dig out, one of the world's most sought after minerals, but they only see a tiny fraction of its profit. malcolm web al jazeera, co wavy democratic republic of congo. finally, it is the thanksgiving holiday in the us today in the annual parade in new york has returned with all the trimmings which the pandemic had posted to abandon the live pictures here from the streets of new york, packed with people and balloons and floats. and marching bands and home instead of everything an event that stretches 4 kilometers through the island of manhattan. ah, right, this is out there and these are the headlines then we have obtained satellite images showing the united arab emirates is providing military support to the european army . the investigation revealed to you a hired to private companies from europe to run military flights into e c. o,

p in sudan rallies, have been held to honor those chills during protest against the military take over last month. demonstrations took place in the capital cartoon, and in other parts of the country. marking the of commemorating issues, at least the 41 people who were killed in the violence at least 27 refugees and migrants heading for britain have drowned off their boat, sank in the english channel. the cali. it is the worst disaster in the channel since the us international organization for migration started keeping record 70 years ago. french and british, they did say they need to step up their joint efforts to prevent people making a dangerous journey. australia is sending troops to the solomon islands to help restore orders. the country faces a 2nd day of rising. the protesters want the prime minister to quit thing. the government is neglected, their islands or from their o'clock. astrology decided to send troops announced the 20 troops at a small number, but they are hitting to from towns will in queensland where i am to honey our as we

speak. and we're going another, a group of but for your heading there on friday. and this is simply to monitor the situation and do what the prime minister said is to try to store stability and security on the ground and of the prime minister that he wants at the strain trip at the help the police. he's also now he's spoken to the prime minister of p g as what happened getting. so it's a bullet health situation. and germany's current of ours death tolls officially passed a 100351 deaths recorded in the past 24 hours. hospitals are rapidly filling up across the country and some have even called for help from other you states, germany announced tougher restrictions last week to curb the outbreak. alright moline will be along to take you to the next few hours of news on al jazeera in about half an hour. it's time the stream is, next of you tomorrow, $1000.00, gmc o, the cur. the 900 pandemic has led to a spike in child trafficking across india. one,

don't want to make those fighting to say one or both children on al jazeera, the, do you regularly deal with racial aggressions, inappropriate, or demeaning comments, or just nasty looks because you're black. 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. so that's being helped me kick off today's episode off 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 on line, what would you like to ask? i guess what concerns questions do you have youtube is right here for you. it's a difficult conversation to talk about mental health. i promise you it will be a safe space. i guess we'll be very kind to you that say hi to the get hannah nicole. some yes, so nice to see you had a please introduce yourself to our international audience. tell them who you are, 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 screwed in the book, the distance cure a history of tell of 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 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 i learned some yes,

i get to have you here. introduce yourself. try international audience. so great to be here. thank you. i'm so me a debate. 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 sarah pay 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 meet between our appointments. and i found that to be such a fascinating and new thing to be able to see that on hold right in front of me. ah ha, take us back to the very beginning of tele therapy. what were the 1st examples of telephone pe? thanks so much for that and starting with segment for it. and the mention of psychoanalysis people have had tim 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, has its own ways of doing mental health care at distance all the way through to the contemporary space of a tele therapies on apps and the pandemic. nicole, we seem to be having this huge boom in apps anyway, but their mental health apps. why do you think i is? i think i am the one hand is because there is this need i'm that they're at are you know something around, you know, 55 percent of people in the u. s. for example, who have mental health issues, but who are not able to receive care and the tech industry or, you know, the ability to use that tech to fill that need. you know, certainly is understandable and it's an area of great interest. i'm going to play me i what was it? no thought that with us as like i said, 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 for a connection and a lot of lots of connection in so many ways. and so sometimes what 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 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 josha koya. he's the founder and c e o of a specific kind of online therapy session. he explains why he did it, and what the need is, in his part of the welt, his joshua, the trigger was the bun demick. i'm the anxiety of me, natalie did what it brought. i really, mr. andre 1000000 africans,

i've been estimated to live with depression. they have limited access to modality. i cannot even afford. yeah, but it will kit is inspired world to over easy and affordable access to lessons. there is for africans anyway in the world. and google actually means strengths his writing. i mean, to reassure us of our center city to do live no matter what's on our up. because picture therapy is you can of screening tests i'm, you can keep it voice diary. what i challenge so far beauty, this is a, we are facing decades of culture, our stigma. somebody that sounds like perfection, right? you're on a, in a part of the well, but you don't have access to a 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 think i think that speaks to such an important and widespread thing that's going

on where it's really hard to get help for 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 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,

i was gonna say what, what i would add to that is that definitely the pandemic. i showed you this if 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 a systemic issues such as, you know, how does care get reimbursed, you know, depending on how you are, 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. either 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 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 it often 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. i'm that, you know, certainly there have been a number of people raising these ethical issues is for several years, you know, since, since absolutely 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 addressed. certainly, data and privacy remain. no good for any questions about these mental health apps. and what uses might be made of data, especially that people may not be aware of. 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 that might be useful for addressing them that they're, there really are just a number of other sort of barriers for, for that kind of i want you to help me with some concerns has some y'all come right like to you recent concerns here that we should really raise and some of our needs 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 are okay. well, as in what ways me, 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. well, by a friendly little bot who's ready to listen. 24, sorry. well, bats been trained in cognitive behavior therapy or approach to mental health that is all about identifying distortions and you're thinking, well, but doesn't do therapy. but he 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. it can help you see patterns in your mode. as he learns about you, he'll do 2 things, like useful strategies and practical tools that have been shown to work. most of these technologies are classified as long as tools and has, are considered low risk, like government agency system. yet the n u. s. meaning that developers don't have a duty of care to work or users human these high rise specific guidance on there

are seen safety policies and whether data is shared or 3rd parties are the solutions are chief and scalable government. healthcare providers can be crashed at the treatment on users and saws, rather than looking into the fashion of preventative services. policy makers should really look into on demanding more long term review of ease solutions and objective measures in place for the monitoring is gone. all users, every single one of i guess, a nodding, 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, re, i wo, bob 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 bite. what's behind that? so in the whole, what's called digital mental health space, there 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's the 1st question and then what is being collected? how is it used? is it being leaked and so on that are other panelists can also address some yeah, i will say that one concern that's come up again and again for people who 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 chief is talking about right now. call for instance says what to say these apps won't. 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? this certain nicole. so at so am i was going to say no, that certainly does. and, you know, i want to again emphasize that there's 2 layers to that. there is 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. we talk about concerns, but have you seen actual examples of this happening? like we do? we 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, you know, in that case, of people being blackmailed with their information. there's also, you know, been a study like a researcher named heartfelt, you know, in 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 a novel voice try conversation. this is linda michael's. he says i, colleges and co founder of the 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 therapist 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 seeking how insurance companies are steering them towards license coaches or telling them basically just to figure it out and help themselves. we can and must do better. people need access to therapist data, insight and relationship and therapist need to be paid fairly. who typical? she's that somebody you help me out with the economy. do you have a therapist in your pocket on your phone? oh, can you right, is that do you out of a job and then hannah, regulations you help me out with regulations as some east on. sure. so in terms of having that therapists to me you can contact all the time. i think the cornerstone of therapy is that relationship someone has with their therapist. and so how are however often someone is meeting with that therapists 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 what 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 his 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 moderators treated us like children, and vulnerable uses, were excluded from minor things. it was a bruising experience. nicole thoughts. 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, 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, 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 mean it, you know, oversight that, that really looks at whether it's like the wild west that handle the question a call it so why waste the app is. all right, satellite laurence from brewer says which mobile therapy app would you recommend? how do you know which app to use? let's land on that 2nd half. that question. some yeah. 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 healthcare. so i would say starting with, what is it, that's your concern. are you having racing thoughts? are you having load? 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 do one more from youtube and this comes from joshua koya. you remember him at the beginning? he had that at the he designed because in his region they just didn't have therapists and there was a lot of stigma guys. so joshua, thank you for watching the show as well. appreciate you. i'm going to put this one to you hannah. prior to establishing his own at he tried. some telepath tell it, excuse me, tele 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 tell us therapy app that claims to be able to help everyone. it's an impossibility. i've got one more voice to add to our conversation so much knowledge english. i really appreciate you get this one, it's in the afternoon, but who is just saying the future. the future is what we're experiencing right now . he's yasmin years ago, over 80000 individuals, there was only one psychologist present today for 99000 patients. there's still only one psychologist present at this street as i causes you'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 than human being or psychologist e, i takes only 3 minutes in masking. you are the therapist with the psychologist would take 60 minutes a i a 75 percent cheaper than regular solutions. e i is available in more than 10 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. when right at the end there's so much debate about yasmine so way, right? no, why is it that for you so much? yeah. ah, right. he's got he got us 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. aha, nicole finish the 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 what ada, it's increasing all of the problems of current mental health care, but at scale, and we have to be careful about 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 went out audience to find out where you all online, have a look at my laptop. they seize 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.

and less than a year. how will host the middle east 1st? well, in preparation, the country is stage in a major settlement with 16 nations going head to head in thanks purpose bill stadiums for 2022 will keep you across the action as council prepared for the region's biggest ever sporting events that be for our cup on algebra a,

a, with a graves of the on main evidence that schools designed to strip indigenous people in the u. s. of their culture also claimed the lives of their children, abuse. corporal punishment forced to child labor loss of identity, loss of language in loneliness. the discipline was terrific. kids were killed. there isn't any native person alive today that hasn't had someone that went to boarding school in their family. very true. on a, just a year. from the al jazeera london broadcast center to people in thoughtful conversation with no host and no limitation, it leads as a person of color. it's always

a struggle here. it would be much easier for me. it's might feel that white people part to go into and sing a song, right, so carry other people, wait a minute, you get way down. you stop what you're doing and maybe one studio b unscripted on al jazeera. ah, this is al jazeera ah, hello molly, inside this is the news our lie from day hall coming up in the next 60 minutes, al jazeera, obtain satellite imagery revealing the u. e is supplying weapons to the ethiopian government asset fight to grand rebels. britain and france trade blame of the desk of 27 migrants and refugees who drowned when their boat sank in the english channel .