Does mental health care need a whistleblower like Facebook?
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Facebook is facing some ominous music. Among the concerns of the whistleblower Frances Haugen, who has been testifying before the Senate Commerce, Science and Transportation subcommittee, are mental health ones. We touched on one of them, the apparent suicidal risks for teenage girls, in our video from September 29, “Daughters Overcoming Ecocide and Suicide.”
Worse yet, perhaps, are the Facebook parallels with many of our health and mental health care systems. Putting profits over people? Check. Those business-controlled systems often put profits over patients, as I discussed in detail in my 1997 book The Ethical Way: Challenges & Solutions for Managed Behavioral Healthcare.
Hidden algorithms? Check. Our for-profit managed care companies can have hidden algorithms for determining medical necessity, which in turn determines reimbursement.
Liability? Check. For-profit managed care companies have largely escaped liability, as has Facebook so far.
Engagement? Check. Social media platforms are psychologically designed to keep users engaged, while managed care and related companies do that by requiring networks of clinicians to be used. All in all, such systems put business ethics over health care ethics.
So far, though, we have not had a significant whistleblower. I hope 1 or more will emerge, and soon. If not, perhaps Congress can turn its attention to our mental health care systems.
Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues relate to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric TimesTM.