Cerebral got investigated

PLUS: Can an avatar treat your depression in the Metaverse?

It’s MY newsletter and I get to make the weird art with pictures of my dogs

My Brethren! It’s Friday! The time for links is upon us!

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Most WTF News of Late:

Bloomberg did an investigative report on telehealth company Cerebral, and it is very yikes. Former employees said they felt like psychiatric Uber drivers who were expected to manage inhumane caseloads, and the Chief Medical Officer told employees that 95% of people who use the app should get a prescription (but that 100% would be too much, because then they’d be a pill mill).

Apparently, people who use the app get assigned a care coordinator named “Eileen Davis”, but the catch is that, she doesn’t exist. One Black former employee told Bloomberg they were “disillusioned after being asked to engage clients under the White-presenting Eileen Davis avatar.”

Carlen Zhu joined the company as a coordinator in August, just as Cerebral was retiring the Eileen Davis alter ego. “It is pretty bizarre to make people believe they’re talking to someone they’re not talking to, and it was strange to introduce myself to clients acting like I was ‘taking over’ from Eileen when she wasn’t a real person,” Zhu says. She had a roster of about 1,000 patients and was so overwhelmed on her first day that she cried. On an average day, she estimates, she fielded about 100 inbound messages; in a typical week she heard from at least a few people in crisis.

(This is not an isolated incident - it’s actually a wider trend for apps in the teletherapy space, because these apps are designed with white women in mind as their target users. For more context, read Therapy Tech!)

My favorite quote from the piece is this one about the CEO:

As a recruiter of prescribers for Cerebral, Stephanie Leonard saw how nurses struggled under the company’s model and, as a member of its headquarters staff, worked closely with Robertson. “The company would be much better off outside of his hands,” says Leonard, who left in June. “He just wants to make money. That’s his end goal. Whenever he talks about ‘providing quality mental health care,’ his eyes are dead. He does not care.”

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Most Annoying News of Late:

I swear to God if I see another article about the phenomenon of women being diagnosed with ADHD in adulthood that does not contextualize the issue by talking about how industries create new markets for products by pushing the same story over and over again in mass media to expand demographics and diagnostic bracket creep, I am gonna scream!!!!!!!! (Okay actually I have not seen anyone talking about that so I should probably assign myself an essay on it.)

All of these stories repeat the same tired line about sexist diagnoses (it’s not just hyperactive boys!) but never do they address the fact that framing inattention and messiness as “female ADHD” traits is itself a pathologization of sexist norms that say women must be attentive and organized. Framing ADHD as “presenting different” in men and women is trying to fight gender roles by...further entrenching gender roles, and implying that those gender differences are biological.

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Thanks, I Hate It:

This doctor is very excited about recent studies on therapy in the Metaverse, like one that found people who got comforted by an avatar while they were LARPing as a baby saw a decline in their depression scores.

Let’s think about the implications of this, though. It’s another consumerist response — more products (VR headsets), more services (prescription therapy, app subscriptions), more isolation (except now we’re replacing human relationships with simulated ones). That’s not a future I’m excited about!

He also discusses the combination of VR therapy with “Non-Invasive Brain Stimulation”, which is another new area of clinical treatment that’s getting a lot of hype. The NIBS umbrella includes Transcranial Magnetic Stimulation or TMS, which is being hailed as a super-safe new depression treatment, and pushed hard through shady marketing that neglects to inform the public of its risks.

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I Did A Thing:

Baby’s first livestream! It was fun! Me and Marta Rose talked about this essay I wrote on the politics of the neurodiversity paradigm and also announced that we’re collaborating on a YouTube channel called The Spiral Lab (like, comment, subscribe or whatever??).

I’m working on some video essays that I’m very excited about!! (Yes, I have been talking about making videos for a long time, I just need a minimum of 8 months to talk about and severely overthink a new project before I start it, as is the sluggy way.)

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Various Articles of Interest:

Why we stopped making Einsteins

Healthcare is for fuck-ups, too

The Drug Supply is Contaminated!