It’s time to stop neglecting the mental health of chronically ill patients.

When we talk about chronic illnesses, mental health normally isn’t part of the conversation. But that doesn’t make the daily psychological struggle faced by these individuals any less real. 6 in 10 Americans live with at least one chronic illness. Untreated depression among this population leads to higher rates of hospital readmission and increased overall medical costs. 

Taking this a step further, diabetes is 4.5 times more expensive to treat when it’s comorbid with depression. The cost of treating both asthma and cardiovascular disease rises by 50% when depression is present. And this problem is steadily growing: over the last decade, the economic burden of depression has increased by 37.9%.

Despite this, mental health care is rarely a standard part of treatment plans for patients with chronic illnesses. This is largely in part to the lack of measurable indicators of mental health diseases. In this series, we dive deeper on the overlap between chronic illness and mental health and how enhancements in technology can bridge the gaps to create more holistic care.

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Unraveling the overlap between chronic illness and mental health

Countless recent studies have shed light on the vital intersection between mental and physical health — as well as the significant gaps in care. Just 2% of Parkinson’s patients receive professional psychological support, despite over half being diagnosed with depression (not to mention countless more who are undiagnosed).

Similarly, up to 50% of autoimmune patients suffer from depression, and depression occurrence is two to three times higher in people with diabetes than the general population, with the majority of cases remaining undiagnosed.

With Sonar Strategies, Kintsugi conducted a study with 2,218 participants over 65 — a population that’s more likely to suffer from chronic illness — and uncovered that nearly a third were depressed. This is nearly double the national reported average depression rate. More than half were not receiving any mental health support.

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The high prevalence of depression among people with chronic illnesses makes sense. The road to diagnosis for many diseases is long and isolating, with some patients waiting a decade or more without answers. During this time, many are made to believe they’re simply imagining their “invisible” symptoms, such as pain or fatigue — especially if they’re women. It’s perhaps not surprising that depression is also twice as common in women than in men.

More often, mental illness is tied to loss of quality of life. Chronically ill patients are often grappling with debilitating pain, disability, loss of independence, increased financial burden and medical costs, and uncertainty about the future. Many grieve the life they once had, and the future that’s been taken away from them.

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Loneliness also becomes prevalent as people may lose the ability to participate in social activities or lack contact with individuals who can relate to their experiences. 

Whatever the source of mental illness, it’s clear that depression doesn’t just correlate with these health conditions. It’s a symptom in and of itself. And the relationship goes both ways: depression causes an increase in stress hormones like cortisol and adrenaline, which can directly lead to worse disease outcomes. Patients struggling with depression also have a harder time taking care of themselves. Overall, they’re 76% more likely than their non-depressed counterparts to not adhere to treatment plans.

So why is mental health care often not integrated into the management of chronic illnesses?

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More holistic, personalized care

When caring for patients with chronic illnesses, we need to consider not just their physical symptoms, but their psychological symptoms too. Screening for and treating mental illness should be a routine part of care plans, but unfortunately, that’s not the case.

Furthermore, standard interventions for depression may not be suitable for individuals with chronic illnesses. For example, antidepressants are not compatible with certain medications, and patients with diabetes, epilepsy, heart and kidney conditions, and more, may not be able to take them. 

Even mental health interventions that aren’t “invasive”, such as exercise or healthy sleep habits, may be challenging for those dealing with chronic pain or disability. A broader array of options needed, taking into account the unique needs of these patients.

People with chronic illnesses are often accustomed to using devices to monitor various health parameters, such as blood pressure in cardiovascular disease or glucose levels in diabetes. These tools give patients objective insights into what’s going on inside their bodies, which empowers them to determine whether or not a particular intervention is working, and when adjustments need to be made to a treatment plan.

What if we could do the same with our mental health? Enter Kintsugi Voice, an AI-powered voice biomarker software that helps people monitor their mental wellness just like they would   any other health parameter — simply by analyzing short, real-time clips of their voice.

Often, mental health is ignored because we can’t keep track of it in a visible, quantifiable way. Kintsugi Voice overcomes this by issuing a numerical score for depression and anxiety severity based on less than a minute of free form speech. Integrating this technology into health care consultations can help individuals and their care teams recognize when behavioral health support is needed, and develop care plans tailored to individuals’ specific needs. 

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With voice biomarkers, patients and health care providers can track how well a specific mental health intervention is working, and make objective decisions as to whether to continue with or change the intervention. 

This gives care teams a fuller picture of patients’ health, and also helps patients better recognize that if they’re not taking care of their mental health, their physical health will suffer too.

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Reimagining chronic disease management

At Kintsugi, we’re already working with a number of healthcare platforms to transform behavioral health diagnosis and treatment for chronically ill patients. 

As one example, we are integrating Kintsugi Voice into Aila Health virtual care consultations. Aila Health provides evidence-based, virtual care for those with autoimmune disorders. By embedding into the Aila Health platform, Kintsugi Voice can help to identify signs of depression and anxiety in chronically ill patients, ultimately providing more holistic care inclusive of both mental and physical conditions. 

We are also partnering with  Beam Health. With patient consent, Kintsugi Voice ‘listens’ during telehealth calls to identify signs of depression in real-time. Clinicians are provided with actionable insights on a patient’s mental wellness — no matter what their medical specialty is or what disease the patient has. This partnership will allow Kintsugi Voice to enable its voice biomarkers in any clinical setting, giving providers ownership over their patients' experience.

Voice biomarkers are creating opportunities for a new paradigm in care that looks at the patient’s full experience. It’s essential that we stop treating mental and physical health as two separate areas. It’s all health. Patients who are struggling need care that addresses all their symptoms, not just those that can be seen.

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