Depending on your age, gender and medical history, you’ve likely had a screening test during a GP appointment, such as a cholesterol test to detect early symptoms of heart disease, a Pap test for cervical cancer or a Prostate-Specific Antigen (PSA) test for prostate cancer.
Screening tests are one of the great achievements of modern medicine, allowing us to identify disease long before any outwardly visible symptoms appear and intervene in a timely manner. Pap tests alone have reduced cervical cancer cases in the United States by up to 492,000 over the past 30 years.
But while regular screening is welcomed when it comes to physical illnesses, it remains underutilized when it comes to mental illness. In fact, depression screening rates in primary care settings are below 5% and even lower among minorities. This is despite the fact that more than 50 million Americans suffer from a mental illness, 1 in 20 have suicidal thoughts, and more than half (54.7%) do not receive treatment for a mental illness.
In addition to the risk of death by suicide and a significantly reduced quality of life, untreated mental illness can directly lead to poorer physical health. A recent meta-analysis found that depression significantly increases the risk of death in people with chronic diseases: 184% for diabetes, 44% for heart attack, and 41% for kidney failure. It also increases the risk of a major heart attack by 52% in people with heart disease, and doubles the risk of dementia in people with diabetes. Additionally, poor mental health can lead to poor self-care, such as forgetting to take medication, engaging in unhealthy behaviors, and missing medical appointments, which increases the risk of hospitalization and overall health care costs.
These statistics highlight serious flaws in our health care system: if testing is central to the detection, prevention, and early treatment of countless physical health conditions, why isn’t the same for mental health?
Hidden Barriers to Mental Health Testing
Experts have long advocated for routine screening of all U.S. adults for depression and anxiety disorders, but this is still far from reality. One reason is that doctors worry about feasibility: Doctors must manage an already lengthy checklist during brief consultations with patients; GP consultations last an average of 17 minutes, with patients only getting five minutes to talk; and when patients have multiple physical health problems, mental health often takes a backseat.
Medical education also still lags behind when it comes to recognizing psychiatric comorbidities: While physicians are mindful of common physical comorbidities (e.g., congestive heart failure as a comorbidity of renal disease), depression as a comorbidity of chronic illness is not typically taught or given attention.
Moreover, unlike physical health screening tests, which show objective signs of illness, mental health screening is highly subjective, relying on a self-reporting model that assumes individuals have the awareness, language skills, and emotional readiness to openly discuss their mental health issues. Mental health stigma unfortunately remains a reality, even in healthcare settings, preventing countless patients from seeking treatment.
How technology is enabling a paradigm shift
Making mental health screening a routine part of primary care requires innovative solutions. Emerging technologies, particularly artificial intelligence (AI), are leading the way. AI can detect signs of mental health symptoms by analyzing short audio clips, providing an objective, scalable screening method. Scientific literature has long shown that voice can reveal hidden mental health issues, just as blood tests can reveal physical illnesses. AI can process these voice biomarkers, allowing for early detection without disrupting clinical workflow or relying on patients to report issues.
It’s difficult to accurately estimate how many lives have been saved through physical health screening tests. AI could be the missing piece of the puzzle to bring the same level of preventive care to mental health. The need is especially important now, given that mental health resources across the country are more scarce than ever. Nearly half of Americans live in areas with a shortage of mental health professionals. Nationwide, 56% of psychologists say they don’t have availability to accept new patients, and even when availability is available, patients must wait at least three months on average to see a therapist.
While emergency psychiatric care and treatment of moderate to severe mental illness is and will always be essential, screening all primary care patients for mental illness could allow for earlier intervention and prevent many severe cases from developing in the first place. Just as abnormal Pap test results can prevent people from becoming cervical cancer patients, early detection of signs of depression or anxiety could prevent future mental health emergencies and reduce the burden on healthcare workers. Regular screening with technology means we don’t have to wait until the disease has progressed so we can take action.
Voice biomarker technology can bring about a true paradigm shift in mental healthcare, paving the way for a more proactive, responsive and comprehensive healthcare system. The technology has the potential to fill gaps in care, ensuring that even those who are unable to express their feelings well are seen, listened to and supported. By integrating mental health testing into routine care with the help of AI, we can create a healthcare system that truly addresses all aspects of human health – both physical and mental.
Photo: Eklynn Rasadney Indy, Getty Images
Prentice Thom, MD, is chief medical officer at Kintsugi, an AI-based mental health platform that detects depression and anxiety in patients with just 20 seconds of free-form speech.
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