The effortless assessment of risk states (EARS) Tool: An interpersonal approach to mobile sensing

Monika N. Lind, Michelle L. Byrne, Geordie Wicks, Alec M. Smidt, Nicholas B. Allen

Research output: Contribution to journalReview ArticleResearchpeer-review

17 Citations (Scopus)


Background: To predict and prevent mental health crises, we must develop new approaches that can provide a dramatic advance in the effectiveness, timeliness, and scalability of our interventions. However, current methods of predicting mental health crises (eg, clinical monitoring, screening) usually fail on most, if not all, of these criteria. Luckily for us, 77% of Americans carry with them an unprecedented opportunity to detect risk states and provide precise life-saving interventions. Smartphones present an opportunity to empower individuals to leverage the data they generate through their normal phone use to predict and prevent mental health crises. Objective: To facilitate the collection of high-quality, passive mobile sensing data, we built the Effortless Assessment of Risk States (EARS) tool to enable the generation of predictive machine learning algorithms to solve previously intractable problems and identify risk states before they become crises. Methods: The EARS tool captures multiple indices of a person's social and affective behavior via their naturalistic use of a smartphone. Although other mobile data collection tools exist, the EARS tool places a unique emphasis on capturing the content as well as the form of social communication on the phone. Signals collected include facial expressions, acoustic vocal quality, natural language use, physical activity, music choice, and geographical location. Critically, the EARS tool collects these data passively, with almost no burden on the user. We programmed the EARS tool in Java for the Android mobile platform. In building the EARS tool, we concentrated on two main considerations: (1) privacy and encryption and (2) phone use impact. Results: In a pilot study (N=24), participants tolerated the EARS tool well, reporting minimal burden. None of the participants who completed the study reported needing to use the provided battery packs. Current testing on a range of phones indicated that the tool consumed approximately 15% of the battery over a 16-hour period. Installation of the EARS tool caused minimal change in the user interface and user experience. Once installation is completed, the only difference the user notices is the custom keyboard. Conclusions: The EARS tool offers an innovative approach to passive mobile sensing by emphasizing the centrality of a person's social life to their well-being. We built the EARS tool to power cutting-edge research, with the ultimate goal of leveraging individual big data to empower people and enhance mental health.

Original languageEnglish
Article numbere10334
Number of pages10
JournalJMIR Mental Health
Issue number3
Publication statusPublished - 1 Jul 2018
Externally publishedYes


  • Cell phone
  • Crisis prevention
  • Depression
  • Individual big data
  • Mental health
  • Mobile apps
  • Mobile sensing
  • Passive mobile sensing
  • Personal sensing
  • Risk assessment
  • Telemedicine

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