Digital Health Innovators: Calmsie. Aim: Support the therapy of depression and anxiety disorders in children aged 8-12 using Digital Therapeutics (DTx)
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We live in a time when – thankfully – mental health is being talked about more and more loudly. However, it is not often to think that artificial intelligence can help in this area. How it’s possible? Marcin Waryszak, COO & Founder Calmsie will tell you about it in an interview with Diana Żochowska.

1. There has been talk of a huge crisis in the psychiatry of children and adolescents for a long time. Huge lines of young people with really serious problems form to see psychotherapists, and in some places signing up for an appointment with a psychiatrist is almost a miracle. How are you going to help them?

Marcin Waryszak, COO & Founder Calmsie: Calmsie is working on a mobile game that will help children aged 8-12 struggling with depression or anxiety disorders. Mission Amygdala is the world’s first game that combines cognitive behavioral therapy and conversational artificial intelligence. We have created a 4-week therapeutic program with interactive animations, stories and discussions with intelligent avatars in real time. For a little patient, it is an experience that involves him in the treatment process and makes it more effective.

Last year in Poland, according to police data, 18 children and teenagers under 2020 attempted suicide. Compared to 80, this is an increase by almost XNUMX%. American Academy of Child and Adolescent Psychiatry indicates that per 100 children should be 47 child psychiatrists. There are 18 of them in Germany, 2 in Denmark, and 6 in Poland… An insufficient number of specialists generates a long waiting time for an appointment and a very high financial burden on the system.

They can be an element improving the system Digital Therapeutics (Ang. DTx – Digital Therapeutics), i.e. software-based solutions aimed at the prevention, management or treatment of specific disorders or diseases. They are based on scientific evidence, their effectiveness is validated by clinical trials, and their approval is managed by special regulatory bodies. An example DTx it is Mission Amygdala.

2. Where did the idea to deal with mental health issues come from? When you think about artificial intelligence, it’s not really the first association

MW: We use artificial intelligence in a conversational form to ensure the highest level of real-time interaction between the child and the avatars in the game. Our technology allows children to talk to avatars, who guide them through cognitive behavioral therapy sessions woven into game elements.

It is a revolutionary approach that enables children to receive evidence-based support in the form of an interactive game. This is especially needed now, after the experiences of the coronavirus pandemic, when the number of children in need of help has soared.

We validate our approach to conversational therapy in a randomized comparative clinical trial in adults. This will ensure safety and efficacy before introducing it to the pediatric population. We obtained preliminary positive results from the first patients that show a reduction in the severity of depression and anxiety symptoms following a program that includes daily interactions with Calmsie’s chatterbot.

3. Do you believe that the solutions you have or will work out could replace therapy in some cases? Or are they more supportive tools?

MW: When creating our products, we do not intend to replace a doctor or therapist. Digital therapeutics are very similar to drugs in many ways. They are prescribed by doctors and may be reimbursed by insurers.

In this model, we provide doctors with an additional tool that they can add to pharmacotherapy and psychotherapy. Thanks to this, the patient can receive help that involves him in the treatment process and is with him in between visits to a specialist, thanks to which he can be cured in a shorter time. In addition to the unquestionable benefits for the patient, it definitely affects the economization of the work of specialists, and therefore has positive effects on the health care system.

4. Cognitive behavioral therapy on which you base your solution is largely based on specific exercises and tasks. How much experience do you get from this trend? How do you plan to develop your product?

MW: Based on the many years of medical practice of the Calmsie medical team and after conducting an in-depth analysis of the literature, we have noticed a great potential in combining artificial intelligence conversational technology (such as chatbots and videobots) with the cognitive behavioral therapy (CBT) trend. Cognitive Behavior Therapy is a structured form of therapy that helps patients deal with their thoughts, feelings, and behaviors related to a specific problem. We incorporate daily CBT sessions into the game so that children can, in the context of the plot, discuss their problems and develop strategies for coping with negative patterns or gain better control over thoughts, emotions and actions.

5. What is the availability of your solutions in Poland?

MW: Digital Therapeutics, as a concept, are already visible in Poland, but they cannot be prescribed by prescription yet, and their use cannot be covered by insurance. Unfortunately, we have not yet developed legal regulations that would allow DTx certification, but observing the steps taken by other countries – we expect that it is only a matter of time. The pioneers in this respect are, above all, Germany and the USA. It is in the United States that we are seeking approval from the FDA – American Food and Drug Administration.

In Poland, we participate, among others, in the POPOJUTRZE 2.0 program, under which we provide schools with a free psycho-educational chatbot. We also published the book “Lila and dragon” to support children and their families who experienced the war in Ukraine. This is a story about a little girl who, fearing the approaching dragon, had to leave the house. Included in the book is an exercise book compiled by Calmsie’s medical team. It is a help and a hint for parents on how to talk to their children about the situation in their home country. We believe that and Mission Amygdala it will be available to Polish patients as soon as possible.

6. Traditionally, I ask our interlocutors a question about three areas in medicine, in which – in their opinion – artificial intelligence will develop the most in the coming years. Could you indicate such areas?

MW: Contrary to appearances, sometimes a greater challenge than creating a technology is its effective implementation – what we will be using in a few years, we can see today. We can observe the future of artificial intelligence in medicine by looking at ongoing research and development projects or the activities of start-ups. If I were to distinguish three areas where artificial intelligence can be crucial, I would distinguish digital therapeutics, diagnostics and data management.

  1. Digital Therapeutics – technology can make it easier to offer patients remote therapy, personalize services and possibly increase the availability of health care, regardless of their place of residence or financial situation. 
  2. Diagnostics – Artificial intelligence can help increase availability and precision. In this area, the concept of digital biomarkers can also be identified, which can play a key role in ensuring that diagnosis is always made as early as possible.
  3. Medical data management – how to effectively collect data from various sources and process them so as to draw conclusions supporting doctors in making decisions or in improving administrative processes.

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