Depression and anxiety suck.
Believe me, I've been in therapy for 10 years trying to keep mine under
control and the process of trying to find a therapist can add even more anxiety.
Right now, the general experience to get started with a therapist in real
life is you go on your insurance, you look at the roster of therapist who
take your insurance, you cold call each of those therapists to see if they're taking new clients.
Most of them will not get back to you, and when they do, they won't have
an appointment for at least four to six weeks.
And by that time you've given up and eaten all the ice cream.
Bea Arthur started The Difference with the goal of trying to change that process.
The Difference is Amazon's very first Alexa skill for therapy.
We connect you with a live human therapist within 30 minutes or less via
your phone or a smart speaker.
Other companies like Talkspace, Happify, Seven Cups of Tea, Woebot and
others are out to make this process easier for patients as well.
And there's a lot of capital to gain in this growing market.
The global behavioral and mental health care software and services market
size is expected to reach $4.31 billion by 2025.
That could be why big tech companies like Amazon are entering the digital health care market.
But is this digital shift good for patients.
I always cherish my time at the therapist's office.
I sit on the comfy couch, I clutch a pillow and I just dish.
So I was really curious to know what this new digital space would bring.
Digital mental health is kind of the natural outgrowth of something that's
been going on for decades now, which is that there's a lot of research showing that therapy works.
That there are ways to teach people to improve their mental health, but not everybody
can make it to one-on-one therapy. Not everybody can afford one-on-one therapy.
Digital mental health is a way to translate what the research has found
about what helps people and put it in a format where people can access it
through phones, through the web, using technology.
I love the idea of digital mental health because, like, it can meet you right where you're at.
Like, literally when you're depressed, you're on your couch anyway.
Why do I have to get dressed and go across town?
Why? I'm already eating ice cream and crying.
Why can't therapy meet me here on this couch?
But as much comfort as the therapist's office gave me, it was always such a
horrible process to try and find a good fit for many reasons.
There are three main barriers to traditional therapy.
The biggest barrier is cost.
Right? This is not surprising at all.
The second barrier is convenience.
You know, you need to commute to a private practice.
You need to leave your work in the middle of the day. Even
to find a good therapist is not easy.
And last but not least, stigma and shame may prevent people from seeking treatment.
A lot of therapists these days, especially in urban environments, will
charge upwards of $100, $150 out of pocket.
So that means that they weren't even taking insurance.
Some will take insurance, but it's notoriously challenging to find
therapists who are available to take on those patients.
That's why these digital solutions could be really beneficial.
Most are cheaper than traditional therapy, and they are certainly more
convenient. It's important to note that these services are not usually
free. When compared to the $100 or more per session that most patients pay
for in-person therapy, services like Talkspace and The Difference are the less expensive option.
I tried these three services, The Difference, Talkspace, and Happify, and
they all do very different things.
The Difference is focused on helping individuals who are going through a
rough patch via a phone call or audio session through Amazon Alexa.
I tried out the difference earlier in the week, over by my desk.
Alexa, open The Difference.
Thanks for joining The Difference.
To talk to one of our therapists, please give me your four digit code.
1-2-3-4.
Connecting you to a therapist now.
Hey, thanks for your patience.
I'm Bea, and I'm going to take care of you today. Tell me what's going on.
The Difference is still in beta right now, but it's gonna be rolling out to all echo devices this summer.
Talkspace is one of the most recognizable companies in this space.
Though it's been around since 2012, it recently grabbed people's attention
with a popular advertising campaign featuring Olympic gold medalist,
Michael Phelps.
It was October of 2014 that I lost all hope.
I was one of the world's most successful athletes.
18 gold medals.
The all-American dream come true.
Talkspace is focused on text and video therapy. For
their system, you create an account and get assigned a therapist who
you'll stick with through the 20+ week counseling program.
You can choose from a text therapy plan where you can message with your
therapist five days out of the week for $49 a week, or a video therapy
plan where you can join a video session with your therapist once a week for $79 a week.
So basically we are offering a solution to all the people that are not able
to take advantage of traditional therapy.
Happify is different as you're not connected to a therapist.
Instead, you play games and learn new resilience and coping skills and
review reports on your progress, all of which is based on research.
The app is free, but it offers a paid premium plan.
There are ways to reliably assess a person's mental health and technology
has this sort of added benefit that you can make beautiful graphs and you
can see progress over years and kind of see what that looks like and get
personalized feedback about what it means to improve five points.
Being able to track your progress over time gives you feedback and it makes
people feel a lot more confident about their ability to maintain the
intervention, to follow the skills that they may have learned.
I think that's one of the real benefits of digital mental health is that
it's happening in the moment as you're living your life.
Happify was a great daily reminder to be more positive.
It felt like a preventative measure to stay mentally healthy, and
Talkspace was nice for getting a bit more personal, talking about my day
and some of the thoughts that were going through my head.
Like I said, it's really important for me to be face-to-face with my
therapist. It helps me open up a little bit more, but that's not the case
for everyone and that's not necessarily what these apps are out to replace.
I think there will always be a role for the human therapist and talking
one-on-one with the patient about some of the problems that they
experience that maybe more deep-seated and they want to see someone in
person, or if it's a very serious mental health condition.
There are uses and there are ways in which it makes sense, and I hope that
it makes therapy cheaper and more accessible overall.
But what about privacy and security.
Talking face to face with a therapist is very different than streaming a video call or texting over an app.
In today's privacy climate, it can be really, really hard to put your faith in these programs.
The basis of health care, especially mental health, is trust. Patients
know that they can trust things when they talk to me as a psychiatrist,
when they talk to therapists, they know that there's even federal laws that guarantee their privacy and trust.
Most of the apps out there that are used by hundreds of thousands, if not
millions of people already do take big steps to protect user data.
Because with any kind of breach of people's health information, that would
essentially end their business. They are in a trust business and they know that. More
people have had their medical records hacked than have ever seen them.
So I think we do need to be really cautious about who we entrust with our
health data, because already we have we have a crisis in terms of privacy and security of that information.
So what are these companies doing to maintain a trustworthy system.
All of the big tech places have issues with surveillance tech.
You know, you're seeing all these things with Alexa laughing and stuff like that.
So we have to kind of like keep, you know, we do overcorrect. Like,
at the beginning of every call for The Difference, we say this call is not
being recorded for privacy assurance.
People receiving therapy with Talkspace are protected by the same level of
confidentiality that they would at their doctor's office or at any health
system across the country.
Amazon has tackled the privacy issue with a HIPPA compliance policy.
HIPPA, which stands for the Health Information Portability and
Accountability Act was enacted in the 90's and it's essentially a set of
federal rules that govern how we store and we share certain kinds of
protected health information with certain entities.
So it doesn't necessarily mean it's a catchall for all health privacy and
all health security. It's
specifically about how health care providers, which are hospitals and
clinics share health information with their business associates, which
might be a company like Amazon Alexa.
So does it work?
Do these digital mental health solutions really help you?
Well I've I felt a difference.
I mean, I'm between therapists right now because of the things that I
mentioned above - cost and time and energy.
So for someone who usually has face to face therapy, these apps were
helpful. But I didn't get to dig down really deep into those issues that I usually get to go into with face-to-face therapy.
It is not going to work for all mental health conditions and for all people
and we should be aware of that.
We don't have the basis of scientific evidence to support that it makes
sense for many more types of therapy than than one specific kind, which is
called Cognitive Behavioral Therapy, and that's a type of therapy that's
specifically aimed at managing anxieties that we, that we experience every
day and coming up with a better framework around them.
It's not the same thing as talk therapy that gets into the deepest darkest
secrets of our childhood.
And I don't know that something like that could necessarily work
digitally.
What does the scientific community think of these apps?
I think if you just kind of look at the scientific, published, clinical
research, talk to people working in the field, I think that we're excited
about the potential of, some of these more virtual therapies.
But I think that there is very little evidence done. What
we have seen in published research studies is very small, a lot of it's
done by the company itself.
At the end of the day, it's important for you to know what forms of help
work for you and what forms of help you have access to.
It's all up to the individual.
The important thing is to start figuring it out.
It's about being heard, being understood, feeling supported and feeling
like it's going to be get better.
Like, 30 minutes of that a day, or even just on bad days needs to be a
regular part of our society.
Everybody would feel and function much better if they felt like they had a
place where they won't be judged, they'll be supported, they'll get
answers, and more importantly, get better coping skills to make better decisions.
If you're in a situation where you feel like you're going to harm yourself, please don't wait to get help.
Call 1-800-273-8255 for the National Suicide Prevention Lifeline.
They're available 24/7 to help you out.