2.6.1 Multi-disciplinary and Participatory Collaboration
The rise of algorithmic technologies has seen computer scientists, engineers and mathematicians increasingly enter healthcare service delivery, research and development. These new entrants may be unaware of the broader politics of mental health and may struggle to engage people with firsthand experience of accessing mental health services.
Some clinical researchers have acknowledged the gap of involving affected populations. For example, clinical psychologist David Mohr and colleagues noted that ‘[w]e have typically not done a good job of getting input from patients about their goals, needs, or preferences’.370 Mohr and colleagues discuss the harm this failure does to the efficacy of technologies that may be validated in research settings but then fail to work in real-world settings:
- Trials often bear little resemblance to clinical settings, having largely emphasized internal validity over real-world issues, such as the technological environment and implementation and sustainment…. Essentially, clinical researchers have designed tools to try to get people to do what we want them to do and how we want them to do it–and then searched for and found people who were interested in or willing to use these tools in our trials. Thus, we should not be surprised that these products and services are not appealing to the general population.371
To address the mismatch between the ‘laboratory’ and real-life, interdisciplinary and applied empirical research is needed, including not just medical researchers, computer scientists, and those involved in service delivery, but also humanities scholars.
Most digital initiatives are concerned with complex social interventions—each occurs in a complex web of formal and informal relationships. Social scientists and humanities scholars are concerned with making sense of the interaction in social, cultural, environmental, economic and political contexts. They can also bring ideas to help guard against persistent reductionist habits in mental health sciences and technological industries,372 including scrutinising claims about what algorithmic and data-driven technology can realistically tell us about people’s inner-lives. Resources from sociology, anthropology, philosophy, and so on, can help determine what role algorithmic and data-driven technologies might play in creating the social conditions that improve relations between people, including acceptance of human diversity and frailty that accounts for extreme mental states and mental health crises, distributes resources appropriately and maximises human flourishing.
- 369 Fjeld et al (n 78) p.31.
- 370 David C Mohr et al, ‘Three Problems With Current Digital Mental Health Research … and Three Things We Can Do About Them’ (2017) 68(5) Psychiatric services (Washington, D.C.) 427.
- 371 Ibid.
- 372 Harrington (n 4)