"Solving the global crisis in mental health" is the name of a new series of reports from the Financial Times.  A recent article in this series that caught my eye was, "The new tech treatments that could improve mental health."  Could?  Why the pessimism, my British cousins?  

Digital health companies are launching weekly in the USA, and the launch pace is accelerating.  Many of these new businesses are focused on mental health because of the enormous burden it imposes. A current estimate of the cost of global mental health disorders is $2.5 trillion per year, and by 2030 this is projected to hit $6 trillion. In addition to medical costs, lost work days, and job quits, we should not forget the significant human suffering, rising incidence of suicide, and families in crisis that these costs do not quantify. For individuals in high-stress jobs, such as first responders, the burden is even greater, as they face daily challenges that can undermine emotional well-being and resilience. One of the groups with a very high incidence of emotional dysfunction and a lack of thriving is law enforcement officers, as I recently wrote about for Tactical Edge magazine published by the National Tactical Officers Association.  With fewer people going into policing, officers retiring early, and an increasing number of public safety staff suffering from mental health disorders, the US is facing a shortage of first responders who keep the peace for all of us, which threatens everyone’s health and happiness.  

Here's the crux of the mental health crisis: Self-report.  

The brain adapts rapidly to new physiologic states.  This adaption makes the new normal appear as the always normal.  For example, when you see a person with schizophrenia (often these people are homeless), who is talking to himself or herself, the "voices" they hear are the reality that they live, that is their normal state of being. Or an elderly person suffering from dementia will typically say they are "doing fine" even though they may not be able to feed or wash themselves.  In their mind, this is their new—and seemingly always—normal.  Or, when people take hallucinogens, like psilocybin or LSD, they often report mystical experiences. They indeed are having extraordinary experiences, as their brains try to make sense of this new normal, in which neurotransmitter levels can be a millionfold higher than in a non-drugged brain.  It is also unsurprising that in some drug users, these experiences have long-last effects.  The brain is what the brain does.  

To sustain itself, the body evolved redundancy in many of its organs.  We have two eyes, two arms and legs, 10 fingers and toes, and two kidneys that give humans backup systems in case of injury or disease.  The brain is the most valuable real estate in the body because it must function effectively or else the body dies.  As a result, the parallelism in the human brain is extraordinarily high.  When neurophysiology is altered, parallel processing often results in a self-reported "I'm OK" conscious response.  The organism is in fact OK, it is not dying, and the cardiovascular system is pumping, even though cognition may be altered.  The redundancy of the brain keeps the body running which is job one for every organism.  It's like driving a car with a failing transmission: the engine is still running, the wheels are turning, and you’re moving forward, but subtle warning signs—like unusual noises or delayed gear shifts—are easy to miss until the problem becomes critical. Similarly, the brain’s redundancy masks early signs of mental health challenges, keeping the body functional while underlying issues go unnoticed. This masking makes it difficult for those in high-stress jobs, like law enforcement or emergency medical personnel, to recognize when they are struggling with burnout or emotional exhaustion, further emphasizing the need for effective stress management tools. 

The "A-OK" self-report is generally not true for other disease states.  Heart attacks, cancer, lacerations, or a splinter in a finger--these all provoke rapid conscious responses in which the brain understands and can tell others that everything is not OK and an intervention is needed before things get worse.  Let me offer an example of this from my own experience.  My mother-in-law, Lorraine, was generally healthy, though was hypertensive and overweight.  One Saturday, her neighbors called me and said she had been sitting on her porch in the hot Southern California sun for a few hours and "did not seem right."  I went to see her and did a standard "orientation times four" exam.  This clinical evaluation queries a patient on whether she knows the date, her location, a fact about the world such as the name of the president, and her own name.  Among these, the last thing to go cognitively is one's name and that was all Lorraine could tell me. She did not know where she was, the date, the president, and I'm not sure she knew who I was.   I led her inside her home, got her to drink some water, and then drove her to urgent care.  "I'm fine, leave me alone" she insisted in her flippant New Jersey patois.  After a quick check, the urgent care doc found she had a fulminant urinary tract infection which, in the elderly, can inhibit cognition below that which is functional. But, throughout the experience, Lorraine insisted she was fine.  Just 24 hours on an antibiotic and her mental state returned to her pre-infection baseline.  

The brain's insistence that it is just fine is not a failing of those suffering from mental health afflictions.  It is a feature of a highly parallel brain.  What the Financial Times article failed to discuss, similar to many other articles discussing the future of mental health which I have critiqued, is that there are digital health technologies that continuously monitor and can accurately predict cognitive and emotional declines before a crisis occurs.   This is the best way to solve the global mental health crisis--measure those who are vulnerable for mental health disorders, share that information with trusted family, friends or clinicians, and implement interventions before a crisis occurs. For those in first responder roles or other high-stress jobs, such tools could help build resilience and prevent the mental health struggles that often lead to burnout or job loss.

The SIX app, from Immersion Neuroscience, continuously measures how well people are thriving neurologically.  It was not developed to predict mental health disorders, though the convolved neural signals it captures from smartwatches identifies the pre-depression symptoms of low mood and low energy with 98% accuracy. This enables SIX users to objectively and privately monitor their underlying unconscious emotional states and if they are not thriving, make changes in their lives, for example, changing their routine or reaching out for support from family, friends, or a therapist, before they have a crisis.  Importantly, the SIX app enables users to choose to share a slice of one's data with trusted others in one’s ‘inner circle’.  SIX allows users to share their general daily well-being status—thriving, coasting, or languishing—only with the people they choose to connect with in the app, encouraging friends or family to check in when needed.  When a run of negative signals occurs for three days in a row, one should reach out and offer help.  Often, just a phone call or getting together for coffee can break the cycle leading to depression or anxiety disorders.  SIX might also predict other cases in which people need help, such as when they abuse drugs, and research in these areas is ongoing.

The basic version of SIX is free - download it today!