Our Newest Project in the U.S. Capitol (and it has nothing to do with politics!)

We’re talking with Woebot Health Founder and President Alison Darcy about a new partnership to bring Woebot to people living in the DC area. And we promise: this has absolutely nothing to do with politics. 

Woebot Health just announced a partnership with the District of Columbia Housing Authority (DCHA). What is its focus?
We’ve created a public/private partnership to offer Woebot to DCHA’s employees and to a pilot group of residents living in the authority’s affordable housing communities.

What does DCHA do?
DCHA is an important independent government agency. It’s one of the top ten largest housing authorities in the country in terms of number of public housing units, and part of its mission is to offer quality affordable housing to low- through moderate-income households. DCHA is actually one of the District’s largest landlords, providing subsidized housing to about 50,000 residents. But they’re not just about housing. The agency is also focused on cultivating opportunities for residents to improve their lives. That’s where Woebot comes in.

What makes this partnership special?
To my knowledge, DCHA might be the first or at least one of the first housing authorities in the country to offer a mental health solution like Woebot to its community. It’s an innovative approach to addressing a mental health problem that’s only getting worse. Many metro areas, DC included, are bearing a double burden of high coronavirus infection and high unemployment rates, and people are feeling a lot of stress and anxiety as a result. But it’s been harder to get treatment, either because of cost or lack of insurance, strict social distancing measures, or the longstanding stigma associated with asking for help. We’re really happy we can offer a solution that can help people who are disproportionately impacted by the pandemic deal with stress and anxiety in an accessible, approachable and anonymous way.

Who will have access to Woebot?
All 800 DCHA employees and a pilot group of 450 residents. DCHA employees are focused on providing housing and fostering the community, and they include administrative, facilities management and security people who are so important to the community’s well being. We’re also running a pilot with several hundred residents living in two family communities. We expect Woebot will be rolled out more broadly from there.

What’s your biggest hope for this partnership?
This is our first public/private partnership, and we’re honored to partner with DCHA in this way. Our hope is we can offer a safe space that helps people better manage their stress and anxiety. We’re all facing unusual and very challenging times this year, though the burden is disproportionately felt among some communities. There’s never been a more important time for our company to be there for people. That’s what I hope most: that Woebot is there for anyone and everyone who needs help.

How’s Your State of Mind During Covid-19?

We’re exploring the impact of the pandemic on mental health, and today announced the results of our first user survey on the topic. Study volunteers confirmed that many are feeling more anxious and down, now more than ever. But the data also show something amazing: our users are finding silver linings in the midst of incredible turmoil. In fact, many say the pandemic has helped them identify personal strengths, increased their appreciation of life and strengthened their interpersonal relationships and spiritual connections.

Athena Robinson, Ph.D., Woebot Health’s Chief Clinical Officer and Adjunct Clinical Associate Professor at Stanford University, talks about the survey results, and offers tips for people who are feeling especially anxious or down. And for an even more personal perspective, check out Masha’s story. She’s a sci fi writer and Woebot user whose anxiety levels jumped as the pandemic hit her hometown of Capetown, South Africa. But she’s finding new approaches for tough times, and that’s helping to change her thoughts, her actions, and her life. 

Why did Woebot Health conduct this survey?

In March, we launched “Perspectives,” the first program of specially crafted coronavirus content to inspire hope, offer empathy, and encourage perspective taking. Then, in early June, we invited users to take part in an IRB-approved longitudinal series of surveys about their Covid-19 experiences. User responses gave insight into their lived experiences, and the data highlighted potential differential impact between groups like essential workers and younger users. The insights will shape future content, as we strive to continue to help people as well as contribute to the professional mental health community.  

What did you learn?

Almost three quarters (71 percent) of the 2,108 respondents said that changes in their way of life given the pandemic have been moderately, very, or extremely stressful, while more than half (58 percent) said they are bothered by being nervous, anxious or on edge more than half the days or nearly every day. About 42 percent say their mental health has worsened ‘very much’ or ‘extremely’ as a result of the pandemic. We also found that essential workers and older age groups report faring better than non-essential workers, and the youngest respondents (17-25 years old) report the highest levels of anxiety and low mood. Despite this, a large portion of users also indicate that the pandemic has helped them identify personal strengths (73 percent), increased their appreciation of life (80 percent) and strengthened their interpersonal relationships (70 percent) or spiritual connections (59 percent), whatever spiritual connection means for the individual.

What surprised you most about these survey results?

Humans are indeed extraordinary. It’s humbling and inspiring that even during this most challenging and unprecedented time, so many users say the pandemic has helped them find positive outcomes. I’m struck by the human capacity to navigate through and find meaning in persistently difficult times. In a world in which we’re hit each day with such bad news about Covid-19—its transmission, its growing numbers, its mutations—it’s just beautiful to see that we can admit pain, but also simultaneously find and even cultivate hope. I think that is a really special attribute of who we humans are.

As a clinician, would you say that’s one of the important concepts for mental health, to try to see beyond the negative?

In psychology, we have a concept called “wise mind.” Wise mind represents the intersection between two different states of mind. The first one is the emotional mind. And that is just what it sounds like: it’s driven by emotions, a lot of passion, a lot of intensity. But the other state of mind, the reasonable mind, is driven by facts and logic. The wise mind is created when these two minds intersect and overlap. It’s a place where we can acknowledge some of the realities of the situation (and there are plenty of realities to acknowledge these days) and also our feelings about it. There’s real strength in being able to talk about both sides. It’s not about just painting some rosy picture. That’s not real, but to ignore the positive wouldn’t be real, either. We need a balanced, wise-minded, perspective.

Why do you think essential workers may be faring better than the general respondent group in terms of overall mood and anxiety?

We certainly have more research to do to better understand the holistic experience of essential workers. A preliminary hypothesis is that it may have to do with engaging in work that others in one’s community need and depend upon. Essential workers are those people who are not just helping others, but creating some sense of normalcy for us all.

Was it surprising to you that the younger respondents seem to be doing worse than anyone? 

Yes, initially, but then I got to thinking that the people more likely to be retired may potentially  find it easier, relatively speaking compared to the younger group, to stay at home. Indeed, the youngest among us have had their life experiences totally disrupted. Think about high school graduation, getting into college, graduating college or trying to find your first job. All these beautiful life transitions that many of us go through from ages 17-25 have been so completely disrupted by Covid-19. The difference that we see here between our older and younger respondents may therefore be attributable to the fact that the life activities expected for each age group are different. If you’re older, and perhaps retired, you may be able to stay at home without the risk of losing out on some key life transitional experiences.

What you would recommend to those who are facing a lot of anxiety and low mood? 

Very broadly speaking, continuing the conversation about how Covid-19 is impacting mental health is key. Being open about what we are feeling, and creating an atmosphere of supportive conversations around mental health and mental illness, is vital. It would be great if we can continue to decrease the stigma and create a safe environment where people can disclose their thoughts and feelings, and be open to treatment, whether that’s something as formal as seeing a psychiatrist or a psychologist or something as self-driven as finding an app-delivered program. The most important part is that we seek and are able to access the mental health care treatment we need.

Mental Health Awareness Month: Caring for our Bodies and Minds

As the COVID-19 pandemic continues to sweep the globe, many of us are experiencing serious worry over our physical health and safety, as well as that of our loved ones. Healthcare workers, grocery store employees, delivery drivers, and others whose jobs involve heightened exposure to the novel coronavirus are at particularly high risk. Especially for these people– and others, like elderly folks or those with underlying physical conditions– it can be hard to focus on any kind of self-care besides hand-washing, wearing adequate personal protective equipment, and constant self-monitoring for the symptoms we have all learned to fear.

Getting through the days and weeks with our work done and our physical health intact can leave us all with little time or energy for other concerns. But this Mental Health Awareness month, we want to provide a gentle reminder that caring for our hearts and minds is important, too– perhaps even more important than before, as we shift and struggle under the weight of these circumstances.

Since the pandemic began, many of us have experienced trauma and stress that we have not yet encountered in our lifetimes. People who have never been diagnosed with mental health conditions might confront unsettling new issues, like insomnia, intense anxiety, or substance dependence. Those who are intimately familiar with trauma could re-encounter the numbness, hypervigilance, or depression they may have experienced during past periods of difficulty. And if you’ve lived with a mental health condition since before the pandemic, you might find symptom management to be more challenging now than ever.

With this in mind, we encourage everyone to look out for each other– not just with respect to physical health, but to mental health as well. Communities around the world have shown admirable levels of accountability and care by socially distancing, checking up on vulnerable neighbors, practicing mutual aid, and sewing masks for people in need. It’s just as important that we show this level of compassion to those who are mentally and emotionally impacted by the stress of living through a pandemic– and, of course, to ourselves.

We certainly cannot suspend all of our feelings and responsibilities. It is perfectly understandable to be worried and scared– these emotions can even be adaptive to the extent that they encourage us to take all the precautions that we can. And though many of us would like to take more time and space to attend to our mental and physical health, work and family obligations can make it tough. That being said, taking even the smallest steps to ensure mental well-being can make a world of difference.

So, during Mental Health Awareness month and beyond, do not hesitate to offer support and express concern to others who are struggling. And if anxiety, sleeplessness, or other issues have made your own life overwhelming, it is okay– and, in fact, important– to ask for help. If you are able, schedule a telehealth appointment with your primary care provider or a therapist. If that’s not possible, consider checking in with a mentor, a family member, a friend, or even an app like Woebot. And emergency services– like the National Suicide Prevention Hotline (1-800-273-8255) or 911 in the US, 999 in the UK, and 112 in the EU– are ALWAYS available. Your mental health is as important now as it was before the pandemic. If you feel you are in danger, it is always best to let someone know.

And even if you’ve been holding steady– take a moment to feel what you’re feeling, to open up to someone you trust, or to breathe deeply for a minute or two. If we approach our emotional challenges with the same care and attention we’d apply to physical signs of illness, we’ll see this through with sound bodies and sound minds.

Woebot in the time of Covid-19

The first time someone mentioned Coronavirus to Woebot was on January 2nd. For the rest of that month, there was a slow creep of mentions. In February, Coronavirus mentions doubled biweekly, then weekly, and finally in March, mentions doubled from one day to the next. Sound familiar? Indeed, the curve that denotes the fear and worry caused by this virus looks just like the graph of contagion of the illness itself.

At the same time that our staff were packing up their desks to work from home, we dropped all other projects and turned our attention to supporting our users through this unprecedented time. Our team and especially our engineers and our writers have worked day and night. We launched our Coronavirus program on March 17th with a lesson called “Perspective”. In typical Woebot fashion, it is whimsical, hopeful, warm and authentic with a touch of humor.

The goals of the program are not to provide more Coronavirus information per se, but rather to lift spirits, and to help people stay grounded during this anxiety provoking time. Over the course of the program, users can look forward to more guided meditations, as well as practical tips like ideas for staving off cabin fever, things to do with others via technology, a story about shared anxiety among chickens called “Chicken Study for the Soul”.

Aside from our regular conversations, we have improved some of our existing tools to deal with grief, and economic hardship. Unlike our thought challenging and mindfulness exercises, these tools are from another evidence based approach called Interpersonal Psychotherapy (IPT) and focus on processing loss and role transitions.

Our Chief Clinical Officer, Dr Athena Robinson, a mother of two, has produced a series of blog posts on how to navigate this time covering everything from social distancing to helping children and parents adjust to distance learning.

In addition, our engineers built a web tool that is a slimmed down version of the Woebot offering that allows people to get immediate access to a helpful tool to manage anxiety, bypassing the need to download an app and register. I’m proud to say this web tool is currently being translated to Italian to help one of the worst affected areas.

In just a couple of weeks the landscape of our company and the world has shifted. The unique ability for digital tools to meet people where they’re at has never been as self-evident and that is a conversation we find ourselves no longer needing to have.

The truth is that the ability to focus our energy on such meaningful work at this time has been a blessing and a privilege. At times like this when there’s so much that one can’t control, it helps to focus on the things you can. So we support people, because that’s what we can do.

The Indoor Days

Mitigating the spread of the Coronavirus requires that we social distance and stay inside of our homes. Yet, how do we successfully adapt to and make the most of life indoors? Truthfully, we are all just learning the answer to this question as we make our way along. Here are a few ideas to contribute to our growing, collective body of knowledge about living our best indoor days.

Build in Structure
Educators, employers, and mental health providers promote building a schedule into your daily life at home. Get up each morning and engage in a routine – shower, coffee, waffles for the kids, etc. Change out of those comfy pajamas. Talk with your partner and family members about how to structure your daily schedule and physical space within the home so that you have time together… and ideally, a wee bit of alone time and space too.

Engage in Small Acts of Kindness – Each Day (yes, each and every day)
Ever notice how being kind to someone can brighten your own mood? Being kind is a gift we can give to both others and ourselves. Offering kindness also temporarily shifts the focus of our attention and worry off of ourselves and onto someone else – which can be a huge help when managing persistent stress and low mood.

Thanking someone is an example of a small – yet powerful — act of kindness. For example, join me now in thanking the employees and people out on the ground; those who are dedicated to helping our activities of daily life continue in regularity as much as possible (i.e., grocers, waste management crews, food delivery services, postal workers, technical engineers enabling virtual communication, and of course, all of the health care providers worldwide.)

Learn & Practice Skills to Tolerate Uncertainty
Uncertainty is a hallmark characteristic of the Covid-19 pandemic. We remain uncertain about various aspects of the illness, how long shelter in place will be sustained, when our children will return to school, when businesses will re-open, the economic fallout of the situation, and more. All this being said,, it’ll be important to build our uncertainty-tolerance muscles in the coming weeks and months. Here are few ideas:

(1) Shift the Panic-Promoting Stories in Your Mind
For decades, Cognitive Behavioral Therapy (CBT) has taught that the way we interpret situations can directly impact our emotions and actions. The potentially panic-provoking stories in your head about the uncertainty surrounding Covid-19 can worsen your mood, increase anxiety, and backfire by reducing health-promoting behaviors. For sustained mental wellness, I invite you to be mindful of the amount of the time and energy you spend thinking through worst-case scenarios and other highly frightening possibilities. Both will necessarily predict the degree of panic you experience. Don’t get me wrong, anxiety is actually quite normative and expected in this situation — it is, after all, literally anxiety-provoking. But panic changes us and pushes us into pure flight or fight – when we panic, we lose our ability to access wise mind, to make choices that are best for our mental and physical health. Panic consumes our time, zaps our energy, reduces clarity of thoughts, and prevents us from being mindful and present during precious moments of calm and enjoyment. CBT skills such as thought restructuring can be instrumental in mitigating the degree of anxiety and panic you experience.

(2) Practice Mindfulness, Relaxation, and Exercise
Get to know your body’s signals of heightened anxiety. For many people, it manifests in a racing heartbeat, sweaty armpits, clammy hands, tight muscles, and/or poor sleep. Upon noticing these body sensations, intervene via a mindfulness meditation, relaxation exercise, and/or physical activity. Taking steps to dial down your anxiety before it escalates may help reduce how many times you hit intense panic.

Infuse calm through:

  • Circumscribing a time block in your day to ingest the news. Be connected to what is going on and select your top media outlets, but be intentional about how much news you consume (and when you consume it). Often, folks find reading the news right before bedtime can disrupt sleep. Experiment with what time works best for you.
  • Find a time each day to get grounded and centered. Diaphragmatic breathing, mindful meditations, and physical activity can be instrumentally helpful.
  • Gratitude journal daily. Write down and/or share aloud with others what you are grateful for each day. Even though it may seem to be odd to practice gratitude during this time, it’s actually more important now than ever– in fact, it can help you build reserves of strength and positivity to draw from when the going gets tough. Perhaps you are grateful that your kids engaged in their distance learning programs (even for a little bit!), you had a delicious cup of coffee, or found a fantastic yoga video on You Tube. Gratitude Journaling gives a microphone to the sunshine in our days.

Our journey through this pandemic will be a marathon, not a sprint. Together, let’s work our way through this.

We’ve Got This.

Let hope be the antidote to fear.
Let solidarity be the antidote to blame.
Let our shared humanity be the antidote to our shared threat.
— Dr Tedros Adhanom Ghebreyesus, Director-General, The World Health Organization

The Covid-19 pandemic feels so surreal. Yet it’s a stark reality we all face together. And we will continue to face it for an undefined amount of time. Across the globe, we are now challenged to dramatically accelerate comprehensive understanding of the illness,adapt to 24-7 life at home, away from our routines and loved ones,perhaps face a quick loss of income,
teach and practice patience and calmness during a storm, maintain, or work to quickly return to, strong physical health,grieve the pandemic’s impact,
appraise our emotional wellness barometer and seek support accordingly,
and above all else, tolerate uncertainty.

It’s quite a list. And I’m sure I’ve left important things off.

Can we do this?
YES. Personal, familial, generational, and global history reminds us about what we have endured, survived, and grown from. We humans possess many attributes that make us fundamentally wonderful. The capacity to love, empathize, learn, adapt, ideate, as well as be creative, scientifically minded, and resilient. Together, we can manifest a path forward, through this pandemic, and into our next phase.

Social Connectivity Matters – Even While Social Distancing
We live amidst critically important recommendations for social distancing, shelter in place, and quarantine. Adhering to these literally means limited physical proximity to loved ones. It doesn’t mean however, that we can’t connect. And connect we must. Social connection and social support are part of the very life blood of being human. We are social creatures. Look around – see the marvelous ways in which we’ve built our world to directly enable connecting with each other. Brick and mortar structures and technological platforms alike have been crafted with the goal of connectivity in mind. In fact, for thousands of years we humans have garnered support, empathy, and love from each other through our conversations and written word. Decades worth of psychological literature also document the power of social support to facilitate in achieving behavior change and recovery from various conditions. Connectivity is essential for vitality, hope and yes, even offers some space for humor in the midst of it all. Let’s leverage technology to help us connect. Call, text, video conference, social-media. Any of them. All of them. Leave no text unanswered; no thread unread. Social support is a reciprocal, mutually beneficial interaction. And remember, as we walk through the real-time impact and wake of Covid-19, we must promote and engage in social connectivity & social support while simultaneously abiding by the distancing recommendations set forth by national and global scientific experts and governing bodies.

My way of connecting is writing and sharing this post. Discover yours. After all, this is the time for it.

Hang in there everyone, we’ve got this.