Digital Mental Health Technologies
(COVID-19 Blog Series)

By Dr Piers Gooding
Research Fellow, Melbourne Social Equity Institute
Mozilla Fellow 2019-20, Mozilla Foundation

Tuesday 31 March 2020

The Melbourne Social Equity Institute supports collaborative and interdisciplinary research that aims to address disadvantage, marginalisation and disempowerment. During this time of enforced physical distancing, we are exploring new ways of working together to ensure we continue to integrate knowledge and methods from different disciplines in order to address pressing societal problems.

Today we share the first in a series of blog posts that will enable some of the researchers whose work we support to consider their research in the light of responses to COVID-19.  Here, you’ll read some personal reflections on the key concerns for research that aims to assist people who are experiencing social inequities during this global pandemic. We hope that sharing these perspectives will not only spark ideas, but provide more opportunities to collaborate as we respond to current events.

Professor Bernadette McSherry
Foundation Director

My recent work has focused on digital mental health technologies, including online counselling and telehealth options, as well as apps for wellbeing, social connection and other aspects of health.

I suspect that one outcome of the COVID-19 pandemic will be a rapid expansion of these technologies. In Australia, a recent spike in calls to mental health phone services like LifeLine and the Kids HelpLine, reflect a growing sense of anxiety and dread as the virus spreads. Earlier this week, the federal government announced extra funding for mental health and family violence services. Part of this funding will accelerate online infrastructure for delivering mental health and other social services.

This is a good thing—but there are steep dangers. I’m concerned there hasn’t been enough thought given to the rights of the users of these technologies, and the responsibilities of the service providers to respect those rights. My recent work as a Mozilla Fellow (2020) on the law and politics of digital mental health technology suggest there is a long way to go.

Mental health data is incredibly personal, and the current internet ecosystem – for the most part – is designed to vacuum it up and monetise it. Certainly, there are responsible technologists and mental health practitioners who wish to do the right thing. But the scale of the lucrative trade in human tracking makes this incredibly difficult. Consider just two examples:

  • Last year, Privacy International analysed over 136 popular web pages related to depression in Germany, France, and the UK. The authors found that about 98% of the pages contained a third-party element, which enabled targeted advertising from companies like Google, Amazon and Facebook.
  • AI-powered advertising can exploit mental health vulnerabilities on an unprecedented scale, especially in the realm of insurance. In the UK, insurers have reportedly deprived access to life insurance and other kinds of coverage to people with depression and anxiety.

As I work from home and consider the scale of physical, social and economic harm of the pandemic, I’m conscious of the need for quick and decisive action to get support to people in crisis while ensuring safeguards to protect their highly sensitive personal information. As a starting point, efforts must be taken to actively involve those most affected—namely, mental health service users and their representative organisations. Strengthening non-discrimination rules in areas like insurance, employment and migration, will also improve responsible governance.

Another concern is that some online mental health initiatives may unduly medicalise what are normal responses to stressful situations. This tendency can individualise problems that are social in nature. Online initiatives to prevent despair during this time of quarantine might instead encourage local and community connection, mutual aid, social networks and local economic exchange.

Dr Piers Gooding's work focuses on disability law, policy and practice. He is the author of A New Era for Mental Health Law and Policy: Supported Decision-Making and the UN Convention on the Rights of Persons with Disabilities (2017) with Cambridge University Press, and he is on the editorial board of the International Journal for Mental Health and Capacity Law.