HOW A MOBILE APP CAN HELP TREAT ADDICTION AND MOOD DISORDERS

Kenneth Gilman

Limited access to mental health care is one of the biggest public health problems facing us today. Technology can help us change that.

Maintaining your mental health while away from your clinician’s office can also be challenging. Technology can also help us with that.

Addiction clinicians have had great success with helping individuals with substance use and mood disorders through a behavioral treatment approach called integrated group therapy (IGT). Developed at McLean Hospital, IGT is an evidence-based approach for addressing coexisting bipolar disorder and substance use disorders.

IGT focuses on group interaction and interpersonal support to teach recovery behaviors and relapse prevention skills. The approach gives people tools and skills to navigate a lot of situations—like high-risk behavior that might cause a person to relapse into using drugs or alcohol.

Unlike a lot of other treatment approaches, IGT addresses mood disorders and alcohol and drug misuse together, not separately. We know that if people don’t address their other mental health issues, it makes them vulnerable to substance use. And, of course, substance use makes their other mental health issues even worse. Working on both issues at the same time is a major benefit of IGT.

Through direct care to patients, we know that IGT works, but we also know that not everyone who could benefit from the therapy can come to places like McLean for help. We also understand that people who receive mental health care need support after they’ve left a clinical setting.

Clinicians have long believed that a mobile app could be extremely useful for addressing such situations. By bringing IGT tools and activities to a smartphone, millions of people in need could be helped. And it would be very inexpensive.

Apps can give people reminders, help them get organized, and help them move forward with their treatment plans. Some apps allow individuals to communicate quickly and securely with clinicians and with others who are dealing with similar health issues. A patient’s ability to track cravings and monitor moods through mobile apps has been helpful in supporting their recovery.

A group from McLean, including me and a few of my colleagues at Fernside, a residential addiction treatment program, started working to make an app a reality. We were given the chance to take part in the Partners Connected Health Innovation Challenge, which is focused on using technology to solve health care problems.

We thought our idea for an IGT-based app had a good chance of winning. And we were right. Our idea won the competition. As winners, we received hundreds of hours of technical support to help us build our app.

It has been interesting to work with software designers and engineers on the project. We have been helping the technical experts translate the principles of IGT to a digital medium. It has been an exciting challenge to find ways to bring the one-on-one, personal support you get with IGT to a digital platform. Whether we’re coming from the clinical side or the technology side, we all want to produce the most effective and user-friendly result—something that’s going to be valuable to patients over time.

The platform will enable patients to monitor their feelings, learn about their illnesses, and more. Using the principles of IGT, the app will have tools to help people navigate a lot of risky situations. The app will include recovery rules, skill-building exercises, and a support group meeting finder.

App users will take part in a daily check-in. This will include responding to questions concerning their use of alcohol or drugs, their mood, and whether they had faced high-risk situations.

To bring in the interpersonal support that’s central to IGT, the app will offer “live supports.” This includes a virtual coach that users can interact with when they have questions or problems. And through patient feedback, the platform gets “smarter,” so the coaching improves.

We’d also like to use established features from other apps to make ours a full-service solution. These add-ons may include enabling users to plug in emergency contacts or offering ways to access crisis services.

The goal is to help people better manage their illnesses. An app like ours will help prevent relapse, hospitalization, and emergency care.

Mental health care providers are increasingly looking to technology
to help enhance psychiatric treatment. McLean’s Ipsit Vahia, MD, for example, has teamed up with MIT’s Computer Science and Artificial Intelligence Lab to test the capabilities of a device called Emerald to help seniors with mental health conditions. This device passively monitors a patient’s activities during the day and night. This continuous monitoring can help detect things such as agitation and sleep disturbances, which can alert clinicians to modify or implement treatment.

Courtney Beard, Ph.D., director of McLean’s Cognition and Affect Research and Education (CARE) Laboratory, is also studying technology’s potential to contribute to mental health treatment. She and other McLean researchers recently found that individuals may be able to change mental habits without visiting a therapist. This could be done through a smartphone app that helps train the user to stop jumping to negative conclusions about everyday situations.

My colleagues at Fernside, meanwhile, have already had some success with using apps to supplement clinical care for patients with substance use and mood disorders. People these days are attached to their phones, so using them as a tool to aid mental health is practical.

These results are exciting–and promising. But the use of digital technology in mental health care is relatively new. We have much more to learn.

The IGT app is based on a proven therapy, so we’re optimistic that it will be effective. We will, however, continuously collect user outcomes to help us evaluate the app’s impact.

Our team hopes to have the app ready to go soon. We’re excited about bringing IGT to millions of people who could benefit from the treatment. For people who need ongoing support, having IGT tools and resources in the palm of their hands will help them get—and stay—on the road to recovery.

Kenneth Gilman is the residential supervisor at Fernside, an addiction treatment program in Princeton, Massachusetts. This McLean Hospital Signature Addiction Recovery Program specializes in helping patients recover from substance use disorders and other coexisting mental health conditions. McLean is a leader in alcohol and drug misuse treatment, with care designed to meet the needs of patients at every stage of treatment. Services are offered at a number of locations, including at the hospital’s main campus in Belmont, Massachusetts. For more information, visit mcleanhospital.org/addiction.