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Emerging Technologies to Improve Care

By Sarah Christen, Convention Manager, NAMI

Ken Duckworth and Keris Myrick recently talked to NAMI about the latest on emerging technologies to improve care as well as their own personal experience on online tools to improve self-management of mental illness.

Keris Myrick is the president of the NAMI Board of Directors and the president and CEO at the Project Return Peer Support Network in Los Angeles County, Calif.

Ken Duckworth, M.D., serves as the medical director for NAMI. Dr. Duckworth is double board certified in adult and child and adolescent psychiatry.

Conversation with Keris Myrick, M.B.A.,
M.S., Ph.D.c

What are some of the latest technologies you recommend?

There has been a rise in the number of online tools to help people with mental illness monitor their moods. And of course with the plethora of affordable smart phones—there's an app for that, too. Some apps are even connected to the online tools. The security encrypted online tools also permit the user to "invite" their providers, family, certified peer specialists and others to view their profiles as a means of support.

Have you used some of these tools yourself?

I have used several tools including a daily mood tracker; which is a simple day-to-day mood tracker using a numerical system and optional space for notes. This technology also sends me a daily text reminder to enter my mood rating because, yes, the novelty can wear off, or I can just get busy and forget. When I see my doctor, if I can't recall my mood over a period of time, I can send him an invite to review the graph of my mood ratings over a period of time or just look at it myself as a reminder of the trend in my mood and any notes. It's very handy for those of us who know how we feel at that moment but might have trouble recalling our mood or trigger that occurred prior to our doctor’s visit.

What others apps and online tools would you recommend?

I would recommend apps or online tools that have been studied or have research based on their outcomes. Beyond mental health apps, there are apps that assist with monitoring physical health, healthy foods and exercise. All would be beneficial for someone to investigate to see if they help improve self-care and promote wellness.

Conversation with Ken Duckworth, M.D.

What are some of the latest examples of emerging technologies in treatment of mental illness?

Repetitive Transcranial Magnetic Stimulation (rTMS) is a recent treatment for major depression that has not responded to medications. RTMS is a technology that involves placing a specialized coil over the scalp, and the magnetic field induces electrical activity in the brain, usually in the left side prefrontal cortex. The treatment takes about an hour and requires no anesthesia and does not induce a seizure. A course of rTMS involves 30 treatments, usually five per week with six taper treatments.

What are some of the arguments against the use of this technology?

rTMS does not work to help people with psychosis and has not been studied as a maintenance treatment for depression. People who have metal (aneurism clips, pacemaker, VNS device) near the device may not use the treatment. Another criticism is that there are no long-term studies of this treatment. Few side effects, other than headache and the rare risk of seizures, are usually noted.

Cost certainly must be an issue in many situations. What are some of the ways around that? Does insurance cover some of this treatment?

A criticism of rTMS is that it is expensive and doesn't help most people. Some insurers are covering rTMS for major depression after trials of medications (and in some cases) psychotherapy have been tried.

How would something like rTMS fit with a treatment plan?

As with many new treatments, where exactly new technologies fit into the treatment plan is still being understood. For example, might TMS be used in place of ECT in the treatment of bipolar or depression? Further research needs to be developed to help understand the role of these new technologies.

Dr. Duckworth recently took a two-day course on rTMS at Harvard University, where he sat in the machine and received magnetic stimulation. Many might find it uncomfortable--a kind of metallic ball hitting your head feeling. Like most people who participate in studies, Dr. Duckworth had no ill effects from the magnetic stimulation.

We look forward to Ken Duckworth, M.D. and Keris Myrick, Ph.D. presenting, “Emerging Technologies to Improve Care,” at the NAMI National Convention on Saturday afternoon, June 29.

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