XPRIZE Measuring Mental Health

Nearly 1 billion people live with a mental disorder. In low-income countries, more than 75% of people with mental disorders do not receive treatment. Behavioral health resources for prevention and diagnosis are lacking. There is no quantifiable measure of what mental health is. There are no biomarkers for depression. Diagnosis is subjective. Impact of interventions are hard to measure.

An XPRIZE for mental health should:

  • Better allocate scarce resources.
  • Expand access to treatment.
  • Reduce anxiety, depression, and suicides.
  • Prevent substance abuse.

Teams would be challenged to quantify mental health, diagnose conditions, enhance resilience, and measure their impact.

Would this be audacious yet achievable? What would be the likely impact of such a prize?

@bnoy, @caitrin, @KateH, I’d like to ask your advice on this idea for an XPRIZE competition in mental health.

@rezafarivar, you may also be interested in the discussion. Please feel free to weigh in!

Background on this prize idea:

  • Mental health is typically measured according to suicide rates; hospitalization rates; utilization rates of health resources; and self-evaluations.
  • Self-reporting of symptoms of mental illness —the most important measure unless patients are hospitalized — is influenced by the stigma associated with it.
  • There are literally hundreds of different ways to question patients about their mental health. (The American Psychiatric Association maintains a comprehensive list of performance measures that pertain to mental health here.) But these questionnaires are usually designed to diagnose mental disorders (anxiety, bipolar, depression, schizophrenia, etc.), not to quantify a person’s mental well-being.
  • Britain uses the Warwick-Edinburgh Mental Well-being Scale, a scale of 14 positively worded items for assessing a person’s mental well-being. This helps lessen the stigma but is still subjective.
  • Wearable devices and applications are being developed to monitor (physical) indicators of people’s emotional and mental state.

One promising example is Sentio Solutions, a San Francisco company that develops biomarkers and digital therapeutics to change the way we diagnose, manage, and care for mental health. In February-April 2020, they monitored and analyzed changes in electrodermal activity, heart rate variability, and skin temperature from a random sample group of participants in Europe and the United States to assess the mental-health impact of COVID-19 lockdown.

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This is a worthwhile prize and an achievable challenge.

There are a spectrum of states on the mental health scale. The worst - long term depression (which can lead to suicide) - could, potentially, be detected with bio-markers. For example, today I posted a study that shows that serotonin levels are reduced by increased levels of histamine caused by inflammation (which itself can be triggered by stress).

So we might be able to assume that depression can be objectively inferred by monitoring specific chemical levels in the body. Similarly, this can be done for stress too.

With regard to the whole spectrum of mental health it is possible to create a trained AI system that is able to detect issues (via Q&A and the above chemistry), and provide education and coaching to improve a person’s mental health.

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Hi @mhackett,
Given your vast experience in the field you might have inputs to share on this prize idea. In your views what are the innovation gaps in mental health space.

My vote - the first two: which are one and the same.

  • Better allocate scarce resources.
  • Expand access to treatment.

There are low cost off patent effective medications that have a poor supply route in many if not all countries, or go unfunded so are unaffordable, for those with severe mental illness. Those experiencing economic disadvantage are the worst affected. They are more likely to be living in rural and remote areas - or in cities unable to afford treatments.

Lay people can be taught to screen for disorders - but there is little point if there is no available treatment.

The WHO are keen on task shifting i.e. training lay people to deliver talking therapies and prescribe medication, under supervision. However there needs to be support and supervision for these lay people.

We need more resources/support in rural and remote communities. However, typically we invest in hospitals in cities that serve the same well served communities.

The best mental health interventions are access to safe housing, clean water, sanitation and food security.

  • Reduce anxiety, depression, and suicides.
    If we can provide better access to screening and treatment these will reduce.
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Oh and we don’t need yet another unvalidated method to screen for disorders.

Improve mental health literacy in communities and find ways to reduce stigma.

We don’t try to reduce car accidents by measuring just how well people can drive.

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Hi @mhackett,
Thanks for sharing your thoughts. Interesting points.

Thank you for your comments, @mhackett! Don’t you think it would be helpful to understand exactly how access to safe housing, clean water, sanitation and food security, etc. impact our mental health? We know this in general, but do we know what percentage of our mental health is influenced by, say, food security? Or how much more likely someone is to develop a mental-health condition if they don’t live in a clean and safe environment?

If we could quantify this, I wonder if this wouldn’t provide stronger arguments to the case for safer housing, cleaner environments, etc.?

We’re wordsmithing what we call the “winning-team-will statement” for this prize: a succinct description of what a competing team would need to do to win.

Here’s the current version, and I’d appreciate your thoughts:

Empower users to improve their mental well-being, and enhance resilience to mental disorders, based on newly-developed, objective metrics of mental health.

The next step are drafting the testing and judging criteria for the prize. Here’s what we have so far:

  • Develop objective metrics of mental health.
  • Contextualize metrics to the user, taking into account cultural, environmental, and social factors as well as diet and medical history.
  • Measure the impact of lifestyle changes on the user’s mental well-being over time.
    • Including social engagement? Social isolation and loneliness contribute to anxiety, depression, and cognitive decline.
  • Prove the metrics’ accuracy by comparing against user self-assessments. (May be a little odd, since self-assessments are imperfect and that’s why we need this prize. But how else could teams prove the metrics they develop are accurate?)
  • Reduce demand for mental healthcare in the area where the solution is deployed.

With regards to mental health, awards for researchers and entrepreneurs to promote innovations in mental health. It also recommended a study prioritizing mental health for further funding. Developing tools that will act as an Expert Support System for mental health professionals is important. We also need to spearhead the strategy with stakeholder to focus on mental health and plan a grant-making via the award route for addressing serious challenges impacting human race.
We should also scope phasing for the mental health data prize for readily available mental health data sources across globe, for example South Africa.

The recent trends are alarming which have been observed in young individuals in with respect to mental health. The youth assess tool of how COVID-19 is impacting one’s mental health and counseling or seeking help for the same through online and offline mediums shall be built for awareness. The peers support and acquaintances going through mental health issues shall be more specific and resource based.

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Some alarming stats from the WHO on that:

  • Only 17% of countries had the resources to meet increases in demand for mental and psychosocial care as a result of COVID-19.
  • 8 in 10 high-income countries have deployed telemedicine and teletherapy to bridge gaps in mental health compared to just half of low-income countries.

@NatashaEO, @Mohammadimr, @mab, @LewisDean, @nowellk, @nrasgon, what is your opinion of this idea for an XPRIZE? Your expertise in behavior change and psychiatry would be very valuable to us here.

We’re in the process of designing a prize competition that would challenge competitors to develop objective metrics of mental health and integrate these into a technology that would empower users to improve their emotional and mental well-being.

The metrics would need to be contextualized to the user, including their culture, living environment, and language, and the technology would need to be able to track the impact of lifestyle changes over time.

The goal is to reduce demand for mental healthcare, by encouraging users to constantly look after their mental health and not wait until they develop more serious problems, as well as to improve diagnostics and therapy when users do need professional care.

These have only been exacerbated since the COVID-19 pandemic. The detrimental impact of COVID-19 on mental health, especially for adolescents. The closure of schools, distancing from peers, and uncertainty regarding the future are only a few reasons for increased anxiety and other mental health challenges. There is a need to encourage champion voices and hear from leading experts committed to improving the mental health infrastructure of the countries.
Additionally, there is a digital divide, which is much more expansive in small towns and rural. Prolonged isolation and exponential rise in internet usage due to pandemic protocols could result in feelings of loneliness due to reduced peer support, and limitation to virtual means is a significant cause of concern.

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@malikammar12345, @sarahkhenry, @areff2000, @adanvers, @Esther_Colwell, @staceyo, I believe you advised on our Gender Data Gap Prize Design in the past. I wonder if you have thoughts on this idea for an XPRIZE, which is about measuring mental health?

Specifically, we have questions about how to judge and test teams competing in such a prize. Here is our draft version of criteria:

  • Develop objective metrics of mental health.

How to assess that?

  • Contextualize metrics to the user, taking into account cultural, environmental, and social factors as well as diet and medical history.
  • Measure the impact of lifestyle changes on the user’s mental well-being over time.

Including social engagement? We know social isolation and loneliness contribute to anxiety, depression, and cognitive decline.

  • Prove the metrics’ accuracy by comparing against user self-assessments.

May be a little odd, since self-assessments are imperfect and that’s why we need this prize. But how else could teams prove the metrics they develop are accurate?

  • Reduce demand for mental healthcare in the area where the solution is deployed.

Is this a fair metric? Is it realizable? Could we easily get such data?

We’re considering broadening this prize and measuring happiness instead of mental health.

Much of the same logic applies: we don’t have objective criteria of what makes people happy, current methodology relies on self-reporting, if people understood happiness better they could take pro-active action to improve their emotional and mental well-being.

@akb, @mhackett, @arshimehboob, what is your opinion of such a change?

@vabot, a happiness focus may be of interest to you as well. Please feel free to join the discussion and let us know what you think!

Thank you @NickOttens for the tag.

UN Sustainable Development Solutions Network, reported Finland as the most happiest nation in the world, where the suicide mortality is above the EU average and among the five highest in the EU27 according to Eurostat.


Mental health problems and substance abuse are among the most serious threats to public health in Finland. In Finland, which has the highest estimated incidence of mental disorders in the EU, close to 1 in 5 are affected. Mental illness has a high economic cost–the cost of treatment, social security programmes, lower employment and lost productivity add up to a total average of 4% of GDP in EU countries. In Finland, it is higher still: an estimated 5.3% of GDP in 2016.
Therefore, in my perspective happiness is very unlikely can be associate with mental health.
Mental health trends differ across demographic groups, seasonal trends have effects on GHQ scores. In other words, it can be said that people who are happy have less chance to prone to the depression, anxiety or stress. Mental health and happiness cannot exist on the same side of a binary.

As mentioned above it can be difficult to objectively quantify “happiness” because it often relies on self-assessing questionnaires; but it is, of course, a worthy goal to improve happiness / well-being. Happiness is one positive attribute that arises as a result of good mental health (and general health and a good lifestyle, etc.). So it sounds reasonable to measure all attributes of mental health including happiness.

The more objective data we can derive on mental health the better. For example, a person with severe mental health problems might be incapable of providing an accurate assessment of their happiness; similarly for someone on drugs (or in the future, perhaps, a Happy Chip).

Happiness sounds very ‘nebulous’ and I’m not sure what you are hoping to achieve by measuring it.

Happiness won’t inform government/healthcare planning or policy.

Unsure how ‘understanding happiness’ could help people ‘take pro-active action to improve their emotional and mental wellbeing’. People who are unwell know other people are happy. Not sure how that helps.

You seem to be looking for a solution without defining the problem.

Thank you for the feedback, @arshimehboob, @akb, and @mhackett! It sounds like it may be wiser to stick with the original idea of measuring mental health.

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