S6, E2: Gaining Control over Mental Health
How can two undergraduates impact the health of people with mental illness? Inspired by her own experience with bipolar disorder, Alison Bowden from Oregon State University created an app to help manage the daily challenges of living with mental illness. She co-founded Wellio with Houston Morgan from Arizona State University.
Scott Bowden, MBA and M.S. in electrical engineering, serving as technical advisor
Bonnie Hemrick, mental health promotion specialist at Oregon State, serving as mental health services liaison and OSU point of contact
Brent Morgan, Ph.D. material science, serving as business and communication advisor
Matthew Viersm associate at Lane Powell, serving as legal advisor
Lee Wise, M.S. RHIA CHCO, health information management director and interim case management director for Clinch Valley Medical center, serving as HIPAA contact and medical resource advisor
RACHEL ROBERTSON: Hey my podcast friends out there. It’s Rachel. I love my job because I get to talk to researchers here at Oregon State who are creating the technology of our future. It’s pretty cool. But then there are stories like the one I’m going to tell you today which kind of blow my mind. And it’s not super technical cutting edge technology. This story is about a student who had vision to do something big.
[MUSIC: Minuets from the Suite in G major, BWV 1007 by Johann Sebastian Bach, performed by Olivia Cheser, recorded by Duncan Robertson.]
ALISON BOWDEN: My name is Alison Bowden. I'm an electrical and computer engineering student at Oregon State University with minors in business, computer science and physics.
ROBERTSON: Wow, okay.
BOWDEN: Yeah, and we founded Wellio.
NARRATOR: From the College of Engineering at Oregon State University. This is Engineering Out Loud.
ROBERTSON: As we all know, engineers solve problems. And in this case, Alison had a problem she wanted to solve that affected her personally.
BOWDEN: I myself live with bipolar, and I've been hospitalized for several manic episodes this last year where I do have a break in reality.
ROBERTSON: So, you might be wondering how engineering can help with this problem. Well, what Alison decided to do is create an app that could help her manage her mental health. That app is called Wellio.
BOWDEN: Every single feature is basically based on something that's happened to me. Like, when I go into my episodes, I will walk out of the house and chase after some imaginary thing that my brain has concocted. If I had "code red," I would be able to tell my family and friends that I was starting to go into an episode and they'd be able to track my location and save hours of searching for me, because it’s really scary when you are out of control and you’re having a break in reality.
ROBERTSON: "Code red" is just one of the features of the Wellio app. What Alison is aiming for is a comprehensive app that can bridge the gap between visits to her medical providers.
BOWDEN: You can only visit a doctor so many times or your psychiatrist or your therapist, like once a week, once a month, once every few months. So there is something that you need to do on your own to help self-care as well. And this app fulfills this, by not replacing professional help, but enhancing the care that is provided by professionals by allowing you to take control of your personal health and with giving you the information to how to make your mental health better, how to cope with the hardships that you encounter through your illness and how to reach out and connect with other people.
ROBERTSON: Speaking of connecting with other people, Alison is not alone in this endeavor.
HOUSTON MORGAN: My name is Houston Morgan I am a business communications major at Arizona State University.
ROBERTSON: Alison and Houston got to know each other last year when Houston was at Oregon State.
BOWDEN: I called Houston up and I said, “Hey this is something that I want to work on that I'm really passionate about, are you in?” Cuz we had worked on a couple business projects together and so I know he has a good business sense and I know I'm pretty good at coding. And it just kind of flourished into this thing where we pumped out a prototype really fast and we started entering competitions and it just really took off.
ROBERTSON: Alison took the roles of CEO and app developer and Houston is in charge of the financial and business related tasks. They have both been developing connections and have several supporters and advisors on the project who are helping them on everything from developing coping skill exercises, to financial advice, to cybersecurity, and to addressing federal medical privacy regulations known as HIPAA.
BOWDEN: Everyone we hear from tells us we have a really great product, or a really great idea, we're still working on the product. But mental health affects 1 in 5 Americans, so that's 43.8 million people across the U.S. And even if you're not living with an illness yourself, you are touched by it: you know someone who lives with it, your family, your friends, your peers, your coworkers. So, all of us are in contact with mental illness every single day, whether we know it or not, and apps like this could really help people live with their illness. And so I think people see that and are passionate about our project because of that.
[MUSIC: “Brooding,” by Mortal Thing used with permission of the artist]
ROBERTSON: One of those people is Lee Wise, the health information director and interim director of case management at Clinch Valley Medical Center in Richlands, Virginia.
LEE WISE: It’s a fascinating idea and why somebody else didn’t come up with it sooner, I don’t know, but I’m glad somebody thought of it.
ROBERTSON: We’ll get back to Lee in a minute and find out more about the role she has with Wellio, but first I wanted to give you a better overall picture of what the app does. As I mentioned before, Alison wanted to create a comprehensive app for mental health — something that doesn’t exist currently.
BOWDEN: Right now the resources we have available to us in the form of apps or websites or even like community forums only hit on one or two aspects of coping with our illnesses but they fail to provide a comprehensive care plan.
ROBERTSON: So, after writing out a list of everything she wanted to see in an app, Alison came up with three main categories which have become the three branches of the app.
BOWDEN: Crisis management, predictive logging, and coping skills.
ROBERTSON: So, let’s break that down, starting with crisis management. We talked about that a bit before when Alison mentioned "code red," which is at the extreme end of crisis management. She is also developing two other levels. The first level is “crisis check.”
BOWDEN: When you go into it, it leads you to a PHQ-9 form, which is what a lot of psychologists use in order to gauge where their patient is at before they visit so they can modify the session based on how the patient's feeling. So, this PHQ 9 form, it's calculated based on numbers. So, it doesn't require a degree to use, which is why our app can use it. And based on that, it'll recommend different types of therapies as well as crisis numbers and walk-in centers, based on what specifications you have. So you can customize it. So like, if you prefer texting versus talking to a crisis line, you would be able to have numbers recommended that are texting lines versus speaking lines. And let's say you prefer walk-in centers to emergency rooms, it'll recommend geolocation-specific walk-in centers around you, and prioritize those over emergency rooms.
ROBERTSON: The PHQ-9 form that Alison mentions is a series of questions that you rate on a scale of zero to four, such as, "Over the past two weeks how often have you had little interest or pleasure in doing things."
The next level of crisis management is pretty simple and easy to understand. It’s just called “help.”
BOWDEN: Because you know you need help. And that will lead you directly to resources to help you reach out and get in touch with those people you need; like, when you click on the links, it'll, immediately get you in touch with a counselor, that kind of thing. And it'll be location-specific, so if you're in Benton County, it'll link you to Benton County people, and if you're in Multnomah County, it'll lead you to Multnomah County people.
ROBERTSON: And then finally, "code red" which could very well save someone’s life in the future.
BOWDEN: The minute you click on "code red," it'll send a text message out to your families, friends, and physicians, or however you set it up, so that they know you're in crisis and they should reach out to you. Additionally, once you have "code red" activated, it'll send a tracker to your location, so that your family and friends can know where you are, and can send help there, or can go there themselves, if need be. And furthermore, the last part of the "code red" is if you do end up in the ER for like a bipolar or a schizophrenic episode, and you're unable to communicate with staff what your emergency is because you're manic or you're schizoaffective, that kind of thing, the data on your phone that you've stored in this app will be automatically transferred to electronic hospital records, based on what you've entered into the app so far. So, this is more effective than a hospital personnel trying to ask someone who is having a schizophrenic episode, and having a break in reality, you know, what their drug allergies are.
ROBERTSON: So, you might be wondering, as I was, how two undergraduates are going to navigate the federal privacy rules of the Health Insurance Portability and Accountability Act (or HIPAA for short) to get that part of the app functioning. It turns out that Houston had the perfect contact for this — his mom. She happens to be Lee Wise who we heard from earlier.
WISE: He reached out to me to find out if I knew anybody who knew anything about HIPAA and said well, one of my roles at the hospitals I’m the privacy manager. You know, children don’t really fully grasp what their parents do until they actually get out in the real world and then it starts clicking. So, once I told him, he was like, “oh so that’s what you do.” Yes, that’s my life, I am the HIPAA queen. I know all of this stuff and I’ve been really able to really get in there and help with resources and contacts to help them make things happen.
ROBERTSON: In fact, the feature to transfer records was Lee’s idea.
WISE: Yes, it makes complete sense. If a patient is in a crisis situation that they might not be able to adequately communicate to the staff on site at the hospital. And any way you can transfer accurate data to the receiving staff in the ER, the better it is for the patient and the quality of care that they get.
ROBERTSON: The hope is that some of the other features of the app will help people manage their illness well enough that they don’t get to "code red." One of those features is predictive logging that will help the user identify situations that trigger symptoms.
[MUSIC: “Underwater,” by Mortal Thing used with permission of the artist]
BOWDEN: On the surface, it just looks like a basic tracker, like a mood tracker and activity tracker and a symptom tracker, all combined into one. But under the hood, it's this really cool neural net that learns from your behaviors. So, for example, if you take a medication every Tuesday--and on Wednesdays you input you have a headache, we might not necessarily connect that to the medication. Or, like let's say it only happens on Tuesdays, if you take the medication and go for a run afterward on Wednesdays, and you get, like, a weird headache and cramps, or whatever, we may not be able to detect that. But, over time, the neural net will be able to learn that behavior and point out these connections, and say, “Hey, maybe you should not go for a run after taking this medication, because it seems to do X, Y, and Z on the next day.” So basically, it'll just identify trends and patterns that the user may not see themselves, and provide feedback, which is something that apps don't do on the market, currently. In fact, the only app that comes close to what we do costs $130 a month.
ROBERTSON: And last but not least, the third branch of the app is coping skills.
BOWDEN: There's going to be a cloud-based library; so the library is going to be ever-expanding, we're going to always be adding to it as we partner with more therapists and psychiatrists and counselors. But basically it's different breathing exercises, different distraction exercises, DBT, CBT, all these different types of little, mini therapy exercises that the neural net will recommend to you based on what kind of day you're having, what's worked for you in the recent past, that kind of thing. Just things to help you, if you're having a rough time or if you just need to calm down after a panic attack or whatever, these different coping skills will help you get through the day.
ROBERTSON: For that part of the app, Bonnie Hemrick, who is a mental health promotion specialist at Oregon State University Counseling and Psychological Services has been connecting Alison and Houston with counselors who are designing the coping skills exercises. Bonnie has also advised them on the design of the app to best fit the needs of college students. And she will be instrumental in helping Alison and Houston test out their beta version in the fall of 2018. Their plan is to release the beta version to 400 students at Oregon State and Arizona State and then in of January 2019 they will have a full version available on Android and Apple platforms for $9.99 a month. They also hope to partner with collegiate mental health programs so the service can be free to students.
[MUSIC: “Harps,” by Mortal Thing used with permission of the artist]
Alison and Houston have also been applying to entrepreneurship programs at both Oregon State and Arizona State to get a much help as possible through mentoring and financial support. They placed third in the Next Great Startup competition, have been accepted to the OSU Advantage Accelerator and they have made it through to the final round of ASU’s Venture Devils program. They have also applied to InnovationX and Launch Academy in Oregon State’s College of Business. You can check out our show notes to find links for these programs.
BOWDEN: I don't know about Houston, but this is the closest I've ever come to, like, doing something that makes this big of a difference. And I don't want to mess it up. And so, we're enlisting all the help we can in order to make this thing happen. Because this is the most passionate I've felt about something in my entire life. I really want it to happen, so we're working our butts off right now in order to make a really great product, promote ourselves, and pair us with great resources in order to help see this to the very end.
MORGAN: Yeah, that's this project has been really eye-opening for me, because I'm historically a very money-oriented person, and I always-- you know, very analytical, very, like, alright, what's the cost and benefit of this. But you know, this is sort of the first project I've done where everyone asks me, “So, how much do you get paid, or how much are you paying yourself,” and I can honestly reply to them and say, “Oh, it really doesn't matter how much money I make because this itself means so much to me in the sense that it has the potential to revolutionize and change the way people interact with mental health.” And to me, that itself, that's like a powerful concept, it's more motivating to me than money.
ROBERTSON: This is a great example of how hands-on projects can be a powerful motivator for learning.
BOWDEN: I feel like I have a purpose. And not to say I didn't have a purpose before, but, like, my purpose is so much more focused -- it's attainable, and it's tangible now.
MORGAN: I can speak to that extremely well. I joke around with a lot of my friends, and one day they're like, “Oh, what are you up to tonight?” And I'm like, “Oh, I'm working on Wellio stuff.” And they're like, “Dude, you're always doing that stuff,” and I tell them, “I have learned more in the past four months, or three months, working on Wellio, than I have in my entire college career so far.” I've been communicating with all these business professionals in a real business setting and achieving tangible goals, like Allison said. So it's been a really rewarding experience in terms of my education and furthering that in a field I'm super passionate about.
[MUSIC: “Washed Away,” by Duncan Robertson used with permission of the artist]
ROBERTSON: See what I mean? How can you not be excited about what Alison and Houston are doing? And I want to thank Alison for her bravery in standing up to the stigma of mental illness and telling her story. And so I’ll let her have the final word.
BOWDEN: Wellio is about taking away the negative stigma of mental illness. It puts mental health in the limelight -- something that makes us a little uncomfortable in society, just because we're taught to whisper about this kind of thing, or talk about it behind peoples' backs, and never say it to their face, or whatever. Wellio takes away this hushed-tone stigma by putting it in the limelight and saying, “Hey, you have access to affordable care, to comprehensive care, and to quality care, that you can take control of yourself.” Once again, this doesn't replace professional care it enhances it. The last six years, I've lived with my illness, and I understand how powerless it can make us feel at times. Wellio is all about taking back that power.
ROBERTSON: Thanks again to Alison and Houston. To learn more about Wellio check out the links on our website engineeringoutloud.oregonstate.edu. And if you are interested in being part of what they are doing, drop them a note. We’ve been having fun featuring our talented students this season. In fact, all of the music in this episode was performed by students at Oregon State, and in some cases recorded and written as well. You can see the details in the show notes on our website.
This episode was produced and hosted by me, Rachel Robertson. Audio magic was performed by Brian Blythe. Our intro music is “The Ether Bunny” by Eyes Closed Audio on SoundCloud and used with permission of a Creative Commons attribution license. Other music and effects in this episode were also used with appropriate licenses.
Finally, do me a favor, my friends, tell everyone you know about Engineering Out Loud. Subscribe to the podcast, rate us or write a review. All of these actions will help us keep doing what we are doing, and I as mentioned I love what I’m doing.
WISE: With those two brains, I think the world can be conquered, pretty much.