Epistemic inequality in the digital era: Unpacking biases in digital mental health

Abstract

This article examines biases in digital mental health and their impact on technical, social, and political systems. Rising health expenditures and the politics of public health have increased individuals’ responsibility for managing their own health. Global e-health initiatives promise mental health metrics through digital technologies. However, obstacles such as neo-colonial workings of the global economy, embedded biases in technology, and exclusion of psychological therapeutic approaches hinder the digital shift in mental health. This article analyzes the ecosystem of digital mental health technologies, challenging assumptions about psychological normality and algorithmic bias. It explores issues in individualized digital healthcare, cultural biases in psychological assessments, and disciplinary biases in psychology and psychotherapy integrated into digital health tools. By exposing biases and power dynamics, the article emphasizes the need for ethical considerations and offers insights into the potentials and limitations of mental health technologies.