F080 How far are we with digitising mental health support? (Christopher Molaro)

Undoubtedly, the global lockdown and economic consequences of COVID-19 caused a lot of anxiety in some individuals, depression in others, it is fair to assume some medical professionals will suffer from PTSD after the worst is over. The good news is, that by today we have many validated digital tools and programs to help people deal with mental health related problems remotely.

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Christopher Molaro first started thinking about the need for better mental health support and care coordination during his work for the US army. When he was 23 years old, upon return from his mission in Iraq, he started noticing how veterans and civilians alike face too many barriers when it comes to receiving appropriate, timely care.

To help curb the problem, he co-founded NeuroFlow - a health care technology company whose goal is to bridge the gap between mental and physical health in all care settings.

“Two thirds of people don’t search for treatment after a mental health diagnosis”

Christopher was in the army for four years before going on the mission in Iraq, but despite all the training, it is impossible to predict and prepare for all the stressors in the environment, says Molaro today. This results in post-traumatic mental health problems, which have long been recognised by the Veteran’s Association (VA).

VA has long recognised the need for PTSD support - the National Center for PTSD to address the needs of Veterans and other trauma survivors with PTSD was founded already in 1989. The persisting problem however, says Christopher Molaro, is that physical and mental health are still treated very separately. “There is a divide between treating your physical health in your mental health. It's all one system, the one affects the other. If you're depressed you're going to have worse physical outcomes, you're going to feel worse. And vice versa - if you feel worse, or if you have physical ailments such as chronic illnesses, you're going to have a higher risk of depression or anxiety PTSD and so forth. We need to treat the whole person to see sustained benefits.”

Looking at the problem more broadly, 40 to 50 million people a year in the US have a mental health diagnosis, which is determined based on the scores at mental health related questionnaires in the doctor’s office . “The doctor may or may not prescribe you a medication or refer you to a specialist, but then it's really on the patient to follow up with that. The tragedy of that is that two-thirds of people diagnosed will never follow up and engage with their treatment.”

This is where NeuroFlow comes in - it is a clinical decision support tool that ties in a mobile application and website that is designed to better assess, track, and engage clients in the time spent between appointments, helping to more efficiently integrate behavioral health across specialties. NeuroFlow uses data analytics to enable measurement-based care and fills in the treatment gap with digital exercises which positively reinforce self-care. Users are assigned homework such as journal entries, rating scales, and CBT style worksheets. Automated nudges help remind users to complete assignments.

Tune in to other mental health related episodes:

F010 Can VR help treat addiction, PTSD, ADHD and other mental health issues? (Skip Rizzo, Institute for Creative Technologies at University of Southern California)

F004 Tackling mental health with digital health? (Dean Ornish - UCSF; Ritvik Singh - Psyinnovations; Richard Lee - Bravely)

The effect of the pandemic on mental health

On April 15th this year a panel of experts published a position paper online in the Lancet Psychiatry, where they outlined a proposed government response to curb the long-term "profound" and "pervasive" impact of the COVID-19 pandemic on mental health.

Calls and texts to the to the American Psychological Association (APA) have gone up by 40 % in April compared to February, says Christopher Molaro.

From NeuroFlow’s perspective, Christopher Molaro sees that the market demand for solutions addressing mental health has grown significantly. He believes that people have become more aware of mental health issues during the pandemic and are more open to talk about it. He predicts that in the post-COVID-19 times, people will be more open to discussing these challenges, thus driving adoption of digital health solutions as well.

“Our mission is to improve access and engagement to mental health so patients can feel better faster,” says Christopher Molaro. His daily motivation as well as the vision of Neuroflow is to help patients access help in a timely manner, which can consequently create a happier world. “When you’re happier, you’re more productive and nicer to people. Mental well-being triggers a snowball effect, which is bigger than any one person.”

One of the things that CDC, WHO and other authorities advise us of doing in case of stress, anxiety, fear, sadness and loneliness in this unprecedented time, is to get plenty of sleep, avoid alcohol and drugs, try to eat healthy, keep in contact with your friends, colleagues and family, and try to de-stress with deep breaths and meditation.

Read WHO recommendations for mental health issues management, as well as the CDC guidelines to ease difficulties occurring during this pandemic.

Tune in for the full discussion:

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The background music in this episode was composed by the pop artist based in New York Cheryl B. Engelhardt. Cheryl suffered from debilitating panic attacks her entire life, tried many coping strategies and in the end composed an album called Luminary and started a daily meditation practice with it. If you wish to find inner calm with her music, you can access it for free on all streaming platforms and meditation apps Insight Timer and Simple Habit. Listen to “Luminary” here

Some questions addressed:

NeuroFlow is a platform to remotely track and manage mental health. Can we go to the beginning of the Neuroflow story — you were a veteran and after coming back home you “experienced firsthand the gaps in the behavioural health system and how veterans and civilians alike face too many barriers when it comes to receiving appropriate, timely care.” Can you take us back in time, and tell us about your past a but and the story of the Neuroflow discovery journey — what gaps in the care you yourself experienced/noticed?
Have any of the problems been solved by today?
One of your satisfied users described the NeuroFlow solution as a platform and tool that strengthens the connection between behavioral health, physicians, and their patients, helping them improve both patients’ experience and outcomes. Can you describe how this actually works? How does it fit in the abundance of solutions clinicians are already using for patient management and patients for their improved wellbeing?
What is the structure of your end-users and at this unprecedented point in time — what trends are you seeing during the COVID-19 pandemic?
Do you think some consequences are going to erupt hardly after the shelter in place order will end? Similarly, as PTSD develops hardly after, not during trauma.
In essence, Neuroflow is a platform enabling interdisciplinary care. Research around collaborative and integrated care models began in the 1970s, so this is not a new idea, but adoption has been tepid. Why is that in your opinion?
Given the new awareness about the meaning of mental health support solutions — are you noticing an increased interest in your solution from the investment side? What are your future expectations regarding fundraising?