The International Space Station in orbit. NASA is currently funding research at Stony Brook University to develop better tools for treating depression in astronauts while they are in space. CAROLINE DAVIS2010/FLICKR VIA CC BY-NC 2.0

NASA-funded researchers at Stony Brook University are assessing applications of e-mental health tools in managing depression, anxiety and stress for astronauts and astronaut-like individuals.

Under the leadership of Dr. Adam Gonzalez, principal investigator and founding director of the Mind-Body Clinical Research Center, psychiatric researchers at Stony Brook are conducting a clinical trial to determine the effectiveness of myCompass, a self-help tool created by the Australian Black Dog Institute, an organization founded in 2002, dedicated to widespread treatment of mental illness and psychiatric research. 

“The project is working to determine the effectiveness of self-help, internet-based intervention for stress and anxiety among high achieving adults,” Juan Hernandez, project coordinator for the NASA-funded study, said. “We’re looking at whether text-based support from a licensed clinician or a video messaging support system is going to be the most beneficial against a treatment-as-usual condition.”

A goal of the NASA-funded study is to determine how effective e-mental health would be for astronauts. The clinical trial will recruit from high achieving adults who are astronaut-like, in that they are similar to astronauts in terms of education, health and stress-levels, and those who work in the STEM fields with advanced degrees and may have high levels of isolation and stress. Most recruits are medical school students with mild to moderate symptoms of anxiety and/or depression.

Gabrielle Carlson, a professor and director of psychiatry at Stony Brook’s School of Medicine, said that the study is intriguing, but has her concerns about whether the project can provide the right e-mental health tools for specific patients. “What’s interesting about Doctor Gonzalez’ study is that…it helps people whose situations preclude help,” Carlson said. “I think it’s a great idea, but like a lot of other things on the internet, it’s hard to have quality control for it.”

But Hernandez says researchers hope that by reaching out to astronauts whose situations make it difficult to seek psychiatric treatment, their study can generalize to those individuals. “We hope the findings here can generalize to those sorts of groups of people, hopefully it can help prevent burnout and improve quality of life for astronaut-like individuals,” Hernandez said.

“We hope the findings here can generalize to those sorts of groups of people, hopefully it can help prevent burnout and improve quality of life for astronaut-like individuals,” Hernandez said.

Providing e-mental health treatments for astronauts can be complicated due to asynchronous communication, which prevents messages from being sent and received instantly between ground control and computers in space.

NASA is funding the study to assess how support can be delivered to astronauts, given that they cannot have face-to-face, real time communication when up above, Hernandez said. NASA scientists said they also wish to know if interpersonal relationships built on asynchronous communication can work, or if the delay develops too much frustration and confusion.

“There’s a lot of documented behavioral health and mental health issues that arise on these sorts of space missions, like higher anxiety, depression, stress, delirium, loss of energy, all those sorts of things,” Hernandez said. “In preparation for those issues, how can we be preventative and make sure we’re giving those astronauts the support that they need?”

The coming phase of the NASA-funded study is called a Randomized Control Trial, or RCT. The RCT works with three randomized groups of recruited patients. The first, a control group, works exclusively with the myCompass self-help toolkit. The second group uses myCompass and receives text-based monitoring and psychiatric help from post-doctorates on the project. The third group uses myCompass and receives video-based support from post-doctorates.

This RCT is made to determine what method of online psychiatric treatment might be best, but Carlson fears that may not be enough. “I think what the whole field probably needs is a way of directing the right person to the right app,” Carlson said.

Due to the sensitive nature of some of the content sent and received, it is extremely important that the transmissions sent to and received by patients are kept secret. For this reason, all contact between patients and post-doctorates is heavily encrypted. The day-to-day work of the RCT mainly entails recruitment of patients for the project and monitoring of myCompass portals to correspond with patients.

The data sought from the RCT is mostly qualitative feedback from patients. The goal of the RCT is to know whether patients enjoyed their randomized method of communication, found communication to be too frequent or too infrequent and what parts of the program patients liked and disliked, researchers of the study said.

“We’re making sure we’re getting everything kind of airtight for the larger RCT that will be enrolling 135 participants, mostly coming from the graduate in-resident program,” Hernandez said. “And pretty much anyone from the medical center that’s available and willing and has mild to moderate symptoms of stress, anxiety or depression. That’s pretty much where we’re at right now.”