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Mental-health experts aren’t fully sold on digital wellness tools.TRU LUV

In 2015, Brie Code was working at leading video game company Ubisoft as lead artificial intelligence programmer when she realized that many people she knew – about half, by her estimation – found video games boring.

“When I was digging into it, I discovered that there are two human stress responses – one more driven by adrenalin and one more driven by oxytocin,” she says. “Game designers use a sense of rising challenge over time to continually stimulate adrenalin. This suggested to me that there could be a complete other model that we haven’t explored yet, where the experience is based on deepening care and connection over time.”

Code left Ubisoft to develop exactly that type of game. Her AI company, Tru Luv, launched its first product, a game appropriately titled #SelfCare, in 2018. Designed with the help of Dutch academic Isabela Granic, a professor at the Behavioural Science Institute (BSI) at Radboud University in the Netherlands and director of the Games for Emotional and Mental Health Lab, the game is centred around an avatar who stays in bed for the day and aims to relax players by using soothing music, muted colours and self-care practices. Think meditative tasks such as word games and guided breathing exercises. There’s no way to win, compete or binge – in fact, it deliberately starts to feel boring after a few minutes of play, which disincentivizes mindless scrolling.

#SelfCare was an instant hit, garnering half a million downloads in its first six weeks without any advertising. It’s also effective – as indie video game designer Kara Stone wrote in an essay last year: “#SelfCare is structured in a way that accepts negative feelings while creating a space for calm, connection and feeling ‘better’ … #SelfCare does promote healing – in the sense that it is additive to a lifestyle set up with activities and behaviours that are life-sustaining rather than life-draining.”

If that sounds less like a game and more like a wellness tool, that’s very much on purpose.

Games like #SelfCare are part of a growing wave of digital wellness tools, which also include popular apps such as Headspace and Calm, for guided meditation; Somryst, an FDA-approved “prescription-only digital therapeutic” that uses cognitive behavioural therapy to soothe chronic insomnia; Clue, a period-tracking app; and Hydro Coach, which tracks water consumption.

According to an April, 2021, McKinsey & Company report, the global wellness market is valued at US$1.5 trillion. The Global Wellness Institute says a large fraction of that value is in “mental wellness” services and products – a category it defines as including “senses, spaces and sleep; brain-boosting nutraceuticals and botanicals; self-improvement, meditation and mindfulness.” And increasingly, the tech sector is finding footholds in this market.

Zoom counselling and therapy apps fall under this umbrella, as do smart devices, including the Apple Watch and the Fitbit. The latter launched in 2007 as a souped-up pedometer, but has since expanded to track all sorts of data, including “breathing rate, heart-rate variability, skin-temperature variation and SpO2 [oxygen saturation],” says Larry Yang, director of product management of Fitbit Devices at Google. The company’s latest device, the Charge 5, also collects data on sleep quality and your body’s response to stress and tracks your heart rate around the clock.

“As the awareness of and need for access to resources for mental health and wellness continue to rise, we’ve also seen an increase in demand for digital wellness solutions,” Yang says. “In the age of digital innovation, people want to see … quantifiable data that can show progress. We know that seeing growth and improvement helps motivate users to achieve their wellness goals.”

This isn’t an entirely new trend, but one that has been steadily picking up steam in recent years. When Apple launched its smartwatch in 2015, it had talk-and-text functionality and users could even make wireless payments through the device, but marketing emphasized its health and fitness applications. The following year, the company made its first major foray into wellness with the Breathe app, which encouraged users to find moments of mindfulness throughout the day. (Breathe has since been reimagined as the Mindfulness app – which, in addition to prompting users to practice deep breathing, also adds a new option called Reflect, which encourages positive thinking by offering users a short phrase to reflect upon.) Standalone apps such as Calm and Clue, have been available for years on all mobile platforms. In fact, according to the American Psychological Association’s 2021 trend report, there are currently between 10,000 and 20,000 mental-health-related digital apps alone.

The pandemic, which compounded mental-health issues for many and highlighted the need for accessible wellness resources, has been a major factor behind the acceleration of such tools.

“There has been a documented rise of symptoms of mental distress,” says Shadi Beshai, an associate professor of psychology at the University of Regina and director of the Depression Cognition and Culture Lab. “This rise widened the gap between need for evidence-based mental-health interventions and access to and engagement with these interventions. Digitization of mental health directly addresses many of the barriers to access associated with in-person treatments,” such financial and time constraints and mobility issues, he adds.

Lockdowns also gave many people the time and/or disposable income to invest in such tools. Last May, TechCrunch reported that apps focused on meditation, anxiety and sleep saw a surge in downloads in April, 2020. That month, the 10 largest English-language wellness apps reached almost 10 million total downloads – a jump of 2 million from January, 2020. And last November, Fitbit reported that its year-over-year sales were up 4 per cent from the previous year. Tru Luv founder Code says the #SelfCare game also saw growth in organic downloads during the pandemic, and the company still receives a steady stream of positive messages about the app.

Still, mental-health experts aren’t fully sold on digital wellness tools. Beshai points out that not all such online resources can offer optimal information or support for those who might be struggling. “There is also some concern that people with more severe forms of distress will see these tools as replacing, as opposed to supplementing, more intensive forms of care with a licensed professional that are sometimes warranted,” he says.

The technology itself can even be a source of stress. Christina Crook, a Toronto digital mindfulness expert and author of the recently released Good Burdens: How to Live Joyfully in the Digital Age, says using digital tools – particularly our propensity for tracking endless data about our steps and sleep habits and mindfulness sessions – can lead to a specific type of anxiety that undermines our reasons for accessing them in the first place.

“I think the problem with getting resourced digitally is that the environment you’re in – whether it’s your smartwatch, phone, laptop, or tablet – is not facilitating traction, it is creating an environment of distraction,” she says. “If you’re constantly relying on those sources of data to move the dial on whatever habit you want to build, you’re going to always be putting yourself back into that distracting environment.”

That’s why Crook recommends setting boundaries around tech usage. She says it’s important to set a goal – such as getting more sleep or being more active – and stick to the wellness tools that directly support that objective instead of trying to change all your habits at once. And she wants people to remember that while tracking stats and learning mindfulness techniques can all readily be done with a click on your device, it’s still important to incorporate those skills into everyday life.

“You can learn online, you can take all that data, but it must be practiced in the real world,” she says. “It’s about focusing on that as your endgame.”

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