Yesterday the American Journal of Psychiatry, one of the most respected medical journals in the world, published a clinical case conference article of great relevance for digital mental health. The paper, “Late-Life Depression: A Role for Accelerometer Technology in Diagnosis and Management” by Ipsit Vahia MD of McLean Hospital and Daniel Sewell MD of The University of California San Diego explores a clinical case of major depressive disorder in a older patient and the role of a wearable fitness tracker in making that diagnosis. The article is unique not for its large sample size, being a case report it has a n of just one, but rather how it underscores the successful integration of technology into mental health.
In the article, the wearable sensor provides the two psychiatrists with new data regarding the patient’s sedentary state. The two psychiatrists add this new data into their clinical differential diagnosis and realize the patient is suffering from depression. The wearable sensor did not detect depression or perform machine learning on the patient’s behaviors – it simply recoded some simple data. The psychiatrists did alter their relationship with the patient because of the wearable sensor and kept the focus on his health – not the technology. Simply put, the wearable sensor was an adjunctive tool that was deftly deployed to the right patient at the right time.
Digital tools like fitness trackers present great opportunity to improve care as shown in the paper. But also as shown in this paper, they need to be utilized in the right way. Now in mid 2016 we know that technology and sensors can capture a glut of health information, and collecting that data is no longer a challenge. Rather the clinical experience and acumen of how to integrate these digital tools into patient care is the new challenge for all of healthcare including mental health. Drs. Vahia and Sewell provide a wonderful example of how it should, and can, be done. Their article is a important read for anyone interested in mhealth, mental health, and medical technology.