This App Tells You — and Maybe Someone Else — When You’re Depressed
This App Tells You — and Maybe Someone Else — When You’re
Depressed
Woebot, Mindstrong tap mobile-phone use to help mental
health
Innovative apps must ease privacy concerns over shared
data
By Caroline Chen July 20, 2017, 2:00 AM PDT
A Facebook message pops up on my phone screen. “What’s
going on in your world?”
It’s from a robot named Woebot, the brainchild of
Stanford University psychologist Alison Darcy.
Woebot seems to care about me. The app asks me for a list
of my strengths, and remembers my response so it can encourage me later. It
helps me set a goal for the week -- being more productive at work. It asks me
about my moods and my energy levels and makes charts of them.
“I’ll help you recognize patterns because ... (no
offense) humans aren’t great at that,” Woebot tells me with a smirking smile
emoji.
So Woebot knows that I felt anxious on Wednesday and
happy on Thursday. But who else might know? Unlike a pedometer, which tracks
something as impersonal as footsteps, many mental-health apps in development
rely on gathering and analyzing information about a user’s intimate feelings
and social life.
“Mental-health data is some of the most intimate data
there can be,” said Adam Tanner, a fellow at Harvard University’s Institute for
Quantitative Social Science.
Chatbots have existed since the 1960s -- one was named
after “Pygmalion” heroine Eliza Doolittle -- but advances such as machine
learning have made the robots savvier. Woebot is one of an emerging group of
technological interventions that aim to detect and treat mental-health
disorders. They’re not for everyone. Some people may prefer unburdening
themselves to a human, and many apps are hindered by bugs and dogged by privacy
concerns. Still, the new technologies may fill gaps in current treatment
options by detecting symptoms earlier and acting as coaches for individuals who
might otherwise never seek counseling.
Warning Signs
Clinicians and privacy experts are welcoming these
inventions with one hand while holding up warning signs with the other.
Technology might be a powerful tool to improve treatment, but an emotional
problem, if it becomes known, can affect insurance coverage, ruin chances of
landing a job or color an employer’s perception. With possible changes coming
to health-care law, it’s unclear if pre-existing mental-health conditions could
once again be used to charge people more for insurance or deny them coverage.
Privacy concerns aside, the promise of collecting data is
the ability to render a holistic picture of a person’s mental state that’s more
accurate than infrequent assessments conducted in a doctor’s office.
Digital Biomarkers
“Our approach is to ask, how can we measure in an
unobtrusive and passive way?” said Tom Insel, former director of the National
Institutes of Mental Health.
Insel teamed up in May with Paul Dagum, a former
cybersecurity expert, to create a startup that mines the information on consumers’
phones to create “digital biomarkers” to try to predict depression, anxiety and
schizophrenia.
Called Mindstrong, the company tracks users’ every tap,
swipe and keystroke, then keeps an eye out for patterns such as reaction
speeds. It looks at locations and frequency of texts and calls. It also tracks
word use. Without reading people’s emails, Mindstrong can look at “word
histograms” that show how frequently certain words are used.
When people become depressed, “there’s a shift in
pronouns, instead of saying ‘we, you, they,’ it turns into ‘I, I, I,’” Insel
said.
Phone Behavior
Early evidence shows Mindstrong may be onto something.
Dagum said they’ve found strong correlations between phone behavior and
traditional cognitive measures. Mindstrong is running a 100-person study with
Stanford and plans to publish its results soon.
Mindstrong also has partnered with an insurance company
that will run a pilot program for 600 members with serious disorders. For the
insurer, which Mindstrong declined to name, early detection of a psychotic
episode or a relapse in depression could help it guide the member to treatment
earlier, avoiding costly hospital stays.
Woebot, too, has data that suggest a benefit. In a study
of 70 people ages 18 to 28, scores measuring depression were significantly
decreased in the group that chatted with Woebot compared with those who read a
National Institutes of Mental Health ebook.
Yet the technology can be buggy, leading Woebot to
misinterpret responses. Prompting me to rewrite a negative thought “so it’s
more positive,” I ask, “How?” and Woebot, following its script, cheers, “NICE!”
Kermit the Frog
Despite occasional miscues, it’s hard to be annoyed with
the cheery Woebot, whose personality Darcy said she modeled after Kermit the
Frog. After two weeks of chatting, the robot has heard more about my daily
moods than any of my friends.
Should I be concerned about how much these apps know
about me?
Mindstrong said it protects customers by avoiding the use
of behavioral data to sell products.
“We’re a health company and we need to build a brand of
complete trust,’’ said Richard Klausner, Mindstrong’s executive chairman and a
former director of the National Cancer Institute.
Darcy promises Woebot won’t sell customer information and
the company’s employees only view anonymized responses. But the app works on
Facebook Messenger, and Darcy concedes that she can’t vouch for how Facebook
will use the data.
Facebook says it collects information including when
users “message or communicate with others” in order to “provide, improve and develop
services.” Spokeswoman Jennifer Hakes said Messenger abides by Facebook’s data
policy, but “we do not read the content of messages between people or people
and businesses.” Facebook also doesn’t target any type of advertising based on
the content of Messenger conversations, she said.
Privacy Concerns
Investors don’t seem inhibited by privacy concerns.
Mindstrong has raised $14 million in a series A funding round, including from
an investment arm of insurer UnitedHealth Group Inc. It’s also cut a deal with
BlackThorn Therapeutics Inc. to track behavior changes as part of a drug trial.
Woebot’s funds have come from friends and family, but
Darcy said she’ll soon seek outside investors. While Woebot already has paying
customers -- after two weeks of free chatting, users are offered different
subscription options -- she said she’d never “gamify it’’ or give points for
checking in.
“As with therapy, the goal is to graduate,” Darcy said.
Graduation, for me, is not imminent. Woebot asks me how
I’m progressing toward my weekly goal.
“Not great,’’ I say.
“Hey it’s OK,’’ Woebot tells me. “In fact, I love when
things go wrong. This is exactly where all the juicy learning is, remember?’’
I don’t remember. But Woebot does.
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