practitioners, crisis management experts, policy makers, and senior civil servants.

The demands of today’s global problems—especially the mental health crisis—also necessitate a fundamental shift in approaching education and workforce development. Individuals in a convergence science workforce must be equipped with deep expertise in their field, while also having literacy and understanding across a broad range of disciplines necessary for transdisciplinary collaborations.

We must be willing to rethink education and training for researchers, clinicians, and others within traditional health care fields. Education needs to shift toward skill sets adaptable to diverse problems. Unconventional skills and topics, such as design thinking, entrepreneurship, computer science, cryptography, and the like, could be incorporated into learning. Creative education opportunities such as mini-fellowships or exchanges may facilitate divergent thinking.

Traditional education pathways as the sole means of involvement in mental health research must also be reconsidered. To develop innovative solutions, a diverse array of solvers is needed. Collective intelligence—including citizen scientists—must be leveraged. Bansho, the Japanese method of collective problem-solving, teaches people to grasp connections and progressions of the thinking needed to develop solutions. It may provide a framework for education and training modules for convergence science researchers.

 was co-founded by Alph Bingham, PhD, and Aaron Schacht to crowdsource solutions to the most intractable solutions.

 As a space for dialogue between specialists and industry outsiders was created, fresh ideas to persistent questions were found. A chemist from Illinois, John Davies, was able to use an idea from his earlier career in construction to help solve the cleanup of the Exxon Valdez oil spill on Alaska’s coast.

 Other organizations have also utilized the InnoCentive model, including 

, which is dedicated to problems in machine learning.

 Both InnoCentive and Kaggle have methods that are currently being adapted to develop solutions for COVID-19 related issues and could be used to develop mental health solutions in the future.

In low- and middle-income settings, where there are few psychiatrists, greater deployment of community health workers is important to provide essential care. This requires transdisciplinary thinking. A recent clinical trial explored the role of lay counsellors in providing a “depression in later life” intervention in Goa, India.

 In this randomized clinical trial, lay counselors provided problem-solving therapy, brief behavioral treatment for insomnia, education in self-care of common medical disorders such as diabetes, and assistance in accessing medical and social programs. The intervention was effective for preventing episodes of major depression in older persons with subsyndromal symptoms. Furthering the reach of lay counsellors, promising trial data now show the value of internet- based behavioral activation with lay counsellor support for the treatment of depression.

A convergence workforce adept at navigating the adoption of new technological innovations is especially important. Technology will continue to fundamentally shift the way we conceptualize and treat mental health conditions. For example, Mindstrong aims to provide continuous digital biomarkers of mood and cognition to support diagnosis, prognosis, and treatment monitoring.

 Born from convergence science, Mindstrong originated from prior work of co-founder Paul Dagum, MD, PhD, in cybersecurity. Adopted for mental health conditions, it may make it possible to detect prodromal stages of mental health conditions, enabling objective measurements and the opportunity for early intervention and prevention.

The same technologies used for early detection and monitoring may also be used to deliver treatment and interventions. For example, 

 builds clinically validated cognitive therapeutics, assessments, and diagnostics that look and feel like video games and has submitted 

for people with attention-deficit/hyperactivity disorder for FDA approval.

 A recent review of the mental health technology field projected there will be 1000 mental health startups by the end of 2020.

 See the Examples of Convergence Mental Health in Action at the end of this article for more information.

The progress in technological advancements like the printing press and developments in science, art, philosophy, and trade that underpinned the Renaissance period was sparked by a convergence approach that merged science and humanities.

 A similar revolution will occur with convergence mental health solutions, ensuring greater integration of social sciences in care. Mental health is an inherently human undertaking. Indeed, convergence mental health should employ considerations from the new field of responsible innovation in mental health, which is “a collaborative endeavor wherein stakeholders commit to clarifying and meeting a set of ethical and social principles by designing solutions to sustainably address the needs and challenges of mental health systems.”

Convergence mental health must also address the social determinants of health and be mindful of the world’s immense cultural diversity. Addressing the social determinants and cultural components of mental health requires rethinking our concept of disease and integration among health systems, local community partners, and coordination at a national or international level. Ensuring that there is a place for social science is critical to achieve a convergence approach and provides an opportunity to prevent mental health disorders, improve mental health at a population level, and reduce social and health inequalities.

Psychiatry has a major opportunity to leverage convergence science that will lead to innovation and progress. Ultimately, convergence mental health will help usher in a new era of care marked by bridging the divergent fields of medical practice, integrating insights from the brain and mind. Convergence mental health holds the potential to integrate technological innovations, insights from other areas of medicine, paradigmatic research shifts that blur existing boundaries between academia and industry, social determinants of health, philanthropy, and unconventional funding mechanisms. These changes will result in better patient outcomes and ensure greater health justice for all people by preparing psychiatry to meet the unprecedented mental health challenges of the 21st century.

We hope to offer brainstorming opportunities and solutions in our forthcoming book, Convergence Mental Health: A Roadmap Towards Transdisciplinary Innovation and Entrepreneurship, scheduled for publication in late 2020. We only hope to keep up with the world that is rapidly changing in front of our eyes.

is Brain Health Venture Executive, Founder and CEO, FacePrint, and 

is Affiliate, Department of Computer Engineering Stanford University, Palo Alto, CA. 

is Distinguished and Emeritus Professor of Psychiatry, University of Pittsburgh, Pittsburgh, PA. 

is Professor of Psychiatry, Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, ORYGEN Youth Health, The Florey Institute for Neuroscience and Mental Health, University of Melbourne, Victoria, Australia. 

is Instructor in Entrepreneurship, Global Brain Health Institute (UCSF and Trinity College Dublin); Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, University of Melbourne; Brainstorm Laboratory for Mental Health Innovation, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA; and Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia. 

 is Professor of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA. The authors report no conflicts of interest concerning the subject matter of this article.

—Dr Berk is supported by a NHMRC Senior Principal Research Fellowship (1059660 and 1156072).

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A paradigm shift is needed in order to solve the unprecedented complexities and challenges associated with the current global mental health crisis.

Erin Smith

Articles

Move Over Data, Brain Capital is the New Oil

Convergence Mental Health: A New Pathway for Transdisciplinary Innovation and Entrepreneurship