#1 A framework for understanding the mental health crisis

Understanding the mental health crisis, a company using video and AI to diagnose autism in children, plus all the latest news in mental health

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Welcome to the first edition of The Hemingway Report, the only weekly publication for people building solutions to our mental health crisis. Each week, we share the latest news and trends in mental health, as well as Deep Dives into topics that will help make an impact on this important problem.

In today’s email;

• Deep Dive: A framework for understanding and explaining our mental health crisis
• Tackling SMI (severe mental illness): The US company that just raised $15m for their integrated care approach to helping people with severe mental illness
• AI supported diagnosis: Using video, data and AI to diagnose Autism Spectrum Disorder in children
• Fine time: the $7M fine handed down to US company Cerebral
• Jobs: open positions at the top mental health businesses

Deep Dive: A framework for understanding and explaining our mental health crisis

In April 2023, I committed my career to improving population mental health. But when I was trying to figure out how I could help solve our mental health crisis, I quickly felt pretty lost.

Before I jump in to try to solve a problem, I need a structured framework in my head for understanding it in its entirety (yes, I used to work at McKinsey…). But when I looked at mental health, it was such a broad and sprawling beast that it was hard for me to get this framework.

I also realised that I needed a way to communicate the problem to others. People are overwhelmed by different mental health stats and frankly, are often confused about what the problem actually is (and isn’t).

Over the last year, I’ve read dozens of books, spoke to hundreds of experts, visited conferences and hired researchers to try get my hands around this problem.

And for the first time, I feel like I have a good framework for understanding mental health as a public health issue.

I realised that there may be others who would find these frameworks and deep-dives helpful. So I wanted to share them publicly.

Each month I will share a Deep Dive into a different part of mental health, providing a researched and structured insight of what you need to know.

This month’s deep-dive is on understanding the problem; providing a framework and set of metrics for assessing the impact of mental health, analysing the data on where the problem is worst and also how it’s trending.  

You can download the full 14 page Deep Dive, including all graphs and sources for free below. (FYI, most of the data in this report is for Australia. In future, we will include global datasets).

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But for those of you who want fast answers, here’s the TLDR (with some pretty graphs);

• The best metric we can use to assess and compare the impact of mental disorders is Disability Adjusted Life Years (DALYs). This give us a consistent framework and dataset for understanding the impact of mental illness on the population and how it’s changing over time.  
• Mental illness has the second biggest disease burden of all illnesses in Australia, more than cardiovascular diseases (such as coronary heart disease and strokes), neurological conditions (such as dementia and Parkinson's disease) and even more than endocrine disorders (such as diabetes).

• It’s important to understand that this large burden of mental illness is driven by both the prevalence of mental disorders (lots of people live with a mental disorder) combined with how disabling they can be for those suffering from them.  
• Anxiety and Depressive disorders have the biggest impact on our population, accounting for 47% of the total DALYs of all mental disorders.
• The problem is getting bigger at an alarming rate, with the total burden of mental disorders increasing by 66% from 2003 to 2023. This is driven by sharp rises in anxiety disorders (+74% from  2003 to 2023) depressive disorders (+46% from 2003 to 2023) as well as autism spectrum disorders (+379% from 2003 to 2023)

• Unfortunately, mental health is a really significant problem for young people (even more so than adults). Almost one in three young people have had anxiety in the last 12 months.
• There are also significant differences between genders in young people, with young girls experiencing anxiety at almost twice the rate of young boys (41.3% vs  21.4%), and experience depression at more than twice the rate of boys (19% vs 8.8%)

•  Mental disorders are also more prevalent in minority populations, with significantly increased rates observed in LGBTQA+ communities (gender diverse students report anxiety and depressive symptoms at over 10 times the rate of male, cisgender peers)
• Early detection and treatment are critical, with 50% of all mental health problems established by age 14 and 75% by age 24.

Future Deep Dives will include;

1. The causes of mental ill health
2. Understanding the mental health system
3. What works and what doesn’t in care (a review of approaches to mental health diagnosis and treatments)
4. A crash course on mental health regulation
5. The promise of emerging treatments (including digital therapeutics, psychedelics and AI)
6. Mental health business breakdowns; why some mental health businesses succeeded when others fail

If there’s a specific area you’d like us to explore in a future Deep Dive, let me know by replying to this email.

News Snippets

• Amae Health picks up $15M to scale in-person clinics providing care for severe mental illness (Fierce Healthcare)
• U.S. private-equity backed Your Behavioral Health expands clinical footprint by acquiring Insight Treatment Programs, a provider of teen mental health and substance use disorder (SUD) treatments in Southern California (Behavioral Health Business)
• The Australian Government announced $4.6m of funding to support translation of mental health research into healthcare treatments to improve the mental health of young Australians (Health.gov.au)
• U.S. mental telehealth company Cerebral faces a $7M fine for sharing patient data to third-parties and using sensitive health data for promotional activities (The Hacker News)
• Black Dog Institute and UNSW Sydney collaborate to create the world’s first evidence-backed PTSD response guideline for emergency service workers (Black Dog Institute)
• The head of Australia’s peak mental health body has resigned citing a ‘lack of traction from the Albanese government despite a national crisis’ (PSNews)

Company Spotlight: Cognoa

• What they do: use data and AI to improve diagnosis and treatment of children with behavioural health conditions (specifically Autism Spectrum Disorder)
• Headquarters: Palo Alto, California
• Founders: Denis Wall
• Founded: 2013

Denis Wall founded Cognoa in 2013 to help give children with behavioural health issues earlier and more equitable access to care. They made the decision to start with autism (a mental disorder which is being diagnosed at increasingly alarming rates) and focus on developing digital diagnostics and therapeutics for young children.

Their flagship product, Canvas Dx, is a diagnostic system that gives more healthcare providers the ability to diagnose or rule out autism in children ages 1.5 to 6 years. It works by collecting survey data from a child’s parent, their doctor and then combining it with videos of the child’s natural behaviour. Cognoa’s algorithms crunch the data and provide an output to the child’s doctor on whether the child may have autism, or if in fact, it can be ruled out.

Cognoa is part of an interesting trend in approaches to mental health diagnosis, moving past simple questionnaires to include other modes of observation and testing.

Jobs

• Healthtech Sales Specialist @ Updoc (LinkedIn)
• Marketing Communications Officer @ Australian College of Mental Health Nurses (LinkedIn)
• Lived Experience Lead @ Victorian Collaborative Centre for Mental Health and Wellbeing (LinkedIn)
• Change Lead @ yourtown (LinkedIn)
• Director Commercialisation (Social and Behavioural Sciences) @ UniQuest (Startmate)
• Partnerships Manager @ Like Family (LinkedIn)

Hiring for your team? Email me to have your roles included in next week’s email.

Make it this far? Let me know by sending me an email. I’d love to know a bit about you and why you subscribed to The Hemingway Report.

Got something else you’d like to see? Let me know about that too!

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Steve Duke

P.S. feel free to connect with me on LinkedIn