March 1, 2021
A psychiatrist offers a blue-sky vision of how smartphone and other data might help with treating mental health concerns from depression to schizophrenia. In Mind Fixers (2019), Anne Harrington cast the history of psychiatry as a series of overzealous efforts to show that if the profession was troubled, "the field's best days lay just over the horizon," whether in the form of 19th-century mental hospitals or the 20th century's surgical treatments, Freudian psychoanalysis, and "biological revolution." Given that unpromising track record, readers may be skeptical of Barron's thesis that digital tools might ease the profession's current ills if only psychiatrists had access to tech like patients' Fitbit stats, social media profiles, and Google search histories ("with their permission of course"). The author, a Scientific American contributor, offers slim, if sometimes-intriguing evidence of the potential uses of such "digital exhaust"--e.g., "Google searches for explicitly suicidal terms were better able to predict completed suicides than conventional self-report measures of suicide risk." Barron also lays out the formidable barriers to tapping such benefits, ranging from patients' fears about how their health data might be exploited to the difficulty of reproducing scientific studies when tech companies are reluctant to share their proprietary codes. Because of the obstacles to much of the research he describes, the author lacks sufficient data to make a convincing case that the "Big Data revolution" in psychiatry will be more successful than the failed "revolutions" described in Mind Fixers and other trenchant critiques. The most interesting parts of this book are Barron's memorable anecdotes, some especially relevant to public health. "During the COVID-19 Pandemic, Google searches for symptoms like 'I can't smell' were almost perfectly correlated with state-level reports of the disease prevalence," he writes. "By pooling one symptom with other common searches," public health officials could follow the emergence of outbreaks. An iffy prescription for how big tech might enable psychiatrists to provide better patient care.
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