How Do Astronauts Look After Their Mental Health?

Image: Black Dog Institute

NASA is funding a study to work out how to treat the mental health of Astronauts on long-duration space missions.

As part of the research, an e-mental health tool developed by researchers at Black Dog Institute will be trialled this month.

myCompass is an interactive self-help tool which gives evidence-based psychological interventions for depression and anxiety, such as cognitive behaviour therapy, entirely via online platforms. The fully automated and free program lets you access personalised treatment plans anytime on your smartphone (or any other device).

Previous studies have demonstrated the clinical effectiveness of myCompass for reducing mental health symptoms in people with mild-to-moderate depression, anxiety and stress. It also facilitated lasting improvements to mood, anxiety and stress, with users experiencing sustained benefits to work and social functioning.

Now for the first time, this technology will be tested amongst "astronaut-like" adults in a clinical trial to see how effective such programs could be when real-time and face-to-face psychological assistance are unavailable, and whether different support functions via video-messaging or text-based messaging with a therapist are useful.

Dr Janine Clarke, leader of Black Dog Institute's myCompass program, said the new study presents an unprecedented opportunity to test the platform in radical settings, helping researchers gain critical insights into the full potential of unguided self-help treatments delivered via the internet.

"Astronauts are only human, and just like the rest of us they are not immune to mental suffering," said Dr Clarke. "With missions to Mars expected to take over two years to complete, equipping astronauts with strategies to handle not only extreme physical environments but also psychological distress is vital."

Astronauts are at a high risk of experiencing mental distress for a range of reasons, Dr Clarke says. They are generally extremely high achieving, on mission they experience long-term social isolation, they confront ongoing physical strain and mental challenges (including persistent threats to their safety) and they have limited access to the types of "supports" that many of us take for granted, including ready access to friends and family, and physical activity.

By researching the delivery of psychological treatments under these extreme conditions, Dr Clarke believes we can unlock a wealth of new knowledge about which approaches can best emulate the mental health impacts that are achieved here on Earth.

The new clinical trial is led by Assistant Professor Adam Gonzalez from Stony Brook University in the United States, who received a four-year $1 million grant in 2015 through NASA's Human Research Program.

"This study will test how we can deliver mental health treatments for depression, anxiety and stress in space using internet-based programs and various methods of providing delayed therapist support," said Assistant Professor Gonzalez.

Assistant Professor Gonzalez point out that Currently, astronauts in the space program only travel to the International Space Station - where direct phone and video contact is still possible, and regularly scheduled check-ups with their ground-based behavioural health specialist are required.

But Assistant Professor Gonzalez wants to investigate whether e-mental health treatments and different modes of providing delayed therapist support can help facilitate mental health in the context of time-lagged communications – a factor which he says is vital to the success of our space travel ambitions more broadly.

The trial will involve 135 participants who are demographically similar to astronauts: well-educated individuals in university settings who are relatively healthy, with elevated distress levels. Participants will include physicians, residents and graduate students.

Over 12-weeks, the participants will be randomised into three conditions to test myCompass in isolation, compared with the myCompass intervention supported by delayed therapist contact via text messages or via recorded video messages.

The time lapse in delivery of therapist support is designed to mimic the delay of up to 44 minutes that would be encountered in real-life interstellar settings.

"This research is critical to inform the best way for NASA to care for the mental health needs of astronauts during missions to Mars and other long duration space travel," says Assistant Professor Gonzalez. "The results may also help to serve as a guide to providing mental health care for individuals in rural settings worldwide where mental healthcare providers are few in number or access to providers is difficult."

The clinical trial will begin on 18 September.

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