Wearable devices collect physiological data continuously. These provide you with a broad range of information concerning your mental health. However, applications in this field are still limited and the need for innovation is high.
Three physiological indicators to measure
Wearable devices can collect data from several physiological systems. Therefore the Carewear project (Vlaio Tetra HBC.2016.0099) aims to enrich burnout prevention in current employee assistance programs and the treatment of depression in clinical practice by facilitating the uptake and use of wearable technology. It is for example possible to capture heart rate, respiratory rate, electrodermal activity, skin temperature and movement. The selection of a limited number of relevant and interpretable indicators is essential to a user-friendly solution. Based on the current literature, three main focal points for Carewear were selected. Firstly, step count and physical activity is a vital contributor to not only physical but also mental health. Secondly, stress plays an important role in the development of burnout and can contribute to depressive episodes. Although stress is difficult to capture, using different sources of information (heart rate, skin conductance, lack of substantial physical activation, and subjective state) allow for a better estimate. Finally, heart rate variability (HRV) can provide a general estimate of vulnerability and resilience and could be useful to monitor long-term changes.
The uptake of relevant and interpretable indicators and the use of wearable technology enriches burnout prevention and the treatment of depression.
The Carewear tools
To be able to use physiological data in mental healthcare, we need adequate wearable sensors, algorithms to translate raw wearable data into relevant indicators, an online software platform, and clinical guidelines. Based on the current literature and capabilities of wearables devices, the wearable sensors need to collect high quality data of the necessary physiological systems mentions above (i.e., skin conductance, blood volume pulse for heart rate, and accelerometer data). Wearable technology has a large potential in the field of mental healthcare, but there are still some challenges in its practical implementation. The current wrist-worn wearables still have difficulties producing valid signals, which decreases the accuracy of the physiological data. Also, most commercial systems use low sample rates and are often closed systems, which makes it difficult to access and use their raw data. In the Carewear project we targetted the Empatica E4 and the Chill+ (imec) as wearable device. Algorithms using artificial intelligence were developed to translate these physiological parameters from wearables into indicators that can be used to assist in the assessment of the mental health of the subject. This physiological data can be inspected and completed on the online Carewear dashboard. We have developed an online software platform allowing healthcare professionals to consult the physiological data that was collected between sessions and implement the knowledge as a useful addition to their current practices. Finally, clinical guidelines inform healthcare professionals on evidence-based interventions to promote mental health using the Carewear platform.
Use cases investigate added value
Preliminary qualitative analyses suggest that professionals indeed supported the idea that it could be a useful addition to current treatment protocols. Participants liked the approach of an online application where physiological data and self-report were combined and the manuals were found to be clear and easy to use. However, they also encountered some technical challenges. Uploading the data from the wearable was a fairly difficult process. There were also some instances where data logging did not occur correctly. Finally, the professionals felt that working with the platform could sometimes be a bit cumbersome and that the design of the interface could be more attractive. Currently, two use cases are running to investigate the added value of this implementation of wearable technology to help prevent burnout and to treat depression. Clients are asked to wear a wristband that registers several physiological parameters. Healthcare professionals can consult the data that is being collected with their clients to observe behaviour and detect patterns. Subsequently, this information can be used to guide the next steps in the treatment process.
Carewear provides a user-friendly platform and clinical guidelines, tailored to elevated stress and depressive symptoms.
Altogether, the Carewear project aims to encourage the use of wearable technology in mental healthcare by providing a user-friendly platform and clinical guidelines. Both are tailored to elevated stress and depressive symptoms, which makes physiological data accessible and comprehensible for both healthcare professionals and clients.