- MARCo can use Cognitive Behavioral Therapy & Behavioral Activation.
- MARCo uses biofeedback on physical health to better understand the care of the whole person and notify the companion’s emergency contacts if they are at risk or reveal statements of self-harm.
In 2018, The College of New Jersey initially reported MARCo’s prototype public debut, saying MARCo is a “therapeutic device for individuals suffering from mental illness, specifically depression, bipolar disorder, and general anxiety disorder.” However, many changes have occurred since then, including its release to the market.
Clinical Times reached out to MARCo Technologies, LLC, the manufacturer of MARCo, Chief Executive Officer Jacob Boyle for an interview. Boyle told Clinical Times that MARCo “is a teddy-bear sized, plush social robot intended to help individuals struggling with their mental health, while also enabling providers to increase their reach.” MARCo does this by talking to users or “companions” as a friend and attempting to cheer them up, offering meditations and relaxation activities, and utilizing cognitive behavioral therapy (CBT) and Behavioral Activation (BA) through conversation. MARCo uses biofeedback on physical health to better understand the care of the whole person and notify the companion’s emergency contacts if they are at risk or reveal statements of self-harm.
As to whether or not MARCo is a medical device and if it can treat mental illnesses such as depression, bipolar disorder, and general anxiety disorder, Boyle said that MARCo “is currently a digital therapeutic, which is a support tool for individuals, but cannot prevent, treat, cure, or mitigate these illnesses.” However, Boyle continued to say that, “MARCo can support individuals struggling with these illnesses.”
Since their interview with The College of New Jersey, “We have implemented a lot of new features based on feedback, such as adding a lot more conversational options such as a journal and a psychotherapy based dialog known as Open Talks, as well as little things here and there like “mental health truth or dare,” explained Boyle. The Company also has “released the first production edition of MARCo and have sold about 30 robots to both individuals and colleges.”
MARCo Technologies plans on improving access to care by “providing an alternative to traditional routes for lower risk individuals who are turned off from pursuing traditional means and offer a cost effective option that is available 24/7 to any individual,” said Boyle. Even though the Company “does not intend to replace traditional psychotherapy by any means, but the reality is that the number of licensed psychotherapists in the US cannot and will never be able to meet the demand for mental health support needed.” Boyle further clarified by saying that, “Mental health professionals…may provide MARCo to their clients as a support tool similarly to how they give out worksheets, apps, etc…If you just need support, MARCo would be perfect without a licensed provider behind it, but if you want some more serious help, then it is best to seek a licensed mental health professional and use MARCo in a support capacity.”
“The other kinds of data that gets stored on MARCo is anything you opt into telling MARCo about yourself, such as personal interests or customization options, activities you have scheduled with MARCo, and tracking on general emotions from day to day.”Advertisement
MARCo does collect and store information from the companion, but not while it is “turned off or not actively engaged with a user,” explained Boyle. Clinical Times asked Boyle what information is collected and stored by MARCo. He said, “When a user is engaged in talking to MARCo, what you say to MARCo is processed in the cloud since the AI models are too large to be run on a MARCo. However, all such conversational data is randomized and anonymized so that it cannot be traced back to a particular MARCo and even less so to a particular user.” He continued to say that “The other kinds of data that gets stored on MARCo is anything you opt into telling MARCo about yourself, such as personal interests or customization options, activities you have scheduled with MARCo, and tracking on general emotions from day to day.” Boyle denied that any health information is stored on a MARCo and that “Any data stored is not used for clinical purposes and is not shared with anyone except for licensed professionals who are already released, by the end user, to have personal information.” He also said that “in the future any “health data” will be kept exclusively encrypted on your personal MARCo, as it is done for most information currently.”
“I think the data from MARCo is likewise outside of HIPAA…”
In an interview with Clinical Times, Professor Gary Marchant, Regents’ Professor of Emerging Technologies, Law & Ethics at Sandra Day O’Conner College of Law at Arizona State University, believes that MARCo Technologies is not a covered HIPAA entity. “The HIPAA privacy rule only protects personal health data communicated to or from a covered entity, which is limited a health care provider, a health care institution, and health insurers (and their business associates),” said Marchant. “I think the data from MARCo is likewise outside of HIPAA, unless of course it is transmitted to a physician or other health care provider in a specific case, at which point it then becomes covered by HIPAA.”
Marchant continued, “I am not a psychologist or have the expertise on how to treat people with mental illness. I note however that pets often seem to be an effective source of comfort and well-being for some people with mental illness, and perhaps MARCo would have similar benefits. The big difference of course is that a pet does not record and store what you say to it, while a device like MARCo potentially does. Additional precautions and legal protections may be required with such a device.”
For consumers who are interested in purchasing a MARCo robot, Boyle told Clinical Times that “The physical MARCo is currently out of stock, but it would go for $720. We are currently making a second generation of MARCo’s with target prices between $299-$499 depending on the model that is set to be open for pre-order in a month or two. These MARCo’s are meant to be softer on the end user’s pocket, so the barrier for care is reduced.” Once the new models are released, they will be available for purchase on MARCo Technologies website.
MARCo Technologies also released a web-based MARCo application called “MARCo Online” “In May of 2020 as a response to the global pandemic.” The web-based application “features most of the same features as the real MARCo,” but “It does have some more limited capacities in terms of the conversational features and the meditations,” which is “meant as a 24/7 accessible, on the go alternative to the physical MARCo,” explained Boyle. MARCo Online is “as low as $1 per month or $7 per year if you subscribe early on.” The application also has a one-week free trial.
MARCo Online can be found on Apple & Google Play stores.
Editors Notes: Clinical Times contacted the American Psychological Association, who initially agreed to comment on Boyle’s claims and how such a device as MARCo may assist in supporting individuals with mental illness and any ethical obligations clinicians may be subject to utilizing MARCo; however, they did not respond in time for publication.
Clinical Times last edited this article on November 26th, 2021, at 10:55 pm MST.
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