Tag Archives: 7 Cups

Tom Insel is “The Smartphone Psychiatrist” at Mindstrong Health | The Atlantic

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Tom Insel is “The Smartphone Psychiatrist” promoting his employer ‘Mindstrong’;
David Dobbs; In The Atlantic; 2017-07.

tl;dr → a promotion of Mindstrong Health, announcing $14M in funding today
tl;dr → a hagiogaphy of Dr. Thomas Insel, its public face.

Occasion

Mindstrong Health Raises $14 Million in Series-A Funding; press release; 2017-06-15.
Teaser: Founding team includes the former Director of the National Institute of Mental Health, Dr. Tom Insel, and former Director of the National Cancer Institute, Dr. Richard Klausner

Tom Insel
  • Mindstrong, startup, Palo Alto, CA
  • Product Manager (Director?), Verily (the ‘V’ in the Alphabet pantheon as Google’s “health” hobby).
  • (ex-)National Institute of Mental Health (NIMH).
  • other institutions in the article.
Mindstrong Health

At the bottom

Mentions

  • Diagnostic and Statistical Manual of Mental Disorders (DSM)
  • Verily of Google
    Mountain View, CA
  • Tom Insel
    • one of four brothers
    • curriculum vitae in the article
    • Pleasanton, CA
  • H. Herbert Insel
    • father of Tom Insel
    • an eye surgeon
    • Dayton, OH
  • clomipramine
  • OCD
  • prairie-vole
  • Insel, Wang, and Young
  • biology vs environment, teach the controversy (nature vs nurture)
  • Thomas Insel; Towards a New Understanding of Mental Illness; TED Talk, 2013.

Promotion

<quote>The force they hope to harness is the power of daily behavior, trackable through smartphone use, to reflect one’s mental health. As people start to slide into depression, for instance, they may do several of the following things easily sensed by a phone’s microphones, accelerometers, GPS units, and keyboards: They may talk with fewer people; and when they talk, they may speak more slowly, say less, and use clumsier sentences and a smaller vocabulary. They may return fewer calls, texts, emails, Twitter direct messages, and Facebook messages. They may pick up the phone more slowly, if they pick up at all, and they may spend more time at home and go fewer places. They may sleep differently. Someone slipping toward a psychotic state might show similar signs, as well as particular changes in syntax, speech rhythm, and movement.</quote>

Snide

<quote>Psychiatry has always struggled to be taken seriously as a science. By the 1980s, the field seemed especially lost. Its best drugs were from the 1950s and ’60s. Most of its hospitals, their failings made infamous by works such as Sylvia Plath’s The Bell Jar and Ken Kesey’s One Flew Over the Cuckoo’s Nest, had been closed. Talk therapy, which often works, but by psychobiological pathways painfully difficult to discern, was frequently lampooned. For these and other reasons, including its penchant for savage infighting, psychiatry in the ’70s was “a collection of diverse cults rather than a medical science,” as Melvin Sabshin, a onetime medical director of the American Psychiatric Association, later put it. </quote>

<quote>A therapist, the joke goes, knows in great detail how a patient is doing every Thursday at 3 o’clock.>/quote>

Background

Theory

the two components necessary to any approach to mental-health care—assessment

  1. collection and analysis of “data”
    • self-attested by the patient
    • logged by the phone
  2. intervention
    • informal social
    • medical support, inpatient
    • medical support, outpatient

prime, an app

  • prime → (Personalized Real-time Intervention for Motivation Enhancement
  • Danielle Schlosser
    • a clinical psychologist
    • recruited to Verily from the psychiatry department at UC San Francisco by Thomas Insel
    • developed prime. a monitoring app, for an outpatient’s phone
  • Concept
    Social proof to the cohort that they are all “normal” people who are able to “function.”
  • Applicable
    • people ages 14 to 30
    • recently diagnosed with schizophrenia
  • Feature-Function
    <paraphrase>

    1. modeled on Facebook
      i.e. a circle of ‘friends’
    2. connecting people so they can turn to one another for help, perspective, and affirmation.
    3. reading material → set of motivational essays, talks, and interactive modules
      [which] guide with decisions and review dilemmas common among the membership.
    4. monitoring & alerting → spotting emerging crises and responding with peer, social-service, and clinician support.

</paraphrase>

Mindstrong Health

  • co-founders
    • Richard Klausner
    • Paul Dagum
    • Michael Friberg
  • Palo Alto
  • something about 2017-05, probably the date of the interview for the article
  • Roles
    • Insel → expertise and connections in the mental-health field
    • Klausner → business
    • Dagum → data-analysis

Statement

<quote ref=”presser>Based in Palo Alto, California, Mindstrong’s patented science and technology was developed by Dr. Dagum, and is based on four years of extensive clinical studies applying machine intelligence to human-computer interactions patterns. Mindstrong products are in clinical trials in numerous partnership projects with payers, providers, academics and the pharmaceutical industry to bring these new tools to bear on answering the most fundamental questions in behavioral health. Its Board of Directors includes Richard Klausner, MD, Jim Tananbaum, MD, Robert Epstein, MD, Thomas Insel, MD, and Paul Dagum, MD PhD.</quote>

Concept

  • Mindstrong does assessment.
  • Mindstrong does “learning-based mental-health care.”
  • Mindstrong does continuous assessment and feedback [which] would drive the interventions.
  • Mindstrong does measurement-based practices [would be for] all therapies

<quote>Smartphones can track daily behaviors that reflect mental health. A phone can sense the beginning of a crisis and trigger an appropriate treatment response. This idea has been floating around Silicon Valley and mental-health circles for several years. Insel estimates that a good five or 10 other companies or research teams—including Verily—are trying to do something similar. Mindstrong hopes to gain an edge by combining Insel’s expertise and connections in the mental-health field with Klausner’s business experience and Dagum’s data-analysis tools and skills—and by moving quickly.</quote>

Plan

  • 2018 & 2019 → testing phone-based data-collection-and-analysis systems,
  • 2019 & 2020 → explore ways to partner with others to provide intervention.

Intellectual Property

three patents for a data-collection-and-analysis system for such purposes.
Paul Dagum designed this system [is a named inventor?]

Checkboxes

  • Mindstrong will collect information
  • Mindstrong will use an opt-in
  • Mindstrong will use encryption
    <quote>all data will be strongly encrypted</quote>
  • Mindstrong will use HIPPA<quote>All data will be firewalled according to strict patient-privacy practices.</quote>
  • Mindstrong will only store metadata
    • not
      • voice
      • typed
    • e.g.
      • semantic structures
      • repeated use of key words or phrases
      • estimated
      • emotional state
      • cognitive states,
        e.g.

        • depression,
        • mania,
        • psychosis,
        • cognitive confusion.

Competition

Verily (Google)

  • Andy Conrad, CEO
  • <quote>a 500-person company (Verily>part of a 74,000-person company (Alphabet)
  • South San Francisco

7 Cups

  • Has an app.
  • Another private venture.
  • Glen Moriarty, CEO
  • Insels daughter NAME is an employee.
  • Demographic
    • young
    • diverse
    • 90% are under the age of 35
    • “likely to go underserved by traditional mental-health care.”
  • Applies DASS‑21Anonymizes the results.
Concept

<quote>7 Cups provides text-based peer counseling and support for people with depression or anxiety or a long list of other conditions. Registering for the simpler services, such as peer connection, takes only seconds, and users can also get referrals to either coaches or licensed mental-health counselors and psychologists.</quote>

DASS‑21

DASS-21 → Depression Anxiety Stress Scales

DASS, University of New South Wales, AU

There is a manual

Questions