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Posted on Monday 2 November 2015


GIZMODO
by Annalee Newitz
10/27/15

Google’s parent company Alphabet has just hired Thomas Insel, the former head of the National Institute of Mental Health, who has some pretty weird ideas about what his new job will entail. Insel told a crowd at Chicago Ideas Week that he still isn’t sure what Alphabet wants him to do. But then he explained what he’d like to be doing, which is using Google’s data-mining tools to research mental health at time when suicides in the US are on the rise. Insel told Fusion’s Casey Tolan:
    We’re not seeing any reduction in mortality in terms of suicide because we’re not giving people the care that they need. We would never allow this to happen for cancer, for heart disease, for diabetes.
So how would we reduce suicides, using technology? Insel says that he’d like to develop a wearable sensor to measure mood, cognition and anxiety. This device would track “sleep, movement” and even “language use” for red flags that could indicate mental health problems. Basically, he suggests, it would be a kind of FitBit for your moods and sanity levels.

But there are a lot of problems with this idea. Unlike a fitness tracker, which keeps tabs your physical activity and heart rate, Insel’s mood tracker would try to correlate your physical state with a possible mental state. And that’s where things get dicey, because not everyone experiences stress in the same way. For example, I recently bought the Spire, a wearable that does some of the mood tracking that Insel suggests his device would: it monitors heart rate and breathing, and then tells you whether you’re “focused” or “anxious” or “active.”

But the Spire didn’t accurately read my moods, despite its accurate readings of my physical state. At one point while wearing the Spire, I had to do something that made me anxious. Despite my stress, the Spire claimed I was “focused”–most likely because I was forcing myself to concentrate and breathe slowly. My mental state did not match my physical one.

And that’s a relatively benign example. If we’re going to be judging people’s mental health based on things like heart rate, sleep patterns, breathing, and word choices, there are all kinds of confounding factors that might make a person seem stressed when they are just excited, or feeling awkward or jetlagged. And vice versa. None of this would be a big deal, however, if it weren’t for the fact that Insel wants to use these wearables to intervene in people’s mental health.

It’s easy to see why Insel would want to use Google’s infrastructure to do this. Suicide rates are up in the US, and studies show that early intervention can save lives. Often people who are depressed will withdraw from the world, isolating themselves from help until it’s too late. In that situation, a tracker that could alert health authorities when somebody is depressed might help. Just wear your device – or something more futuristic, like a skin circuit–save your data to the cloud, and any aberrant readings will be analyzed and sent to a mental health professional.

Except, of course, you’re now sharing a lot of hard-to-interpret health data with … whom? Your company’s psychologist? Your local health department? A doctor chosen from your insurance network? Then there’s the question of what healthcare workers will do when they believe you’re not in an optimal mental state. One can easily imagine a message popping up on some poor desk jockey’s monitor: “You’re not in the right mood today. Please take a day of unpaid leave.” Or, worse: “We’ve detected signs of mental instability, based on how you’ve been talking and sleeping. Please report to a doctor immediately.”

This is all made so much worse when you consider the kinds of specious correlations that Insel has already worked on in his previous job as a research neuroscientist at Emory University. There, he tried to show a correlation between genes, hormones, and a predilection for infidelity. I shouldn’t need to spell out how many problems there are with trying to find a physiological measure for something like “fidelity,” which is an idea that comes from culture in humans, and is interpreted in wildly different ways across social groups.
The fact is, we don’t have a technology that can accurately measure emotional turmoil. We have tech that can offer hints, certainly. There are predictable patterns to mental illness, but they aren’t universal. The idea of a mental health monitor whose data is being analyzed by algorithms should make us wary.

Insel wants to prevent people from suffering when they experience mental illness, which is a worthy goal. But his ideas about how to do it may cause more harm than good.
  1.  
    Bernard Carroll
    November 2, 2015 | 3:02 PM
     

    As I was saying

  2.  
    Catalyzt
    November 2, 2015 | 6:34 PM
     

    I think the idea of a smartphone or fitbit-style app for mental health is an incredible idea.

    By that, I don’t mean that I think it’s a good idea, I mean ‘incredible’ in the sense of impossible to believe. There’s an important distinction between an idea that’s simply bad and one that’s terrible; the latter has a certain majesty to it, like the worst heavy metal songs or most puerile television programs. A really terrible idea has a certain gravitas, a portentous quality that’s almost humbling. It inspires one to think, “No. This cannot really be happening. Someone didn’t really say that out loud, or put that in print.”

    There are ideas that one thinks of, chuckles at, and promptly forgets… and then there are ideas like this, which make me want to drop to my knees and pray that our planet will be invaded by some benevolent higher life form that will chuckle at our folly and provide some words of gentle reassurance. “Oh, but of course!” They will say. “Your species is simply going through the Technological and Economic Obsession Phase. It’s not at all surprising that you would believe, at this point in your development, that there would be some empirical biological signature for mood and mental status that could be accurately measured with some instrumentality, or that someone would try to monetize that information. We got through that phase without annihilating ourselves, so do most sentient races in the galaxy. Here are a few textbooks in logic and biology we’ve translated into a few of your languages, just read these and everything will turn out right in a few centuries or so.”

    Also: Very much enjoyed Dr. Carroll’s blog posts— the metaphysical matrix, 16th century astronomy, etc. Interesting that the University of Chicago is somehow mixed up in all this. I’m sure it’s a fine school, but I’ve always thought of their economic theory as raving crackpottery, not that I presume to any expertise in such things.

  3.  
    November 2, 2015 | 9:12 PM
     

    Catalyzt,

    Brilliant prose!

  4.  
    felonious grammar
    November 3, 2015 | 12:08 PM
     

    Amazing how subtle mental illness has become. If a person is experiencing measures correlated with high stress, but is getting on with their day like there’s nothing wrong, should that person worry? Your affect could be a tad too much, or too little. You might have strange thoughts, for instance, you might think that your moods are being monitored remotely and that you are, at every juncture, being evaluated according to a range of measures of your breathi— no wait, that’s just crazy.

  5.  
    James O'Brien, M.D.
    November 3, 2015 | 12:35 PM
     

    Google and Facebook and Instagram and Twitter came to power when people were more exhibitionistic than wise. We slouched into an Orwellian world not only without a fight but gleefully.

    It’s kind of interesting that physicians are constantly worried about 50K HIPPA fines for a stolen laptop but that Anthem kind of skated on its massive data breach.

    Big data concerns me 1000x more than big pharma. The scariest part is that most people aren’t concerned but eating up the bread and circuses.

  6.  
    diane
    November 3, 2015 | 3:48 PM
     

    Because about 10 or so billionaire tech moguls, utterly disconnected from the realities most live under, fervently search for immortality, the rest of us are increasingly being subjected to twenty four/seven mental and bodily surveillance to determine whether we are ‘flawed.’

    This is utter and horrid insanity.

    The epidemic in suicides has near everything to do with financial and human (versus bot) support safety nets being pulled from underneath people’s feet – and the ongoing attempts to create a Soldier Class who can never escape that caste system – and nothing, at least initially, to do with biology.

    As a breast cancer patient, I find myself unwilling to pursue many issues for the simple fact that 24/7 slightest imperfection searching can be physically and psychically deadly and have one both crippled, and living in a cardboard box, under a bridge. I’ve faired better than many others with breast cancer, following those instincts but I resent not being able to discuss them.

    And yes, after that horrid DSM 5 manual, everyone and their mother auto suggested I be treated as if I were mentally ill, as if the huge tumor weren’t bad enough; which delightfully arrived while uninsured, right after I somehow lost the vocation I worked so hard at because I was considered over the hill, and tossed under a Google Bus, over a decade from retirement age, in Google’s [Facebook’s, Twitter’s, etcetera] own, Silicon Valley.

  7.  
    Tom
    November 3, 2015 | 7:59 PM
     

    Ah, I look forward to the day when my FitBit can detect and destroy a psychic scud launch from my unconscious, a psychological missile capped with a long disavowed and repressed impulse, which otherwise would overwhelm my Star Wars defensive shield and penetrate my ego space, BEFORE signal anxiety comes into my awareness. I shall enjoy the freedom from anxiety such an Inselian Brave New World promises!

  8.  
    James O'Brien, M.D.
    November 4, 2015 | 10:27 AM
     

    “Democracies will change their nature; the quaint old forms—elections, parliaments, Supreme Courts and all the rest—will remain. The underlying substance will be a new kind of non-violent totalitarianism. All the traditional names, all the hallowed slogans will remain exactly what they were in the good old days. Democracy and freedom will be the theme of every broadcast and editorial—but Democracy and freedom in a strictly Pickwickian sense. Meanwhile the ruling oligarchy and its highly trained elite of soldiers, policemen, thought-manufacturers and mind-manipulators will quietly run the show as they see fit.”

    – Aldous Huxley, Brave New World Revisited, published 1958

  9.  
    James O'Brien, M.D.
    November 4, 2015 | 6:11 PM
     

    So what’s his idea about what to do if these suicidal persons are identified? We know from the NNT/NNH data that SSRIs for that problem are pushing on a string.

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