How technology is helping plug the gaps in mental healthcare

Sounds of thunder and rain to lull you to sleep, posts about being kind to yourself, reels of aesthetic room makeovers and napping kittens during me-time breaks—social media throws up a million ways to soothe frayed nerves, until it falls short.

Anxiety, depression, sleep and stress related disorders have been on the rise.

The National Mental Health Survey (NMHS) 2015-16 found that 10.6 per cent adults in India suffered from mental disorders. The survey also painted a grave picture of the country’s unpreparedness to deal with the rising burden of mental illnesses, calling the current mental health systems ‘weak, fragmented and uncoordinated.’

There is an acute shortage of qualified mental health practitioners. According to NMHS, the availability of psychiatrists per lakh population in Madhya Pradesh was as low as 0.05, while in Kerala it was 1.2 – falling woefully short of the WHO recommendation of 3 per one lakh population. Nearly 150 million Indians required mental healthcare services, but less than 30 million were seeking them.

Post pandemic, the acceptance and conversations around mental illnesses have been noteworthy. However, access to reliable mental health support has been limited for a long time – unaffordability and unavailability of desired specialists being key factors. According to reports, there were only 3,372 registered clinical psychologists in India as of last year.

The dearth of mental health practitioners and the steep cost of therapy has spurred the launch of several online apps and platforms over the past few years. From AI chatbots and tools that diagnose the condition to peer support groups and virtual reality (VR) solutions, these tech-led offerings are attempting to rehaul how mental health is perceived and preserved in India.

Apps assemble

MindPeers, which calls itself a mental strength platform, has designed a digital tool called CogniArt to help people understand where they stand in relation to their mental health through art.

“10-20 per cent people know that they need therapy; the rest don’t. This is where CogniArt comes in,” says Kanika Agarwal, who founded MindPeers in 2020 after having been through severe anxiety attacks and a long hunt to find the right therapist.

CogniArt can analyse drawings – of a childhood memory or a dream home for instance – based on 30 different parameters and inform the person about their condition in a more efficacious way than, perhaps, words can. The platform also has neuroscience games, pre-screener tests, and a panel of psychologists, psychiatrists and psychotherapists.

Infiheal’s ‘advanced AI companion’ Healo is a sombre-looking, green-coloured bot who is eager to help. If you are undergoing work-related stress, Healo may suggest journalling and breathwork to cope with it.

A ‘personality assessment report’ is generated few minutes into the chat, and one has the option to book a session with a psychologist (1.5 to 10 years of experience) to delve deeper.

An in-person session with a therapist in a metro could cost anywhere between Rs 1,000 and Rs 5,000 an hour, depending on the therapist’s qualification, years of experience and the disorder being treated. On a platform like MindPeers, it could cost Rs 600-700 per session.

Mohini Mehta, a 32-year-old research scholar, moved to Sweden in the throes of the pandemic. She recalls it being a debilitating time having lost a close family member back home in India, settling into a new country, and battling extreme loneliness. That’s when she realised “online therapy is not that bad”; she had favoured in-person therapy for many years.

“It was really important that I work with somebody who understands my cultural context better. When you are in distress, the last thing you want to do is make someone understand where you are coming from. So, the only option I had then was online sessions.” She found the right fit with MindPeers and signed up on the platform in early 2021.

A worthy supplement

Dr Vishal Indla, Psychiatrist, INDLAS Hospitals, sees great merit in invoking VR to treat certain conditions such as obsessive-compulsive disorder and social anxiety.

The VR therapy by Avika Mind Health, where Indla is a medical director, involves a mix of relaxation module and exposure response prevention (ERP) module. If a patient has social anxiety, for example, they will virtually be taken to a place like a supermarket and then gradually be exposed to increasing levels of complexity, people, noise, etc, with a voice over in the local language to help them work through the stressors.

“Previously, this was all done in person, where the therapist would make them imagine these scenarios. But now with VR, there’s no need for imagination; it’s right in front of the patients, very vivid with all the instructions so they can systematically desensitize themselves from the anxiety,” he says.

At the heart of mental health platform SoulUp’s services is peer support: making it easier to find and connect with someone who has emerged from a similar situation or is sailing in the same boat.

There are one-on-one peer video calls, where the caller can talk to a suitable peer who is verified and trained by SoulUp, and there are support groups where five or six people dealing with the same challenge, be it going through a divorce or smoking addiction, come together to solve it together in the presence of a therapist.

On SoulUp, a one-on-one peer conversation can be booked for Rs 399-699, whereas a support group programme comprising six sessions costs Rs 3,500.

“Most people equate mental health to mental illness, and hence equate it to therapy; however, the majority do not need that. The majority are going through real life challenges, where there is no obvious solution, and trying to grapple with what is possible,” says Punita Mittal, Co-founder, SoulUp.

Relationships are the source of almost 40 per cent of the problems people in the 25-45 age group face, followed by mental illness, where people undergoing therapy are looking to connect with others like them, and issues such as anger management and body image, she adds.

Hansika Kapoor, researcher and psychologist at Mumbai-based Monk Prayogshala, says peer support networks help build a sense of community around a ‘diagnosis’. “It helps those with a mental health disorder understand that they are not alone, and they are not ‘making a big deal about something’.”

Employers, too, are signing up on these mental health apps. From merely ticking the mental well-being box in their to-do list, HR managers are keenly looking for implementable solutions given the high incidence of workplace toxicity, and friction owing to a multi-generational workforce. Helping corporates “revisit their cultural framework to take psychological safety also into consideration” comprises 70 per cent of MindPeers’s business today.

A chatbot addressing mental health concerns is not a concept mental health practitioners are likely to warm up to yet. “A lot of the AI chatbots are based on large language models that are trained on a corpus of linguistic information. So, it also depends on whether those large language models can take context and culture into account,” Kapoor says.

Dr Indla, while skeptical about AI standing in for a real therapist, says it can work well in a supporting role, especially in ensuring medication compliance – the lack of which could lead to a relapse.

On the Avika app, there is a compliance tracker which sends out an alert to the patient’s caregiver and doctor in case they skip a dose. Reminders to make journal entries and finish therapy-related homework, and detecting any alarming signals from the patient are some other practical ways AI can chip in.

The implementation of AI, VR and online tools to supplement mental healthcare might be just what the doctor ordered.