Now available on your cell phone: when asked about the signs and symptoms of depression, Google will now direct you to a self-screening assessment questionnaire. The offering was developed in conjunction with the National Alliance on Mental Illness (NAMI). This is the first time Google has promoted its own mental health assessment, which uses the Patient Health Questionnaire or PQH-9. The tool is considered to be a clinically valid assessment tool that uses nine questions to filter answers into five categories of severity that range from no depression detected to severe depression and includes options for next steps.
Here is what you can expect. Using your smartphone, go to Google and search for “depression” and you will see a teal green box with the words “clinical depression” across the top and an image of a woman’s face with a brain superimposed over her head. Below is a button that is a quick definition of what clinical depression is. From there, you can click the button that reads “Check if you’re clinically depressed” and the test will begin. Google asks the user, “Over the last two weeks, how often have you been bothered by any of the following problems?” and then asks nine different questions such as “Little interest or pleasure in doing things” or “trouble falling or staying asleep, or sleeping too much.” The options for answers are “not at all”, “several days”, “more than half the days”, and “nearly every day”.
The PQH-9 is a screening tool for depression that was originally developed by a group of researchers at Columbia University in the early 1990’s. The team of researchers had been looking for a way to detect multiple aspects of depression and so they developed the PHQ self-assessment tests modeled after the PRIME-MD, which until then was used by mental health professionals. The first PHQ had 59 questions and evaluated for 12 different mental and emotional disorders by filtering for responses on mood, anxiety, eating, alcohol, and other disordered behaviors. This first test was known as the PHQ-59 and would go through several evolutions until the widely used PHQ-9 was developed in 1999 thanks to a grant by the Pfizer drug company.
The Pfizer company owned the patent on the PHQ-9 quiz, but that has timed out and the test has become public domain, which means that anyone, including Google, may use it. This is excellent news because it signals that widely available free screenings are a positive step toward reducing the stigma of mental health and increasing utilization of treatment.
Ideally, Google will direct folks toward NAMI and local resources and not paid advertisers. Given the proliferation of texting and messaging services online by mental health professionals, that seems dubious. According to an article on BuzzFeed, “Google’s parent company has also shown interest in treating depression directly.” BuzzFeed goes on to report that Alphabet’s life-science team called Verily is looking to “develop ways of using smartphone sensors to screen for signs of depression and mental illness.”
The use of self-assessment quizzes to detect mental health disorders seems to be a natural progression in smartphone use. Information consumers already Google everything from weird health symptoms to advice on how to handle interpersonal relationships. With the privacy of a self-administered quiz, a person who feels like depression may a problem doesn’t have to also worry about the cost of seeing a therapist and having to unpack their emotional or mental symptoms in front of a stranger. The quiet pocket of privacy can give someone the immediate answer to the question, “do I need help?”
NAMI is a wonderful and primarily grassroots movement nationwide with local meetings in the greater Bangor area. Bangor meetings are held on Tuesday nights at Acadia Hospital. Attend a meeting or a free training and you’ll meet very friendly and welcoming folks who are seeking improved mental health. To help support efforts to destigmatize mental health and to raise awareness you can check out NAMI’s Steps Against Stigma walk on September 10th.