The techno-politics of computing the mind: Opening the black box of digital psychiatry

Abstract

Psychiatry has recently witnessed the launch of digital phenotyping as a new research agenda. According to digital phenotyping’s hypothesis, data about a patient’s daily behavior can be continuously collected through wearable monitoring devices and used to build software that would send warnings of mental relapse or would tailor treatment choices. The research is exploratory, and the claims upon which it is based are contentious. Drawing on interviews, we followed a research team that aspired to build a digital system that could send such warnings to patients with mental health disorders like depression and epilepsy. This enabled us to learn how a new instrument to measure mental function becomes constructed and what translations take place in this process. Here we pay particular attention to the role of patients as research collaborators. We observed the frictions and debates in the research team between different mental health knowledge regimes, seeing them before they were black-boxed and lost from sight. We aimed to understand how actors anticipate software and data analytics to function alongside physicians and patients, as well as how different accounts reconstitute the ‘mental’, ‘therapy’, or the ‘social’ itself. We discuss several ‘dissociations’ that occur along the research trajectory regarding: less motivated and underrepresented patients, the role of clinical knowledge derived from patient self-reporting, and the social, political, and economic aspects of a patient’s life affecting mental health. In this sense, we want to open the black box of this new behavioral technoscience.