Pandemic Has Exacerbated Mental Health Care Demand, but There Is a Supply Shortage: Can AI Help?

The COVID-19 pandemic has receded in the United States and many parts of the world except for some European countries and China, where there was a sharp rise in infection caused by the omicron subvariant BA.2, which is more transmissible than the original omicron (BA.1). In general, the world is trying to get back to the pre-pandemic normal. In the U.S., most pandemic-induced restrictions have been removed in all 50 states. It is unclear how states and counties would respond if BA.2, which is currently the cause of 85% of all reported infections, causes a surge like in Europe. Health officials have cautiously warned that some, if not all, mandates may come back if a quick surge in cases is observed. Have we learned to “live with the virus”? That is not entirely clear. The good news from the U.K. is that, unlike with the delta and omicron variants, ICU admissions and deaths did not rise with the latest surge, suggesting that immunity from the vaccine and/or previous infections helped keep the blow mild and the virus at the endemic level.

However, it is too early to predict anything, and it seems as though we are living inside a thriller movie that has twists at every turn, forcing everyone to sit on the edge of their chairs with continuous anxiety. This anxiety has led to deterioration in mental health for many. The world has grappled and is still dealing with a sharp rise in mental health care demand, making this a major issue of the pandemic years. May is Mental Health Awareness Month. Hence, in this article, I would like to shine a light on how mental health management has emerged as the key challenge during the COVID-19 pandemic and how new technology innovations are aiding as tools to tackle this frontier.

Growing Demand for Mental Health Care

The pandemic created unexpected and unwanted isolation for many people. Cities around the world went under lockdown or shelter-in-place. Schools, offices and places of prayer shuttered their doors and disallowed congregation. Humanity was suddenly trapped within the four walls of individual dwellings. Multiple surges in hospitalizations and deaths drained frontline medical workers, who found themselves to be overworked, under-resourced, emotionally drained and often exposed to the wrath of the virus more than their patients. Social isolation created endemic mental health issues, from depression to anxiety disorders to more serious conditions. The situation was exacerbated by the loss of jobs, homes, food, equitable access to education and the lives of friends and family members to the virus. It is true that demand for mental health was rising even before the pandemic, with supply shortages everywhere. According to a global Lancet study, mental health conditions are not only on the rise but also are identified by doctors only 47.3% of the time and noted only 33.6% of the time. Lack of diagnosis of mental health issues led to more than 60% of people, who could have benefited from an intervention, falling through the cracks.

The Pandemic Changed Our Lives

Clinicians today are asked to do a lot. Many suffer burnout, and worse, suffer silently. Companies are also waking up and taking notice of the situation. Large corporations have extended their mental health benefits to employees, including access to care through partnerships, the creation of new company holidays and additional time off. At one point, many companies thought they would change the working model permanently to remote work or work from anywhere. However, social isolation and other issues of working from home led them to believe that employees would like to come back once the pall of the pandemic is lifted. It is interesting that whereas the unwanted social isolation worsened the mental health crisis, opening the economy and workplace is also creating social anxiety among many – an interesting conundrum. It is no wonder that this once-in-a-century pandemic has changed most of us. Some people underwent huge changes in their daily lives, including slowing down and making shifts in how they live. In a Washington Post article about the fear of returning back to normal, Lucy McBride, a primary care doctor in Washington, D.C., says the main culprit in this is trauma. As a result, we see a strange ambivalence among people to return to normalcy. Such stressors have kept mental health care demand high despite the receding pandemic.

A Growing Gap Between Demand and Supply of Mental Health Care

During one of the highest demands of mental health, mental health care providers are changing careers at a rapid pace. Job transition, which is defined as the transition to a new role, not just a new employer, has increased by 42% since 2019. How can we meet this crisis head-on? It is not possible to create mental health workers overnight or even in a few years. If the gap between the demand for and availability of licensed practitioners widens, what kind of society will we become? I agree with many pundits that we must rely on technology to be humanity’s savior. Many new apps have hit the market and grown substantially as marketplaces to connect psychiatrists, clinical psychologists and licensed social workers to provide on-demand, remote care to care seekers. The apps typically collect demographics and various preferential parameters from the patient and then match them with providers on their network and finally setting up video visits. Those apps also use several questionnaire-based diagnosis tools to assess acuity of the mental health condition. Depression and anxiety disorders are the most common conditions for which such apps are used. Although apps are great for connecting people with providers, the problem of a declining pool of mental health practitioners still lingers.

Utilizing AI-driven Voice Analysis for Mental Health State Detection

Recently, artificial intelligence (AI) is being targeted as a potential solution to the lack of health practitioners. This new research paradigm is based on the premise that the sound of a voice is a decent predictor of the person’s state of mental health. It is possible that a well-trained AI could detect the changes in someone’s voice during speech that would be imperceptible otherwise and determine whether urgent help is needed and, if so, connect a telehealth provider along with the analysis details to speed up diagnosis. It is not a replacement for the provider per se, but the tool could help in diagnosing issues that many times go undetected, as well as ensuring that a provider session is efficiently utilized. Machine learning researchers today can detect depression and anxiety from voice features, as well as other mental illnesses such as schizophrenia and post-traumatic stress disorder. Deep-learning algorithms can also uncover other patterns and characteristics in the voice that might not be detected – even by trained experts – over a telehealth session. In other words, this technique could potentially provide a more biomarker-based diagnosis of mental health instead of the traditional subjective assessment.

However, such AI-driven voice analysis for mental health detection is not without challenges. One of the major sources of errors could be an inherent bias in the training dataset. Patients can come from diverse language and cultural backgrounds. If certain language and cultural aspects are not adequately represented in the data, the bias could under- or over diagnose issues. AI is as good as the data fed into it. One California Bay Area-based start-up working on this is trying to mitigate such biases by creating vast and diverse voice recordings from different parts of the world. It is still too early to say that this method would be successful and reliable, but there is a lot of promise. If detecting mental health could be as easy as detecting a fever by using a thermometer, it would help many people self-diagnose their issues in the privacy of their own homes. Once someone knows they have an issue, we hope that they won’t fall through the crack and would be able to take appropriate actions to take care of themselves. During this Mental Health Awareness Month, let’s hold that optimism high.