Apply HN: Hacking Mental Health | Hacker News Reader

Apply HN: Hacking Mental Health

4 pointstcj_phx7 comments

PROBLEM

People sometimes become depressed, or develop other serious mental conditions. The mental health establishment precisely diagnoses patients’ symptoms using the meaningless labels in the DSM-5. Most are then treated with FDA-approved drugs to hopefully lessen the problematic symptom. Patients whose condition does not allow for informed consent are evaluated, ‘prosecuted’, and forced to take whatever drugs the professionals think they should take.

BACKGROUND

My girlfriend ended up being subjected to court-ordered treatment when she became acutely psychotic after quitting methadone & alcohol cold-turkey. Because the forced drugs treated effect instead of cause, she suffered through 6 months of ineffective and harmful treatments.

During her sixth hospitalization, I obtained the prescription drug and other substances that my research indicted would help. She was still very delusional when released from that facility. My treatment protocol has enabled her to rapidly recover to a ‘normal’ state, without the need for ongoing sedation. The interventions are non-addictive, cheap, and used as-needed to adequately control her anxiety and depression.

SOLUTION

Better mental health is obtained by addressing the chain of causation behind a person’s suffering. The science has been done, but is inconvenient.

PROPOSAL

I propose leveraging the Hacker News Fellowship to begin designing an exponentially more effective approach to mental health.

TEAM

ME: I developed a nerve condition in college, and suffered through a computer science degree. After graduation I focused on hacking health. Over six months, my new friend went from ‘hopeless self-medicator’ to quitting cold-turkey. Over the next 6 months, I went from looking up “psychosis” to figuring out effective treatment strategies that address the causes of my girlfriend’s condition.

OLDER FRIEND: My first Mental-Health success. GIRLFRIEND: See above.

I agree that there a huge opportunity for improvement in mental health treatment. However, I'll be blunt: you seem woefully underprepared for this undertaking. Your care for your girlfriend is admirable, but it was one single case. Without scientist co-founders with deep knowledge of this field, along with much more anecdotal evidence suggesting that your new approach will work, I don't think that your startup is remotely investable. Again, this isn't a personal attack; it's just my prediction of the response that you'll encounter if you go out and seek funding.

Thanks for your comments. One of my goals is to "falsify" the current approach to mental health. It shouldn't take much to embarrass the medical system into fixing itself.

Before this case, I had another who was a hopeless alcoholic. 15-16 years ago she took herself off methamphetamine, then the anxiety started. Her doctor gave a prescription for Xanax, then some other parents at her son's hockey game shared their Vodka/grape juice. Her thinking then was, "What do I need Xanax for, when I have Schmirnoff?" I met her about 3 years ago. She'd tried to stay sober after 2 years in prison for her 3rd DUI. But then life happened, she couldn't handle it, and started drinking again. She is doing quite well now.

I do have other things going that I haven't mentioned here. I manufacture a few niche-market items. One weekend I had a flood of orders - a radio show host had told his audience to search for a specific term that my site is on the 1st page of results for. The HN audience is not my target market, so I don't want to link there now. ("A startup should give its competitors as little information as possible." - http://www.paulgraham.com/avg.html )

Years ago I tried manufacturing the supplement that's been helpful for my girlfriend, but I didn't know how to market it, and what I'd manufactured wasn't quite as good as the original version sold by someone else. I gave a bottle away to a woman who needed it. When I called a few days later, she said "THAT STUFF REALLY WORKS!" When I called back months later, her sister said that she was in the state's psychiatric hospital. Supplements don't fix everything, especially when poverty is a factor.

I want to file an New Drug Application (NDA) with the FDA, so I could manufacture that supplement as a gel-cap, and then get FDA approval for a little claim, such as "improves memory", or another claim that is very valuable to a certain target market. Then I'd branch out into other uses.

The $20,000 for this HN fellowship is not a lot of money. I'd buy a camera, a wireless microphone, and probably spend most of the funds on travel expenses. Access to the ycombinator platform would be much more valuable, and is not available at any price.

I would also leverage the fellowship to solicit some people I know as investors. I'd want the corporation set up before I go around asking for money.

That inspires a bit more confidence, but it actually does take a lot to embarrass the medical system into fixing itself. Many, many people have written indictments of the medical system. Based on recent events surrounding drug prices, it takes a congressional hearing to effect change. :)

For your startup, I suggest that you first convince a couple people who are from the medical system to be (informal) advisers. There are just so many "miracle cures" out there, created by charlatans (or worse). As a potential investor, I wouldn't even initiate due diligence unless you had already convinced a couple doctors or researchers from respected hospitals or universities that your company could succeed.

> I wouldn't even initiate due diligence unless you had already convinced a couple doctors or researchers from respected hospitals or universities that your company could succeed.

There is much inertia in maintaining the status quo. What you say here about 'convincing doctors or researchers' is a bit of a chicken-and-egg problem. It's being worked on by a Psychologist (PhD) I know and his colleagues, but the progress is glacial.

Soon after my girlfriend got siphoned off into that world where the patients never get better (court-ordered treatment), I emailed the president of an organization of changework professionals whom I'd had a session with months before. His organization is on the fringe of acceptability to the broader sphere of conventionally-practicing psychologists and psychiatrists. I wanted to draw attention to the plight of people who get stuck in the care of people who think they're more competent than they really are. He wrote back to tell me that "the missionaries get eaten by the cannibals," which I thought was a good point.

Now we're at the point where I can join the hecklers, and also share my insights. It's been about 6 weeks since her last discharge. The injected Aripiprazole (brand name: "Abilify", which is sold as an "anti-psychotic") wore off 2 weeks ago. She is now unmedicated and hasn't slipped back into psychosis like the professionals were sure would happen if she didn't take their brain-shrinking drugs. Last week she was hired for a real job, and started training today. It's a low-skill position, but it's just right for her at this time.

There is a regular stream of submissions on HN about mental health, so I know there's interest. I have an idea...

Thanks again!

oh yes, the health care system and the mental health care system are broken - especially because of our idiotic obsession with making everything privatized. Of course, this wouldn't have been an issue if we had health care entrepreneurs who opted to grow their brand by focusing on quality of service as opposed to by focusing on profit-maxing strategies. The problems you have described is sadly not the exception, but the norm.

I commend your idea, and I hope that you succeed in forging a new path for entrepreneurs in the area of providing services that maintain human rights. Hopefully you'll get good questions from experts in this area from fellow hackers.

my question: I understand your vision, but not how you plan to implement it. you'll have to scale up the process you used for coming up with a treatment plan for your gf. The company can't individually interview every patient, gather enough information to isolate root cause(s), then prescribe personalized treatment for said patient. Also, will you prescribe medications, or will you limit yourself to suggestions (including alternative treatments) that can be fulfilled over the counter? Even in the latter case, you may need some government approval depending on how the process is conducted.

Thanks for your comments, and your encouragement. My girlfriend represents an extreme case. Most people don't get stuck in a well, they fall into ruts. There are many possible ways to get out of a rut, but only one way out of a well.

Most of the contamination of the mental health system has to do with the pharmaceutical industry's lust for profit. My girlfriend's worst treatment was at the hands of the psychiatrists employed by the County's behavioral health hospital.

> I understand your vision, but not how you plan to implement it. you'll have to scale up the process you used for coming up with a treatment plan for your gf.

For the most part, people just need better information so they can better help themselves and their family & friends. I need to experiment some more, make sure the approach generalizes, and fill in the details.

> Also, will you prescribe medications, or will you limit yourself to suggestions (including alternative treatments) that can be fulfilled over the counter?

Most people can get by with what's available OTC. Some of the more useful drugs need a prescription, but it shouldn't be a problem to get them from a reasonable physician, as they are not 'scheduled' (drugs that are frequently abused).

I have an idea for a supplement that I could apply for FDA approval. This would allow me to make claims: "improves memory", etc, and to put it into a more useful form.

> Even in the latter case, you may need some government approval depending on how the process is conducted.

One of the more useful things I've found involves industrial gasses. I have two cylinders in my father's garage. One is easy to obtain anywhere, the other is a custom blend of gasses. I'm paying cylinder rental for the custom blend, and by this point I've paid more for rental than for the gasses inside. (I didn't know the cylinder would be so heavy, or that it'd last so long...)

Years ago I went to an "oxygen bar" in Telluride, Colorado. I didn't notice anything, and now I know that using supplemental oxygen in that manner is not at all beneficial. But the 'air spa' business model is a possibility. For the one cylinder, regulations probably don't apply. The more 'recreational' of the gasses would be a bit of a regulatory minefield. But it'd be good to let people know about that 60-year old book.

When describing the process of getting someone involuntarily committed to be evaluated for court-ordered treatment, the engineer at my graphite manufacturer said “Really, you can do that? … I’m going today.” One of his old friends has been self-destructive/’crazy’ for a while. They suspected he was using methamphetamine.

On the one hand, people who are ‘crazy’ won’t seek and can’t consent to medical care. This is certainly how we ended up with “mental health courts” and “court-ordered treatment”. But most of the treatments that the courts order people to submit to are palliative rather than curative. The courts have to order people to take the worst of the drugs, the sedatives (”anti-psychotics” [1]), because they wouldn’t take them otherwise [2].

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4118918/ [2] "Drugs and Behavior: An Introduction to Behavioral Pharmacology", by William McKim

If society is going to force treatment on people, we ought to help them while we’re at it. But the system I’ve observed over these past few months is little more than a haphazard collection of poor practices. Robert Whitaker [3], author of Mad in America, does a good job of heckling the status quo, but they haven’t reached a threshold where they can demonstrate dramatically better strategies for helping people through their mental problems.

[3] http://www.madinamerica.com/robert-whitakers/

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