On the Road to Convergence Research

Climate change. Lack of food security. Limited access to basic healthcare. These are just some of the big, complex problems facing humanity. Solutions will require out-of-the-box innovation, which is why many governments, institutions, and entrepreneurs around the globe are beginning to embrace the concept of convergence research. The US-based National Science Foundation describes convergence as “a deeper, more intentional approach to accelerating discovery.” Following interdisciplinarity and multidisciplinarity, it is the next stop on a continuum used to describe approaches whereby scientists and experts learn from each other and collaborate across disciplines. It aims to integrate the natural, computational, social, economic, and health sciences in a humanities context, thereby transcending the traditional boundaries of those fields and creating unique opportunities for problem-solving. The concept of convergence research is taking hold, but how effectively is it being implemented? This chapter explores examples from research networks, research institutes, and the private sector to better understand how convergence research is addressing some of society’s most pressing issues. From disruptions in indigenous food systems to emerging issues in mental health, the author explores the benefits and challenges that arise from a convergence research approach.

Toward Multi-Omic–Informed Psychotropic Prescribing

Matching individuals to tolerable and efficacious pharmacotherapies in mental health has proven challenging. As such, efforts to personalize psychotropic prescribing in mental health has received considerable attention over the past decade. This attention has been fueled by technological advances in genomics, specifically, pharmacogenomics, and, more recently, epigenomics, transcriptomics, proteomics, and metabolomics that have facilitated the identification of clinically useful biological markers to guide medication selection and dosing. The convergence of these omic technologies is arguably the future of personalized psychotropic prescribing. This chapter provides an overview of the current genomic, epigenomic, transcriptomic, proteomic, and metabolomic knowledgebase as it relates to psychotropic drug response in an effort to identify promising linkages between and facilitate convergence across these approaches to guide safe and effective pharmacotherapy relevant to psychiatry.

A Social, Behavioral, and Implementation Science Perspective on Convergence Mental Health

Convergence is best approached through a systems science lens because it includes multiple levels of influence and organization and a host of mutually reinforcing elements. Each of these factors requires behavioral and social science research to ensure that convergence is appropriately anchored in the experience of patients and their communities. For example, the continuous assessment of mental state made possible through real-time mobile app recording of voice, movement, and biosignatures will be much less effective if people reject it because of privacy concerns or if this monitoring is not adequately linked to choices for self-care. Patients may need in-person contact with a therapist to choose an appropriate app and in-person boosters to support effective use. Use of the app and its effectiveness accordingly depend on social-behavioral factors. Likewise, the social and behavioral sciences are central for shortening the time between development and translation of mental health treatments and programs. Including the social and behavioral sciences in mental health convergence science suggests the need for broad-scale efforts that link mental health to population science to systems thinking. This effort places mental health within the broader framework of population health and to implementation science for reducing the time from development of a new treatment to its widespread use. The approach has implications for data collection and analysis in that it entails much larger datasets and need for greater computational power.

Stanford’s Brainstorm Lab for Mental Health Innovation

Stanford Brainstorm, the world’s first lab for mental health innovation, taps into the combined potential of academia and industry—bridging medicine, technology, and entrepreneurship—to redesign the way the world views, diagnoses, and treats mental illness. Convergence science has facilitated Brainstorm’s emergence as a pivotal protagonist in the history of the mental health innovation field. In turn, Brainstorm has catalyzed innovation within mental health by applying convergent approaches to tackle the scope, immediacy, and impact of mental illness. Stanford Brainstorm’s thinking about mental health represents a shift in the discipline of psychiatry from a focus on one-to-one delivery to collaborative and sustainable solutions for millions.

Trans-Sectoral Neuroscience Innovation for the 21st Century

Humanity is on the verge of a radically productive era in brain science, yet far too many important and impactful ideas will never leave the lab due to the profit-driven infrastructure supporting translation. BrainMind is a platform and private community connecting people developing high-impact innovations in brain science with capital and entrepreneurial resources at scale. The BrainMind ecosystem is driving the coordination of expertise, capital, and infrastructure to bring critical life-saving ideas out of the lab and into real-world. clinical and commercial use. The BrainMind community includes members from research, medicine, entrepreneurship, investing, philanthropy, and policy, with the community growing to include more interdisciplinary voices including experts in statistics, clinical psychiatry, ethics, computer science, philosophy of mind, and economics, to name a few.

Convergence and the Changing Nature of Innovation

Convergence has the potential to shape cultures of innovation in health and medicine by providing a framework integrating perspectives from multiple disciplines and sectors to tackle challenges such as understanding and addressing mental health disorders and improving well-being. This chapter discusses examples of efforts to establish cultures that support convergence and lessons learned from multiple sectors. The chapter highlights changing perspectives from institutions engaged in convergent research, including universities, industry, philanthropic foundations, and government agencies. Facilitating progress toward solutions that could not otherwise be obtained serves as a critical motivation for pursuing convergence, even when approaches that rely on convergence challenge conventional institutional incentives and structures. Indeed, barriers to establishing and supporting convergence arise where existing organizational practices and structures misalign with the changing nature of innovation. Nevertheless, examples from across the innovation ecosystem, from American research universities to the biotechnology industry, reveal some of the strategies such organizations are using to actively create and foster cultures that support convergence. Federal agencies are also beginning to investigate funding incentives to support convergent work through their grant-making programs. The chapter concludes with an array of actions others have used to help foster convergence institutionally. These lessons learned may have relevance for those interested in establishing convergence in the realm of mental health.

Convergence Mental Health

Precision health arose from a need to treat not just a person’s symptoms retroactively, but a holistic person proactively. Its tenants involve incorporating one’s genome, social, and medical characteristics, in addition to environmental and day-to-day factors in effort to not just treat people, but to keep them healthy. Many of the procedures and technologies in place to foster precision health in the physical medical space may also be extrapolated onto the mental health sphere as well, otherwise known as convergence mental health. This chapter outlines the principles and practices of precision health, including its current state of the science; how private, public, and government institutions may collaborate to foster better preventative mental healthcare; and the barriers and solutions to the universal adoption of precision health/technological integration into mental health-based practices. The four major identified barriers are (i) insufficient scientific evidence; (ii) insufficient data sharing between relevant health partners; (iii) lack of field-wide coordination; and (iv) difficulties with access, including: insurance, providers, and availability of practice.

Blockchain for Convergence Science in Mental Health

Blockchain is an innovative data management technology using distributed ledgers that has potential to achieve efficiency in data processing and greater control over healthcare record access. Interest is growing beyond uses for cryptocurrency, but blockchain technologies remain poorly understood in the general public and healthcare community. While there are many promising uses for healthcare and supply chain, most potential uses of blockchain for mental health are still in the pilot or development stage. This chapter presents blockchain to the mental health community with a detailed introduction to the unique facets blockchain with a few examples of current uses of blockchain in healthcare with promising proposed uses for mental health.

Framing Definitions

The opening chapter consists of a glossary of terms and definitions relating to convergence mental health.

A Roadmap Toward Convergence Mental Health

The shift toward convergence mental health will be underpinned by developments in three main areas: (i) research, (ii) initial commercialization, and (iii) scaling up market penetration. Unique barriers exist within each area. Within the research stage, the main challenges are in the following areas: informational, leadership, structural and organizational, and education and workforce development. This chapter addresses each of these areas and provides recommendations for moving forward. Further, this chapter examines where the mental health sector currently is and where it is heading to understand the challenges and opportunity to advance convergence mental health from research to initial commercialization to scaling up market penetration to advance brain science discoveries and translate these findings from the lab to make them readily available and accessible.