Google recently partnered with NAMI: the National Alliance on Mental Illness to create a depression test. NAMI’s chief executive officer Mary Gilbert shared her optimism about the joint venture in a brief statement. Her reference to the PHQ-9 indicates that anyone may respond to a 9-line Patient Health Questionnaire online, thereby indicating the severity of their depressive state in a digital venue known for ease of use but also for privacy-ending attacks. Upon completion of the survey, members of the public are then invited to access NAMI’s website and services in order to seek resolution to their depression. What is not indicated in Gilbert’s statement, though, is whether or not Google is slated to become a significant part of the mental health world. Several important implications would arise with that development.
Patient Confidentiality – Guaranteed or Gone for Survey-takers?
The World Health Organization (WHO) has stated that 350 million people worldwide suffer from depression, a cause for half of the world’s suicides. It remains to be learned if anyone taking that PHQ-9 survey, or anyone who is being treated for depression as a result of doing so, can be exposed by Google. There are multiple means for making that happen. Let’s look at a few of them.
Sophisticated Google searches can expose vulnerable coding to be abused by anyone who wishes to hurt members of the public or specific organizations and industries. Ransom ware threats are only one way to cause such harm. There are others. Devastating consequences can result, particularly to vulnerable people with psychological issues.
Google’s ability to reduce the privacy of Gmail and Google search engine users raises a second issue: the question of public safety from voyeuristic eyes. Google and its offshoot Gmail use algorithms to predict future online user behavior, which advertisements are likely to garner purchases (that prompts their appearance on your monitor), and which URLs to reveal in response to online information searches. Staff members of Dropbox, Uber and Google itself have been found guilty of stealing and abusing such data plus other property.
In today’s digital world, data breaches are common from situations such as Aetna reveals HIV status of customers on envelopes to banking data breaches with credit card and social security numbers revealed for anyone to see. Even Equifax’s credit ratings for millions of people were leaked in early September 2017. Online activity is no guarantee of privacy; it simply poses a large, tempting, easily accessible target to people who want to end someone’s retreat from the sharing of discretionary information. PC magazines have addressed the compromises thus imposed on privacy issues. Private information has become a matter of offline life, though efforts to protect its secrecy have been compromised, too. Improved privacy protections are thus necessary with the NAMI-Google venture into private matters.
So much for sitting at your computer to learn which movie star likes to frequent various restaurants, how many yoga positions are known to cause back pain and how many hurricanes happened in September 2017. Knowing that anyone can find out what you looked for is a reality to adapt to or for tweaking your ad blocker and cookie collector. Your PC technician already knows which porn sites you watch; a quick study of your Internet history shows the information. Mental health patient records are in a different category altogether, not for casual observation.
Mental health patient records are allegedly protected by confidentiality laws, as are all health care records. Without those guarantees in place, many people would not feel safe accessing healthcare resources of any kind. They might be motivated to avoid public exposure, shaming, or problems with insurance rates, and thus refrain from accessing any form of mental health care whether online or in real life. As NAMI or other mental health records interact with Google, clients seeking therapy might refrain from the possibilities of having their privacy constrained. The advent of such concerns calls for improved privacy protections.
Though a significant number of digital media users have willingly surrendered their privacy with social media messages that resemble online diaries, people seeking mental health help are not necessarily among them.
The Past Proceeds to the Future
Indications that Google would become a part of the mental health treatment world first arose in September 2015. The prestigious PubMed site and organization summarized the development in one succinct paragraph within a February 2016 Tech giants enter mental health notice:
In September 2015, the Director of the National Institute of Mental Health (NIMH), T. Insel, announced his departure from the NIMH to lead Google’s Life Sciences Mental Health Division. His decision attracted global attention. Interestingly for the field of mental health, Google intends to only back innovations expected to be ten times (“10x”) better than competitors. Indeed, mental health care and research are beset with myriad challenges that may be better tackled using the informatic capacity that tech giants can leverage.
NAMI seems poised to make Google an influential part of the online mental health world. If patient privacy ends in the public sphere because of that development, consequent mental health risks and outcomes could prove to be a suicidal gamble.
When medical and/or mental health professionals consider privacy-compromising Google a reasonable member of their profession, it might be safer for patients/clients to turn to offline surveys and practitioners for reasons of personal safety and confidentiality until online privacy is better protected.