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Gila Tolub

Rethinking Mental Health Diagnosis - Part 3

Pathways to Improving Diagnosis in Mental Health

The challenges of diagnosing mental health disorders have never been more pressing in Israel than they are today. Following the events of October 7th, the need for accurate, reliable, and consistent diagnostic methods has become a national priority. As the country grapples with the mental health fallout from these traumatic events, refining our approach to diagnostics is essential for providing effective care and ensuring the resilience of our society. Crucially, improving diagnostics is also about laying the foundation for personalized care. Without accurate diagnostics, treatment plans risk being too generalized, failing to address the specific needs of individuals.


A medical professional analyzing brain scans

















To address the current diagnostic challenges, Israel must adopt a multi-faceted approach that includes standardizing diagnostic methods, leveraging data and analytics, and exploring the potential of biomarkers. By doing so, we can create a mental health system that is not only more accurate but also more efficient and responsive to the needs of those affected by trauma. These improvements will help ensure that each patient receives the personalized care they require to heal and rebuild their lives.


Back in 2021, the Shalvata Mental Health Hospital, associated with Clalit Health Service, established a unit specializing in diagnosing and treating PTSD in soldiers and veterans. It has treated over a thousand soldiers, offering personalized therapeutic protocols tailored to each individual’s needs. "No two treatment plans are the same," Prof Shlomo Mendlovic says. "Each one is customized to meet the specific needs of the patient. And that starts with an accurate and precise diagnosis. This is what sets us apart and improves the outcomes".


Standardizing Diagnostic Methods

One of the most critical steps towards improving mental health diagnostics is the standardization of diagnostic methods. Currently, the field is characterized by a multiplicity of diagnostic tools, each with its own criteria and protocols. This lack of standardization can lead to inconsistencies in diagnosis and treatment, making it difficult to compare data across studies and evaluate the effectiveness of different interventions.


A unified diagnostic approach would ensure that mental health professionals across Israel are using the same criteria and methods, leading to more consistent diagnosis and treatment outcomes. This standardization would also facilitate better communication between healthcare providers, researchers, and policymakers, enabling a more coordinated response to the mental health crisis. Most importantly, standardized diagnostics are essential for personalized care, as they provide a consistent foundation upon which individualized treatment plans can be built.


Standardizing diagnostic methods does not mean eliminating the flexibility needed to address individual patient needs. Instead, it involves creating a framework that provides clear guidelines while allowing for professional judgment and the incorporation of new research findings. By adopting a standardized approach, Israel can ensure that all patients receive the same high standard of care, regardless of where they are treated. This approach helps to ensure that treatment plans are not only consistent but also tailored to the unique needs of each patient.


Leveraging Digital Tools, Data and Analytics

In addition to standardizing diagnostic methods, Israel can improve its mental health diagnostics by leveraging digital tools, data and analytics. The use of data analytics in mental health care is still in its early stages, but it offers significant potential for improving diagnostic accuracy and treatment outcomes. 


By collecting and analyzing large datasets, mental health professionals can identify patterns and predictors that might not be apparent through traditional diagnostic methods. Prof. Eyal Fruchter, former head of Mental Health of the IDF and director of Medical and Scientific Affairs at ICAR Collective, is excited about the potential of new tech tools.


"We now have the ability to leverage data from social networks, mobile phones, and wearable devices to track physiological markers like sleep patterns and social media usage. By integrating these technological tools, we can enhance our diagnostic capabilities, allowing us to assess whether someone is struggling with issues such as sleep or social interaction. This approach enables us to standardize functional diagnosis which is crucial for more accurate and comprehensive mental health assessments."

This data can help identify risk factors for certain mental health conditions, track the progression of symptoms over time, and assess the effectiveness of different treatment approaches. These insights are invaluable for tailoring treatment plans to the individual needs of patients, ensuring that care is both precise and personalized.

Advanced analytics can also reduce reliance on subjective methods such as self-reporting and clinician intuition by providing objective data that can support and enhance clinical judgment.


This is particularly important in the context of Israel's mental health system, where the demand for services far exceeds the supply of trained professionals. By integrating data analytics into diagnostic processes, mental health professionals can make more informed decisions, leading to better patient outcomes.


To fully realize the potential of data analytics in mental health diagnostics, Israel will need to invest in the necessary infrastructure and training. This includes developing systems for collecting and managing data, as well as training mental health professionals in the use of analytics tools. By making data analytics a central part of its mental health strategy, Israel can improve diagnostic accuracy, optimize treatment plans, and ultimately provide better care for those affected by trauma. Personalized care will be enhanced as data-driven insights allow for more precise and individualized treatment strategies.


Exploring the Potential for Biomarkers

Another promising area for improving mental health diagnostics is the development of biomarkers—biological indicators that can be used to diagnose mental health conditions. Currently, most mental health diagnoses are based on subjective assessments of symptoms, which can be influenced by a variety of factors, including patient self-reporting and clinician interpretation.


Biomarkers offer the potential for a more objective approach to diagnosis.[1] One example is salivary alpha-amylase (sAA) which has gained recognition over the past 15 years as a valid and reliable indicator of autonomic nervous system (ANS) activity. However it is not used broadly in clinical practice due to a lack of standardized measurement protocols and the complexity of interpreting results which are influenced by various factors beyond stress. Further validation and research are underway to identify biomarkers for Post Traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD), and Generalized Anxiety Disorder (GAD), including blood and saliva tests that could indicate the presence of these disorders. While this research is still in its early stages, and it feels like slow progress, it represents a significant step forward in the quest for more accurate and reliable mental health diagnostics.


The development of biomarkers could also help reduce the stigma associated with mental health conditions by providing a clear, scientific basis for diagnosis. This could make it easier for patients to accept their diagnosis and seek treatment, as well as for healthcare providers to develop targeted, effective treatment plans. By integrating biomarkers into the diagnostic process, mental health care can become more precise, enabling highly personalized treatment plans that address the specific needs of each patient.


To advance the use of biomarkers in mental health diagnostics, Israel will need to invest in research and development, as well as in the training of healthcare professionals to use these new tools. By embracing this cutting-edge technology, Israel can position itself as a leader in the field of mental health diagnostics and provide better care for its citizens. This investment in innovation will pave the way for a more personalized approach to mental health care, ensuring that every patient receives the treatment that is best suited to their unique condition.


Conclusion

Improving mental health diagnostics in Israel is a complex but essential task, particularly in the wake of recent traumatic events. By standardizing diagnostic methods, leveraging data and analytics, and exploring the potential of biomarkers, Israel can create a more accurate, efficient, and responsive mental health system.


These improvements are not just about better diagnostics—they are about ensuring that every individual affected by trauma receives the care and support they need to heal. By taking these steps, Israel can strengthen its mental health system and enhance the resilience of its society, demonstrating that even in times of great challenge, the country is committed to innovation, improvement, and the well-being of its people. Most importantly, these advancements will allow for truly personalized care, ensuring that every patient receives the specific treatment they need to recover and thrive.



Sources

[1]Nater UM, Rohleder N. Salivary alpha-amylase as a non-invasive biomarker for the sympathetic nervous system: current state of research. Psychoneuroendocrinology. 2009;34(4):486–96. https://doi.org/10.1016/j.psyneuen.2009.01.014.


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