CAMH scientist Sean Kidd and software developer Amos Adler co-created the A4i app for patients with severe mental health issues.Jennifer Roberts/The Globe and Mail
As new digital tools powered by AI raise fears of misinformation, a Canadian startup has gone the other way: Using technology to help patients with severe mental-health illnesses perform reality checks of their hallucinations.
The digital health app, called A4i (which stands for “App for Independence”), was created by software developer Amos Adler and Sean Kidd, a senior scientist at the Centre for Addiction and Mental Health. The company was spun out of CAMH and is now being adopted by some mental-health hospitals in Canada and the U.S., including the Waypoint Centre for Mental Health Care in Ontario and the Riverside University Health System in Southern California.
The hallmark feature is an auditory hallucination detector, for which the company got a patent in 2023. A patient can use the app to record sounds around them and, by answering prompts, help sort out whether what they are hearing is real or imagined.
Dr. Kidd said the inspiration for the feature came from a patient. The young man had schizophrenia and was experiencing persistent, distressing auditory hallucinations. He’d bring audio recordings taken in his apartment to sessions and ask Dr. Kidd if he could hear sounds such as voices or yelling. Dr. Kidd usually couldn’t.
That led the psychologist to look into what phone-based tools might be available for such patients – he couldn’t find any.
“If you’re a little bit anxious or depressed, you’ve got thousands of digital options for you to be mindful in a thousand different ways,” he said. “But if you had something like psychosis or something more severe happening, there’s literally nothing.”
He approached CAMH’s tech-transfer office, where director Klara Vichnevetski connected Dr. Kidd with Mr. Adler, whose company, MEMOTEXT, made digital health apps. They founded A4i in 2018.
A4i stands for ‘App for Independence’ and is now being adopted by some mental health hospitals in Canada and the U.S.Jennifer Roberts/The Globe and Mail
What followed were years of research, trials and pilots at hospitals across North America. The team said an important guiding principle was codesigning the app with clinicians and patients. “Really working with people most affected to try and understand what their needs are and iterate on building interventions that are going to be relevant,” Dr. Kidd said.
The hallucination detector is meant to help patients develop coping strategies for those symptoms. There are other features, including a tool for a patient to regularly record their mood and medication intake, which can be monitored by their clinical team, as well as a messaging service with their clinician. There is also a social-media feed where patients can anonymously share pictures and messages with other patients, with all posts moderated by a team of peer support workers.
Mr. Adler said the way the app connects patients with their care team and peers has led to “seven-plus, nine-plus months worth of consistent engagement, which is kind of unheard of in health apps.”
That’s part of the return-on-investment that A4i pitches hospitals, as longer engagement leads to patients better managing their symptoms and being less likely to need to be readmitted to hospital.
María Martha Moreno, mental health services manager at Riverside University Health System, said it also helped with early intervention. For example, in one incident, a specialist monitoring a patient’s use of the app noticed their mental health appeared to be deteriorating.
“They did a home check and they were able to take that person to the hospital, instead of that being escalated to a crisis where you have police coming in,” she said.
Mr. Adler said he considered A4i a “late-stage” startup with monthly recurring revenue. They are aiming for a round of seed funding in the first quarter of 2026.