Dreaming big with little therapy devices: automated therapy from India.

Abstract

This paper examines the aspirations, imaginaries and utopias of designers of an AI-based mental health app in India. By looking at automated therapy as both technological fix and sociotechnical object, I ask, What can we learn from engaging with psy technologists' imaginaries and practices of health care futures? What are the assumptions they encode in the app? How does automated therapy reconfigure the geographies and temporalities of care? While automated therapy as instantiated by Wysa provides, I argue, a modest mental health intervention, the scalar aspirations of designers are anything but small. The paper proceeds in three steps. First, it turns to designers' imaginaries of what it means to care for current mental health needs in digitally saturated lifeworlds and how they inscribe them into the app. It identifies nonjudgmental listening, anonymity, acceptance, reframing, and agency as key ideas encoded in Wysa's sociotechnical algorithms, along with a congruence between entrepreneurial and encoded ethics of care. Second, it situates automated therapy within anthropological scholarship on 'little' technical devices in global health to argue that automated therapy devices such as Wysa articulate dreams for minimalist interventions with macro effects. Finally, it explores the new geographies and temporalities of care that automated therapy spurs, tracing the ways the app bridges various spatial and temporal gaps and obstacles of human therapy and upends common global health pathways. This paper contributes to recent scholarship on aspirations, dreams and utopias and on digitization and datafication in global health.