Introduction | X2AI

X2 delivers on-demand, affordable, quality psychological support using artificial intelligence, with a mission to help 1 billion people. To achieve this, we have created an administration panel and electronic health record (EHR) that allows for customization of our core AI chatbot called Tess. Authorized members are granted a log-in to access the administration panel for a restricted view of only their patients / clients / users and content to help monitor for safety and effectiveness. This administration panel can be integrated with existing EHR systems for convenient record keeping of patient notes and take over of conversations when human intervention is required such as in the case of crisis. This gives our customers the ability to customize and maintain the content, personality, and communication channel of their AI chabot version in order to best meet the needs of the target demographic. X2 educates customers on the ethical AI code and has an ethical advisory board that evaluates each new chatbot to mitigate risk and maximize benefit on a quarterly basis. You can think of Tess as the parent among the X2 family of AI chatbots (graphic A).

The World Health Organization began when their Constitution came into force on 7 April 1948. This organization is in now in more than 7000 people working in 150 country offices, in six regional offices and at our headquarters in Geneva, Switzerland. Working with 194 Member States, across six regions, and from more than 150 offices. WHO mission is committed to achieve better health for everyone, everywhere. They stand to combat against several different diseases worldwide.

X2 mission aligned with the WHO goals and commitment of health in the healthcare system, by providing an affordable, on-demand, scalable support in mental health. 

Mental Health System 

Definition

According to the WHO (2014) mental health is defined as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. Moreover, the WHO (2001) understood and portrait in their constitution that mental health is defined health as “State of complete physical, mental and social well-being and not merely the absence of disease or infirmity".

Mental Health Disorders World Wide

The WHO (2017) in Genova, Switzerland conference establish that four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide. Moreover, during this conference the WHO (2017) sustain that even though treatments are available, nearly two-thirds of people with a known mental disorder never seek help from a health professional. Among many reasons, stigma, discrimination and neglect prevent care and treatment from reaching people with mental disorders.

According to a report form the United Nations called "New Understanding, New Hope" the organization urges governments to seek solutions for mental health that are already available and affordable for their communities. Governments should move away from large mental institutions and towards community health care, and integrate mental health care into primary health care and the general health care system, says the WHO (2017).

The WHO (2017) sustains that the responsibility for action lies with governments. Currently, more than 40% of countries have no mental health policy and over 30% have no mental health program. Around 25% of countries have no mental health legislation. The magnitude of mental health burden is not matched by the size and effectiveness of the response it demands. Nowadays, more than 33% of countries allocate less than 1% of their total health budgets to mental health, with another 33% spending just 1% of their budgets on mental health. A limited range of medicines is sufficient to treat the majority of mental disorders. About 25% of countries, however, do not have the three most commonly prescribed drugs used to treat schizophrenia, depression and epilepsy at the primary health care level. There is only one psychiatrist per 100 000 people in over half the countries in the world, and 40% of countries have less than one hospital bed reserved for mental disorders per 10 000 people.

According to the United Nations and WHO (2017), people who live under social vulnerable conditions often bear the greater burden of mental disorders, both in terms of the risk in having a mental disorder and the lack of access to treatment. Constant exposure to severely stressful events, dangerous living conditions, exploitation, and poor health in general all contribute to the greater vulnerability of the poor. The lack of access to affordable treatment makes the course of the illness more severe and debilitating, leading to a vicious circle of poverty and mental health disorders that is rarely broken.

Urgent need for increase investment

The WHO (2017) proclaim an urgent need to increased investment since in many countries, there is no, or very little, support available for people with mental health disorders. Even in high-income countries, nearly 50% of people with depression do not get treatment. On average, just 3% of government health budgets is invested in mental health, varying from less than 1% in low-income countries to 5% in high-income countries.

Investment in mental health makes economic sense sustain the WHO (2017). Every US$ 1 invested in scaling up treatment for depression and anxiety leads to a return of US$ 4 in better health and ability to work. Treatment usually involves either a talking therapy or antidepressant medication or a combination of the two. Both approaches can be provided by non-specialist health-workers, following a short course of training, and using WHO’s mhGAP Intervention Guide. More than 90 countries, of all income levels, have introduced or scaled-up programs that provide treatment for depression and other mental disorders using this Intervention Guide.

Failure to act is costly. According to a WHO-led study (2017), which calculated treatment costs and health outcomes in 36 low-, middle- and high-income countries for the 15 years from 2016-2030, low levels of recognition and access to care for depression and another common mental disorder, anxiety, result in a global economic loss of a trillion US dollars every year. The losses are incurred by households, employers and governments. Households lose out financially when people cannot work. Employers suffer when employees become less productive and are unable to work. Governments have to pay higher health and welfare expenditures.

A recent WHO-led study estimates that depression and anxiety disorders cost the global economy US$ 1 trillion each year in lost productivity. Some jobs may carry a higher personal risk than others (e.g. first responders and humanitarian workers), which can have an impact on mental health and be a cause of symptoms of mental disorders, or lead to harmful use of alcohol or psychoactive drugs. Risk may be increased in situations where team cohesion or social support are lacking.

AI as a primary solution in Mental Health Care System

According to the WHO (2017) a possible solution towards the tremendous flaws in the mental health system is through psychological interventions that are potentially scalable. This interventions include modified, evidence based psychological treatments, such as: brief, basic, non-specialist-delivered versions of existing evidence-based psychological treatments (e.g., basic versions of cognitive-behavioural therapy, interpersonal therapy). Self-help materials drawing from evidence-based psychological treatment principles, in the form of self-help books, self-help audiovisual materials, and online or app-based self-help interventions. Guided self-help in the form of individual or group programs, providing people with guidance in using the above mentioned self-help materials.

According to the WHO (2017) scalability is not an all-or-nothing concept. Some interventions have features that make them more scalable than others. Interventions become more scalable when they rely less on specialist human resources. To make interventions potentially scalable, aspects about the intervention are changed so they become feasible in communities that do not have adequate access to specialists. Such modifications can create more accessible care that reaches a larger number of people. These modifications could include using non-specialists to deliver the intervention, or innovative delivery strategies such as self-help books or using mobile devices. Some of these interventions, implemented at scale, may prove to be somewhat less effective than conventional models of psychological treatment. This, however, may be acceptable in exchange for the increased coverage and accessibility gained in return. This compromise can be assessed using cost-effectiveness research methods from the field of health economics.

The WHO (2017) establish that global access to care for people with mental health and psychosocial problems could be significantly improved by developing, implementing, and evaluating scalable interventions.

Tess’s impact on Mental Health System

Tess is a chatbot which mission is  “Affordable, on-demand, high quality mental health support using artificial intelligence”. Tess is trained to deliver emotional support that aligns with recommendations from mental health experts. While Tess is not a therapist, she is trained by industry leaders to ensure your interactions are high quality. Tess is available to connect via text messaging whenever and wherever you need. Available 24/7, able to support anyone in the moment they need it most to make them feel better, and boost their resilience.
Tess already has proven 18% of reduction in anxiety symptoms and 13% reduction in depression symptoms.  Through artificial intelligence is possible to scale the help while reduce the cost of the budget. For instance, Tess has been able to send more that 55,944 messages, that would take on average 1.2 minutes to write a Tess message if a person would have to do it. Regular shift workers would take: 1,119 hours, which is equal to 160 full time days, and 3 staff members to type and send all these messages to the users. Tess delivers culturally sensitive support around the globe. Tess delivers support through 22 mental health approaches. 168 unique emotion categories. 712 unique topics. 63,475 number of unique sentences. 3,243,914 number of unique conversations. 31,200 hours of work by psychology professionals to create and improve content.

Resources

United Nations (2001, October 4) One in four people worldwide affected by mental disorder.  Retrieved from https://news.un.org/en/story/2001/10/16612-one-four-people-worldwide-affected-mental-disorder-un-health-agency-says

The World Health Organization (2014,August). Mental health: a state of well-being. Retrieved from http://www.who.int/features/factfiles/mental_health/en/

The World Health Organization (2017,August). Scalable psychological interventions. Retrieved fromhttp://www.who.int/mental_health/management/scalable_psychological_interventions/en/

The World Health Organization (2017, March30). Depression: let’s talk" says WHO, as depression tops list ofcauses of ill health. Retrieved from http://www.who.int/news-room/detail/30-03-2017--depression-let-s-talk-says-who-as-depression-tops-list-of-causes-of-ill-health

The World Health Organization (2017,October 4). Mental disorders affect one in four people. Retrieved from http://www.who.int/whr/2001/media_centre/press_release/en/

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