Mind Ease: a promising new mental health interventionpost by PeterBrietbart · 2018-10-23T17:34:31.200Z · EA · GW · Legacy · 8 comments
What is Mind Ease? EA-relevance Does the world need this? Is this useful to me or people I know? What interesting findings so far? How will we be able to compare this with other interventions? Who is working on this project? How can I help? None 8 comments
What is Mind Ease?
We’ve developed an anxiety management tool called Mind Ease. Our intention is to make it the most effective tool in the world for quickly calming down whenever you are feeling stressed, anxious or tense. The aim is to grant you control over your anxiety symptoms whenever you need it (rather than being a tool for the long term treatment of anxiety disorders).
Whenever you feel stressed or anxious, you just open the app, and it selects a technique automatically to help you calm down in under 10 minutes. Over time, it learns what works for you, becoming better and better for you specifically, but we also learn from the data more generally in order to improve all the techniques for all users. Right now, the app uses 11 different techniques to calm you down, all of which we've demonstrated the efficacy of in our own randomized controlled trials. There are some specific implementations of familiar techniques included, such as meditations, CBT, and gratitude journaling; and some less well known exercises, such as progressive muscle relaxation and anxiety defusion.
What we envision is a world where people who suffer anxiety always have a reliable way to feel better whenever they need it. We want people to directly suffer less, have their lives less negatively affected by anxious-avoidance, and have greater control over their own mental states.
We are currently developing Mind Ease as a web app. Android and iOS versions are coming soon.
Mental health as a promising EA cause area has been discussed a few times in the past couple of years.1 Neither GWWC nor GiveWell have many clear pointers for people who want to contribute in this space, perhaps due to the low perceived tractability of the problems involved. The large majority of the work done on mental health takes place in healthcare and academic research, which can make a person feel like all they can do is contribute a small drop in an ocean of other activity. GWWC suggested that one neglected area is discovering which interventions work best for different mental illnesses.2 And for anxiety, that’s what we’ve tried to do.
Does the world need this?
Yeah, a lot. Anxiety is the most common mental health disorder in the world,3 is a major predisposing factor for depression,4 is strongly negatively correlated with subjective wellbeing,5 impairs cognitive performance6 including everyday tasks and problem solving,7 and has been linked as a trigger for asthma, coronary heart disease, irritable bowel syndrome, ulcers, and inflammatory bowel disease among other conditions.8
The 2018 Clark et al. cost-effectiveness analysis of mental health and wellbeing estimates that, "Eliminating depression and anxiety would reduce misery by 20% while eliminating poverty would reduce it by 5%".9 Of course, these numbers are speculative, but even conservative estimates mark this as a problem worth solving.
Is this useful to me or people I know?
We believe it is, if you or people you know are anxiety sufferers. You can check out the Mind Ease splash page and beta app here – feel free to use it or share it with people who could benefit from anxiety relief, but keep in mind that we have numerous improvements planned and we're rapidly iterating. We'd love any feedback you have about how we can make it better.
In particular it will be likely to help:
those who suffer from acute anxiety, or who struggle with anxious thoughts. Our data suggests that the higher a person’s GAD-7 score (i.e., the more they suffer from anxious symptoms), the better our interventions work.
those who have a predictably stressful life. Mind Ease really shines if you know you will be encountering sources of stress as part of a routine, as the short interventions allow you to pre-emptively defuse the negative feelings.
those who do not consider themselves anxious, but who often encounter anxious thoughts and feelings that reduce quality of life.
What interesting findings so far?
The big one is – based on an internally run study of 250 uses – Mind Ease reduces anxiety by 51% on average,10 and helps people feel better 80% of the time.11 We think this is extraordinarily good, and it's the result of testing a lot of different interventions in randomized controlled trials, and refining the techniques repeatedly.
In a separate study, we found that 70% of moderate/high-anxiety people (and also a surprising 37% of non/low anxiety people) are interested in using the app.12
In yet another study, we took a random sample of people (n = 303) recruited via Positly, gathered their GAD-7 score, and asked them, “do you identify as an anxious person?”. Commonly, a GAD-7 score of 5-9 represents “mild anxiety”, 10-14 “moderate”, and 15+ “severe”. We found that at scores of 5 and up, the vast majority of people (94%) consider themselves to be “an anxious person”. That’s 73% of all participants, i.e., if the study generalises, only 27% of people do not consider themselves to be an anxious person.
How will we be able to compare this with other interventions?
It’s a good question, and the answers aren’t clear-cut. There have been a few attempts at evaluating mental health interventions in terms of comparable metrics, notably Elizabeth van Nostrand’s laudable work.13
The parts of the equation we need are:
Effectiveness in terms of QALYs/DALYs/LS/SWB. This is tricky as we use a custom evaluation scale that uses three 7-point likert scales measuring general affect, mental well-/ill-being and bodily well-/ill-being (measurements are taken before and after each intervention).
Additionally, we’d need counterfactual impact measurements. We don’t include a group that does no exercises but instead we run a control group who do a relatively boring “learning about anxiety” exercise that has no clinical justification/support. Interestingly, this exercise shows non-zero effectiveness, showing that regression to the mean is a likely explanation for some of the improvement that users see. Notably, in another study we conducted, 54% of ‘moderate’ and higher anxiety (GAD-7 scores of 10 and up) say they don’t have a reliable method to calm down when they need it.
Cost – also tricky, as it’s unclear how best to measure this. Ordinarily we’d want to use the cost of treatment, but the app is currently free. Once the app has a monthly fee in wealthy countries and reaches profitability, further benefits to users will essentially become free (as the cost to administering it becomes negative for us!).
One important thing we’re able to do is directly compare the effects of radically different anxiety-management interventions. In the academic psychology literature, unless two studies use very similar methodologies on very similar populations, comparing the results in terms of effectiveness is super difficult. Since all our exercises follow the same data measurement practices and methodology, we don’t have this generalisation problem to the same degree.
Who is working on this project?
The project is run by myself (Peter Brietbart) and supported by Spencer Greenberg. An extremely talented bunch are working on the app, including Mihai Badic, Peter Moorhead, Teis Rasmussen, and Elysia Segal.
How can I help?
A few ways:
Send the beta version of Mind Ease to people who you think could plausibly benefit from it. The splash page with links to the app is at mindease.io. You can access the app directly at mindease.io/beta
Participate in discussions of mental health as an EA cause area. The facebook group Effective Altruism, Mental Health, and Happiness is a great place for it.
Try out the app and send me feedback. As I've mentioned, we're still in beta and iterating fast, so your feedback would be especially helpful right now. I’m firstname.lastname@example.org
Thanks for reading!
References and footnotes:
1. Elizabeth Van Nostrand (2017). Mental Health Shallow Review. http://effective-altruism.com/ea/1ha/mental_health_shallow_review/
Michael Plant (2017). Is effective altruism overlooking human happiness and mental health? I argue it is. http://effective-altruism.com/ea/yv/is_effective_altruism_overlooking_human_happiness/
2. Konstantin Sietzy (2015). Mental Health Interventions May Be More Cost Effective Than We Think. https://www.givingwhatwecan.org/post/2015/12/mental-health-interventions-may-be-more-cost-effective/
3. Twenge J. M. (2000). The age of anxiety? Birth cohort change in anxiety and neuroticism, 1952–1993. Journal of Personality and Social Psychology, 79, 1007−1021. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.360.8349&rep=rep1&type=pdf
4. Bagby, Joffe, Parker, Kalemba, & Harkeness (1995). Personality Disorders and the Five-Factor Model of Personality. Journal of Personality Disorders: Vol. 9, No. 3, pp. 224-234. https://doi.org/10.1521/pedi.19126.96.36.199
5. DeNeve KM, Cooper H. (1998). The happy personality: a meta-analysis of 137 personality traits and subjective well-being. Psychological Bulletin Sep;124(2):197-229. https://www.ncbi.nlm.nih.gov/pubmed/9747186
6. Seipp B. (1991). Anxiety and academic performance: A meta-analysis of findings. Anxiety Research, 4(1), 27-41. http://dx.doi.org/10.1080/08917779108248762
7. Matthews G., Coyle K., Craig A. (1990). Multiple factors of cognitive failure and their relationships with stress vulnerability. J Psychopathol Behav Assess 12: 49. https://doi.org/10.1007/BF00960453
8. Edelmann, R. J. (1992). The Wiley series in clinical psychology. Anxiety: Theory, research and intervention in clinical and health psychology. Oxford, England: John Wiley.
9. Clark, Flèche, Layard, Powdthavee and Ward (2018). The Origins of Happiness. Princeton University Press. New York.
10. This was from a paid pilot study on 49 people, run via Positly over the course of 5 days. The 51% average was computed by looking at interventions completed (not partial ones) and for people who had any negative feelings to start (based on any of our 3 likert scale questions having a negative value) we calculated the average % reduction in these negative feelings (which would be negative if a person's negative feelings increased).
11. Meaning that people's initially reported negative feelings are reduced by the end of the completed intervention.
12. Based on reading a description of the app and it's purpose.
13. Elizabeth Van Nostrand (2017). Measuring the Impact of Mental Illness on Quality of Life. http://effective-altruism.com/ea/1he/measuring_the_impact_of_mental_illness_on_quality/
Elizabeth Van Nostrand (2017). Cost Effectiveness of Mindfulness Based Stress Reduction. http://effective-altruism.com/ea/1hx/cost_effectiveness_of_mindfulness_based_stress/
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