Innovation key in moving from mental illness to mental health

15 JUNE 2022

Innovation is key to changing the narrative around mental healthcare

 By Jessica Spira

While the focus of the world has been solidly on the COVID-19 pandemic over the past two years, a new crisis has come to the fore in 2022. Mental health conditions now affect more people than ever, and increasingly they are taking their toll on the younger generation. Addressing this challenge requires more than just better treatments or different medicine – it needs an entirely new systemic approach.

This was the key message of the recent Healthcare Innovation Forum held by RMB, which provided RMB’s healthcare sector clients with access to inspirational speakers, including the global leader in mental health from the USA, as well as local experts in and advocates for mental healthcare in South Africa.

The mental health crisis

One area the experts all agreed on is the fact that we are in a mental health crisis. This is not limited to South Africa, but is a global phenomenon that has been both exacerbated by and brought to light by the challenges of the ongoing Covid pandemic.

Dr Thomas Insel, the keynote speaker, is a neuroscientist and a psychiatrist. He is also the pre-eminent mind in mental health in the United States of America and the author of Healing: Our path from mental illness to mental health. He spoke at length on the mental health crisis facing the USA and how outcomes for mental illness remain poor despite having effective treatments available.

One area he highlighted was the stigma attached to mental health disorders, and how this leads to discrimination against those who are suffering. He believes that the crisis we face now is due to failure to provide the kind of care that people need to effectively recover from and live with mental illnesses.

This message was echoed by local experts Dr Jaclyn Lotter, Academic Dean at the South African College of Applied Psychology, and Dr Samke Ngcobo, medical doctor, author and mental health advocate, during the panel discussion. Lotter spoke about the need to focus on preventative care rather than just curative interventions, valuing wellness over remedy, and increasing collaboration across the healthcare sector to better equip primary healthcare providers, social workers, traditional healers and counsellors to provide first line support.

Ngcobo agreed that proper interventions and collaboration are essential, and stressed the need to break the strong cultural, social and religious stigma that exists in South Africa around people living with mental illness. People with serious mental illness are more likely to be homeless, incarcerated or unemployed, because they are a neglected sector of society. As a medical professional and a mental health advocate living with an ongoing mental health disorder, her key message was that understanding and acceptance are key to favourable clinical outcomes .  

Redefining mental health

Historically, mental illness has not been treated equally to physical ailments – with most diseases, the sicker you are, the more likely you are to receive treatment, but with mental illness the opposite is true. The reality is that the sicker you are with mental illness the less likely you are to seek help. It’s part of the impact of the illness. Most of the system is only geared towards treating the sickest.

There is also a lack of engagement around mental health issues, and a lack of accountability for the outcomes of mental disorder treatments. Both in the USA and locally, many people simply cannot access mental health services, or if they do, they cannot afford to continue their treatment until they are on the road to recovery.

The training of mental healthcare practitioners is also problematic – this issue was brought up by Dr Insel and by Dr Lotter, indicating that it is a global challenge. Training needs to be adapted to reflect the latest evidence-based treatments, using technology to reach people at scale, and importantly, outcomes need to be measured so that we are better able to learn from our results.

There also needs to be a shift in the way we define and talk about health versus healthcare. Health, particularly mental health, involves many other facets besides healthcare, especially socioeconomic factors. While the problem of mental illness may be medical in nature, the solution needs to be looked at from a broader context, including social and relational support, environmental needs, and even political intervention. Helping people to live with mental illness is not just about giving them medication – it needs to include a recovery model, helping people to connect with each other and find their place and purpose.

Technology innovation can change the game

Technology can play a massive role in helping to transform mental healthcare, improving the way we connect and use information, which can help on every level to change the narrative. Digital mental health services can help people to access person-centred online resources that can provide a better quality of care through real-time feedback and interaction, structured therapies, coaching and support, delivered via mobile interventions from anywhere in the world. This fast-growing sector has democratised care in a way that was not previously possible, helping to reach thousands of people who were not able to access care in the past.

There are also exciting innovations taking place in the field of diagnosis and treatment of mental illness. One of the issues has always been a lack of ability to conclusively diagnose a mental health problem, which leads to perceptions that mental illnesses are not real diseases. Through innovations in technology, we now have a far better understanding of the way the human brain works, which helps to inform when there are problems.

Dr Christos Profyris, Head of Neurosurgery at Helen Joseph Hospital and a neurosurgeon at the private Connectomix Clinic, is using personalised brain mapping, powered by an artificial intelligence (AI) and machine learning (ML) engine, to better diagnose mental illness. This powerful tool provides a visual and comprehensive way of objectively identifying mental health conditions, in the same way as an x-ray can identify a broken bone. Profyris is using this insight not only to definitively diagnose mental illness, but also precisely target and tailor transcranial magnetic stimulation (TMS) treatment for major depression and anxiety.

A multi-faceted approach is key

Technology innovation is key in improving mental healthcare – it can be used to democratise care and provide access to treatments to thousands more people easily, it can be used to enhance training interventions at scale, and it can even deliver better diagnosis and better treatment of mental health conditions.

However, the core takeaway from Dr Insel and our local experts is that mental health treatment is not one-dimensional; we need an integrated approach, and while technology plays an essential role, this very human problem needs a human element in its solution. From the ways we diagnose mental illness to the training of mental health practitioners, the systems that support mental health to the way we talk about the problem, and even the way we use technology, we need to rethink the entire paradigm.

Innovation, supported by cutting-edge technology, will be the key to changing the narrative and moving from mental illness toward mental health.

Spira is Sector Head for Healthcare at RMB