The IT4Anxiety newsletter #2

Dear readers,

We are coming to the end of this year 2020 which has been both unique and extremely challenging, particular in the health sector.

As all European projects, IT4Anxiety was greatly impacted by the Covid-19 crisis, making it impossible for all face-to-face meetings between partners to take place, which always play such an important part and greatly contribute to the success of such projects. The last face-to-face event took place in Amsterdam on March 9^th and 10^th: our kick-off meeting! A few days later, most partners experienced the lockdown for the first time, in accordance with their respective governments health policy. We had to adapt in order to stay on course and move our activities forward.

The circulation of the virus which accelerated again after the summer also led us to postpone our first hackathon “New technologies and mental health” that we should have organised in October, in France. However, all the other main project activities were able to be maintained. IT4Anxiety has now effectively kicked off and is delivering its action plan.

In this newsletter you will find a contribution from our partners at Vrije Universiteit Amsterdam on the advantages of blended therapies in mental health, i.e. those which combine traditional medicine and the use of new technologies.

The preparatory work for the experimentation of solutions developed by start-ups in healthcare establishments started in 2020 as planned. The validation and ethics committee of the IT4Anxiety project is also one of the subjects covered in our newsletter.

With 2020 now behind us, we are looking towards 2021, with a next important event scheduled for March 18^th and 19^th: our first hackathon in Amsterdam, which will be organized in a hybrid way (videoconference / face-to-face), the face-to-face part will obviously depend on the status of Covid-19 situation at the time.

We thank you for taking the time to read this newsletter. On behalf of the entire IT4Anxiety team, I wish you a Merry Christmas and a Happy New Year. We look forward to hearing from you in 2021!

Advantages of Blended Therapies in Mental Health

IT4Anxiety is attempting to address needs of patients with anxiety disorders by understanding how technology can be adopted as an add-on to face-to-face therapy, internet-based psychotherapy or as a component of blended therapy. However, what is this blended therapy, what are its advantages and why is it so important to focus our attention on this approach?

Blended therapy (BT) for mental disorders provides a new, distinct format, which combines face-to-face therapeutic sessions and digital components into one integrated standardised treatment proto-col. Such components may involve internet- and/or mobile-based elements or, more recently, videoconferencing. As such, it provides an alternative to other formats of psychotherapy introducing online sessions to the protocol: guided treatment, where clients receive regular feedback and sup-port by therapists or trained volunteers, or unguided therapy, where such feedback is not provided. The aim of blended therapy is to achieve the best clinical benefit for patients while making an optimal use of time and expertise of therapists. The application of the digital component can be sequential, allowing for bridging the waiting time before face-to-face therapy or for follow-up care, or helps to integrate the overall therapy content by reminding or reinforcing it between face-to-face sessions. Few studies have yet been conducted but results are promising both in terms of clinical and cost-effectiveness.

First of all, blended therapy creates the opportunity to reduce the current treatment gap. Patients referred to a mental health care specialist often encounter long waiting lists due to limited time re-sources of psychotherapists. Blended therapy may lower the workload required to treat one patient placed on the psychotherapist by delegating part of their tasks to web- or mobile-based platforms. Psychoeducation, for example, can be accessed online, while face-to-face sessions may be used for more cooperative content of psychotherapy or for any explanation needed from the side of the therapist. This treatment-element outsourcing may then create more time for treatment of other patients, or simply contribute to lessening of the pressure placed on psychotherapists.

At the same time, the personal contact with the psychotherapist is preserved. Thus, BT is often more acceptable to patients who need a different approach than a pure internet-based intervention, such as individuals who prefer personal contact, although they are open to a transfer of a portion of the therapy content online. BT also shows increased treatment adherence rates in comparison to guided internet-based interventions (i.e., interventions delivered solely through internet with regular feedback from a therapist or a trained e-coach) and potentially also face-to-face cognitive behavioural therapy. Moreover, thanks to the increased contact with the psychotherapist in comparison to the former, BT offers more room for personalisation of the content of the online sessions.

Inclusion of the online sessions between the face-to-face ones also allows for a full exploitation of what technology has to offer. Using their computer, smartphone or wearables, the patient can monitor their emotion and behaviour by real-time or close-to-real-time means. These can include, for in-stance, ecologically momentary assessment or regular administration of questionnaires. BT is also very convenient for both psychotherapists as well as patients due to its far-reaching coverage, not necessarily dependent on time of the day or the location where the interaction with the online platform takes place. Patients can thus complete the online sessions at their own pace, whenever and wherever it is comfortable for them. Therapists, on the other hand, can provide their feedback when it suits them, as long as they follow the pre-agreed time frame in which the face-to-face sessions and feedback to the online component should take place. This creates an opportunity for individuals for whom it is complicated to attend every session in person, such as inhabitants of rural areas, pa-tients with increased workload, with irregular or unusual working hours. Last not but least, the treat-ment structure, and both the therapist’s and patient’s compliance with this structure, is also support-ed by the online component.

All in all, there is a wide range of advantages BT has to offer and its potential to become embedded in routine mental health care services or primary care is high. It would be unfortunate to become disheartened by potential obstacles to its implementation, such as technical problems, cost of acquisition of digital products or limited internet access. Therefore, to support its implementation into routine care, thorough research into BT is warranted. IT4Anxiety creates an important step for this endeavour.

Authors (from left to right on the pictures below): Marketa Cihavora, Khadicha Amarti, Christiaan Vis and Heleen Riper (VU Amsterdam)

IT4Anxiety Validation and Ethics Committees

The Global Connected Health Market is expected to attain a compound annual growth rate of 30.27% and above 232K million USD by 2025. aims to connect medicine and people (all though data, devices and applications) safely, securely and smoothly. The ultimate goal is to enable personalised healthcare. The EU NEW IT4Anxiety project’s main aim is to support start-ups or small-medium enterprises (SMEs) in testing and implementing innovative technology solutions that reduce the anxiety of patients with post-traumatic stress disorder(PTSD) and Alzheimer’s or their caregivers in the Northwest of Europe. Specifically, it is a collaborative effort of a variety of organisations ranging from entrepreneurs, academic institutes, and clinics based in Belgium, Luxemburg, Germany, Netherlands, Scotland, Northern Ireland and France. Currently, four start-ups are part of the project ELDOM, In-Spir, Brainscan and Sentimentics. By the end of the project, the consortium aims to have included and welcomed a total of 15 start-ups or SMEs. Two expert committees were created specifically with the purposes to assist the start-ups and SMEs in the IT4Anxiety project are the Validation and the Ethics Committees. In collaboration with all partners, Ulster University leads the conformation of both committees, since both are part of the work package that deals with technical piloting and validation (WP2).

The Validation Committee seeks specifically four key objectives: (1) To identify promising start-ups or SMEs with actual innovative technological solutions, offering novel and useful possibilities for e-Mental health therapies for anxiety; (2) To identify whether the start-ups and SMEs solutions are aligned with or have the potential to be easily aligned to IT4Anxiety project’s main aim, and (3) Recognise which start-ups and SMEs are more likely to achieve the testing of their technological solutions within the time frame of the project (before September 2023), and (4) Recognise whether or not the IT4Anxiety team can contribute towards supporting the SMEs and start-ups in piloting their inventions.

The validation committee is comprised of a multidisciplinary team and includes expertise in areas of Finance, Psychology, Psychiatry, Innovation management, implementation science, Engineering, Information Technology, Research and Project Management experts. Members belong to a subset of partners and sub-partners of this project, which are highly reputable organisations and companies (CNP St Martin, VU Amsterdam, Ulster University, EvKb, CCOMs, HEPN, and GAC). Two screening and selection filters were designed to ensure the selected start-ups and SMEs are appropriate to join the IT4Anxiety project: An initial and an in-depth filter. The latter employs valuation methods to systematically assess risks and opportunities with the start-ups and SMEs. The Validation Committee is chaired by VU Amsterdam and Ulster University.

The Ethics Committee acts in an advisory capacity in the ethics requirements and applications of SMEs and start-ups that joined the project. The ethics committee aims to help start-ups and SMEs to be well prepared before submitting to the local committees (i.e. early access to feedback) with the hope of accelerating the process and enhancing the probabilities of attaining a successful outcome. The committee is chaired by Haute Ecole Bruxelles-Brabant (HE2B) and supported by Ulster University. Members comprising the committee are from the partners of IT4Anxiety Ulster University, HEPN, EvKb, VU Amsterdam and CNP St Martin.

Authors: Karla Muñoz Esquivel (Ulster University), Joan Condell (Ulster University) and Christiaan Vis (VU Amsterdam)

Presentation of Start-ups

Sentimentics is a research company focussed on modelling human expressions and states using visual, auditory and textual input. The models can classify expressions and states that are highly dynamic, such as emotions and sentiment, and that are more persistent, such as mood, clinical states and personality traits. Sentimentics is currently focussing on conducting research with these instruments to test their usefulness, validity, and limitations in different domains.

Sentimentics is a sub-partner of VU University Amsterdam, which is partner in the IT4Anxiety project. In collaboration with VU University Amsterdam together we will design and conduct experiments; and embed the classification models in architectures that were developed in previous EU research projects, such as E-COMPARED and ICT4Depression.

Sentimentics uses visual, auditory and textual modalities for modelling human expressions and states, based on the assumption that each modality can contribute to explaining the target variable at hand. In the case of IT4Anxiety one can think of modelling clinical anxiety, clinical depression, stress, or mood. By carefully designing experiments where participants react, or answer questions, that invoke relevant information, we will investigate the extent to which models can use their responses to correctly classify the participant states and expressions.

Innovation will be achieved by exploring model performance, and limitations, based on data gathered from specific experimental designs, that relate to usage in clinical practice. For instance, such models could be used in the pre-treatment stage to assess current symptomology, or to assess best treatment options; or in the treatment stage, for the personalization of treatment, or in the post-treatment stage, to monitor the participant and to prevent relapse.

Eldom creates light without electricity from photoluminescence, a technology made from natural minerals that can absorb daylight and emit light in darkness.

Since 2014, the two partners, Elouan Le Gouge and Dominique Gicquel, have been marketing their solutions in France. Eldom's core business is the creation of fully autonomous night markers for a clientele of communities, businesses, manufacturers and now medical centers.

Following more than a year and a half of experimentation in a hospital center in Brittany, Eldom has indeed developed a “Photoluminescent Night Comfort” kit for healthcare establishments which has also been awarded by the Médéric Alzheimer Foundation in Paris in 2019.

The objective of the solution is to increase the prevention of falls, promote vigilance, reduce nocturnal anxiety, increase the feeling of well-being, regulate the circadian cycle, while achieving considerable energy savings related to reduction in electricity consumption.

Eldom joined the IT4Anxiety project to make its solution available to partners with the aim of improving research. The Night Comfort kits will be installed in the rooms of patients suffering from anxiety disorders. As part of the IT4Anxiety project, the experiment will focus on tests that will measure the reduction in patient anxiety levels through photoluminescence.

The first experiment will be carried out in Scotland, in partnership with the National Health Services Western Isles, also a partner of IT4Anxiety.

SAVE THE DATE

You are a mental health professional, mental health service user, start-up or SMEs looking to develop a solution in e-mental health or a PhD student in medicine, mental health, engineering or entrepreneurship?

Then this hackathon is for you!

More information on what is a hackathon, how it will be organised and what you can win: here

To register to the Hackathon stay tuned via our website or social media, we will publish the link to register very soon!

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