5 mental health technologies with the potential to greatly improve care and efficacy of current therapies

Mental illness, also known as mental disorder, is characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation or behaviour. In 2019, approximately 970 million people around the world were living with a mental disorder. However, current treatments, such as psychiatric medication therapy, can lead to harmful side effects and severe problems. Technologies have the potential to revolutionize the field of mental health treatment by improving access to care, enhancing diagnosis and monitoring, and offering new avenues for therapy. In this article, Alcimed explores 5 emerging mental health technologies that can complement existing treatments to improve the overall quality of care for clinically diagnosed medical disorders.

The World Health Organization (WHO) estimated that by 2030, mental diseases would become the most significant factor contributing to the global burden of disease. A mental disorder is the harmful failure of internal mechanisms to perform one of its psychological functions. While drug-based treatment can be effective for individuals living with chronic mental illness, issues such as long-term reliance on medications, debilitating side effects, variation in treatment response and treatment non-adherence, may affect the effectiveness of current mental health treatments. The use of mental health technologies can complement existing drug treatments to improve the overall quality of care of severe and chronic mental disorders.

Mental health technology n°1: Digital Therapeutics (DTx) to prevent and manage mental illnesses

DTx are treatment approaches based on behavioural interventions that have shown promising results in preventing or managing various forms of mental illness. In fact, more than 500 clinical trials have been conducted on digital therapeutics between 2010 and 2019, with over 40% of those trials focusing on mental health^[1]. One example of a therapeutic area where digital therapeutics could improve standard of care is attention deficit hyperactivity disorder (ADHD). Current therapy options for ADHD primarily involve pharmacological interventions that may have long-term risks and side effects. In June 2020, the FDA approved EndeavorRxTM (AKL-T01) as a prescription DTx for children with ADHD. While most digital therapeutics products are administered when patients are awake, the Monarch external Trigeminal Nerve Stimulation (eTNS) system stands out for its ability to work while the patient is asleep. This small electronic device stimulates the brain’s trigeminal nerve through a patch applied to the forehead before bedtime, targeting areas of the brain involved in mood disorders, epilepsy and attention.

Mental health technology n°2 : Non-invasive brain stimulation technology to shift brain activity patterns

Non-invasive brain stimulation (NIBS) techniques use electrical currents (induced by magnetic fields) as a method to treat mental and neurological disorders. NIBS when combined with psychosocial intervention has been shown to have a significant positive effect in alleviating moderate to severe depressive symptoms. Depression is one of the most severe mental illnesses around the world, affecting more than 264 million people globally^[2]. An example of such a mental health technology is the device from Pulvinar Neuro, a UNC-Chapel Hill spinout company, that works by shifting brain activity patterns for patients suffering from a mental disease. The technology can apply different wave forms to shift and change brain activity patterns to provide tangible symptom relief for many patients. Further research into this technology should look at providing more evidence of combination treatment compared with NIBS alone and psychosocial intervention alone.

Mental health technology n°3 : Brain implants to improve long-term care

Brain implants are medical devices that are typically placed inside the brain to directly stimulate or modulate neural activity. The benefits of brain implants include their ability to alleviate symptoms that are resistant to other forms of treatment and offering personalized therapy approaches. US researchers and clinicians at the University of California San Francisco (UCSF) have developed an implant that acts like a pacemaker for the brain, utilising a precision-medicine approach that has successfully managed a patient’s treatment-resistant depression by identifying and modulating the circuit in the brain that is uniquely associated with the symptoms. The implant is embedded in the skull and wired to the patient’s brain using deep brain stimulation to trigger electrical charges that reset brain functions for the patient. Developments in the brain implant space explore innovations in soft implantable electrodes, energy efficient devices and high-resolution sensing array processors. For example, EPFL researchers have combined low-power chip design, machine learning algorithms and soft implantable electrodes to produce a neural interface that can detect and suppress symptoms of various neurological disorders.

Mental health technology n°4 : Transcranial Magnetic Stimulation to overcome drug resistance

Around 20-60% of patients with psychiatric disorders are affected by drug resistance, which is associated with increased healthcare burden and cost. For this group of patients, transcranial magnetic stimulation (TMS) could be an alternative therapy. Driven by the improved understanding between neuroactivity and regulation of mood and behaviours, it applies electromagnetic induction to target the specific areas of the brain that control mood and thereby modulate the neuro activity. A recent clinical study has indicated that 47% of patients with treatment-resistant depression (TRD) responded to TMS and 30% went into remission and were no longer defined as clinically depressed^[3]. Compared to brain implants, this is completely a non-invasive approach and provides a safe and effective therapy for patients who need medical intervention in the short term.

Mental health technology n°5 : Virtual Reality therapy for psychosis treatment

Virtual Reality (VR) therapy or Visual Simulation Technology (VST) uses computer-generated environments to create a realistic and immersive experience, allowing individuals to confront and overcome specific fears or anxieties related to their mental health. VR therapy has been shown to be effective in treating a variety of mental health conditions such as psychosis and anxiety disorders. In 2022, a British startup (OxfordVR) that uses VR to deliver cognitive behaviour therapy has been granted a Breakthrough Device designation by the FDA for its treatment of schizophrenia and other serious mental illness, a process that will help to expedite its ultimate approval if clinical trials pan out. OxfordVR has developed a treatment that employs VR headsets to help guide patients through everyday situations, such as visiting a store or riding a bus, that can cause fear and anxiety for those with psychosis. This prescription service utilizes automated prompts to deliver cognitive behaviour therapy (CBT), a form of talk therapy.

The future of technology in mental illness is promising, as emerging technologies have the potential to greatly improve care and efficacy of existing treatment options. However, the adoption of mental health technologies as treatments will ultimately depend on companies being able to prove their safety and efficacy. In addition, companies must demonstrate that these mental health technologies, when used in conjunction with or as an alternative to existing treatments, have an overall benefit to the care of severe and chronic mental disorders. Alcimed can support you in your projects related to HealthTech. Don’t hesitate to contact our team.

[1] Gregory P. (2021). The expanding role of digital therapeutics in mental health. Psychiatric Times. https://www.psychiatrictimes.com/view/the-expanding-role-of-digital-therapeutics-in-mental-health
[2] Collaborators G: Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017.2018. Doi: 10.1016/S0140-6736(18)32279-7
[3] Efficacy of repetitive transcranial magnetic stimulation in treatment-resistant depression: the evidence thus far. (2019) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738665/

About the author, 

Xianjin, Consultant in Alcimed’s Healthcare team in Singapore
Ismail, Project Manager in Alcimed’s Healthcare team in Singapore