Protecting the Privacy of Mental Health Data

The paranoia of everyday life

Read this article in the Indiana Daily Student here….

When speaking about the rights of an individual to his/her personal information, it’s easy to overlook the “personal” nature of mental health data. And, within the rhetoric of mental health, we spend a lot of time expressing the behavior, feelings and thoughts of those who suffer from mental illness, but we forget about the a deeper issue: who should know about it?

How much can more data actually help us? With so much information about ourselves, it’s easy to be misguided. Some, like Jesse Singal of NYMag’s “Science of Us,” have decried the calls of certain mental health issues at universities  tremendously serious, yet suffering from confirmation bias or similar statistical fallacies. [6] If anything, we might just well be overwhelmed by how much we know about ourselves scientifically that we forget the humanistic aspect of ourselves. Basic science research in psychiatry hasn’t reached the goals it has claimed to make over the past few decades. Will turning to the social sphere, like Insel suggests, do any better?

As science and medicine call for greater access to information for the purpose of research and clinical treatment, privacy becomes an issue. When we collect information from an individual, whether it’s a medical record from a hospital or a meeting with a school therapist, we have to protect his or her rights. How can we make sure data doesn’t fall into the wrong hands? What if a scientist’s data is used without permission or for unintended purposes?

“But we would want you and your family members…to take part because we want to have that information…And that’s obviously also going to be very sensitive but very important because it’s such a problem in this country.” – Francis Collins[7]


Mental Illness as a Language


Read this article in the Indiana Daily Student here….

Mental health is an increasingly important issue. The World Health Organization estimates mental disorders will have become the world’s largest cause of death and disability by 2020. [3] Alongside this, we’ve put forth tremendous effort to understand our mental health from a scientific point-of-view. Our post-Enlightenment positivist view of scientific happiness has exponentially grown in accuracy. Though we’ve been doing this since the eighteenth century, in recent years, we’ve become more and more observant and critical of how our minds truly function in the scary world. All of our actions, behaviors, and moods can be measured down to a very fundamental level. But these efforts ignore the socio-political and cultural tendencies that have driven mental health over the centuries. In spite of this, it’s no wonder mental illness is on the rise.

Still, some criticize the field of psychiatry for being scientifically backwards. But far more insidious is the cultural deafness. Many of us have forgotten the role culture plays in mental health because we have tried to only use science to explain mental health.[1] However, our knowledge of the brain is is still very far from explaining mental disorders. We should remember the symptoms of mental illnesses are, not only scientific issues, but also a language through which we express ourselves. And we need to understand our culture and history to figure out what our distressed unconscious tries to tell us.[1] Maybe mental illness is not a “harmful defect we shun” and more a way we understand who we are. Seen this way, the mental issues we face are less of “biological flaws” and more of ways we express ourselves in society.

Speaking of the 21st century, our anxieties and insecurities are probably more philosophically and existentially grounded than we like to think. Many of us struggle with the postmodern irony and individualism that simultaneously shuns tradition while embracing conformity. Some of us call ourselves “introverts” as a form of self-identification to internalize some of our behaviors as “natural” or “acceptable.” We look at all the other amazing introverts and find some sense of belonging. But labeling ourselves just covers up who we really are. Others among us chase ideas and culture in hopes that we can find something unique about ourselves, that separates us from other people, but we’re only sharing the same social assumptions about what defines us.

The same way culture fashions us to understand aesthetics, value, ethics, and other humanistic qualities, our struggles with the emotions of mental illness could be the way our bodies understand the world. Einstein himself found solace, not only in science and art, but in the philosophical work of Schopenhauer, as he wrote on Planck’s 60th birthday:[4]

To begin with, I believe with Schopenhauer that one of the strongest motives that leads men to art and science is escape from everyday life with its painful crudity and hopeless dreariness, from the fetters of one’s own ever shifting desires. A finely tempered nature longs to escape from personal life into the world of objective perception and thought; this desire may be compared with the townsman’s irresistible longing to escape from his noisy, cramped surroundings into the silence of high mountains, where the eye ranges freely through the still, pure air and fondly traces out the restful contours apparently built for eternity.

Maybe our searches for “objectivity” of understanding mental illness are caused by these similar desires that motivate scientist. In this sense, our mental health is the way we search for meaning and satisfaction in the world.

All the world’s a stage, And all the mentally ill merely players.


De-Stigmatizing Mental Illness: An Inquiry into Depression

‘Nature vs. Nurture’ vs. ‘Nature and Nature’

Here at IU, we have a lot of campaigns directed towards the de-stigmatization of mental illness. Last year, the Hutton Honors College hosted a discussion about issues with Autism in Pop Culture. Though the discussion mostly consisted of sharing personal stories of those with the disease and speaking of our desire to let them know that it is okay to have it, there wasn’t much critical thought put into the assumptions upon which our views toward mental health are built. We were too intimate with a desire to accept one another for who we are that we didn’t try to understand what autism, or any disease, really is.

As a science enthusiast, I believe it’s important for us to realize how our biological frameworks of disease affect the stigma of mental illness. One might adopt a view of mental illness in which everyone (not just those who suffer from mental illnesses) has different genetic mutations, and some of those mutations are caused by diseases. With this in mind, despite the way biology affects who we are, everyone still has responsibility, personhood, goodwill, etc. This will reduce stigma as we understand disease as something that does not detract from who we are, but, rather, something “natural” that comes about through the same biological processes that make up everyone. These mutations may have affects on proteins, cells, etc., and give rise to various phenomena., etc. At first glance, it seems as though this mentality would reduce stigma of mental disease. But how effective is it?

A recent article in the Hedgehog Review suggested that emphasizing biological roots of disease actually causes us to view mental illness more negatively:

Over the past two decades, both the general public and patients themselves—historically quite resistant to disease models of emotional and psychological problems—have become relatively more biologically minded. This change correlates with an increased endorsement of seeking professional help and using prescription medicine, as well as some reduction in attributions of blame: three of the central goals of the public anti-stigma campaigns (and pharmaceutical advertising). The change, however, also correlates with more intensely negative attitudes toward those with mental health problems, attitudes that are shared even by sufferers themselves.

Joseph E. Davis explains that a “trade-off” between responsibility and medical roots causes this negative attitude. I believe the issue is that there is a misconception that the existence of a disease/illness creates a trade-off between nature and nurture, when, in reality, the disease/illness do not detract an individual’s rational ability to make decisions for him/herself. It only means that a person’s ability to make decisions and his/her personhood are now in a different “context,” and that the person still has the same control over what he/she chooses to do. “Nature vs. Nurture” implies a tug-of-war between which the existence of forces on one side diminishes the other, so it might be better for us to adopt a more accurate phrase: “Nature and Nurture.”

A Different Kind of Disease?

Is mental illness really as “natural” as other types of diseases? Mental illness not only affects our physical body (most notably through neurological changes), but affects the very way we think. Through our inquiry into mental health, we must approach disease with a critical look at morals, values, and humanism in what we do. This separates mental diseases from others, and, for this reason, we might be inclined to view them as, frankly, different kinds of diseases.

Depression, a common disease of the mind, has been seen as both a mark of honor and as a stain of shame, with ethical challenges to both viewpoints. Freud noticed that the melancholic “has a keener eye for the truth than other people who are not melancholic. When in his heightened self-criticism…, it may be…that he has come pretty near to understanding himself.” The romantic genius burdened by age-old questions of existence and the unsocial artist obsessed in his craft may both be seen as filled with woe in light of their gifts. Isaac Newton, David Foster Wallace, and Montaigne have battled with feelings and perceptions inherent to depression, yet we still highly regard their mentalities as though they were heroes. Maybe depression is a different kind of disease in the sense that we may sometimes glorify it? Despite any intellectual value, our society still generally sees depression as something that should be abolished as we have put forth tremendous amounts of effort to help people overcome depression. But positing depression as something that should fight may conflict with our belief that it is “okay to have depression.” More generally, our motives of de-stigmatization vs. treatment are often at ends with one another. Simultaneously, we should also be skeptical of the way we glorify the melancholy as those who are truly in-tune with the harsh reality of the world. The way I see it, it’s very dangerous to view depression as “accept yourself the way you are because that’s what you are.” Though we want more people to realize the reality of depression, image and stigma of depression are still too harsh for us to use depression as our identities. And these challenges in our approach to the disease are similar to be found in any mental disease.

Is Mental Illness at odds with Reason?

We are in love with our ability to think rationally. We want to accept ourselves as creatures most closely defined by reason, and we closely associate our argumentation, rhetoric, and similar abilities with our identities. But how does mental health affect this identification? Kant would say depression is “the weakness of abandoning ourselves to morbid feelings,” and, since, according to Kant, this detracts us from our ability to reason, it means that Kant would have viewed depression as something connected to reason. This might explain why, despite our anti-stigma campaigns, it is difficult for us to swallow the idea that mental illnesses are just like other diseases. One might argue that, as a result of this account, we ironically have identified, not as masters of reason, but slaves to it.

Depression is not an emotion like other emotions, and, if one believes emotions are adversarial to reason, depression might just be the manifestation of undesirable thoughts that result from pushing reason to the extreme. But one might, in addition, declare that depression should still be avoided at all costs as, while it might not be a weakness in and of itself, its potential to create further weaknesses makes it too unreliable as a means of reasoning. This may compromise our view as depression as a beneficial, acceptable characteristic while avoiding the consequences of blindly praising it. 

And, though there may be similarities between depression and other mental disorders, it would be an oversimplification to paint the entire category of mental illness with a broad brush. Rather, we should embrace a more nuanced approach to different types of mental health issues with science, philosophy, and humanism leading the way. 

The Eclectic Lunatic: At The Crossroads of Knowledge

The other day I had the wonderful opportunity to meet up with a high school friend. Through our conversation, we serendipitously wandered through topics of Nietzsche, statistical inaccuracies in peer-reviewed literature, ethnography, and much more that we had both studied. It was only speculation of both of our limited backgrounds, though. Neither of us intended to claim expertise on any of the subjects nor could reliably do justice to all of the topics we mentioned, but would enjoyed to muse about little things we had read here and there. Particularly, she was very interested in my academic background of physics and philosophy.

On a purely anecdotal level, I’ve already met plenty of students with studying disparate fields. Combinations like biology and art history, mathematics and philosophy, theatre and literature, and neuroscience and gender studies are just a few examples of degree programs of students only satisfied in intellectual diversity. These paths of disparate majors might have unexplored value, as well. We are already seeing more humanities majors entering medical school, and a students have perceived greater gains when studying seemingly unrelated fields.

“A man cannot serve two masters.”

Here at IU, many of my friends enter college with a lot of AP credits or exemption from certain classes. Some of us take advantage of this space to broaden our horizons or explore completely new fields of study. It’s also easy to find several course offerings that do not lie in a strict single “field,” and, instead, may invite knowledge from various areas (for example, the History and Philosophy of Science, Bioethics, Medieval Philosophy, etc). While I highly recommend pursuing academic excellence in disparate fields, I’m a bit more skeptical of the value of these interdisciplinary courses. They may compromise value from multiple fields for the sake of explaining a one-size-fits-all course that fails to do justice to any single field. It is better to understand how to approach problems from different points-of-view through specialized training of those different fields. Since we are at a university campus with monumental levels of diversity of course offerings, it makes sense that many of us choose to study subjects that may seem unrelated. But is our love of disparate disciplines only caused by having the luxury of being able to explore them? Or is it the result of something else?

Getting the best of both worlds meant everyday was something different for me. Sometimes I would be enamored by phase-space diagrams and other days it would be a classical dialogue. As the nights would linger on, I would spend each moment poring through the infinite of my laptop in a constant cycle between physics, philosophy, and probably something important. Sometimes my attention would become so I can hardly keep focus on a single thought for more than a few minutes at a time. I can’t help but wonder if our obsession with disparate fields is at least partly caused by an inundation of new, varied information everyday. But even before the advent of smartphones and personal computers, the unpredictable yet exciting problems of the 20th and 21st century have called for a certain intellectual flexibility that cannot be approached through simple, straightforward training programs anymore. The way we explore multiple fields might have value in the way we create a liberal arts education.

The type of undying curiosity and ambition hearkens back to the days of da Vinci and Michelangelo. Back to the days when engineers crafted sculptures, musicians wrote books, and philosophers had jobs. The University of Southern California created the program, “Renaissance Scholars” specifically for students who have studied disparate fields. One of my previous philosophy professors wasn’t too fond of the title “Renaissance Scholars.” “The Renaissance is over,” he declared. The Renaissance may be over, but let’s hope our re-birth of disparate knowledge never ends.