Public Comment

I'm prefacing this essay with an admission that what I'm alleging is speculative. I don't have any direct evidence of algorithms being used in directing my treatment. But if they were used, I would never be told about it, and thus having direct evidence is not reasonably possible. 

It is increasingly popular for government and other agencies to use algorithms when dispensing medical treatment and numerous other services. Algorithms in this case are an attempt to use computer models to predict people's outcomes. And if you are being deprived of help for unknown reasons, it is possible that algorithm usage could be a factor. 

Healthcare is known to use algorithms, and in a basic search quite a few articles have shown up that indicate algorithm use is racist. But other than racism, ageism and disablism are factors fed into the algorithm software. At age 58, it is likely I won't get the kind of help that would be given to a younger, more promising mental health consumer. At my age, and with my history and diagnosis, algorithms probably predict that I'm on the verge of going defunct. 

Classism and not having significant college are other marks against me. These, too, are factors that could go into the prediction software. This could produce reduced effort exerted by doctors to treat major health concerns. If the prediction by a computer is that I'm about finished, why do an expensive coronary bypass? Why get a good surgeon for it? Why not use a beginner, or someone not as good at keeping patients alive? 

An algorithm is a mathematical, artificial intelligence entity, a beast to which you feed in numerous variables, and it spits out likely outcomes. It is a statistical thing, and based on that, it could be accurate when we are speaking of large numbers of individuals. But for one individual, it should be much harder to draw a conclusion. 

Algorithms are racist because minorities aren't given a fair chance at life, and thus it is harder to predict a good outcome. If the playing field was remotely level, race could not be used as a predictor. Yet, because society is so unequal, and even due to people's racist attitudes, being black is a mathematical mark against you. 

In mental health treatment, algorithms deprive some people of much needed help therefore could have devastating effects on our lives. 

Clinicians are sometimes faced with dilemmas of where and to whom their limited resources should go. And when something seems to work to produce a better outcome, they may not continue doing more of the same, as common sense would lead you to expect. They may decide that a mental health consumer has received the benefit and can be transitioned to a more independent phase. This sometimes works and sometimes doesn't. I know that whenever I've received a service that helped me, removal of that has caused me not to do as well. In some areas of mental health, there may be no such thing as: "you're cured, and you don't need this anymore." 

This is conjecture: Mental health organizations, from a corporate standpoint seek good statistics for their companies. When they have good numbers, it looks like the company is doing its job and is a great performer--worthy of more investment. Anything that will produce better numbers for a mental health corporation is going to be done. Because of that, algorithms are perceived as valuable. 

I need to add here that at the venue where I obtain most of my mental health treatment, I have received a huge amount of help. Regardless of algorithms, decision makers have decided that I'm worth an investment of time and resources. This is to the credit of the individuals and the company where I receive treatment. 

But when algorithms have become a heavy steel door locking us out of help, the feeling is indescribably sad.