Data on Your Mind: Good Public Health or Mental Health Surveillance?

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Experts have warned us how we are increasingly being socialised into surveillance capitalism which seeks not only to use our data to sell us more stuff, but to manipulate our behaviours. Vast numbers of data points gathered about us means our behaviours become more predictable, and this becomes very useful to a range of industries looking to maximise returns, productivity and reduce risk.

What if this same idea was applied to how we predict mental health conditions? Let’s say governments wanted a population level screening tool that could comb your social media or other online trails, and through machine learning and algorithms build a profile about the kind of person you are likely to be, and more importantly the likelihood that you fall into certain psychological/psychiatric classifications of concern. This isn’t an episode of Black Mirror; this is the emerging world of digital phenotyping in psychology and psychiatric research, and it should concern us for several reasons.

Illustration of a blue face; the back of it is dissolving into computer codePut simply, the term digital phenotyping refers to the use of digital and other online data to draw conclusions about mental states or psychological characteristics of a person. Some digital phenotyping projects are focussed on capturing self-report data via smart devices to “build a rich, personalised digital picture of behaviour, track markers of depression and anxiety, and develop new ways to diagnose illness, choose effective treatments and detect relapse before it occurs”. Some research approaches trawl social media and public online sources to develop these digital phenotypes while other research seeks to capitalise on the ubiquity of smartphone use:

“Building on the widespread adoption of smartphones as the principal enabling technology, digital phenotyping has been enthusiastically adopted as a research theme in mental health.”
–Huckvale, Venkatesh, and Christensen

The ethics of data harvesting is murky, particularly when it comes to publicly available information. Concerns regarding digital surveillance are outlined in the Health and Human Rights Journal, and they echo global concerns around the ways in which profiling technologies can be used to perpetuate discrimination and racialisation.

There are instances in Australia where the use of data has resulted in extraordinary harms to people receiving government support payments and where governments have used technology and profiling to intervene and dehumanise the lives of Indigenous people (for instance, the cashless debit card). These examples of punitive welfare are premised on notions of who are the deserving/undeserving poor, which as will be shown has origins in psychological classifications. While these examples are specifically from Australia, they are not unique to this context and numerous examples of data violence can be found elsewhere.

In addition to ethics of data harvesting, there are long histories of harms enacted by psychological and psychiatric research, particularly relating to racial discrimination and racism and to the ways in which psychology has contributed to the erosion of Indigenous culture in Australia. Although there have been public apologies and moves to rectify some of the harms done, questions remain as to how such harms emerge from these human sciences in the first place.

A key mechanism of these kinds of violence is to use psychological knowledge to turn social, political, and cultural problems into problems of the individual. An historical example of this is the psychological classification of ‘feeblemindedness’ which was conceived in the mid-19th century as a personal characteristic that emphasized a “lack of mental development and inability to make good in society”. Whilst this may seem an innocuous descriptor, what it gave rise to was a range of psychological tools (such as intelligence testing), language and practices. The term was subsequently used to classify Indigenous, ethnic and migrant communities and was also claimed to be an observable sign of a genetic flaws, ultimately deployed in service of the eugenics movement which believed that so-called social ills could be eradicated through “racial improvement” and “planned breeding”.

Psychological classifications are not benign labels, they can result in a cruel kind of victim-blaming as can be seen in recent psychology research on poverty which states “resource-scarce individuals should be encouraged to improve themselves and bridge the poverty gap through their own efforts, instead of destroying others’ advantages”. While the research does acknowledge that poverty is significant problem worldwide, it situates the problem of poverty as one of “mindset”. According to critical psychologist Thomas Teo this can be understood as epistemological violence, which he describes in this way:

“The term epistemological violence as it is used in the argument does not refer to the misuse of research in general but is specific to theoretical interpretations of empirical results that have negative connotations for the Other in a given community”.

The psy-complex plays a significant part in curating the background of how we understand socially what it is to be a capable/good/well/stable/fit human. These normative categories operate as what Foucault termed “dividing practices”, whereby the people can be divided within themselves or divided from others, and examples are “the mad and the sane, the sick and the healthy, the criminals and the ‘good’ boys”. Thus, psychological concepts and classifications can seep into society and give credence to moralisations about ways of being.

For over 20 years homosexuality was regarded as a disorder by the official diagnostic manual of psychology/psychiatry (the Diagnostic and Statistical Manual of Mental Disorders), only being removed in 1973. Despite its removal, the residue of it being labelled a disorder continues to embolden discrimination and harmful practices such as conversion practices. Fifty years on, this authoritative text still contains something known as ‘transvestic disorder’ which is described as a disorder “characterized by at least 6 months of experiencing recurring sexual arousal brought on by the act of cross-dressing”. The classifying of cross-dressing as a disorder surely has the capacity for similar harms through stigma, discrimination, violence and adds fuel to anti-trans disinformation.

While these historical examples might seem to be outliers, we could also point to a number of more recent psychological classifications that are laden with certain cultural values and/or moralisations (e.g. premenstrual dysphoric disorder, gambling disorder, social communication disorder). As social or cultural issues these things may indeed exist; the question is, what happens when they become properties or characteristics of certain ‘kinds’ of people?

Philosopher Ian Hacking’s work focuses on the human sciences (in which he includes psychology and psychiatry). His work seeks to understand the ways in which these human sciences create “kinds of people” that in some way did not exist previously; he refers to this as “making up people”. He proposes that much of the work of these sciences is to develop, define and maintain classifications of these “kinds”. Traditionally these ideas of classification have been explored under the philosophic tradition of nominalism; however, Hacking’s is more dynamic than this, as he believes people interact with the classifications, thus changing them and how they are understood. He refers to this dynamism as the “looping effect” and “once a new description, associated with a classification, becomes socially available, it prompts reactions by enabling new conceptual possibilities for being and acting”. This looping effect has important implications for how the psy-complex operates as a cultural producer and product of modernity.

Digital phenotyping has a host of conceptual issues not explored here, but it can be regarded as another example of the the psy-complex’s compulsive methodologism, the “uncritical privileging of scientific methodology over other research concerns”. Thus, the concern isn’t only the use/misuse of people’s data, it is the emergence of more tools for the psy-complex to classify and moralise behaviours and ways of being. As shown here, it is often marginalised communities that then feel weight of these classifications. For government and policy makers these new psy-technologies could serve as short-hand for victim-blaming whilst under the cover of preventative public health, thus influencing who is deemed deserving of funding and who is not.

“Particularly in psychiatry, objective, continuous quantitation using patients’ own devices may result in clinically useful markers that can be used to refine diagnostic processes, tailor treatment choices, improve condition monitoring for actionable outcomes, such as early signs of relapse, and develop new intervention models.”
–Huckvale, Venkatesh, and Christensen

At a time where there are increasing rates of psychological distress and insufficient psychological and psychiatric services to address them, mental health surveillance could easily become a part of government strategies. Proponents of these digital methods will rationalise the approach as proactive, cost effective and will insist on its utility as a screening tool. However, data harvesting is also about exposing vulnerabilities and therefore the danger of data being used for social control and behaviour change is very real.

With socioeconomic, political, and ecological issues impacting people’s health and wellbeing, psychology and psychiatry should be pursuing approaches that maximise human dignity and address the complexities of psychological distress. They should be focussed on the material inequities that underpin poor health, and advocating for approaches that empower communities and their collective, cultural wellbeing.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

8 COMMENTS

  1. This is quite a statement, and really puzzling: “Digital phenotyping has a host of conceptual issues not explored here, but it can be regarded as another example of the the psy-complex’s compulsive methodologism, the “uncritical privileging of scientific methodology over other research concerns”.”

    I don’t really see that it’s about science, it’s about scientism. Mind control to get people to ignore what a society (whether its Capitalistic, Communist or anything else such as Religious or Social) what that society does to marginalized people by giving rewards to incentivize exploitation, denial, discrimination etc. this isn’t “science” unless you are going to say learning how to deceive people, or buying into deceptions for rewards is science. Neither is the drug companies selling the idea that happiness or being normal, or functional, or fitting into the mob, or even such bizarre things as recovering from shyness to go to the Prom (they actually had commercials on TV promoting anti-depressants for this), you can get this as easy as popping a pill, this isn’t science either, it’s conning people into believing things that don’t pan out (except for drug company profits, which I can’t say is science either, would science have value), and using scientism to do that. And then when things get worse scientism says it’s that they need more pills, rather than seeing cause and effect.
    Chemical imbalance comes from the medications, which has been conclusively shown to be true, but it hasn’t at all shown to come from a “disease,” the only “science” involved is that people can be made so alarmed, annoyed, up at arms about the challenge of their emotions, that they will believe such conjurings of false logic. That ISN’T science, neither is it when they use scientism to dismiss what happens to marginalized people, or people in a war zone, or people whose nature is significantly different than the status quo.

    • They are not entirely unrelated, but the focus here is really on the desire for psy to find new methods for conducting research (which may indeed be in service of scientism). It may have been more correct to state it as “scientific” methodology, as I agree sometimes it’s hard to see how this is about actual science at all. Thanks for taking time to read and comment.

      • Well, given that torture is also considered a form of science… I like to think that science is something else… And torture is mind control which is what is going on when you deny the suffering a person goes through in order to what in order to what? This is science when you fixate on ways to deny the suffering and make it out to be a disease? I don’t know what science is supposed to be when that’s included.

  2. I worked at a State University in which found out that I had been on SSDI in the past and used that to discriminate and harass me because I didn’t follow along with the reorganization of the department. I worked for the international center and the candidate from another country used gaslight8ng to make power moves. This is disturbing that those we are supposed to be helping can be used to be manipulated for their own agenda.

  3. What a fascinating article!
    Thank you for this link.

    I google science to be precise with my comment:
    “Science is the pursuit and application of knowledge and understanding of the natural and social world following a systematic methodology based on evidence. Scientific methodology includes the following: Objective observation: Measurement and data (possibly although not necessarily using mathematics as a tool)”

    If math is changed to tools and technology, I think the next step is people doubting about science (if not already) and this may be how nature corrects itself!
    Evidence based on technology has many holes. One of those holes is unlimited data without controls and making decisions based on this data because the sheer amount of it will be too hard to resist for capital gain!

    Either you want scientific society or technological society because very soon we may not be able to have both.

  4. ‘With socioeconomic, political, and ecological issues impacting people’s health and wellbeing, psychology and psychiatry should be pursuing approaches that maximise human dignity and address the complexities of psychological distress. They should be focussed on the material inequities that underpin poor health, and advocating for approaches that empower communities and their collective, cultural wellbeing.’…I so agree and can I add that it is also time to cease the relentless pursuit of psychopathologcal gene research…mental health disorders are not caused by faulty DNA sequences…great article…onwards 🙂