Yale University settles lawsuit alleging it pressured students with mental health issues to withdraw

Associated Press

Originally posted 25 Aug 23

Yale University and a student group announced Friday that they've reached a settlement in a federal lawsuit that accused the Ivy League school of discriminating against students with mental health disabilities, including pressuring them to withdraw.

Under the agreement, Yale will modify its policies regarding medical leaves of absence, including streamlining the reinstatement process for students who return to campus. The student group, which also represents alumni, had argued the process was onerous, discouraging students for decades from taking medical leave when they needed it most.

The settlement is a “watershed moment” for the university and mental health patients, said 2019 graduate Rishi Mirchandani, a co-founder of Elis for Rachael, the group that sued. It was formed to help students with mental health issues in honor of a Yale student who took her own life.

“This historic settlement affirms that students with mental health needs truly belong," Mirchandani said.

A joint statement from Elis for Rachael and Yale, released on Friday, confirmed the agreement "to resolve a lawsuit filed last November in federal district court related to policies and practices impacting students with mental health disabilities.”

Under the agreement, Yale will allow students to study part-time if they have urgent medical needs. Elis for Rachael said it marks the first time the university has offered such an option. Students granted the accommodation at the beginning of a new term will receive a 50% reduction in tuition.

“Although Yale describes the circumstances for this accommodation as ‘rare,’ this change still represents a consequential departure from the traditional all-or-nothing attitude towards participation in academic life at Yale,” the group said in a statement.

The dean of Yale College, Pericles Lewis, said he was “pleased with today’s outcome.”

The info is here.

The potential good news: The lawsuit against Yale is a step towards ensuring that students with mental health disabilities have the same opportunities as other students. It is also a reminder that colleges and universities have a responsibility to create a supportive environment for all students, regardless of their mental health status.

Is the world ready for ChatGPT therapists?

Ian Graber-Stiehl

Nature.com

Originally posted 3 May 23

Since 2015, Koko, a mobile mental-health app, has tried to provide crowdsourced support for people in need. Text the app to say that you’re feeling guilty about a work issue, and an empathetic response will come through in a few minutes — clumsy perhaps, but unmistakably human — to suggest some positive coping strategies.

The app might also invite you to respond to another person’s plight while you wait. To help with this task, an assistant called Kokobot can suggest some basic starters, such as “I’ve been there”.

But last October, some Koko app users were given the option to receive much-more-complete suggestions from Kokobot. These suggestions were preceded by a disclaimer, says Koko co-founder Rob Morris, who is based in Monterey, California: “I’m just a robot, but here’s an idea of how I might respond.” Users were able to edit or tailor the response in any way they felt was appropriate before they sent it.

What they didn’t know at the time was that the replies were written by GPT-3, the powerful artificial-intelligence (AI) tool that can process and produce natural text, thanks to a massive written-word training set. When Morris eventually tweeted about the experiment, he was surprised by the criticism he received. “I had no idea I would create such a fervour of discussion,” he says.

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Automated therapist

Koko is far from the first platform to implement AI in a mental-health setting. Broadly, machine-learning-based AI has been implemented or investigated in the mental-health space in three roles.

The first has been the use of AI to analyse therapeutic interventions, to fine-tune them down the line. Two high-profile examples, ieso and Lyssn, train their natural-language-processing AI on therapy-session transcripts. Lyssn, a program developed by scientists at the University of Washington in Seattle, analyses dialogue against 55 metrics, from providers’ expressions of empathy to the employment of CBT interventions. ieso, a provider of text-based therapy based in Cambridge, UK, has analysed more than half a million therapy sessions, tracking the outcomes to determine the most effective interventions. Both essentially give digital therapists notes on how they’ve done, but each service aims to provide a real-time tool eventually: part advising assistant, part grading supervisor.

The second role for AI has been in diagnosis. A number of platforms, such as the REACH VET program for US military veterans, scan a person’s medical records for red flags that might indicate issues such as self-harm or suicidal ideation. This diagnostic work, says Torous, is probably the most immediately promising application of AI in mental health, although he notes that most of the nascent platforms require much more evaluation. Some have struggled. Earlier this year, MindStrong, a nearly decade-old app that initially aimed to leverage AI to identify early markers of depression, collapsed despite early investor excitement and a high-profile scientist co-founder, Tom Insel, the former director of the US National Institute of Mental Health.

The info is here.

Global health without justice or ethics

S Venkatapuram
Journal of Public Health
https://doi.org/10.1093/pubmed/fdaa001

The great promise at the start of the twenty-first century that Anglo-American philosophers would produce transformative theories and practical guidance for realizing global health equity and justice has largely gone unfulfilled. The publication of The Law of Peoples by John Rawls in 1999 formally inaugurated the emerging academic field of global justice philosophy.1 After 2000, numerous monographs, journal articles and conferences discussed global justice. And new academic associations, journals and research centres were established.

One remarkable aspect of the new field was that the stark inequalities in health across societies were often the starting concern. Despite our diverse philosophical and ethical views, reasonable people are likely to be morally troubled about the large inequalities in life expectancies between some sub-Saharan country X and the USA or another rich country. This initially shared moral intuition or indignation, then, motivated diverse arguments about what precisely is morally bad about global health inequalities and global poverty and the possible demands of justice. Some philosophers described what ‘our’ duties are or, indeed, are not, to help ‘those people over there’. Others minimized the distinction between us and them by arguing for theories of radical global equality, the arbitrariness of political borders and duties that follow from our complicity in transnational harms experienced in other countries.

Progress in global justice philosophy seemingly promised real-world progress in global health equity and justice, because health inequality was the foremost issue in philosophical debates on global inequality, poverty and claims of the ‘global poor’. At the same time, largely driven by HIV research, bioethics went global as it was exported alongside medical research to resource poor settings. Bioethicists also began to go beyond clinical and research settings to examine public health ethics, social inequalities in health and social determinants—from local conditions all the way to global institutions and processes. Nevertheless, as of 2020, it is difficult to identify any compelling conceptions of global justice or global health justice or to identify any significant philosophical contributions to the practical improvement of global health and inequalities. What happened?

The rest of the article is linked above.