Real Time Surveillance of Global Mental Health and Emerging Crises

The systematic and significant diminishing of mental wellbeing across successive generations points to a future health catastrophe amidst the ongoing mental health pandemic magnified by COVID-19. We track evolving global mental wellbeing to identify risks and generate insight into social and environmental determinants for strategic population-level mental health management.

Dr. Tara Thiagarajan, Founder and Chief Scientist

Mental health challenges evolve with environmental and societal changes, significantly impacting societal productivity and conflict. For example, ongoing and necessary public health measures to minimize COVID-19 spread have taken considerable social and financial tolls on already vulnerable populations. Isolation and job loss are fueling a dramatic increase in significant mental distress that has serious repercussions for wider societal health and wellbeing. In America, adults reporting symptoms of anxiety or depression increased from 10% to 40% from 2019 to 2020 and young adults with clinical symptoms increased to 44%. Our initial data, acquired across 8 countries in 2019-2020, shows adults reporting clinical level challenges increased from 14% in 2019 to 26% in 2020, equating, at a global population level, to 2 billion people in ongoing mental distress. As people contend with the ongoing pandemic, there is a vital need to 1) understand how the pandemic affects this pre-existing and rapidly growing mental health pandemic so society can immediately put measures in place to address it and 2) identify social and environmental determinants of positive and negative mental health outcomes to strengthen global efforts for strategic and preemptive mental health management and intervention during future times of national and international emergency.

Despite increased awareness of the societal and financial burdens caused by mental illness, there are still no large-scale surveillance systems to provide decision makers with the necessary insight on population mental wellbeing to support broad-scale, evidence-based policy development for effective prevention and resource allocation. Our solution aims to fill this knowledge gap for governmental and non-governmental agencies to facilitate the translation of large-scale, real-time data insights into actionable policy updates and initiatives with tangible impacts. We are engaging multi-sector NGOs and governmental organizations through webinars, round table and one-to-one discussions, and strategic planning cohorts. Together, we are filling a critical need for data acquisition and insights aligned with stakeholder needs so services can be delivered in an effective, accessible way. Over time, we expect this process to evolve and inform changes to our MHQ (i.e. the addition of new questions or co-factors) to ensure the data we collect is relevant to global trends and partner interests. Beyond these NGOs/governmental organizations, we will also partner with employers and universities to offer tailored assessment to measure and more strategically manage the mental wellbeing of their workforce or student body as they adapt to the changing demands of their workplace or campus settings.

Our solution provides essential knowledge infrastructure necessary for managing public health and wellbeing. It can be used for early identification of evolving mental health challenges and to direct policy and programming that relieves societal suffering, lowers distress, and enhances positive functioning. All generated data are freely available in the public domain to independent researchers and organizations desiring access for non-commercial use. Our openly available data 1) furthers scientific understanding of the drivers of mental wellbeing through independent scientific investigation and publications, 2) provides supporting evidence for campaigns promoting mental health, 3) provides insights to guide policy decisions and development strategies. We will also make data publicly available in a user-friendly format via our free, interactive data visualization tool and work collaboratively with stakeholders and mental health advocacy groups to understand & use data for policy design initiatives. As an organization, we will publish an annual report, as well as peer-review publications. Our WorkforceMHQ and StudentMHQ tools (WMHQ and SMHQ) are also available as low-cost paid products for companies and universities/schools to track the mental wellbeing of their workforce or student body for more strategic management. Profits from these sales will feed back into our public not-for-profit initiatives.

Individual MHQ respondents are directly impacted through the comprehensive mental wellbeing profile they receive, including suggestions for strategies to mitigate their challenges. Aggregate data directly supports multi-sectoral stakeholders including NGOs, government agencies, universities, and employers by providing insights into their target populations which can strengthen social and economic policymaking to promote population mental wellbeing. The resultant targeted, strategic public policies and interventions will help protect vulnerable populations and improve global mental wellbeing. We engage with stakeholders through webinars, roundtable discussions, forums, and one-on-one conversations to teach organizations how our data and insights can benefit decision-making. This also helps us adapt our data acquisition to ensure better analysis and actionable insights that serve our partners in the future.  For example, we are working on a collaboration with Golden Seed in Arizona to propose the Arizona school system uses SMHQ for effective measurement and management of students’ mental wellbeing. We are similarly engaging with AARP, American Society for Anxiety and Depression, National Council for Behavioral Health, Canadian Mental Health Association, World Mental Health Federation and others on how we can move towards solutions.

The MHQ is currently available as an online assessment tool in English, giving us a potential reach of 682 million respondents who have internet access. In 2020, we collected an initial dataset of nearly 50,000 responses from 8 countries with large English-speaking populations including USA, UK, Canada, Australia, New Zealand, India, Singapore and South Africa using Facebook and GoogleAds as our main recruitment channels. So far in 2021, we have also expanded into Ireland and Nigeria and collected an additional ~40,000 data samples.  We will roll out translations of the MHQ in Spanish and Arabic in Q2 2021, focusing our initial recruitment on 20 countries in Central/South America and the Middle East which will add ~800 million people to our potential respondent pool (1.5 billion total). In three years, we will have translations in at least 15 other popular languages to extend our potential reach to over 3 billion internet users. We aim to double responses collected each year to reach 1,000,000 by the end of 2024. To date, we have started discussions with 15 impact partner organizations and have outlined a partnership engagement strategy to be regularly collaborating with 50+ partner organizations by the end of 2024.

Our impact goals are for data to be used for 1) real time surveillance of mental wellbeing across populations of interest and on a global scale, 2) identification of individual and integrated risk factors across different demographic groups to inform targeted intervention and support strategies, 3) identification and prediction of populations at risk for mental health challenges, allowing for earlier provision of support and intervention, and 4) more extensive analysis of the social, environmental, economic, and cultural determinants of mental wellbeing using cofactors from other data sources (e.g crime statistics, weather data) to enable clear policy recommendations for large-scale population shifts in health and development.

We monitor and evaluate our impact by: 1) tracking the number of successful completions of the MHQ; 2) monitoring partner engagements using HubSpot; 3) recording the number of people who request access to our publicly available dataset on Brainbase;  4) monitoring mentions and citations of our data and reports in the news media, social media, and peer-reviewed publications. Finally, our greatest impact will be driving initiatives to fruition that move the needle on mental wellbeing. The number of evidence-based policies/strategies using our data will serve as a direct measure of this success.

1)  Advertising expense- Compared to other research studies, we are fortunate to have a low acquisition cost pp with high click and completion rates since respondents are incentivized to take the survey because they want their own mental wellbeing profile.

2)  Representative /unbiased sampling- Recruiting through the internet means our sample is biased to the internet-enabled world. As sample sizes increase many issues will be mitigated, but people who are unwilling to take an online assessment may have a different profile than those who are willing to. This is true of any study.

3)  Multi-language complexity – Certain words differ in meaning in regional translations of the same language e.g. Mexico vs. Argentina vs. Spain. We spend time working with expert translators to select language that appeals across all countries where a language is used.

4)  Cultural sensitivities- It’s difficult to draw global comparisons when what equates to happiness or stress varies in different cultures. E.g. “success” is viewed differently in collective cultures like Japan vs. individualistic cultures like America. As a solution, we ask “life impact scale” questions to assess how persons consider qualities in the context of their own culture/ how they are impacted in their own environment.

Sapien Labs

We are currently fully operational, producing useful data, and beginning to connect stakeholders with our data to drive direct impact. We need additional funding to scale up our data collection to include non-English speaking countries, further develop our analysis infrastructure, as well as scale up our marketing and public relations campaign to attract partner institutions that can take our data and create tangible results. Trinity Challenge can help us overcome our cost barrier as well as provide invaluable connections to potential partner organizations such as nonprofit, employers, data scientists, and healthcare companies. Access to Trinity Challenge’s university and nonprofit members would also provide us partners for obtaining parental consent to survey under 18-year olds and provide valuable access to one of the most vulnerable groups of respondents. This would serve our goals to better understand adolescent and youth mental health, ultimately also assisting the partner universities and schools to better manage the mental health of their populations. Since adolescence is often when mental health issues first manifest, access to this age group is vital to an accurate picture of world mental health over time and the success of our solution.

Partnerships with Trinity Challenge founding members Google and Facebook is one of the most important opportunities for us. The majority of our expense for scaling involves targeted advertising to MHQ respondents via Facebook and Google Ads. Partnership with their staff to improve our targeted advertising or in-kind donation of the advertising budget would help us successfully meet our 3 year impact goals. Additional partnership with prominent nonprofits like the Bill & Melinda Gates Foundation would open a world of invaluable connections to partner organizations that can utilize our data and models to inform their own programming. Other valuable potential partners include universities and large-scale workforce employers seeking to gain a better understanding of their students’/employees’ wellbeing. These partners would set up a customer base for the paid WMHQ/SMHQ version, where profits go directly to long term sustainability of the public, free MHQ for the greater good.