a similar plot, but if you wanna find out more about that story and everything related to it, go to our website al jazeera dot com. you can see that we've got a whole story there. and of course, other developments that from nasa to get the latest on this launching of a so called suicide spacecraft to kick a potential asteroid. of course, should it be heading to earth. ah, anal reminder of the top stories on al jazeera, at least 33 people have died after their small boats sank while trying to cross the english channel from france. several rubber ding east set off from cali on wednesday in the hope of reaching the you case. southern shores. local officials say this could be the most deadly incident involving migrants and refugees attempting the crossing. this disaster underscores how dangerous it

is to cross the channel in this way. and it also shows how vital it is that we now step up our efforts to break the business model of the gangsters who are sending people to see or in this way. i say to our partners or across the channel. now is the time for us all at to step up to work together to do everything a we can to break these gangs who are literally getting away with murder. 3 white men have been found guilty of murdering omen aubrey who was chased down and shot dead in the georgia neighbourhood. last year, greg mc, michael was found guilty on all charges including malice, murder, his father, travis, was found guilty of felony murder, a 3rd man who joined the chase and filmed the killing william bryan, was also found guilty of felony murder. that they pursued the 25 year old black man who was out joking with their truck or 3 men, claimed that they acted in self defense. they will now face life in prison. a

deadly new wave of corona virus cases continues to sweep through europe. several countries are seeing record, high case counts, and the e. u has made a u turn on the recommended booster shots. the head of the public health agency now says 3rd jobs should be considered for all adults daily cobra related deaths across the you are now at an average of more than 4000. that's nearly double the level 2 months ago. ethiopian prime minister, avi ahmed, says that he's heading to the frontline to lead his troops as fighting between the government and rebels. escalades rebels from t gr i have pushed into the amara and a far regions and down a major road running to the capital at this up. those are the top stories they with us. the scream is coming up next. i'll have more news for you in half an hour. thanks for watching. ah

ah. do you regularly deal with racial aggressions, inappropriate, or demeaning comments or just nasty looks because you're block? well, i am here to help. my name is being i'm an artificial intelligence created by artist rashad, newsome to help the black community deal with the trauma you experience when you're mistreated because of your race that's being helped me kick off today's episode of the stream. we are looking at digital mental health care. that was one example

digital mental health care. looking at the benefits and the potential dangers. if you get your mental health support from online, what would you like to ask? i guess what concerns questions do you have? youtube is right, a for you. it's a difficult conversation to talk about mental, how i promise you it will be a safe space. i guess we'll be very kind to you that say hi to the guests. hannah nicole: some yes, so nice to see you had a please introduce yourself to an international audience. tell them who you while what you do. hi. thank you so much for having me. my name is hen, as even i teach at u. c. berkeley and i have just written the book, the distance cure a history of tele therapy for mit press. good to have you. hello, nicole. introduce yourself to our international audience. hello, i'm nicole martinez martin. i am an assistant professor at stanford center for biomedical ethics. i and my research um, recently has been on others of digital mental health tools and a i. all right,

and thank you very much for having. oh, thank you for making the time and highlighted some. yes, i get to have you here. introduce yourself. try international audience. so great to be here. thank you. i'm so me that they, i'm a psychiatrist and an author and i teach narrative medicine at mount sinai. do you remember some? yeah, the 1st time you saw digital therapy or online therapy, cuz your psychiatrist went, when did you remember a do you remember when you saw that? i do. so it was actually during my own psychiatry residency training when people would come into the clinic and they would tell me, hey, i know i'm seeing you in the office, but i'm also using these other tools to help me in between our appointments. and i found that to be such a fascinating and new thing to be able to see that in the field right in front of me. how to take us back to the very beginning of tele therapy. what was the 1st examples of tele farrah pe? thanks so much for that. starting with sigmund freud and the invention of

psychoanalysis. people have had to make use of all kinds of technology, all kinds of media to meet each other where they are and to receive care. and so every single you know, decade has had its own technology, its own ways of doing mental health care at distance all the way through to the contemporary space of tele therapies, on apps and the pen mac. nicole, we seem to be having this huge beam in, well, anyway, but their mental health apps. why do you think that is? i think i'm the one hand it's because there is this need and that they're at are you know, something around, you know, 55 percent of people in the u. s. for example, of who have mental health issues about who are not able to receive care and the tech industry or, you know, the ability to use that tech to fill that need out. you know, certainly is understandable. and it's an area of great interest. i'm going to play

me, i yet thought the he says like i say, oh no i would just yeah, i would like to add to to what was said, which i think was such a great explanation for that that i think also during the past couple of years we've had this increase need her connection and a lot of lots of connection in so many ways. and so sometimes with these apps can do is also restore that in some way. i and i think i had a go ahead. i'm going to so can guess you just take out no, go ahead. i also think that there's an additional thing here, which is that they're heavily marketed as effective as safe as a good, easy alternative and as cheap or even one. sometimes that's not the case. and it's been really successfully done. so what i'm going to bring in here is josh acoya. he's the founder and ceo of a specific kind of online therapy session. he explains why he did it and what the need is in his part of the wealth. his joshua,

the trigger was abundant mc. i'm the anxiety of b methylated. what it brought, our reason is that andre 1000000 africans, i'll be estimated to live with special the of limited access to middle school. i cannot afford. yeah. but it will chip is inspired world to over easy and affordable arses to lessons. there is 4 africans anyway. and award good will actually amend strength is why i need to reassure as of authenticity said, do life no matter what's on up because picked it up is going to have screening test and you can keep it voice diary. what i learned so far. butte in this is up, we are facing decades of culture are stigma. tony, that sounds like perfection, right? you're on a, in a part of the well, but you don't have access to therapy to even have a, a mental challenge is frowned upon. so why can't an out fill in that gap?

is this the future, you know, i, i think that speaks to such an important and widespread thing that's going on where it's really hard to get help for a mental health. and there can be so many ideas depending on the culture, on the communities where we were raised in the ideas around mental health itself to, to make that appointment. and then she even see if there's a provider and we can make that appointment with so apps and other sources of technology can fill in that gap because i think one thing we've seen again and again and we continue to see is that there is such a need for mental health care, and it's so hard to find that mental health care all across the world kind of thoughts. well, yeah, i mean, just to add on that before the current corona virus pandemic, the w h o already stated that we were indeed in a pan down mac of both anxiety and depression worldwide. and so the question is, what kinds of care can be furnished remotely and how they actually address those gaps? rather than this kind of am creep of more and more proliferation of digital mental

health, where it's not necessarily addressing those gaps. and that's a complicated conversation. i'm, i'm just, i think young i am at. yeah. from that they are what, what i would add to that is that definitely the pandemic i showed, you know, this is celebration into the use of tele, mental health and mental health apps. and, but it also showed was, you know, those kinds of gaps that hannah was talking about, that you can't just, you know, sort of drop these tools in, ah, and expect them to fill a need when there are already, uh, systemic issues such as, you know, how does care get reimbursed, you know, depending on how you are on that. many people now have smartphones, but there may be additional infrastructure needed in order to use the apps effectively, as well as if you do have a therapist who's using the apps. are there a lot of questions about best practices? you know, what, who are these actually best for i, you know,

can they be used for people who have more severe mental health needs as opposed to being best directed towards people with maybe more moderate needs. and so i, you know, that the, this really raised a number of these questions quite sharply when there was this accelerated push, then to a digital mental health. nicole, when does this, i am medical and ethical conversation happen is a, after all the apps are out that no problems or is it before i get out that well that, that's, that's a great question. um that, you know, certainly there have been a number of people raising these ethical issues is for several years, you know, since, since apps have, you know, really been raised as a way of addressing these mental health needs. but i, i think that in the pandemic what it, what it showed was that while the concerns were raised, that a number of them still hadn't been address. certainly data and privacy remain a, you know, i thought any questions about these mental health outs and what uses might be made

of data, especially that people may not be aware of. i'm so for example, an app can collect location data and a number of health inferences can be drawn from that data. and so then there's concerns about, you know, whether there's transparency about that, whether people are aware that they may be trading that data for their mental health care. and these concerns have been raised for a while. and i think part of the trouble is, is that certain areas like regulation. uh huh. that might be useful for addressing them that they're, there really are just a number of other sort of barriers for, for that. hannah, i want you to help me out with some concerns. has some y'all come right like to you recent concerns here that we should really raise and some of our audience on youtube. also raising, i want to start with an a i act called whoa bought. i'm not miss, we're not pronouncing the the are okay. whoa,

as in what ways me know. so going to start with a little a little promo for that. and then i'm going to take you to alex sauntering, who is raising some concerns about mental health care on apps. whoa bought 1st meat. whoa, by the friendly little bot who's ready to listen. 24, sorry. what bots been trained in cognitive behavior therapy and approach to mental health? that is all about identifying distortions and you're thinking what about doesn't do therapy, but it can be your guide to help you figure out things on your own. every day he asks how your day is going, how you're feeling, and what you're up till. he built an emotional model of you over time and can help you see patterns in your mouth. as he learns about to help you to things like useful strategies and practical tools that have been shown to work. most of the technologies are classified as long as tools and has are considered low risk,

like government agencies, as with yankee, n u. s. meaning that developers don't have a duty of care towards their users. here, these are actually vice city guidance on there are seen safety policies and whether data is shared or 3rd parties are the solutions are cheap and scalable. government health care providers can be crashed at the, on his treatment on users and sauls, rather than looking into the fashion of preventative services. policy makers should really look into on demanding more and long term review, ease solutions and assa objective measures in place for the monitoring has gone all users. every single one of i guess and nothing, it's getting to articulate the knows how to use stuff. well, i think there's a lot here, and one thing that we haven't yet addressed is also do they work? right? so there are all of these questions about say they work then. okay, is this a fair trade off in the process of receiving mental health care? but as was just raised, right, whoa, bought is providing

a very specific kind of care. it's not therapy. so 1st of all, it's a sort of mental health tool with a cute robot avatar. but what's behind that? so in the whole, what's called digital mental health space, there are thousands of applications which is already hard enough to navigate. and then only one percent of them have their claims backed by evidence. so that the 1st question and then what is being collected, how is it used? is it being leaked and so on that are other panels can also address some yeah, i will say that one concern that's come up again and again for people whom i've seen is that exact question? what information of mine is going to be shared? how is it going to be used? because not only is that a concern, it's also hard to figure out the answers to those questions. i don't think even the research behind knowing who's sharing what is very clear to obtain. so that's very, very tough. and i think that we're already asking people to give vulnerable

information and put themselves in this position where they're sharing things that may be very hard to talk about. and then there's this big idea around where that information is going. you call before i come to you, i'm going to put something that you choose is talking about right now. call for instance says, what the say these apps, well, why went off with mental health issues? that's a problem with apps anyway. we give them our information, but if we need mental health support, that makes us even more vulnerable, doesn't it? that, that certain nicole so at so i'm going to say no, that certainly does. and, you know, i want to again emphasize that there's 2 layers to that. there's the, the information about your mental health about, you know, your behaviors that you're sharing as part of therapy. there's also the other types of data that can be collected through these apps where, you know, they can be analyzed and inferences drawn from that. and, you know,

that's part of where i was talking about regulation earlier. is that, you know, i think to take a step back is that a lot of ethical obligations like confidentiality, like, you know, having that duty of care that comes from the relationship. that is, you know, between a caregiver and a patient. and that's where, when you drop these tools into that, you don't necessarily have the framework that seems established sense of the relational obligations from which, than, you know, confidentiality, privacy, those duty of care of, you know, what, what you do when this person is at crisis. and, and that's really, you know, sort of where we've been pushed very quickly from the pandemic. and the issue of, you know, what next steps need to be taken? privacy is obviously a big issue with that. regulation in many places is,

is certainly part of what's needed. because of, you know, the sort of lack of established obligations, whether it's companies, you know, whether in some cases it's the algorithms themselves. but in establishing you know, what those duties of care are, who has those ethical obligations, india sort of new new types of relationships that are established using these tools to talk about concerns. but have you seen actual examples of this happening like wheatley worst case scenarios as well? so let's see there's in finland. this came up in a wired magazine article last year that in finland there was a big data hack of a therapy app that did not have sufficient data protection. and there were many instances i, you know, in that case of people being blackmailed with their information. there's also, you know, been a study like a researcher named heart fail, you know,

and the u. s. let us study looking at whether, you know, with mental health apps, whether they were actually following their own data protection guidelines. they put out there and they found out that a significant proportion of the apps were not, in fact, actually doing what they said they were doing and were actually sharing people's personal information with 3rd party apps. and so, you know, definitely there's these examples out there. i want to bring in another voice track conversation. this is linda, michael. she says i colleges and co founder, if a psychotherapy action net, what it made me wonder about how therapies think about this digital progression in that profession. how are they handling it? his linda? it's always been hard for people to find their kids to take their insurance with the panoramic and more people seeking help. it's harder than ever. also,

insurance companies are in business to make money. so they're introducing things that cost less, such as apps, online, self help tools, and even coaching, which is completely unlicensed and unregulated. so again, when more and more people are thinking how insurance companies are steering them towards and license coaches or telling them basically just to figure it out and help themselves, we can and much to do better. people need access to therapist, insight and relationship. and therapists need to be paid fairly. oh, kendrick issued by somebody you helped me out with the call. we have a therapist in your pocket on your cell. no. can you right? is that do you out of a job? and then hannah, regulations, you help me out with regulations. somebody start? sure. so in terms of having that therapist whom you can contact all the time, i think the cornerstone of therapy is that relationship someone has with their

therapist. and so however, however often someone is meeting with that therapist that's forming the framework of their care. and it's very, very hard to have that similar type of framework without having that human connection and to add to it. linda was saying so eloquently, i think that trust is so important and it can take so much time to build that trust with someone. and of course we're talking about the most vulnerable things someone may be experiencing. and so having that trust and not knowing if you can have that trust can be really tricky places for someone to go when they're going to a service to help them with the very top parts of their lives. i absolutely agree with that and it was, you know, and with what linda was saying and at that last piece as well, not just regulation but also the fact of scale is really the central thing here. and so we are living in a moment where the word therapy is losing its meaning, we're wellness is coming over the top of therapy. and so this entire space is it's

very difficult to know what one's getting a, is it a person mediated by an i a phone? that's one thing. is it an app that is using some kind of a self help tool? that's another, is it a game? and all of these other ways of doing care skirt regulation almost entirely, and that just leaves it up to the consumer who is a patient who needs care in the 1st place, which is over have her unfair and incredibly difficult. i am going to use you hannah and nicole somewhere as a resource because we've got so many youtube comments and questions, i can get you to respond very quickly to them. so music says i left a mental health chat app because the walls have been drawn up without use an input . the moderates is treated as like children, and vulnerable uses what saluted for minor things. it was a bruising experience. nicole votes. so, you know, you, you certainly see that,

that goes partly on to what you know, hannah was saying in terms of, you know, you may be going to these apps with a variety of needs and we're using this word therapy. you know very broadly ethan, you know, the therapists are often trained and, and specialized and particular types of conditions. ah, you know, they may have, you know, different different areas of expertise. and so that can be very important and that often isn't necessarily accounted for, ah, you know, in the environment as well as no oversight in terms of, you know, the, the type of chat that, you know, this question comes from where there may be no oversight that that really looks at whether it's a wild west that i handled a question nicole while wasted at it's all right. satellite low is from brewer says which mobile therapy app would you recommend? how do you know which app to use? land on that 2nd half that question. sonya, how do you know which app to use?

so that can be very tricky and i think it depends on what your concerns are and what you would like to get out of the app. now i see the apps primarily as a supplement to that health care. so i would say starting with, what is it that you're concerned? are you having racing box? are you having low mode? are you needing someone to just be in contact with? and i would start there and then try to find apps based on those needs. because there's so many apps out there that claim to do a lot. i'm going to see one most new chief in this comes from joshua korea. you remember him at the beginning, he had that app that he designed because in his region they just didn't have therapy. and there was a lot of guys. and so joshua, thank you for watching the show as well. appreciate you. i'm going to put this one to you, kind of prior to establishing his own app. he tried since telepath telepaths gives me 10 tele therapy apps that they were globally recognized. but he couldn't really connect culturally with the therapist because he had a very different background. hannah, so i think that that's, you know,

unfortunately going to be an increase in common experience when it, especially in the a i space. the idea is a universal patient. and unless you match both what's happening mentally and culturally and socially that universal patient, that is a script that the counter script is running off of. it's not really going to work. and so when we opened with being app, which we did, right, that's a really different approach, right? it's not all about scaling up for corporate profit. and i think that's the kind of space to look at is a way from the corporate tele therapy app that claims to be able to help everyone. it's an impossibility. got one more voice to add to our conversation. so much knowledge alicia, i really appreciate and guess this one is from yasmin bought. who is just saying, ha, the future, the future is what we're experiencing right now is yasmin. years ago, over 80000 individuals, there was only one psychologist present today for 99000 patients is still only one

. psychos is present at the st as i causes we're not going to be able to solve the problem with artificial intelligence. scan, e, i is already 80 percent a grade and disease detection was a 37 percent higher. then human being are side causes. e, i takes only 3 minutes in matching. you are the therapist with the psychologist would take 60 minutes a i a 75 percent cheaper than regular solutions. e, i is available and more than down languages which has the ability to cover for really people across the world. it's reliable, it's cheaper, it has no gender, it has no religion, it has no buyers. it's the future. oh yes, we like that the end that so much debate about yasmina. oh wait, right. no. why is it that for you so much? yeah man. ah, right, he's got he got to thinking but i'm only going to give you guys one sentence. the future of digital mental health pay is what finished the sentence. some ya

is a part of helping mental health be treated with the same complexity and nuance as physical health. a ha, nicole finished a sentence is, is using it as a tool as a part of an existing system, and that needs to be restructured for more equity and access to the future of digital online mental health care. it's watts ada. it's increasing all the problems of current mental health care, but at scale, and we have to be careful that we're addressing them only via the attack. oh my goodness, you guess i've spent so much good time with you so much good information. i wanna audience to find out where you are online. have a look at my laptop. this is hannah and nico and some yeah, i highly recommend you check them out online. thanks for watching. i will see you

next time. take care everybody. ah ah. ah the cubic 19 pandemic has led to a spike in child trafficking across india went to want to even meet those fighting to save honorable children on al jazeera, the latest news, as it breaks it in the brazilian rainforest means these areas are now emitting more carbon dioxide than they're absorbed with detailed coverage country like surely

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with the way that you tell the story isn't what can make a difference. ah hello and barbara are in london. these are the top stories on al jazeera. at least 33 people have died after their small boat sank while trying to cross the english channel from france. several rubber dingey settle from cali on wednesday in the hope of reaching the you case. the southern shores, or local officials say this could be the most deadly incident involving migrants and refugees attempting the crossing. this disaster under schools how dangerous it is to cross the channel in this way. and he also shows how vitally to .