Op-Ed: Hope for High Tech Health

COVID-19 is sparking a global mental health crisis - but digital and telemedicine interventions are a ray of hope. In this Op-Ed piece published in the Herald Sun (7 April 2020) Professor Kim Cornish, Director of the Turner Institute, explores how digital technologies have the potential to support those in need.

The global community is going through rapidly escalating change in ways that were almost unthinkable just at New Year. Even those of us untouched by COVID-19 directly have felt the effects in the risk to our physical safety and our loved ones, coupled with economic shock, constant bad news, social isolation and reduced freedom.

It’s no wonder then there has been a huge rise in calls to mental health support services in Australia. Early research on mental health in this crisis, largely from China, shows unsurprisingly a high prevalence of anxiety, depression, stress, trauma and insomnia.

We are in uncharted territory with a number of elements of this crisis unique to our era: from a mental health perspective, this includes the enormous global scale and scope of this crisis and the impact it will have, as well as the role technology will play in our lives over the coming weeks and months - now we’re all suddenly learning how to connect on Zoom (myself included).

We have also seen rapid digital change - telemedicine has transformormed more in the space of the last few weeks in Australia than it has in years - with Medicare support now available for phonecalls, Skype and Zoom calls with your doctor.

We know that economic recessions, like the global financial crisis in 2008, are understandably associated with an increase in mental health problems.

One of the differences since 2008 is that mental health is finally very much part of the national conversation. This was evident when the Government announced a $74m package for mental health earlier this week, a commendable rapid response to what will be an enduring public and mental health crisis.

We now have an opportunity to advance the way mental health support is delivered across Australia and beyond using digital technology and telemedicine - and in fact COVID-19 leaves us with few other options.

The previous model for mental health support has been slow to change. It meant you would wait until you understood you had symptoms, then you might seek support, wait for an appointment, have tests done and follow up with any services you can afford.  There were significant barriers for someone to access mental health services requiring time and the navigation of a multi-stage process.

New technologies allow us to get to where people are, reach a lot of people more rapidly, and do so at an earlier stage and deliver personalised care. We know in mental health, early intervention matters - and this is where we can go beyond telemedicine and look at other technology to support people.

Insomnia is one example - evidence shows it’s on the rise right now. We also know insomnia is an important mediator of mental health. Here at Monash University’s Turner Institute for Brain and Mental Health we are investigating how tackling sleep can be an indirect way of addressing mental health problems and how sleeping better can reduce anxiety and depression.

While people may be aware they have insomnia, they may not be aware how it affects them. Using technology, sleep can be monitored and assessed remotely through an app in a watch or smartphone, and individuals can get updates, support and referrals much faster than they might have otherwise, or otherwise might not have realised they could get support.

Despite the fact that digital technologies have enabled us to reach and support more people earlier than before it’s important to note that technology can be a barrier for some groups. This is especially true of vulnerable groups like children and the elderly, who may not be able to articulate their feelings or needs as well as others, the same is true for disadvantaged  communities.

We need to proactively think about how we can engage with these groups, especially the elderly, and make sure any interventions are designed with different communities in mind and with their input.

Technology is not a replacement for social connection. But it is a way to provide immediate support to people who need it wherever they are, and help people understand they need support or who wouldn’t normally front up at a clinic.

We believe digital mental health intervention delivered at scale and accessible to all Australians is a game changer. In the long term we hope that can mean better access to mental health support much earlier than before, for anyone who needs it - during the COVID-19 pandemic and beyond.

Professor Kim Cornish, is Director of the Turner Institute for Brain and Mental Health, is a leading researcher at Monash University and a Sir John Monash Distinguished Professor.