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Mental healthcare vs. disruptive innovation

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Mar 7, 2017

Untreated mental illness silently plagues a large portion of the United States population. Roughly one in five adults in America suffer from some form of mental illness in a given year, and approximately 60 percent of those cases go untreated. These statistics are similar for teenagers; and educators report that depression, anxiety, and social phobias among youth seem to be on the rise.

Fortunately, a new menu of online mental health resources start to address these unmet needs; and some pioneering options have efficacy results comparable to face-to-face therapy. Programs such as MoodGYM, MyCompass, and Beating the Blues teach principles and techniques from cognitive behavioral therapy (CBT) to help people suffering from anxiety and depression. Other online solutions designed for teens, such as Bite Back and Base Education, teach students how to focus, reduce stress, handle difficult emotions, and improve social relationships.

Will online alternatives disrupt traditional face-to-face therapy in the not-too-distant future? To answer that question, consider how they measure up to the disruptive innovation litmus tests.

1. Does it target nonconsumers or people who are over-served by an incumbent’s existing offering in a market?

A handful of factors contribute to the widespread lack of treatment for mental illness. To start, many people cannot afford regular appointments with a mental health care professional and do not have coverage for mental health treatment as part of their health insurance plans. Also, many patients find that office visits with a psychologist or counselor are only available during the workday, and few working adults can regularly take time off work for therapy appointments. Additionally, people suffering with mental illness must overcome pervasive cultural stigmas associated with mental health treatment. Last of all, few psychologies are on call during the unpredictable life moments when patients experience the greatest psychological distress—suicide hotlines being one notable exception to this problem. These reasons, and others, point to the causes of widespread nonconsumption of mental health care.

2. Is the offering not as good as an incumbent’s existing offering as judged by historical measures of performance?

Online alternatives to therapy fall short on many fronts when compared to visits with professional psychologists. Current online software cannot read and interpret patient’s verbal and nonverbal cues to diagnose mental illnesses with professional accuracy, nor can it identify patients’ needs, preferences, and life circumstances to develop custom-tailored advice. Software also cannot form relationships with patients to motivate them and hold them accountable.

3. Is the innovation simpler to use, more convenient, or more affordable than the incumbent’s existing offering?

Although online mental health support may not be able to provide individualized diagnosis and treatment plans, it is definitely superior to traditional therapy and counseling on these fronts. Accessing mental health support online or through an app is much simpler than finding a trusted recommendation for a therapist and setting up an appointment. A person can access online mental health support at whatever time it is convenient to them, as opposed to having to schedule around a therapist’s available appointment slots and then spend time traveling to the therapist’s office. Last of all, whereas the cost of seeing a therapist can range from $75 to $200 per hour, with costs recurring over many sessions, the one-time cost for online solutions range in the ballpark of $150 to $320. Some options, such as MoodGym, MyCompass, and Bite Back are even free.

4. Does the offering have a technology enabler that can carry its value proposition around simplicity, convenience, or affordability upmarket and allow it to improve?

The long-term disruptive potential of online mental health solutions really depends on how quickly the technology can improve over time. It’s impossible to predict with certainty how mental health technologies will evolve, but a number of potential advances look promising.

Virtual reality simulations could provide patients with practice at navigating challenging life circumstances. Augmented reality could provide coaching in real life. As artificial intelligence, optical recognition, and voice recognition technologies improve, they could help online mental health software provide more accurate diagnosis and more personalized treatment.

The algorithmic nature of online mental health programs could also drive them toward more reliable patient outcomes than traditional therapy. Online platforms can easily collect data to analyze treatment efficacy and conduct A/B testing on new treatments. Online programs could also outflank human therapists in their ability to stay up-to-date with the latest research on effective treatment. Additionally, online systems can avoid the common tendency among therapists to deviate from evidence-based practices and offer advice based more on personal opinion.

5. Is the technology paired with a business model innovation that allows it to be sustainable with its new value proposition?

Online therapy has the classic advantage of most software-based business models. Developing an effective and reliable online solution can be expensive. But once a solution is good enough to generate demand, the marginal cost of delivering that solution is practically zero. In comparison, the business model of traditional therapy will always require billable hours from professionals who hold expensive degrees.

6. Are existing providers motivated to ignore the new innovation and not threatened at the outset?

Although professional psychiatrists, psychologists, and counselors may scoff at the limitations and risks of online mental health support, online options will not threaten professionals’ livelihood any time soon. Online options may be effective for helping people with moderate and untreated anxiety, depression, and addiction, but they have a long way to go before they can match high-quality professional treatment for more debilitating conditions such as severe depression, bipolar disorder, and schizophrenia.

If online mental health solutions have the potential to disrupt the traditional model of mental health care, the unfolding of this disruption cannot come soon enough for K–12 education. School psychologists, nurses, and social workers are in short supply, and many students do not receive needed mental health treatment. Meanwhile, many teachers find themselves shouldering students’ mental health needs on their own. Unfortunately, when mental illnesses go untreated, students pay the price in lower academic achievement and overall well being.

As my colleagues Julia Freeland Fisher and Michael Horn have written, schools that aim to address student achievement challenges need to integrate across factors beyond academics that affect students’ ability to learn. Mental health is definitely one such factor, and convenient, low-cost, disruptive alternatives to traditional mental health care may prove critical for unlocking schools’ capacity to bring high-quality mental health care under their roofs.

Thomas Arnett

Thomas’ research focuses on the changing roles of teachers in blended-learning environments and other innovative educational models. He also examines how teacher education and professional development are shifting to support the evolving needs of teachers and school systems.