Mental illness is the largest cause of disability in the UK. One in four adults experience a mental health problem each year (NHS-England), costing £105billion (Department-of-Health). The COVID-19 pandemic is causing a parallel outbreak of depression and anxiety, which governments must manage appropriately (Yao, The Lancet, 2020). Social isolation is known to worsen pre-existing mental health conditions and has the equivalent health impact of smoking 15 cigarettes per day (American-Psychological-Association,2019). Quarantine leads to three times the levels of psychological distress compared with non-quarantined populations during disease outbreaks (The Lancet,2020).
Unlike other areas of medicine, mental healthcare lacks quantifiable metrics and robust data-driven methodology. Clinicians obtain data they need through time-consuming qualitative procedures and questionnaires delivered during face-to-face meetings. Not only does this waste valuable in-session time, increasing wait lists (compounded by COVID-19), but clinicians must also address the problem of collecting high-quality patient data remotely during quarantine. Furthermore, care providers require new methods of supporting patients in-between appointments to combat psychologically damaging effects of social isolation during the current pandemic.
Limbic are a digital mental health company that augment cognitive behavioural therapy. We have already developed a friendly mobile chatbot that engages patients and can provide a level of companionship during COVID-19 isolation measures (\>50% of patients still active on the platform after 6 weeks). When Limbic detects a low mood, it prompts the patient to note down associated thoughts, and even offers personalized coping strategies, designed by the therapist. Limbic further collects validated clinical outcome measures (e.g. GAD-7 and PHQ-9).
In this Innovate UK project, we seek to (1) develop new CBT dialogues for COVID-19-associated mental health concerns, and (2) develop a clinician mobile app to 'close the loop' such that clinicians can easily review data, generate referrals, and create personalised content for their patients. The project will allow Limbic to deliver a fully mobile experience for patients and clinicians, and will augment remote therapy during and beyond COVID-19 quarantine measures. The impact of Innovate UK funding will be to improve access to therapeutic support, improved methods to identify at risk patients, reduce the need for in-person check-ups, and increase the efficiency of mental health care delivery generating significant savings to providers and improving the patient experience.
Once Limbic’s fully mobile platform is established, the extension of this project will allow Limbic to define commercial strategy, marketing approaches and ultimately launch the Limbic product into the psychotherapy market. Additionally, the extension will provide the scope to develop the technical support infrastructure to allow for the scaling of the Limbic platform across the mental health market.
Due to continued budget cuts to the NHS, mental health patient waiting times are longer than ever. In a nationwide 2018 survey, 25% of patients waited more than three months to see an NHS mental health specialist, 6% had waited at least a year, and some patients waited up to 13 years (Guardian,2018). A study completed by the Royal College of Psychiatrists found that 37% of those who faced a wait to access specialist help saw their mental health deteriorate during that time, 36% said they experienced relationship difficulties as a result, 34% had problems at work, including losing their job, and 32% had suffered financially. CCG's and hospitals are now looking for innovative technology solutions to reduce clinician time needed with patients in order to be able to facilitate more patients and reduce the growing and damaging waiting list.
Over 1.7 million people were referred for the Improving Access to Psychological Therapies (IAPT) under the NHS in the UK in 2017, costing £11.9 billion. However, 8/10 GPs still believe mental health treatment is a product of trial and error. (NHS-England,2018). There are currently no technology solutions that can provide quantifiable information on the patient's emotional state throughout the mental healthcare process, which includes: screening health issues; communicating feelings and experiences to a therapist; measuring the impact of therapeutic intervention; and reliably assessing whether someone is stably cured and can be discharged. As a result, patient engagement is low (only ~50% engagement in IAPT), leading to delays and inconsistencies in clinical decision-making, and discharging of patients who are prone to relapse.
Limbic, in collaboration with KCL and Dr Julian, aim to build a scalable solution for mental health monitoring using the world's first wearable emotion-detection AI for mental health patients. Limbic have developed a new technology to predict emotion from data collected by consumer wearable devices, continuously and passively in the background. Limbic now seek to apply the technology to a specialist mHealth solution for patients suffering from mental health issues.