Our Clinical Diversity Advisory Board, formed at the start of this year, fosters conversation and action to make mental health more accessible to marginalized groups. The board’s members come from a variety of backgrounds and have a range of expertise in areas of age, gender, race, sexual orientation and ethnicity. Dr. Carolyn Green’s background is particularly unique. An associate professor of psychiatry and director of team science at University of Arkansas for Medical Sciences’ Translational Research Institute. Dr. Greene has expertise in digital therapeutics and rural health and in delivering culturally- competent, evidence-based healthcare to underserved communities.

In this timely and important conversation, Dr. Greene spoke to us about her observations of the industry, and her hopes for impact.

Let’s kick this off by asking you about your background. How did you come to have a passion for making mental health care more accessible?

I’ve been doing digital mental health since 2004, starting when I lived in Hawaii. I had moved there from New York and was working with native Hawaiians and Pacific Islanders and other underserved groups. We started using video teleconferencing as a way to deliver care. I wasn’t particularly excited about technology, but I knew that we had patients who really needed help, and they lived in places where help wasn’t available. So unless we could get to them or they could get to us, they were going to go unserved. When I started getting involved in research to prove that it’s really effective, that became exciting because then we started thinking about what other kinds of interventions we could implement. Over the years, I’ve done more web and mobile and work with online self-help courses. For the last four years, I’ve been living in Arkansas.

What’s the situation there?

There are fewer resources, and it’s a lot harder for people to get access to care. It’s a very poor, rural state. The work that I’m doing is about creating interdisciplinary teams and really trying to find innovative solutions to solving healthcare problems and increasing access.

Why did you join Woebot Health’s Clinical Diversity Advisory Board?

How could I say no? I mean, this is something that I’ve been preaching for so long, that technology is a way of decreasing health disparities, of enabling these medically underserved populations to have access to good quality care. And I know that that the actual technology you have and its ability to create a therapeutic alliance is pretty impressive. That’s been a hard nut to crack. And that is consistently the issue: how do you get people to feel as connected through technology? I heard about your product and what you were doing, and met some of your principles, and I wanted to learn from you. I wanted to be a part of this.

What is the impact that you hope to make with this group?

What I’m really hoping is that in a couple of years, we’ll have a strategy for how to be more inclusive of underserved populations, and that that is a core building block of how products are developed and how the whole intervention is thought of. So making inclusion be part of that process, as opposed to a side consideration.

What are some of the important considerations companies need to make as they continue to focus on diversity, equity and inclusion, not only in products, but in practice?

You just hit on it. I think it’s really understanding the diversity in needs of potential customers. People in rural areas don’t feel like any of these kinds of fancy digital things are for them, because they don’t see people that look like them in the advertisements. They’re under the impression that it’s just not for people like them. They feel overlooked. I will say that technology has a diversity problem. I think that it’s more about reception than the actual diversity in some cases. And so I think that that’s another area where we need to have more visibility of diverse people who are working in technology. Honestly, that’s part of why I felt kind of obligated to take advantage of this opportunity. We need young people of color, young people from disadvantaged backgrounds, people who don’t think of themselves as being particularly sophisticated or cutting edge to realize that they can contribute to the process of developing digital tools.

What are some of the unique opportunities for digital therapeutic companies to break the status quo and provide better access to care for historically underserved populations?

Right now we have a unique opportunity within digital health because of the pandemic. People suddenly have a much better understanding of the benefits of remote delivery. What can we do to take advantage of this opportunity? We need to go out and talk to people who have been using technology in the past year and learn from them. I think we have a natural experiment in front of us, to find out what was getting in the way for people who might really benefit from some of these tools. As an industry, we need to be very introspective about what worked well in the last year and what didn’t work well. We need to reach out to policy makers and show them the evidence.

That’s a strong close: speak less and listen more.

It’s about having more voices at the table at every step of the process. And really listening to lots of voices, including people with low health literacy who might be intimidated by technology. If we want to be inclusive, we have to talk to the people who aren’t in the inner circle. That’s why I’m so proud of the work that we’re doing with this board.