Mental health has been a significant part of my life for an incredibly long time. My adoptive parents struggled with mental illness, and at an early age, I understood first hand the devastating impact it has on individuals and their families. Those experiences, etched in my memory as integral moments from which I experience pain and derive my purpose, call upon me to create and cultivate Singula Institute to solve the problems that I introduce to you here.
The most incredible moments of my career as a Psychiatrist is when my medical and research training, that I worked so hard to access and achieve, results in patients getting better from their illness. The worst moments are when it doesn’t. The field of mental health is still in an infancy in that we cannot adequately or sufficiently identify within a patient the parts of our organ (ie. the brain) or the biological processes that cause illness. We are therefore forced to make our diagnoses solely based on subjective, rather than a mixture of subjective and objective clinical assessments. This approach leads to a sequelae of problems such as diagnostic inaccuracy that cause treatment failures and delays in care, a lack of mental health parity by insurance providers, and a reinforcement of stigma that can prevent individuals from engaging in mental health care.
And, this is further complicated by the fact that our current treatment armamentarium is formed from and informed by vastly different perspectives of mental health; A tug of war and to-and-fro between two models of mental illness, each one growing expansively and somewhat divergently; A medical one that posits that illness is primarily a biological problem (i.e. Psychiatry) and a psychological one that posits that illness is primarily a problem of the “mind” (i.e. Psychology).
One of the most commonly used psychological interventions, psychotherapy, is an experiential treatment modality executed within a learning atmosphere and guided by a trained clinicianthrough verbal and non-verbal communication in order to identify psychosocial contributions to mental illness and enhance cognitive, emotional, and behavioral skills (i.e. coping strategies) to help someone navigate their lives with fewer barriers. Unfortunately, the sheer number of branded and unbranded psychotherapies (~150 and growing) has brought about a consumerism approach to psychotherapy. Is any one psychotherapy technique a singular solution to a mental disorder? Or, does each psychotherapy add to the repertoire of methods to help someone learn through the internal and external challenges of their mental illness?
In existence, there is a limited number of biological treatment options (ie. medication and neurostimulation) with a narrow understanding of how they work, and for whom they work. The indications for biological treatments for depression and anxiety remain tethered to the larger syndromic category despite research demonstrating that antidepressant medications help some, but not all people with these conditions. For example, compared to placebo, antidepressants improved depressive and anxiety symptoms in only roughly 20 more people out of 100. Yet we do not know who this subset of individuals are, and why it is that it has worked for them and not for the others.
Given such different, and somewhat disparate ways to solve the problem, it is no wonder why insurance driven clinics and hospitals have encouraged “split treatment”, which assigns a person to a therapist (of varied training and background), and to a psychiatrist who “manages medications”. Sadly, these two vaguely defined “split” roles introduce a great deal of confusion and inefficiency.
Circling back to the issue of Depression, which in some age groups (18-25) has been increasing in frequency and severity at an alarming rate, we do not currently have a scientific method to study and learn about how the individual person becomes mentally ill, and more importantly, how the individual person becomes healthy. In essence, the current mental health system just doesn’t have the bandwidth of solving the problem of the individual person with mental illness.
I am one of many mental health clinicians who strives for a future of mental health treatment to work for the individual. Over the last year and a half, I have been fortunate to meet like-minded clinicians, researchers, engineers, entrepreneurs, and other brilliant, talented, and generous individuals who stand for the same initiative. Some of them have joined me on this journey and are Singula Co-Founders, Board members and Advisors. I am confident that, together, we will innovate mental health care and, most importantly, transform the lives of people suffering from mental illness.
The recent global COVID-19 outbreak and social unrest in communities nationwide remind us of the grave reality about mental health needs, access to mental health care, and its critical importance to our perseverance as a society, as symptoms of anxiety and depression have increased dramatically at this time. From illness to remission and relapse prevention, we will introduce a proactive rather than reactive mental health treatment paradigm. It is finally time to take the guesswork out of the diagnosis and treatment of Anxiety and Depression.