The construction of mental health as a technological problem in India

Mills, China; Hilberg, Eva

doi:10.1080/09581596.2018.1508823

Cited by 19 publications

(13 citation statements)

References 43 publications

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“…In their survey of the messaging of mental health apps, Parker et al [186] argued that prominent apps tend to overmedicalize states of distress and may overemphasize "individual responsibility for mental well-being." There may be legitimate reasons to demedicalize some approaches to supporting people in distress via digital initiatives and remain cautious about framing the matters as medical problems amenable to digital technological solutions [193,199]. Rose [194] argues that: most forms of mental distress are inextricably linked to problems of poverty, precarity, violence, exclusion, and other forms of adversity in people's personal and social experiences, and are best addressed not by medicalization, but by low intensity but committed and durable social interventions guided by outcomes that are not measured in terms of symptom reduction, but by the capacities that people themselves desire in their everyday lives.…”

Section: Overmedicalization and Concerns Of Techno-solutionismmentioning

confidence: 99%

Ethics and Law in Research on Algorithmic and Data-Driven Technology in Mental Health Care: Scoping Review

Gooding¹,

Kariotis²

2021

JMIR Ment Health

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Background Uncertainty surrounds the ethical and legal implications of algorithmic and data-driven technologies in the mental health context, including technologies characterized as artificial intelligence, machine learning, deep learning, and other forms of automation. Objective This study aims to survey empirical scholarly literature on the application of algorithmic and data-driven technologies in mental health initiatives to identify the legal and ethical issues that have been raised. Methods We searched for peer-reviewed empirical studies on the application of algorithmic technologies in mental health care in the Scopus, Embase, and Association for Computing Machinery databases. A total of 1078 relevant peer-reviewed applied studies were identified, which were narrowed to 132 empirical research papers for review based on selection criteria. Conventional content analysis was undertaken to address our aims, and this was supplemented by a keyword-in-context analysis. Results We grouped the findings into the following five categories of technology: social media (53/132, 40.1%), smartphones (37/132, 28%), sensing technology (20/132, 15.1%), chatbots (5/132, 3.8%), and miscellaneous (17/132, 12.9%). Most initiatives were directed toward detection and diagnosis. Most papers discussed privacy, mainly in terms of respecting the privacy of research participants. There was relatively little discussion of privacy in this context. A small number of studies discussed ethics directly (10/132, 7.6%) and indirectly (10/132, 7.6%). Legal issues were not substantively discussed in any studies, although some legal issues were discussed in passing (7/132, 5.3%), such as the rights of user subjects and privacy law compliance. Conclusions Ethical and legal issues tend to not be explicitly addressed in empirical studies on algorithmic and data-driven technologies in mental health initiatives. Scholars may have considered ethical or legal matters at the ethics committee or institutional review board stage. If so, this consideration seldom appears in published materials in applied research in any detail. The form itself of peer-reviewed papers that detail applied research in this field may well preclude a substantial focus on ethics and law. Regardless, we identified several concerns, including the near-complete lack of involvement of mental health service users, the scant consideration of algorithmic accountability, and the potential for overmedicalization and techno-solutionism. Most papers were published in the computer science field at the pilot or exploratory stages. Thus, these technologies could be appropriated into practice in rarely acknowledged ways, with serious legal and ethical implications.

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Section: Overmedicalization and Concerns Of Techno-solutionismmentioning

confidence: 99%

Ethics and Law in Research on Algorithmic and Data-Driven Technology in Mental Health Care: Scoping Review

Gooding¹,

Kariotis²

2021

JMIR Ment Health

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“…The significance of this approach lies in making visible the ‘black box’ (Porter ) of the mhGAP‐IG and its associated products, i.e. the social, cultural and political processes, that produce systems of classification but are often obscured in technical language (Mills and Hilberg ).…”

Section: Methodology: the ‘Social Life’ Of Mhgap‐igmentioning

confidence: 99%

‘Built for expansion’: the ‘social life’ of the WHO's mental health GAP Intervention Guide

Mills

Hilberg

2019

Sociology Health & Illness

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The focus of this study is the WHO's mhGAP‐Intervention Guide (mhGAP‐IG) 2.0 (2016), an evidence‐based tool and guideline to help detect, diagnose and manage the most common mental disorders, designed for use by non‐specialists globally but particularly in low‐ and middle‐income countries. This research is a starting point in tracing the multiple ‘doings’ of mhGAP‐IG – connecting questions of how it is ‘done’ and what does it ‘do’ – to the living histories and wider global mental health assemblages that make the tool possible and shape its global circulation. We examine the conditions of possibility that produce and legitimate mhGAP‐IG, and the ways these are ‘black boxed’ through casting mhGAP‐IG in technical rather than epistemological terms. The study illuminates how its explicit design for global expansion positions mhGAP‐IG as open to questioning from those who are technical ‘insiders’ and setting the epistemological parameters of its own critique. It analyses mhGAP‐IG as an ‘inscription device’ that inscribes and materialises algorithmic imaginaries of mental health that impact on design and local implementation. This study is one attempt at initiating dialogue with the WHO from perspectives and methodological approaches not usually included in the conversation.

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“…With more Indians getting access to the Internet, the current Indian government has repeatedly emphasized that it intends to use ICTs to improve healthcare facilities (Indo-Asian News Service, 2018). It has made health an important aspect of its 'Digital India' campaign (Mills & Hilberg, 2018) with the goal of transforming India into 'a digitally empowered society and knowledge economy' by using information technology in the field of public services (Government of India, n.d.). Digital technology is often perceived as a panacea for health issues in India today, and the government has launched various apps in this regard, including the Aarogya Setu app in April 2020, with the reported purpose of tracking COVID-19 infections in the country (Banerjea, 2020).…”

Section: Contextual Background: the Healthcare Sector In Indiamentioning

confidence: 99%

“…Not every ailment may have a technology-centric solution. However, as Mills and Hilberg (2018) emphasize, health issues in India are often presented today as problems with technological solutions.…”

Section: Using the Information Posted On A Facebook Page/ Profile To Select The Right Doctormentioning

confidence: 99%

Looking for Medical Advice in Everyday Digital Spaces: A Qualitative Study of Indians Connecting with Physicians on Facebook

Mishra

2021

Vikalpa: The Journal for Decision Makers

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In a world afflicted by COVID-19, many people consult doctors through a digital interface or over the phone, as face-to-face consultations are almost impossible during a lockdown. The Medical Council of India and the NITI Aayog, a policy think tank, formulated new guidelines to empower medical practitioners to practice telemedicine in India in March 2020. Even before the COVID-19 pandemic gripped the world and made digital consultations a necessity in specific cases, academic studies located within a health promotion framework in Western contexts indicated that patients have been very much interested in using social media tools to communicate with their physicians. Previous studies have also highlighted the advantages of information and communication technologies for patient–doctor interaction. Since changes introduced by digital health technologies have primarily been analysed from such health promotion perspectives that often adopt a ‘techno-utopian’ lens ( Lupton, 2013 ), it becomes imperative to critically interrogate how such changes construct specific subjectivities and shape our understandings of health and normative healthcare practices. Specifically, scholars have highlighted how social media platforms and apps act as ‘performative devices’ ( Johnson, 2014 ) that influence ‘everyday management of illness and health’ and help create the ideal of the ‘digitally engaged patient’ ( Lupton, 2013 ). In the Indian context, media reports highlight a growing trend in the use of social media platforms and apps by physicians and patients. However, academic research on such emerging phenomena in this country is still scarce. This exploratory study examines why some Indians connect with physicians on a social media platform such as Facebook, the nature of communication between them and their understandings of health. It uses in-depth interviews and draws upon neoliberal governmentality as a theoretical anchor. The findings show how the internalization of neoliberal values and assumptions are associated with participants’ search for lifestyle and medical advice in everyday digital spaces such as Facebook. This study strives to extend the concept of neoliberal governmentality to performances in everyday digital spaces such as Facebook. In terms of practical implications, the results of the study highlight the critical need for policies that regulate the medical content available in social media spaces. Most importantly, some of the issues highlighted by the participants in this study can help policymakers take adequate precautions while formulating guidelines on digital consultations, especially during pandemics and their aftermath when there is tremendous pressure to promote telemedicine.

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The construction of mental health as a technological problem in India

Cited by 19 publications

References 43 publications

Ethics and Law in Research on Algorithmic and Data-Driven Technology in Mental Health Care: Scoping Review

Ethics and Law in Research on Algorithmic and Data-Driven Technology in Mental Health Care: Scoping Review

‘Built for expansion’: the ‘social life’ of the WHO's mental health GAP Intervention Guide

Looking for Medical Advice in Everyday Digital Spaces: A Qualitative Study of Indians Connecting with Physicians on Facebook

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