The Mental Health Challenge in Asia: Is HealthTech an Opportunity to Address it?
Given May is (U.S.) Mental Health Awareness Month we thought it fitting to pen a few facts and insights about how digital technology is positively impacting the mental health space.
What is Digital Mental Health (DMH)?
As you could imagine digital mental health, aka MentalTech, is that space where digital technology is bring about improvements in mental health preservation, therapy access, and services delivery efficacy and efficiency.
DMH spans the care continuum from prevention to diagnosis to treatment to recovery. It touches the major classes of disorder from depression to bipolar to anxiety to ADHD to psychosis to schizophrenia, and even dementia. They are not only capable of avoiding illness, but also of increasing wellness.
They come in formats that are both consumer- and treator administered. They leverage technology ranging from websites to rich audio/video content to mobile apps/messaging to wearable & ingestible sensors to telephony to virtual/augmented reality to big data and artificial intelligence.
Though currently centered in the consumer and psychology and medical sectors, there is potential for its expanded benefit in social services, education and law enforcement. Indeed, digital offers the capability to overcome social stigma and transcend the silos which keep these sectors from working better together for the benefit of the consumer, society, treator, payor and healthcare system.
Digital mental health is needed in a global situation where:
- the burden of mental illness is growing as the WHO forecasts that close to half billion globally, suffer from some mental illness, Asia-Pacific’s adult prevalence ranges anywhere from 4% in Singapore to 20% in Vietnam, New Zealand or Australia, and Lancet found that disability-adjusted life years in China have grown from 7% in 1990 to 11% in 2013 for mental, neurological and substance-abuse disorders, 
- there is a shortage of mental health treaters, where a 2014 WHO report cited that against a global average of 9 mental health workers per 100,000 population, the Southeast Asia region sits at 4.8, and the Western Pacific Region (including China) sits at 8.7, 
- there is a significant supply/demand mismatch reflected in rural populations lacking adequate access to services, and even urban populations have long services waits,
- too often system silos cause lost time, money, care and outcomes when records are inaccessible and care continuity is lacking, and
- there is societal stigma which causes too many to shy away from care, outlined in a study that 50% of Singapore’s population still believes that mental illness is a "sign of personal weakness" and 90% felt that the ill could get better if they wanted to. 
Though daunting and opportunistic, these challenges are exasperated in Asia, where stigma is more pronounced, treators are more scarce, modern society is making populations more susceptible to stress, populations are larger and geographic dispersion is greater. That said, the opportunities, hope and promise which DMH offers are energizing and for warrant accelerated, responsible adoption.
DMH has the potential to:
- improve "mental health literacy” via psycho-education content on websites and online social communities
- allow remote services access,via phone, videoconferencing, chat, to remote and disabled populations
- expand treatment impact of a limited treator population across a greater geographically-dispersed consumer base, even expanding the role of caregivers and traditional medicine practitioners, as well as using AI robots which have potential to substitute for humans in some mental health care contexts
- provide more accessible records to allow cross-silo care coordination between consumers, caregivers, treators, education, social services, law enforcement and payors
- provide services anonymously and discreetly to those afraid of stigma
- strengthen the mental resilience of Asia’s populations, from pressured youth and careerists, to generation-sandwiched middle aged, to the aged
- facilitate community, versus institutional, care, with its ability to remotely monitor the health of sufferers.
Additionally, when we compare low-cost solutions being created in the East and South and high-cost solutions in the West, we see the opportunity for demographic and psychographic matching of solutions across regions. Think: low cost solutions transferring to rural and low income populations in the US & EU, while high end solutions in the US are transferred to affluent population segment in the East and South. By the way, this is not unique to mental health, but extraordinary in its potential to address mental health directly, and its comorbidity with chronic diseases.
DMH Investment in growing globally; and anecdotally in Asia
When we look at investment in this space generally, as Asia specific stats for this sector are not available, we see growth. In a mid-2017 CB Insights article, they estimate that US digital mental health investment was $202 million in 2016 and tracking towards $237 million in 2017. The most prevalent players are meditation apps, electronic cognitive behavioural therapy (eCBT) and tele-counselling services. 
While we do not have specific Asia investment figures, we can note an anecdotal increase in the number of firms launching in this space in the last few years. A few of the players I have come across are noted below and there are a number of others which space does not allow at this time.
Asian DMH Players
In my time here in Asia, I have been glad to discover Asian DMH firms. A few I have encountered are:
- Cogniant, a Singaporean care coordination & delivery platform addressing mental health in chronically ill populations
- DoctHers, a Pakistani telehealth firm matching semi-retired female treators with medical appointment demand all over the world, inclusive of psych services.
- MindFi, a Singapore-based meditation app leveraging micro-meditation sessions to offer the benefits of mindfulness.
- MindLinc, a Singapore & US based mental health records firms using AI as a means to derive advanced insights from large mental health datasets
- Neeuro, an EEG wearable & game firm, reading brain waves and providing brain and concentration training
- Ooca, a Thailand-based, telepsychiatry service providing anonymity and safety hopefully resulting in greater numbers of sufferers seeking help.
Detailed analysis of other Asia based digital mental health firms can be found on Galen Growth Asia’s HealthTech Alpha analytics platform include (amongst many more): 525XL, Ayuka Mental Health, CNSDose, DoctorOnCall, Hasiko, iCare, MediBio, Miew, Mind Companion, Moreless, Sympatica.co, TruWorth Wellness, WellTeQ, YDL, etc. In addition to these Asian firms, we have seen moves by western firms, like American Well (telehealth), making moves eastward.
So we see a certain “perfect storm” of needs and opportunities in Asia that makes this space ripe for fruition amid its challenges. If not tackled well, the threat of mental un-wellness stands to have grave social and economic impacts in Asia. This lends an urgency to act to accelerate the responsible adoption of these technologies for the good of the greatest number, we as we are all as susceptible to mental un-wellness as to physical.
Galen Growth Asia would like to thank Craig DeLarge for his support and stewardship of the GGA Advisory Board over the past two years and wish him luck in his new endeavours in the USA.
Author: Craig DeLarge
Editorial: Julien de Salaberry
© Galen Growth Asia 2018
- Out of the Shadows: Mental Health in Asia Pacific
- 2014 Mental Health Atlas
- Mental Health Startups See Boost With Rise Of Meditation And Wellness Trends
- Mental Health & Integration