It’s no secret that being a teenager can be a harrowing experience. Your hormones are on the fritz, everyone else seems to be cooler than you, your self-esteem fluctuates like a sin(x) graph and – speaking of math – you’re constantly being told that your next exam will make the difference between an Ivy League university and living in your parents’ basement.
Many of the factors that- lead to teenage depression are amped up in East Asia. The hyper-competitive school environments in places like Hong Kong, Singapore, and mainland China are enough to throw anyone’s life out of balance. If you add in the pressures of bullying, body image issues, and a lack of robust school/community counseling programs, it is easy to see how many teens in the region could be going through tough times.
"At the intersection of psychology and technology there’s a lot of new research and ideas taking shape around using mobile and gamification to improve people’s mental health," says Jamie Chiu, a psychology doctoral candidate and co-founder of Hong Kong-based Lulio. "There’s also a growing body of research on using video games for therapeutic interventions and assessments."
Lulio aims to bring that research into the real world. By analyzing teenagers’ mental health through mobile games, Jamie and her co-founder, Mark Altosaar, hope to gather data that could spot warning signs of depression or even suicidal tendencies.
Psychology meets technology
"When I was 13 years old, I moved from Africa to Australia," says Jamie. "I was lonely and couldn’t fit in. I sounded different, I felt different from everyone else and I thought that if I could change myself, I’d be happier. But wanting to be someone else just kept me miserable."
Mark had similarly tumultuous teenage years, saying, "I struggled with depression and anxiety during school, and I know how isolated it can make you feel."
But just having gone through the emotional ups and downs of teenagehood first-hand obviously isn’t enough experience to launch a startup dedicated to helping teens with depression. This pair, however, has the work experience to back it up.
Jamie comes from a clinical psychology background, and now works as a school counselor while studying for her doctorate in psychology. "My training has always been more focused on academia and research – which, honestly speaking, is not the most tech-savvy field."
That’s where Mark comes in. "Before coming to Hong Kong, I worked for one of the world’s largest edtech companies," he says, mentioning that he managed products used "by millions of teachers and students around the world."
In addition to the two founders, Lulio’s team includes consultants and advisors covering everything from psychology research to product testing. And, of course, a team of tireless interns.
Lulio founders Jamie and Mark
Putting the research to the test
"In the US and Europe, there are a few apps out there that aim to reduce anxiety or depression using a gamified approach," Jamie says. "A few have been tested and showed effectiveness, so it’s encouraging that technology can be used in such a way to make a positive impact."
Jamie is quick to say that research analyzing the effects of apps on teenage depression is still in its early stages, but the results have been promising.
Depressed individuals, for example, have been shown to have decreased spatial memory – the ability to remember information about your environment, and the location of things nearby. Spatial memory is something that’s very easy to check for in video games – just think of how many games involve paying sharp attention to your character’s environment.
And while it’s far from a sure sign of depression – after all, some people are just more observant than others – it is the kind of data point that, when combined with many others, could help form a psychological profile.
"All of our mini-games are designed bottom-up. From current scientific literature, specific measurable factors were identified that are strongly associated with adolescent mental health," Jamie says. "We then create a game layer on top, making it interesting and not very obvious what we are looking for."
The games gather a large number of data points that can be tied to emotional wellbeing: reaction times, selective attention, flexibility to adapt to changes, errors made to logic games, empathy, memory span, problem solving, sensitivity to social cues, and more.
Lulio is currently working on two different apps. One, called Lulio Game=Strong, is a series of mini-games that subtly test the factors mentioned above. The other, Lulio Antipodes, is a multiplayer role playing game that tests those factors as well as things like empathy for others and teamwork.
Mock-up image from Lul.io
Working with schools
Developing psychological profiles of users isn’t much use unless there is then a way to intervene and offer help. Also, it is more than a bit creepy to imagine a game developer you’ve never met having a pretty detailed roadmap of your cognitive strengths and weaknesses.
That’s why Mark and Jamie plan to roll out Lulio as a program within schools. With teachers and counselors involved, it would be possible notice the warning signs of depression and suicide and pay more attention to a specific student.
"Instead of a stand-alone technology, our solution also offers matching guides and resources for teachers so that the everyone in the school is involved in the wellbeing program," says Jamie.
"Schools have been receptive to the idea, but there is always concern with any technological solutions about data collection, student information privacy, and storage," she continues. "There is much data that can be pulled from how a student plays the game. That being said, we respect student privacy and school policies."
Lulio’s games are still in development – both on the technical side and the clinical one. The Lulio team has been working with psychologists on their school pilot studies, and the company plans to launch its first games in February 2016.
Preparing to launch
"So far, people have been really excited about what we’re doing and we’ve received great support," says Jamie. "I think the biggest question is whether this works. And with the development process, we test it every step of the way."
"With Lulio Game=Strong piloting in 2016, we will test it out rigorously to ensure effectiveness," adds Mark. "We have experts acting as our advisors to guide our research. I’m very excited about this."
Lulio plans to make money through licensing contracts with schools. Many schools in Hong Kong already have a certain budget for student wellbeing programs and anti-bullying efforts – Mark cites a figure of about US$10/student for a typical wellbeing product – and that is money that could readily be used on Lulio.
So far, Jamie and Mark have been largely bootstrapping their project, but they might not have to for long – they recently won cash awards from Incu-Lab in Hong Kong and a grant from the Cyberport Creative Micro Fund. They were also admitted to SOW Asia’s Incubation to Investment Accelerator Program.
"Things are progressing well and we’re at the stage where we would like to increase our reach and accelerate development, and we have started looking for external investment," says Mark.
Lulio will launch in Hong Kong in February. The company is taking things one step at a time, but is also eyeing other potential markets for the future.
"Singapore and China both have really high rates of bullying among students," says Jamie. "One of the key themes in our program is fostering compassion, which has positive impacts on bullying issues. I believe we can really make a difference."
Do you think an app can be used to combat depression and identify suicide risk? Leave your thoughts in the comments below.
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