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A safe space where one feels emotionally connected and heard without judgment is usually with another person. Can a robot make you feel the same? Predicting human behaviour is no more restricted to mental health professionals, it is increasingly being simulated as an AI (artificial intelligence) function too. After the humongous success of internet-based applications, we have entered the phase of attempting emotional connections with AI! In a world where we talk about the digital divide, we are finding comfort in willingly pouring our hearts out to an AI-generated bot. As per John McCarthy, artificial intelligence is the science and engineering of making intelligent machines, especially intelligent computer programs. It is related to the similar task of using computers to understand human intelligence. In the realm of mental healthcare, synthetic intelligence takes to interfaces: chatbots and robots.

Pragya Lodha, the curator of this edition

As we traverse the apps of artificial intelligence for mental health, some of the oft-encountered computerese will be that of machine learning (ML), deep learning, natural language processing (NLP) and computer vision. For the tech buzz, IBM clarifies these definitions in a foundational way. In tandem to mental healthcare, machine learning and deep learning have enabled chatbots to diagnose better and predict patient outcomes; computer vision makes understanding the non-verbal cues possible and NLP can simulate human conversations- does that mean that the AI could be your therapist very soon?

A simplified explanation of artificial intelligence can be found here.

In 1950, Alan Turing asked, ‘Can machines think?’ and today, in 2023, we can affirmatively answer this question with confidence. The Turing Test was curated for a human interrogator to attempt to distinguish between a computer and human text response; and it is a cinch to get through with AI nowadays! Is this scary or should we see this as triumphant? What does this have to offer for mental health, especially, in times when we need much more emotional support as the mental health burden on the rise, in consequence to the global pandemic?

Since the 1960s, scientists and researchers have been attempting to advance and enrich the quality of chatbots, powered by AI and ML, to function as psychotherapists. From ELIZA to ChatGPT, the journey has been towards sophistication of the chatbot, better in-built knowledge, cost effectiveness, quicker access and persistent efforts to make the bot mimic as emphatically as the human therapist! Predominantly, AI applications for mental health care are circumscribed to countries that have digitized systems of working, though, mental health apps are ubiquitously accessible across the globe. In its current form, artificial intelligence is being used to perform several tasks within the mental health treatment realm- NLP enables to transcript the conversations between therapists and clients to maintain quality control over therapists; AI can also keep a track of how much conversation during therapy was constructive versus chit-chat; machine learning and deep learning allow for doctors to personalize treatments, make more precise diagnoses, choose the right treatment framework and also identify variants in diagnostic formulations; and that AI can help validate to choose therapy, for example, cognitive behavioural therapy / CBT conversations, before medication for cases of mild depression and anxiety.

Reckoning, there are chatbots such as Wysa, Woebot, Cogniant and many others that are adept at simulating the cognitive behavioural therapy techniques and procedures to provide mental health support for its users. Chatbots are being viewed to advantageously improve efficiency, affordability, convenience, and patient-driven access with an implicit assumption that this will improve health equity and social inclusion. With more than 20k mental health apps in existence (as of 2021), more people are downloading the apps and pushing the keyboards to talk with chatbots. Thus, with the possible aforementioned functions of AI, there is a huge prospect of destigmatising mental health care. A global survey of workforce employees revealed that 82% people wanted to talk to a robot over a manager about their depression and anxiety. Now this may be promising in times when there is increased need of mental health support, feeling non-judgmental while sharing vulnerabilities with a non-human, sparsely available professionals and long-waiting hours with existing professionals- AI may be emulating a pocket therapist!

However, it is not as straightforward and easy as there are several challenges that come along. Time and again, psychologists and researchers accentuate the fact that robots cannot replace human therapists for several reasons: research is still on-going on the efficacy of robot-delivered therapy; confidentiality and privacy are called into question; issues pertain to poor social and cultural inclusion; and that bots will not be able to empathize like humans till they can only simulate empathy. Though AI has brought a whirlwind of changes in the mental health field, the success quotient is far from conclusive. The trickier concern with AI raises the question that if it can embody consciousness, can an AI assisted robot then be diagnosed with a mental illness too? This is a question of ensuring philosophical inquiry and scientific research.

Human therapists are not just empathetic but also have the superpower to co-regulate, pick up nuanced non-verbal signs and are adept at using humour. We are yet to testify if people would respond just as effectively to a robo-therapist. As an eclectic practitioner, I await to see the day when robots are able to adapt to this approach, fulfilling the diverse needs of clientele in psychotherapeutic practice. Artificial intelligence is changing the world but it is not a substitute for human intelligence, it is a tool to amplify human creativity and ingenuity. If you are befuddled with what to do with AI, just one thing to bear in mind is that to be able to benefit from AI, like any other technology, is to know its merits and demerits along with its judicious use with the right know-how. What and how much is judicious, is a matter of individual choice and comfort. We will not know better unless we try it, and only if we want to!

CW: Mention of the COVID-19 pandemic

Shreyasi smiling at the camera in a red dress amidst greenery — Curator Shreyasi Tripathi

All my friends are sad and bright by Cameron-Awkward Rich (excerpt)

I think door & there is. Open & here’s a room

where everything you’ve lost is washed ashore.

We’ve seen the news. We know the story.

How even our bodies hurt us sometimes

so much. Room of broken mirrors. Room of salt.

Room of marigolds & it’s your party, baby

here’s a crown, here’s a gown & no man

just around the corner, all your eyes on you.(find the rest of this poem here)

In 2020, when it still felt like the pandemic could end without obliteration of the world as we know it – I described my loneliness to a group of 20-something One Future Fellows. I believed loneliness was my life’s work. “the broadest of my purposes” I called it & why shouldn’t it have been? I have spent a very large portion of my life with it.

Born a woman, in India, at a time when we are made to feel that women must pay for equal opportunities in perfection. That they must hold the top of their class, while co-parenting their siblings, learning to become adequately skilled, socialising, and doing chores, while being grateful for the chance to do it at all. I, like most women of my generation, have shaped my life in the quest of attaining the impossible.

Olivia Laing, in the first book (The Lonely City) that gave me language for what I have felt my whole life has said: “loneliness doesn’t necessarily require physical solitude, but rather an absence or paucity of connection, closeness, kinship: an inability, for one reason or another, to find as much intimacy as is desired.” The binaries the world tries to divide us into do not allow for the wholeness of a person to be seen and experienced by those around them. Parts of me that were deemed not-good by those around me – boisterous, queer, neurodivergent, opinionated, likely to say no – were tucked in the ponytail I made for school. (because bad girls have unruly hair). (more on this in the AMA section)

With time, I had to learn to stretch a hand out to the world that said: I am open for the business of belonging. I had to learn to become serious about connection – seeking it, finding it, nurturing it. In any way possible. The smallest steps were to grow plants! to befriend neighborhood cats & crows & dogs & peacocks – all of whom now recognise me (though they choose to ignore me often). I tried Bumble friends. I started a book club. I started attending group activity classes. I walked up to people at parties and started conversations. I really listened. I tried to remember. Little by little, others remembered me too. They saw me – my entire self, if only for a few hours once a few weeks. The biggest risk here was rejection. My plants could die. The cats could (did) scratch me and run away. People I walked up to rolled their eyes. I often said the wrong thing & ended up losing a lot of plants, books, and flowers in the process (my love language is gift-giving). I also received books. I received postcards that read like they knew their intended audience. All this shrunk my pie of loneliness. Once loneliness became less omnipresent, more space was created for me to occupy.

My occupying space created more opportunity for others to.

Chosen Family by Rachel Eliza Griffith (excerpt)

When you find your people you’ll still look over your shoulder sometimes

to see if you’re being followed. You’re hoping one or two people you don’t

know will want to see where you’re going. When you find your people

they won’t ask you where you came from because they’ll already know

& if they don’t they’ll be busy putting good food on your plate & asking you

if you’re hungry or broke. When you find your people they’ll tell you

to use any bathroom you want, marry anybody you want, work side-by-side

together for long hours in close quarters without any fear of being harmed…(find the rest of the poem here)

Who you invite in your community is a vital source of perspective and holds immense political power. Practically and in matters of the heart: who you know affects where you go. When our political powers fail to care for us, it is our communities that come to our rescue such as during the COVID-19 pandemic. It was only through mutual aid that my family, and so many families like mine survived that time.

A chosen family is a group of individuals who deliberately choose one another to play significant roles in each other’s lives and is essential for queer folks to thrive. When most people think of a family, they think of parents, marriage, siblings and children—a lot of these shun or are inaccessible to queer individuals in large parts of the world. This remains true for any of us whose families are sites of exclusion and, therefore, loneliness. This is where our communities step in. In light of social injustice, it is communities choosing to step up that can, if at all, protect the democratic principles.

Our social networks can sustain us, or tear us apart. Nicholas Christakis, a professor at Yale, wrote about the power of Social Networks in his book ‘Connected: How your friends’ friends’ friends affect everything you think and do’. With decades of data, he proved that emotions live in clusters of our social networks. My actions and emotions will affect those of my friend’s friend’s friend & theirs will affect me. We must put effort in social networks, study them, nurture them just as we do a family, or a romantic relationship. When Emily Dickinson died, it was her friend Mabel Loomis Todd who collected, edited, and made sense of all of her handwritten works. The only reason we know of Dickinson is because she cultivated friendships with just as much care as she did her poems.

An image of children dancing as an elephant plods along. — Source: Soyeon Kim from Wild Ideas

Our world is designed to hole us up in nuclear families, isolating LED-lit cubicles, sad cab rides with the rain pattering down, not even knowing the name of the person who brings up home. The neoliberal world is full of messaging to go at it alone! you can do it all, if you try hard enough! The thing is – you don’t have to. You can ask your friends! & since kindergarten, hasn’t the world been shinier & gigglier when we have a friend to share it with? Why not choose the giggles?

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An antidote to loneliness | One Future Post