Psychiatrists are on the front lines of the troubling state of mental health care in America. Our patients demonstrate the diversity of problems faced in mental health, including poor access, demand that far exceeds supply, high costs, and stigma. As the US population grows, insurance coverage and reimbursements shift, and the cohort of psychiatric providers is unevenly distributed across the country, the supply and demand mismatch will only worsen. Awareness of these limitations often makes it difficult to appreciate that we are also at the front lines of exciting, hopeful new solutions to these problems—as long as we pay attention to the progress happening around us and learn how best to integrate it into our practice.
There is a strong imperative to develop innovative and scalable solutions that address the gaps in access to and quality of care; and solutions are being created by various parties (eg, entrepreneurs, investors, insurance companies, politicians, hospital administrators, and patients). It is now more important than ever that we join forces with stakeholders and share our ideas and expertise to create new ideas that work for our patients and for the systems in which we function.
Brainstorm, the Stanford Laboratory for Brain Health Innovation and Entrepreneurship, is the first of its kind—an academic laboratory dedicated to transforming brain health through entrepreneurship. Brainstorm applies the biopsychosocial model of disease to tackle problems on the systems level. Launched by a founding team of physicians from around the country, we unite the worlds of medicine, business, and technology to foster innovative ventures that optimize health and human potential. We accomplish this through education, collaboration, and creation.
Through research and collaboration with academic and industry leaders, we have found that for an innovative solution to successfully address challenges, it should be safe, effective, accessible, affordable, measurable, and scalable. Technological innovations are rapidly emerging because they are uniquely suited to meet these criteria—and meet them quickly. From the more familiar text messaging, video conferencing, and mobile phone applications to the newer areas of virtual reality, augmented reality, behavior tracking, wearables, sensors, and chatbots—these are the solutions that can change the future of psychiatry.
To avoid any conflict of interest or perception of endorsement in this article, we discuss the technologies in general categories instead of giving specific examples or using company names. Many mental health technological ventures are early stage and are still working toward clinical validation and/or development of a sustainable business model.
Technology as a solution
Accessibility. Technology gets care to patients who cannot otherwise reach care. Whether the issue is transportation, inconvenience, or short-staffing of psychiatrists in a particular geographic location, the problem is the same—patients lack access to quality mental health care. What many people can access, however, is a smartphone, computer, or their local, tech-friendly hospital. Innovators are using tools for patient care that are not very different from the ones we know (eg, FaceTime), which we use to chat with family or friends around the world. Technology is being used to provide app-based therapy, coverage in psychiatric emergency departments, consultation to medical care, and rounds on inpatient psychiatric units—all in settings that previously may not have had access to psychiatric coverage.
Affordability. Digital mental health services provide affordable alternatives to traditional care. They lessen some of the fixed and variable overhead costs of more human resource-heavy solutions, such as office space, waiting rooms, and administrative staff. This means that care can be delivered by providers more efficiently, and it can be obtained by patients more affordably.
Dr. Vasan is Founder and Director of Brainstorm: The Stanford Laboratory for Brain Health Innovation and Entrepreneurship, Chief Resident in Adult Psychiatry at Stanford University School of Medicine, and MBA Candidate at Stanford Graduate School of Business; Dr. Chaudhary is Founding Partner at Brainstorm, Chief Resident in Child and Adolescent Psychiatry at Massachusetts General Hospital/McLean, and Clinical Fellow at Harvard Medical School; Dr. Aragam is Founding Partner at Brainstorm and Chief Resident in Adult Psychiatry at Massachusetts General Hospital/McLean; Ms. Nagpal is Junior Fellow at Brainstorm and Founder of CS+Mental Health; Ms. McKenzie is Junior Fellow at Brainstorm and a student at Stanford University; Ms. Chen is a Scholar at Brainstorm.
Dr. Vasan receives royalties from Wiley as the author of Do Good Well: Your Guide to Leadership, Action, and Social Innovation; Dr. Chaudhary, Dr. Aragam, Ms. Nagpal, Ms. McKenzie, and Ms. Chen report no conflicts of interest concerning the subject matter of this article.
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