How Voice Biomarkers are Shaping the Mental Health Space

November 9, 2022

One in six people is struggling with mental health at any given time. In certain populations, the figures are even more shocking: one in every three young people in the US suffers from anxiety, and well over half of elderly Americans with a chronic disease have some degree of depression.

The worst part is that most of these people suffer in silence. Stigma and fear of judgment still sadly prevent many from seeking help. When patients don't speak up, it's difficult for their healthcare providers to know they are struggling. As a result, primary care physicians correctly detect mental health conditions just 47.3% of the time and are likely to note them down only 33% of the time. As a result, about 60% of people never receive any treatment, making mental illnesses one of the least diagnosed areas in medicine.

Despite the very real symptoms that patients experience, the medical field tends to ignore health conditions that are difficult to measure, like long covid or chronic fatigue. As a result, it takes millions of people suffering before these conditions are even officially recognized. For individuals, it can take years and numerous visits to countless healthcare providers before they receive the correct diagnosis. 

Mental health conditions also tend to lack these measurable indicators of disease, also known as biomarkers. For example, paper-based tests diagnose depression and anxiety based on the patient's self-reported experience. However, true biomarkers are more objective and quantifiable. One of the best-known examples is a high blood glucose level, which helps clinicians detect diabetes and its severity.

At Kintsugi, we are bringing diagnostic precision to mental health. We've created technology to analyze biomarkers in peoples' voices, the physiological and psychomotor aspects of using the muscles in our vocal articulators to push sound through our vocal tract. Clinicians and mental health providers have long maintained that voices can indicate signs of depression and anxiety. The result is a scalable, quantifiable, reproducible, and non-invasive tool that can screen every individual in the US for mental health conditions.

The challenges of measuring mental health

Mental health as a medical specialty has traditionally been more of an art than a science. As a result, it is an area with few quantitative tools available to the clinician to assess the presence of disease. Notably, it also relies heavily on patients' self-awareness of their symptoms. This means clinicians can have difficulty picking up on the subtle cues of mental health conditions – if there are any.

Unconscious bias can prevent practitioners from recognizing signs of mental illness, especially in minority groups. For example, Black patients are half as likely to be screened as white patients, and retired adults are half as likely to be screened as their working-age counterparts. Overall, depression screening takes place in less than 5% of primary care interactions, using tests that can take up to 15 minutes to administer.

Screening for mental health conditions should be part of every primary care visit. Hospitals routinely monitor blood pressure, weight, and temperature, so why not a patient's mental health? In reality, there are existing objective tools that can offer insights into an individual's mental health status, such as electroencephalography (EEG) or magnetic resonance imaging (MRI) scans. Unfortunately, the existing tools are cumbersome and administratively costly for a primary care setting. 

A mental health diagnostic tool that is objective and easy to use has been lacking until now; this is where voice biomarkers come in. Using voice biomarkers as a diagnostic tool is not a novel discovery. Scientific papers dating back to the 1970s describe the subtle vocal indicators of these health conditions, including reduced range of pitch and volume and more pauses in speech. Today, advances in computational power and artificial intelligence have enabled us to turn this academic knowledge into a diagnostic tool that can seamlessly integrate into clinical workflows. While seeing their doctor, a patient can simply speak into their phone or a recording device. Our voice biomarker technology can identify any signs of depression and anxiety in real-time, helping clinicians ensure their patients receive the right support in their moment of need.

Use cases

In addition to embedding into routine physical wellness exams, voice biomarker technology can also assist in telehealth and call centers. Telehealth is increasingly becoming a vital healthcare touchpoint for the most vulnerable populations – such as people with disabilities or those living in rural areas – who cannot easily and regularly visit a primary care physician. Our platform runs seamlessly in the background with the caller's permission and can let providers know whether these patients might benefit from mental health services.

The COVID-19 pandemic has made virtual health visits more popular than ever. But it can be even more difficult for practitioners to detect signs of mental illness. So we need to ensure that patients get the same level of care as they would during traditional face-to-face visits. With Kintsugi, clinicians can screen patients for mental health conditions in real-time without interrupting the session. Our algorithm analyzes the patient's voice as they speak (not what they are saying, but how they say it) and provides a mental wellness score in real-time.

Imagine a patient arranges a virtual visit for ongoing migraines or back pain. It has been known for years that chronic pain has high comorbidity with depression, but it is not always easy for the physician to diagnose, especially in a virtual environment. Tools like Kintsugi can help clinicians identify that the patient’s pain might be impacting their mental health, ultimately painting a fuller picture of the patient for proper treatment. 

Finally, our API can be integrated into existing clinical workflows, eHRs, call-centers, telehealth platforms, and remote patient monitoring apps, supporting home care beyond the traditional health system setting. Facilitation screening, triage, and scheduling is one way to streamline and operationalize access to mental healthcare across the health system

A paradigm shift in mental health

Our tool has the potential to change the way we view mental health. Traditionally, our society's approach has been physician-centered and tends to focus on disease. When we can assess everyone's mental health, we can broaden the scope of what's possible. Rather than just focusing on one end of the mental health spectrum – or, more specifically, the absence of health – we can stratify the population based on mental wellness. 

We can also stratify care options. For example, many patients don't require therapy but could benefit from a meditation app, journaling, or exercise. In addition, if people can reliably assess their mental wellness regularly, they are more empowered to take action. Just like counting your steps provides quantitative feedback, using voice biomarker technology to measure your mental health and wellness can allow you to make minor adjustments to ensure that your health stays on track.

Finally, we all experience moments of feeling low. Tools to track mental health can help people better identify when "normal" sadness has transitioned into clinical disease. In addition, monitoring symptoms is significant for first-time sufferers, such as postpartum moms or those being diagnosed with a chronic condition, who may believe that what they're experiencing and feeling at that point in time is something everyone goes through. It's time to give these people a voice.

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