Apple is developing technologies aimed at aiding in the detection of mental illnesses such as depression. These would augment the wide range of health-related features the company currently offers through its devices.
The researchers make use of user data that can be collected through the iPhone’s sensors to devise algorithms that can extract signals that identify possible mood disorders. Physical activity patterns, sleep quality and duration, and even how a person writes can help in making a preliminary diagnosis.
This initiative, made public by the Wall Street Journal, is in the early stages of development, and may take several years to be included in the functions of iOS or never see the light. Although some scientific studies have shown that people who suffer from some kind of mental disorder use their devices differently, it is still necessary to demonstrate that an algorithm is capable of detecting this type of pathology, even in a preliminary way. A diagnosis made by professionals will always be needed afterwards.
Unlike potential physical health problems that the Apple Watch can help users identify, mental illnesses and brain disorders are more complicated to detect. Simple quantitative comparison of collected data is not possible; it requires follow-up by specialists. But not everyone has access to it, and Apple wants to offer a large-scale alternative that makes it easier to at least take the first step in dealing with a mental illness: being aware that you are suffering from one.
Mental health, a silent pandemic
The health crisis we face has still shaken the foundations of our society. It has imposed on us new ways of socializing, working, or seeking medical care. And, when COVID-19 collapsed the public health system, mental health care halfway around the world came to a standstill. There was a more urgent problem to deal with: people dying in hospital corridors.
This collapse coupled with confinements, uncertainty, deaths and bereavements that could not be lived and managed with the time they required exploded a problem whose seed was already planted in our society.
More and more people are suffering from mental health problems. It is a silent pandemic.
Iñigo Errejón, of Más País, called in March for an “update of the mental health strategy, because every week that passes there are thousands of Spaniards suffering.” “We must double the number of psychologists in public health because someone to give you a hand when you are alone and you have a terrible time cannot be a luxury for those who can afford it”.
According to the World Health Organization, mental health is a fundamental component of health, understood as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Only a mentally healthy person is able to cope with everyday stress, work productively and contribute to the rest of the population.
“The ED data is not going down. Before the pandemic we had three or four suicide attempts a week. A few weeks ago we were more than 20 and last week we reached 35 cases,” said the manager of the children’s hospital of Sant Joan de Déu, Manel del Castillo.
According to the CIS, since the beginning of the pandemic, 6.4% of Spaniards have resorted to a professional for symptoms related to anxiety and depression. The scarce resources allocated to mental health in the Spanish public health system and its collapse indicate that we can only see the tip of the iceberg of a serious problem for society that must be treated urgently. But how can the big tech companies help?
What can techies like Apple do about it?
Biogen, a US multinational biotech company, announced in January a collaboration with Apple to launch a study later this year to investigate the role that the iPhone and Apple Watch could play in tracking people’s cognitive performance and detecting cognitive decline, including mild cognitive impairment (MCI).
It is expected to last several years and will have both young participants and older adults with different ranges of cognitive performance. The main goal is to develop a pattern that allows both monitoring of cognitive performance and identification of early signs of cognitive decline.
Aging affects the agility and accuracy of people’s cognitive faculties. Memorizing information, sustaining attention for long periods of time, or recalling a name become increasingly difficult tasks. These are all part of aging, but it’s important to know how to spot and differentiate the signs that suggest a person is showing early signs of MCI or Alzheimer’s.
Some patients affected by MCI eventually progress to dementia. Symptoms occur when the disease process is already advanced, so the progression of the disease continues to accelerate even if palliative treatment is started.
One of the major goals of the study is to identify genetic markers that allow a diagnosis of Alzheimer’s in early stages or even before the development of the disease itself. This is where Apple aims to help through artificial intelligence algorithms. These will use data collected through the iPhone and Apple Watch to detect MCI early to recommend the user to seek medical attention.
Apple Watch / Kirkwood student media
Biogen is keen to see this study come to fruition. Its new Alzheimer’s drug, Aduhelm, was approved by the US Food and Drug Administration in June. As well as being the first to be approved since 2003, it is also the first to be based on tackling the underlying cause by reducing the build-up of beta-amyloid protein in the brain.
Together with the University of California, Los Angeles (UCLA), Apple is conducting another study in parallel to detect symptoms of stress, anxiety or depression. It began in late 2020, and the next phase started this week with the help of 3,000 volunteers.
It will use the iPhone’s video camera, keyboard and microphone, and the Apple Watch’s heart, motion and sleep sensors to analyze through machine learning algorithms facial expressions, physical activity or the speed at which people who suffer from some kind of transient mental disorder type. According to the documents to which the American newspaper has had access, even the amount of cortisol through the hair follicles of the participants will be measured.
The aim is to find peculiar and quantifiable data that will serve to identify with some reliability these symptoms on a large scale. Any clues may be useful so that comparisons can be made with the level of energy, ability to concentrate or emotions shown by the patients. All these data will be compared with questionnaires and follow-ups carried out by professionals. Within the collaboration with Biogen, these will be contrasted and compared with standard psychological tests for MCI and brain scan tests.
The third study being conducted is with Duke University. It focuses on the detection of childhood autism. The multinational company hopes to create together with the team of researchers at the university an algorithm capable of detecting symptoms of autism using the front camera to analyze the focus of attention of children. The aim is, as in the rest of the studies, to detect possible pathologies as soon as possible and recommend the user -or parent or guardian in this case- to go to a professional to make an appropriate diagnosis and begin treatment as soon as possible if appropriate.
Google for its part, although it has not yet presented a study or clear collaboration to be used in the future within their smartphones, is another of the multinational technology companies interested in health with initiatives aimed at designing algorithms that can help pathologists to classify prostate cancer more objectively and easily or assist the user in the early detection of possible skin diseases through the smartphone camera.
At what price will tech like Apple or Google help?
The ambitions of technology companies together with different laboratories and universities in the field of health do not only depend on their engineers and researchers. Users have to trust their smartphone manufacturer to make good use of the information they extract from them and how it will be used. The above-mentioned research is taking place while the company is facing multiple criticisms for its planned automatic detection system for child sexual abuse content.
The feature, which was to be integrated into iOS 15, scans the mathematical data of the photos its users upload to iCloud Photos for potential crimes. The main criticism is that, despite the laudable purpose, the multinational has implemented a backdoor that breaks the encryption of photographs and could be used in the future to track other types of content in countries such as China or Russia.
Apple defended itself by arguing that privacy remains one of its pillars, but that this serious problem needs to be attacked at the same time. However, the launch of this function has been delayed due to the concerns and criticism shown by public opinion after learning about the initiative and its delicate implementation.
As for the specific health-related functions that the company already includes in its watch, both the collection of biometric data and its processing is done through dedicated chips and algorithms in the iPhone itself. Therefore, the information never leaves the iPhone and Apple can offer these benefits without compromising the privacy of its users.
However, in terms of mental health, the data would not be limited to blood oxygen level or heart rate, but would analyze facial expressions, what you write, and even how you feel. This is even more sensitive and intimate information, the collection and analysis of which may cause some consumer suspicion.
The key to protecting the user is that the information never leaves the personal device and ends up on a server. This is something Apple has always emphasized, until certain governments force them to make concessions, as in China.
Wikimedia Commons/Agência Brasil Fotografias
A help, not a solution
“Like everyone else, for the last year and a half I’ve been cooped up and isolated and it’s shocking to be back in a place that felt like my second home. But it’s not anymore, and this is a very drastic change,” Miley Cyrus admitted in the middle of a concert a few days ago after suffering a panic attack upon entering the stage. She made public and normalized what she felt just as Simone Biles did at the Tokyo 2020 Olympics by refusing to compete in most of the finals in which she was eligible for a medal.
The pressure singers and athletes are under is taken far too lightly. The same goes for everyone else whose environment has forced them since childhood to not be able to have the right to be sad, suffer anxiety attacks or tell and seek help.
It is of little use for technology to recommend that we seek professional care if society continues to look the other way or if public health resources are clearly insufficient to quickly and effectively care for the millions of people who suffer from mental health problems.
That tech companies take an interest in collaborating in their early detection and that celebrities acknowledge that like everyone else they occasionally feel prey to anxiety and panic are major steps in beginning to try to remedy the great problem of mental health.
Mental health is a silent pandemic that we must combat as a society, in the first instance, by feeling entitled to talk about it normally.