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The key to addressing mental health may lie in business innovation theories.
Business anthropology—the use of anthropology constructs, theory and methods in organizations, marketing, consumer behavior and design—can improve product and service success.
The burden of mental health and cognitive disorders is projected to increase to around USD $16 trillion per year in lost economic productivity by 2030.1 For the sake of the economy (and the human needs it serves), innovations to address these disorders are urgently needed.
Our field is embracing the potential of novel deep technology approaches: artificial intelligence (AI), omics, sensors, brain imaging, virtual reality (VR), and augmented reality (AR).2 Deep technologies may optimize screening, diagnosis, treatment, and prevention for mental health and cognitive disorders, from attention-deficit/hyperactivity disorder (ADHD) and depression to Alzheimer disease and beyond. Single-point solutions are also converging into multicomponent product symphonies (eg, singular digital and omic solution integration into app platforms, electronic health records, and other clinical operating systems).3
Beyond the enthusiasm for new technology, market trends suggest an increase in company formations and the requisite capital investments.4 Indeed, more money was invested in the first 5 months of 2021 ($1.9 billion) than the whole of 2020.5 Without an appreciation of the mindset and respect for the practical concerns of brain-health clinicians and health managers (spanning neurology, psychiatry, psychology, primary care, psychologists, and beyond) and their critical support staff, we all stand to see the momentum (and hope) for our field fall short if new products and services fail to be deployed effectively in the market. Investment dries up in the face of failure. This would be a tragedy, as sustained, multidecade engagement is needed.
Our field focuses on science and technology and rarely the broader business context and environment of deployment, implementation, and utilization. Inspired by Gillian Tett, PhD’s new book, Anthro-Vision: A New Way to See in Life and Business, we turn to rapidly deployable business anthropology principles for guidance.
What Is Business Anthropology?
Applying business anthropology principles to brain health innovations can optimize deployment and bolster success. Business anthropology uses anthropological constructs, theory, and methods to study organizations, marketing strategies, consumer behavior, and design.6 Applied to the brain health technology market, business anthropology will provide a better understanding of the social, clinical, and commercial milieu. This informs how to best implement brain health technologies in a manner that supports better-run organizations.
Business anthropology integrates design principles to ensure that consumers and families are recognized as key stakeholders. Combining ethnographic research methodologies and first-hand observation and interviewing techniques with of theoretical knowledge from studying human societies across the world, business anthropology can offer the multidimensional approach required to promote brain health innovations. Table 1 provides an overview of tips and tools which can be used.
Putting Business Anthropology’s Principles Into Practice
Business anthropology operates in 3 domains. First, it examines complex organizations to understand the nature and functioning of the organization internally and externally. Secondly, it explores the needs of consumers and their global context. Lastly, it observes the interactions of individuals and their environment to drive product design. All are particularly relevant in promoting better mental health. As the brain health technology field rapidly advances, business anthropology can help navigate the unprecedented complexities, changes, and challenges.
For example, the US Federal Drug Administration’s (FDA) controversial recent approval of a new Alzheimer treatment, aducanumab, has impacted the clinical and commercial milieu of Alzheimer disease. As aducanumab has been released onto the market, a new set of challenges have arisen. The entire healthcare ecosystem—payers, providers, and patients—must answer questions related to cost and value, screening, safety, and effectiveness. This controversy has led many authorities to pen appropriate use recommendations, which aim to provide guidance in clinical settings.7 However, questions around cost, reimbursement, and implementation remain.8 Some major health systems are refusing to administer the drug.9 Aducanumab’s approval has also spurred the advancement of emerging biomarkers, diagnostic tools, and monitoring systems. Business anthropology will assist brain health stakeholders in understanding and navigating these dynamics. Further, business anthropology helps all parties better understand the culture of medicine that surrounds aducanumab’s controversial approval. As Robert Pearl, MD, notes, we can only make sense of the FDA’s recent actions concerning aducanumab through a cultural lens.10
Telepsychiatry is another example. In the wake of COVID-19, there is now a hybrid of in-person and remote patient care in mental health settings, especially in psychiatry and psychotherapy. Innovations in hybrid in-person and remote patient care include asynchronous patient care, hybrid face-to-face and digital interventions, digital biomarkers, sensors for at-home monitoring, and telepsychiatry. Business anthropology can help ensure that health care delivery is conducted in a way that engages patients.. It can improve patient engagement through optimal implementation of technologies that bridge in-person and remote care.
Brain health advancements will continue to emerge, and with the insights of business anthropology, these scientific breakthroughs can reach patients in effective and cost-conscious ways. Psychedelic utilization for brain health will create many clinical, ethical, and practical management challenges.11 Shifting from dementia care to dementia prevention will change the way brain health is approached throughout the lifespan.12 Subtyping brain health conditions such as depression to develop a precision medicine approach to brain health promises to alter current treatment approaches too.13 All of these create major reconsiderations for clinical workflow, product design, and reimbursement. Table 2 outlines key brain health stakeholders and their major concerns.
The aging population will require more thoughtful and inclusive design of products and services.14 Ensuring health data privacy with new health care technologies and delivery models will be a priority.15
Technologies such as AI, omics, sensors, brain imaging, VR, and AR will continue to be developed and adopted to address the many brain health challenges that we face. Rapidly deployed business anthropology principles will help brain health stakeholders navigate these changes and successfully integrate brain health technologies into health care systems. Anthropology has played a formative role in shaping the research and understanding of brain health conditions.16 Likewise, applying business anthropology principles can lead to more successful implementation and utilization of proven innovations in brain health.
Erin Smith is a director at the PRODEO Institute, an Atlantic Fellow in Brain Health Equity at the Global Brain Health Institute (GBHI) at the University of California, San Francisco (UCSF) and a Thiel Fellow at Stanford University. Dr Lenze is a geriatric psychiatrist at Washington University School of Medicine, St Louis. Dr Aragam is Chief Commercial Officer with Stanford University’s Brainstorm Lab and adjunct faculty with the Massachusetts General Hospital, affiliated with Harvard University. Dr Kaiser is CEO of Determined Health, Director of Geriatric Cognitive Health at the Pacific Neuroscience Institute (PNI) and adjunct professor at the University of Southern California. Dr Fu is an adjunct professor in engineering at Stanford University. Dr Leboyer is professor of psychiatry at the University Paris Est Créteil, in charge of the psychiatric and addiction centre at the Henri Mondor University Hospitals, director of the DHU PePSY, and director of the laboratory of “Psychiatrie Translationelle” Inserm U955, France. She is also operational director of the FondaMental Foundation. Dr Chen is an adjunct faculty member at UC Berkeley and Singularity University. Dr Berk is Alfred Deakin Professor of Psychiatry at Deakin University and director of IMPACT at Deakin University (Institute for Mental and Physical Health and Clinical Translation). Mark Heinemeyer is cofounder of the PRODEO Institute and CEO of PRODEO. Dr Eyre is cofounder of the PRODEO Institute, colead of the OECD NIPI, and holds adjuncts roles with IMPACT at Deakin University, GBHI at UCSF and Baylor College of Medicine.
1. The Carter Center. Mental illness will cost the world $16 USD trillion by 2030. Psychiatric Times. 2018;35(11).
2. Smith E, Au R, Mossé M, et al. Rebooting late-life mental health innovation and entrepreneurship with convergence science. Am J Geriatr Psychiatry. 2020;28(6):591-596.
3. Smith E, Ellsworth W, Reynolds CF, et al. Convergence mental health: a new pathway for transdisciplinary innovation and entrepreneurship. Psychaitric Times. 2020;37(7).
4. Shah RN, Berry OO. The rise of venture capital investing in mental health. JAMA Psychiatry. 2021;78(4):351-352.
5. Burroughs C. Mental health startups have raised a record $1.9 billion in 2021 as COVID-19 pushed VC investors further into the space. Insider. May 11, 2021. Accessed August 16, 2021. https://www.businessinsider.com/mental-health-startups-hit-quarterly-funding-records-amid-vc-interest-2021-5
6. Jordan AT. Business anthropology. Oxford Research Encyclopedia of Anthropology. October 30, 2019. Accessed August 16, 2021. https://oxfordre.com/anthropology/view/10.1093/acrefore/9780190854584.001.0001/acrefore-9780190854584-e-4
7. Aducanumab: will appropriate-use recommendations speed uptake? Alzforum. August 5, 2021. Accessed August 16, 2021. https://www.alzforum.org/news/conference-coverage/aducanumab-will-appropriate-use-recommendations-speed-uptake
8. Rabinovici GD. Controversy and progress in Alzheimer’s disease — FDA approval of aducanumab. NEJM. July 28, 2021. Accessed August 16, 2021. https://www.nejm.org/doi/full/10.1056/NEJMp2111320
9. Coleman J. Cleveland Clinic, Mount Sinai not administering new Alzheimer’s drug. The Hill. July 15, 2021. Accessed August 16, 2021. https://thehill.com/policy/healthcare/563146-cleveland-clinic-mount-sinai-not-administering-new-alzheimers-drug
10. Pearl R. Making sense of the FDA’s ‘indefensible’ decision to approve Aduhelm. Forbes. July 19, 2021. Accessed August 16, 2021. https://www.forbes.com/sites/robertpearl/2021/07/19/making-sense-of-the-fdas-indefensible-decision-to-approve-aduhelm/?sh=35d309c022b4
11. Vann Jones SA, O’Kelly A. Psychedelics as a treatment for Alzheimer’s disease dementia. Front Synaptic Neurosci. 2020;12:34.
12. Livingston G, Huntley J, Sommerland A, et al. Dementia prevention, intervention, and care: 2020 report of the LancetCommission. The Lancet Commissions. 2020;396(10248):413-446.
13. Williams LM. Precision psychiatry: a neural circuit taxonomy for depression and anxiety. Lancet Psychiatry. 2016;3(5):472-480.
14. Gibson R. What design for aging gets horribly wrong. Fast Company. August 2, 2021. Accessed August 16, 2021. https://www.fastcompany.com/90660516/what-design-for-the-elderly-gets-horribly-wrong
15. Rubin J. What the Facebook scandal can teach us about health data privacy. Morning Consult. October 21, 2019. Accessed August 16, 2021. https://morningconsult.com/opinions/what-the-facebook-scandal-can-teach-us-about-health-data-privacy/
16. Kohrt BA, Mendenhall E, Brown PJ. How anthropological theory and methods can advance global mental health. Lancet Psychiatry. 2016;3(5):396-398.