De­tect­ing de­pres­sion: Apps could mon­i­tor teen angst

Miami Herald (Sunday) - - In Depth - BY LIND­SEY TAN­NER


Ris­ing sui­cide rates and de­pres­sion in U.S. teens and young adults have prompted re­searchers to ask a provoca­tive ques­tion: Could the same de­vices that some peo­ple blame for con­tribut­ing to tech-age angst also be used to de­tect it?

The idea has sparked a race to de­velop apps that warn of im­pend­ing men­tal health crises. Call it smart­phone psy­chi­a­try or child psy­chol­ogy 2.0.

Stud­ies have linked heavy smart­phone use with wors­en­ing teen men­tal health. But as teens scroll through In­sta­gram and Snapchat, tap out texts or watch YouTube videos, they also leave dig­i­tal foot­prints that might of­fer clues to their psy­cho­log­i­cal well-be­ing.

Changes in typ­ing speed, voice tone, word choice and how of­ten kids stay home could sig­nal trou­ble, ac­cord­ing to pre­lim­i­nary stud­ies.

There might be as many as 1,000 smart­phone “biomark­ers” for de­pres­sion, said Thomas Insel, former head of the Na­tional In­sti­tute of Men­tal Ill­ness and now a leader in the smart­phone psy­chi­a­try move­ment.

Re­searchers are test­ing ex­per­i­men­tal apps that use ar­ti­fi­cial intelligence to try to pre­dict de­pres­sion episodes or po­ten­tial self­harm.

“We are track­ing the equiv­a­lent of a heart­beat for the hu­man brain,” said Dr. Alex Leow, an app de­vel­oper and as­so­ci­ate pro­fes­sor of psy­chi­a­try and bio­engi­neer­ing at the Uni­ver­sity of Illi­nois’ Chicago cam­pus.

At least, that’s the goal. There are tech­ni­cal and eth­i­cal kinks to work out – in­clud­ing pri­vacy is­sues and mak­ing sure kids grant per­mis­sion to be mon­i­tored so closely. De­vel­op­ers say proven, com­mer­cially avail­able mood-de­tect­ing apps are likely years – but not decades – away.

A par­tic­i­pant in a Stan­ford Uni­ver­sity study, Lau­rel Foster, 15, ac­knowl­edges feel­ing stress over aca­demics and “the usual” teen friend­ship pres­sures and says de­pres­sion is ram­pant at her San Fran­cisco high school. She said us­ing the ex­per­i­men­tal smart­phone app felt a bit like be­ing spied on, but with so many on­line sites al­ready track­ing users’ habits “one more isn’t re­ally a big dif­fer­ence.”

“I feel like it’s good to ac­tu­ally find out what is stress­ing you,” Foster said, en­dors­ing the idea of us­ing smart­phones to try to an­swer that ques­tion.

“Peo­ple of­ten feel that these things are creepy,” be­cause of the tech in­dus­try’s sur­rep­ti­tious track­ing of on­line habits for com­mer­cial pur­poses, said Uni­ver­sity of Ore­gon psy­chol­o­gist Nick Allen.

Us­ing smart­phones as men­tal ill­ness de­tec­tors would re­quire in­formed con­sent from users to in­stall an app, “and they could with­draw per­mis­sion at any time,” said Allen, one of the cre­ators of an app that is be­ing tested on young peo­ple who have at­tempted sui­cide.

“The big­gest hur­dle at the mo­ment,” Allen said, “is to learn about what’s the sig­nal and what’s the noise – what is in this enor­mous amount of data that peo­ple ac­cu­mu­late on their phones that is in­dica­tive of a men­tal health cri­sis.”

De­pres­sion af­fects about 3 mil­lion U.S. teens, and rates have climbed in the past decade. Last year, 13 per­cent of 12- to 17-yearolds had de­pres­sion, up from 8 per­cent in 2010, U.S. gov­ern­ment data show. One in 10 col­legeaged Amer­i­cans is af­fected.

Sui­cide has risen to the sec­ond lead­ing cause of death for ages 10 to 34. Rates among teen girls dou­bled from 2007 to 2015, climb­ing to 5 per 100,000. And among boys, rates jumped 30 per­cent, to 14 in 100,000.

If smart­phones prove to be ac­cu­rate mood pre­dic­tors, de­vel­op­ers say the ul­ti­mate goal would be to use them to of­fer re­al­time help, per­haps with au­to­mated text mes­sages and links to help lines, or dig­i­tal alerts to par­ents, doc­tors or first re­spon­ders.

The on­go­ing re­search in­cludes:

A Stan­ford Uni­ver­sity A study in­volv­ing about 200 teens, in­clud­ing kids at risk for de­pres­sion be­cause of bul­ly­ing, fam­ily cir­cum­stances or other life stresses. As part of the re­search, teens who have been tracked since grade school get an ex­per­i­men­tal phone app that sur­veys them three times daily for two weeks with ques­tions about their mood.

Re­searchers are com­bin­ing those an­swers with pas­sive smart­phone data, in­clud­ing how ac­tive or seden­tary kids are, to iden­tify any changes that might be linked with fu­ture de­pres­sion.

At UCLA, as part of a A broader ef­fort to bat­tle cam­pus de­pres­sion launched in 2017, re­searchers are of­fer­ing on­line coun­sel­ing and an ex­per­i­men­tal phone app to stu­dents who show signs of at least mild de­pres­sion on a screen­ing test. About 250 fresh­men agreed to use the app in the first year. Per­sonal sens­ing data col­lected from the app is be­ing an­a­lyzed to see how it cor­re­lates with any wors­en­ing or im­prove­ment in de­pres­sion symp­toms seen in in­ter­net ther- apy.

At the Uni­ver­sity of


Illi­nois’ Chicago cam­pus, re­searchers study­ing de­pres­sion and ma­nia in bipo­lar dis­or­der are us­ing crowd­sourc­ing to test their ex­per­i­men­tal phone app. Any­one can down­load the free app, and nearly

2,000 have so far, agree­ing to let the re­searchers con­tin­u­ously track things such as typ­ing speed, num­ber of key­strokes and use of spellcheck. Par­tic­i­pants in­clude healthy peo­ple, and their data will help re­searchers zero in on changes in phone use that may sig­nal on­set of mood prob­lems, said Leow, the psy­chi­a­try and bio­engi­neer­ing ex­pert who helped de­velop it.

The study is for ages 18 and up, but if proven to work, the tech­nol­ogy could be used in kids too, Leow said.


Lau­rel Foster, shown Nov. 1 with her phone in San Fran­cisco, is among teens in­volved in Stan­ford Uni­ver­sity re­search test­ing whether smart­phones can be used to help de­tect de­pres­sion and po­ten­tial self-harm.

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