Mental Health in Your Pocket – Digitization and the Reconfiguration of Mental Health in India

In this research search project, I examine the role and position of digital technologies targeted at people with mental health issues in India. Digital mental health technologies act as “band-aid” solutions for people who struggle to manage their everyday life, helping them to live with stress or overcome mental illness. The designers and programmers of apps and web interfaces for mental health services make multiple assumptions about the contexts or the forms of life in which these aids are put to use. They produce streamlined understanding of health and illness and literally encode the global psyche in these technologies, thus rendering it portable. Building both on studies of Science, Technology, and Society as well as on medical, digital, and design anthropology, I explore the various ways in which the global psyche is encoded in digital mental health technologies, and how this affects care and ethical regimes, expertise, human-techno relations, and habitual behaviour in urban India. I attend both to techno-scientific aspirations of digital innovation in mental health and to critiques of digital surveillance and data security, analysing their local and everyday effects. Fieldwork includes both participant observation and online ethnography with digital mental health start-ups and their users in Bangalore.

Mental health and well-being have emerged as issues of concern and targets of intervention in global health. Simultaneously, the Covid-19 pandemic and the associated disruption of everyday life have not only exacerbated the global mental health crisis but also normalized digital mental health technologies. Digital mental health affords novel ways of knowing, caring for, and controlling individuals and populations. Online counselling interfaces and mental health apps move mental health out of the clinic into everyone’s pockets, while mood-tracking apps and digital phenotyping transform the traces of our everyday lives into potential symptoms of mental pathology. They assemble digital governmentality, entrepreneurial culture, and techno-morality, and they link psychological and IT expertise globally. By stressing self-sufficiency, they depoliticize suffering and sidestep larger structural questions. Interventionists and entrepreneurs celebrate them as innovative technologies that bridge a presumed treatment gap, circumvent stigma, and intervene even in cases in which face-to-face interaction fails. Developers display an obvious techno-optimism in their aspirations to promote well-being by mapping behaviour and caring for users in a dawning digital future, while critics worry about surveillance, control, and technocratic governance.

As extensions of psy regimes, digital mental health technologies enable and are enabled by new forms of human–technology relationships. Through them, novel assemblages of different human and non-human actors with heterogeneous elements and relationships are emerging. These have deep effects on how people think and care about their own and others’ suffering and well-being. Moreover, digital technologies provide care and affective support characterized by continuity and discontinuity with other forms of care in various social contexts. New forms of care and support are characterized simultaneously by disciplining, monitoring, and the agency of users. As an expanded clinic or even counter-clinic, digital mental health technologies integrate psychiatric, psychological, neuroscientific, and spiritual techniques but function outside the clinical setting. Such digital technologies of the self build upon and produce neoliberal self-responsibility, propelling production and consumption.

Scholarship on digital health technologies tends to be divided. While some scholars criticize the new tools as instruments of monitoring and disciplining that tend to control and dehumanize patients, others conjure up utopian images of technology as a means of empowerment, agency, and equity. In this project, I move beyond normative assumption to investigate how people actually put digital mental health technologies to use. What are the political, economic, and moral aspirations that foster the proliferation of such digital tools? Which new forms of care, self-care, and intimacy do they produce, and how are these mediated by prevailing social contexts? What kinds of critique do they spark?