We are living in the midst of a mental health crisis — in the U.S. and across the globe. According to the World Health Organization,depressionaffects nearly 15 percent of adults worldwide, and diagnoses have risen 33% since 2013, according to areport from health insurer Blue Cross Blue Shield.Researchers Aaron Reuben and Jonathan Schaefer even recently proved that we are all more likelyto experience a bout of mental illness in our lives than we are to develop diabetes, heart disease or any kind of cancer.

The Most Dangerous Public Health Issue of Our Time

Put simply, this epidemic is the largest and most dangerous global public health issue of our time, and our solutions are far from adequate.

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Even among those who acknowledge the crisis, some fundamental questions are not being answered: Are more people suffering from more mental health issues now than ever before? Maybe. Or perhaps asstigma decreases and awareness increases, there is simply more visibility. The issue could also be environmental: technology has accelerated the pace of our lives and created another epidemic — that of loneliness. Surely, the state of global politics isn’t helping anyone sleep better at night, either. It could be all of the above. But the mental health crisis can’t simply be characterized in terms of its prevalence.

More to the Puzzle than theDSM

Yet diagnosing and treating mental health issues has not evolved much since 1952, when the first edition of theDiagnostic and Statistical Manual of Mental Disorders(DSM) was published. As psychiatrist Daniel Carlat described in a recent interview withNPR,“It’s very hard to make a psychiatric diagnosis and we’re not talking about a diagnosis where we can get a blood scan or a brain scan or an X-ray.” Diagnoses of mental illness are still based on simple interactions between therapist/psychiatrist and client about self-reported, anecdotal data “how they’re feeling, what they’re thinking, how they’re sleeping, what their concentration level is, what their energy level is,” in Carlat’s words. From there, the clinician does their best to put the pieces together into a hypothesized diagnosis, which they check against the criteria outlined in theDSM-V. This is guesswork, like trying to make out the contents of a very complex photo at an extremely low-resolution.

Mobilizing the Sciences

Psychiatrists, psychologists, geneticists, neurologists, immunologists, data scientists and public health leaders, all try, in their respective fields, to find new approaches to understanding, diagnosing, and treating mental illnesses, and many of them understand the multivalent nature of their psychological, social, biological, neurological, and genetic origins.

Recent research reflects this, particularly in the field of genomics. The journalSciencerecently published the largest genomic study of brain conditions ever conducted, which compared the genetic data of 265 patients and 784,643 control participants in order to see if there were links between genetic variants and brain disorders. The researchers ended up finding many links between gene variants, brain disorders, and physical and cognitive traits; for example, they foundschizophrenia, major depressive disorder (MDD) and bipolar disorder share multiple genetic variants. “One of the big messages is that psychiatric disorders turned out to be very connected on the genetic level,” Verneri Anttila, the first author on the paper toldScientific American.

Another study published this year inNature Geneticscomparing the genomes of individuals with depression and those of individuals without depression identified 44 genetic variants that may contribute to therisk of depression.  While the scientists analyzing the data were not able to identify one single gene variant that presents a strong risk factor for depression (like the BRCA1 gene does for breast cancer), they concluded that each one has an incremental effect on depression.

Let’s try to take a step back and consider — generally and in broad strokes — what would need to happen in order for us to see large scale progress.

These three goals may not seem within immediate reach, but I have a strong sense of how we can move toward a new framework and a more integrative and unified model of mental health care.

A New, data rich Framework for Behavioral Health

The scope and complexity of the problem is way beyond the capabilities of existing science, and demands a Kuhnian paradigm shift. What I suggest is a stand-alone global project, dedicated to super-large scale data collection and analysis. Call it a paradigm shift, a unified behavioral health theory, even the next Human Genome Project. That is the breadth of the effort we will need to commit to in order to properly aggregate and regress all the data sets required to achieve such a dramatic — and necessary — breakthrough in this field.

Through massive application of machine learning, millions of personal, environmental and lifestyle factors of very large samples could be analyzed and isolated in order to determine their effect on human behavior, mood, cognition, and overall mental health. Such a project would merge real time data streams about behavior, lifestyle, and environment (diet; physical activity; heart rate; gait; breath patterns; substance use; the weather and pollution levels of your location; more) with all the data about patients’ mental health that we’ve captured in the past with standard psychological and psychiatric evaluations. The large-scale regression of such data corpuses will likely reveal a much more detailed and accurate picture of the hidden complexities driving our mental health, and could generate an entire new set of “templates” — patient patterns that may, in turn, even lead to a whole new set of diagnoses.

These outcomes would help us create a truly personalized framework that would lead to far more effective predictions, preventive measures, and dramatically more effective therapies for mental health conditions. This could help us create a world in which mental health could be understood not only based on your clinical health record, demographic and socioeconomic information, and visits with a psychologist, but also neurological scans, data about your physical activity, as well as your diet, environment, and genomic data.

The Time is Now

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