Therapy with a robot? How AI could help those struggling with mental health

NEWARK - Jacob Boyle was graduating from college two years ago and struggling with his mental health, but when he reached out to a counseling service he was told there was a three-month wait. 

Boyle was frustrated, but he knew he wasn't alone. Many of his friends were trying to cope with anxiety and depression as well, and they, too, had trouble finding help.

"There was this gross imbalance between the number of students seeking care and the number of professionals being able to provide it," Boyle, 24, of Hillsdale, Bergen County, said.

Boyle was working on a solution. He has created MARCo, an interactive robot that can become an instant friend or therapist to help teens and young adults through the complexities of life.

With the device, Boyle hopes to join other New Jersey start-ups that are developing technology that can expand behavioral health care services to a population that in the COVID age is at their wits' end.

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It remains unclear if a robot, mobile app or text can be an effective stand-in for in-person therapy. But private investors are funneling millions of dollars into technology companies to develop products that can allow mental health counselors to provide more care.

"Because of all the pressures that young people are facing today, there's so much need and so many opportunities for technology to really play a meaningful part," said Joanne Lin, a principal with Newark Venture Partners, an investment fund.

Boyle knows first-hand. He said he battled anxiety, depression, self-harm and suicidal thoughts throughout high school and college as the pressure to succeed weighed on him.

He attended The College of New Jersey in Ewing, where he studied mechanical engineering and physics, while working full-time at a military robotics company. But he shifted gears to provide mental health assistance instead.

Boyle came up with MARCo, short for the mental health assisting robot companion. Weighing less than 2 pounds, it is soft and cushy with two nonjudgmental eyes and no mouth.

It looks like your favorite stuffed animal from childhood to whom you told your secrets. Except if you hold its hand to activate it, MARCo can respond, listening for key words to dispense advice or alert your contacts in case of an emergency.

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MARCo Technologies LLC is in its early stages. It has two models, selling online for either $499 or $720. But Boyle said he is working to build a robot that costs about $300. 

"As common as the conversation is about stigma and mental health these days, there are still a lot of people who just won't open up about it," Boyle said.

Can technology fill in the gaps?

The demand for mental health services is climbing.

During COVID-19, some 55% of high school students said they were emotionally abused by an adult in the household; 44% felt persistently sad or hopeless; and 37% said they experienced poor mental health, according to the U.S. Centers for Disease Control.

Meanwhile, half of workers reported that their mental health has deteriorated since the start of the pandemic, and just 38% thought their mental health was adequately addressed by their managers, according to a survey released Monday by The Conference Board.

There aren't enough mental health counselors to go around. Just two-thirds of New Jersey's population has enough clinicians, according to the U.S. Department of Health and Human Services. 

And the rest of the country has far more ground to make up than the Garden State, the agency reported.

The mismatch between supply and demand has sparked an arms race to develop technology that can help counselors provide more assistance. 

Mental health start-ups attracted $5.5 billion worldwide in 2021, up 139% from the previous year, according to CB Insights, a research firm.

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In New Jersey, Newark Venture Partners, a fund whose backers include RWJBarnabas Health and Horizon Blue Cross Blue Shield of New Jersey, is investing in tech entrepreneurs.

Among them: Handspring, a Jersey City-based company, said this week it closed on $6.2 million in funding from an investment group that included Newark Venture Partners.

Handspring is trying to redesign mental health services for children. It plans to have counselors on staff and brick-and-mortar offices, starting with one in Morristown this fall. It plans to have a technology platform to help clients practice coping skills. And it is trying to sign up insurers to make the services affordable, co-founder Sahil Choudhry said.

Therapists ideally could treat mental health illness in fewer sessions, improving the outcome for their patients and opening up time to care for more.

It would be nice to have plenty of therapists, "but what we really should do is think of therapy as treatment," Choudhry said. "You learn skills and you improve. You should be able to go into a maintenance phase where you need don't need therapy, but you're able to practice the skills you learned."

Is artificial intelligence far behind?

Mental health experts say technology has its limits. For example, it is easier to make a diagnosis if they can observe body language or facial expressions. And patients might easily lose interest in digital-only therapies.

But they aren't dismissing technology's importance. They found success during the pandemic talking to patients on the phone and video. And more tools like mobile apps are on the way.

"These things are in their infancy, but there is tremendous opportunity to develop these types of approaches to provide better, more creative and effective care, in addition to what we're doing right now," said Dr. Gabriel Kaplan, chief medical officer for the RWJBarnabas Health Behavioral Health and Addictions Service Line.

Could a robot, equipped with artificial intelligence, be far behind?

Boyle still has obstacles. He has a patent pending. He has taken on the task of assembling it himself, at least for now. And he would need to get approval from the U.S. Food and Drug Administration if he wanted to market MARCo as a diagnostic tool that could be prescribed by clinicians.

For now, MARCo can be sold as a toy — one that has a plain, friendly face, a neutral gray color, and, Boyle said, your best interest at heart.

"My hope is that MARCo can be something that, at worst pulls them out of (the low points), and, at best, make sure they never hit that point to begin with," Boyle said.

Michael L. Diamond is a business reporter who has been writing about the New Jersey economy and health care industry for more than 20 years. He can be reached at mdiamond@gannettnj.com.