I wonder if ACEs science is known, considered or used by a neuroscientist such as Insel? I read stories, like the one below as a parent and a trauma survivor and am as fascinated as I am troubled. My hope is that technology and health data tracking will be used to better treat people and to treat people better?
Here are some excerpts from an interesting article in Wired which was written by Adam Rogers:
Insel’s hopes for research have always been outsized. You might remember the hypothesis—somewhat controversial—that the hormone oxytocin is a key to human attraction and relationship-formation. That was his work. Insel brought to NIMH a commitment to finding neurochemical and other quantifiable markers for psychiatric disorders rather than relying on behavior and self-reported feelings. He even wanted to throw out the Diagnostic and Statistical Manualof Mental Disorders, the bible of psychiatric symptomatology. For the past few years, well before moving to Verily in 2015, Insel was writing about using biomarkers and mobile technologies to create “precision medicine for psychiatry.”
Apparently it didn’t work. “I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs—I think $20 billion—I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness,” Insel says. “I hold myself accountable for that.”
If biomarkers can’t diagnose mental health issues, maybe a “digital phenotype” can. In 2015, Insel told Technology Review that this was why he was jumping to Alphabet: the idea that a combination of your medical records (electronically stored, duh) and how you use your gadgets—tracking of activity correlating with depression or future self-harm, let’s say—could be a Big Data bonanza for predicting and treating health issues. “For a bipolar patient whose mania is manifested in rapid, uninterruptible speech or hypergraphia, their disease could be characterized by the frequency, length, and content of participation in social media,” write the researchers who defined the term in Nature Biotechnology. In fact, mood is one of the things that Verily’s $100 million Baseline study will track among its 10,000 eventual participants.
At Mindstrong, one of the first tests of the concept will be a study of how 600 people use their mobile phones, attempting to correlate keyboard use patterns with outcomes like depression, psychosis, or mania. “The complication is developing the behavioral features that are actionable and informative,” Insel says. “Looking at speed, looking at latency or keystrokes, looking at error—all of those kinds of things could prove to be interesting.” Maybe in five years digital phenotypes will have gone the way of neurobiology and genetics in mental health, Insel acknowledges, but for now the tech ideas are worth a look. Full article:
I get a bit creeped out by the idea that keyboards and mobile phone use will be analyzed and assessed. But, maybe that is not so different than other instruments such as thermometers or stethoscopes that monitor body temperature and heartbeats. I don't know...
I hope individuals and communities can use technology to self-soothe, to monitor, to regulate our emotions and symptoms in ways that benefit us and those we love. We, as parents, partners and professionals are often tasked personally or professionally (or both) with the job of looking out for the health of others. Physical health. Emotional health. Tools to do so more easily and accurately might be wonderful.
I worry though that more sophisticated tracking of symptoms and health records though will be another way to manage symptoms, people and expenses rather than to understand, address and respond to the root causes of suffering?
What if funds were used, instead, to measure and support health and healing instead?
What if instead of studying people and patients we poured resources into actually listening to what people express wanting and needing before, during and after times of crisis?
Maybe someday, we will be much more empowered when it comes to our own health care, management, and tracking. In the past, consumers of mental health services have had little voice and ability to impact the very systems we often relied upon in times of need. However, today I'm encouraged by this growing ACEs community sharing and using ACEs science.
Maybe individuals and groups will have more choice, power, and ability to impact the insurance and medical industries in major ways? I think of how one shift can impact an industry (think Airbnb and hotels or Uber/Lyft and taxi service companies).
I know as parents and patients we have to stay central to research, conversations, and applications of technology central to the health and well-being of us all, individually and collectively.
I'm glad we have spaces such as this one in which to do so.
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