Over 1 billion people worldwide live with a mental health condition, but only 7 out of 100 people actually get treatment — typically medication and/or therapy or counseling. From the start of treatment, much of the process is trial and error, leaving people caught in the current system that assesses mental wellbeing treatments through subjective self-reports. 

Yet, wellbeing tools like the Healthy Minds Program (HMP) — a free app by Humin based on the Healthy Minds Framework — can shift wellbeing within days, while standard questionnaires are collected every few weeks. Early improvements can go unseen, with no way to know who will benefit or who may be at risk of worsening. What if there were a more timely, nimble and accurate way to measure people’s mental wellbeing to understand when treatment starts working and for whom? 

A multi-disciplinary team of University of Wisconsin–Madison researchers, led by the Center for Healthy Minds (CHM) and the Wisconsin Institute for Discovery (WID), is set to expand an on-going study dedicated to exploring this question. 

"For years we've measured depression by asking people how they feel on a questionnaire,” says Dr. Ross Jacobucci, lead scientist on the new study cohort and research associate professor at CHM. “That tells us something, but it's slow and subjective. It can't see change as it's happening. This project asks whether the signals already coming off someone's phone and wrist can give us an objective, moment-to-moment readout of mental health.”

The new part of the project is supported by an up to $6.6 million award from the Advanced Research Projects Agency for Health (ARPA-H), a federal agency within the U.S. Department of Health and Human Services. WID Director Dr. Jo Handelsman is the lead researcher on the overall study, called The Lucida Project, and Jacobucci leads the ARPA-H-funded study cohort set to begin this fall. CHM Core Faculty Dr. Simon Goldberg and Dr. Matt Hirshberg, as well as Affiliated Faculty Dr. Brooke Ammerman are also collaborating on the study.

Researchers want to know if biological and digital signals collected from participants throughout their daily lives can pick up early improvements in wellbeing or warning signs of things getting worse – within one to three days, and even hours, after starting HMP. They are also testing if they can predict future mental wellbeing changes months out. 

Two Study Cohorts to Better Understand Changes in Wellbeing 

The Lucida Project has two linked parts that investigate different but complementary questions: how do people respond to mental health exercises and how does depression progress on its own? 

The first part of the study is a randomized control trial testing how people respond to the Healthy Minds Program against an active control and usual care. Researchers assess 1,500 participants before they try HMP, a brain games app, or continue with any care they received before the study, and then they follow changes in wellbeing for six months. Researchers draw signals from people’s smartphone behaviors (screenshots, typing and location patterns), a wearable wristband (heart rate variability, sleep, and more), weekly videos, and deep biology (whole-genome sequences, gut microbiome, inflammation and more). Next, they combine these streams of information to create and test four new measures:

• A Digital Behavioral Health Index, which summarizes patterns in phone-based behavior. 
• A Physiological Regulation Composite that reflects how well the body’s stress systems are functioning.
• A Social Engagement and Mobility Index, which captures how people move through the world and interact with others. 
• Finally, all of these feed into something called the “Multimodal Rapid Change Indicator” which is designed to detect quick shifts in overall mental and physical wellbeing. 

The second study cohort, which is specific to the ARPA-H funding, follows how depression might develop. Before starting the study, a group of 300 adults with mild to moderate depression symptoms will first be profiled in depth through various biological signals and then tracked with weekly symptom check-ins. The extensive biological data provided by participants before the study and continuous symptom tracking during the study will allow researchers to observe how symptoms change naturally over time and identify new methods of detecting who may be at risk for worsening depression. 

The second study cohort, which is specific to the ARPA-H funding, follows how depression might develop. Before starting the study, a group of 300 adults with mild to moderate depression symptoms will first be profiled in depth through various biological signals during an observational period and then tracked with weekly symptom check-ins for six months. The extensive biological data provided by participants before the study and continuous symptom tracking during the study will allow researchers to observe how symptoms change naturally over time and identify new methods of detecting who may be at risk for worsening depression. 

The Lucida Project is one of few studies in which researchers are collecting continuous phone sensing, physiological data, weekly video and deep biology markers on the same people at the same time, across about 1,800 participants. To his knowledge, Jacobucci says “that breadth of behavioral and biological data on one group of people is something few mental health studies have attempted together.” In earlier work, their models have predicted suicidal ideation from smartphone screenshots alone with strong accuracy, he says. 

The team believes that a scalable application of this work could shift public‑health practice and help create a flourishing world. Ultimately, they envision a future where mental health treatment can help more people when they need it most.

“The project has the potential to move mental health diagnosis and treatment recommendations into a new era based on quantitative factors,” Handelsman says. “It will also open doors to new avenues of research that explore the links between the human genome, physiology, and the microbiome in fostering mental health and depression."

By Victoria Vlisides, CHM digital content editor

Featured photo credit: hirun/iStock.com 

This research was funded, in part, by the Advanced Research Projects Agency for Health (ARPA-H). The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the U.S. Government.