Mind the Gaps: Ethical and Epistemic Issues in the Digital Mental Health Response to Covid-19

Well before the Covid-19 pandemic, proponents of digital psychiatry were touting the promise of various digital tools and techniques to revolutionize mental health care. As social distancing and its knock-on effects have strained existing mental health infrastructures, calls have grown louder for implementing various digital mental health solutions at scale. Decisions made today will shape the future of mental health care for the foreseeable future. Here, in hopes of countering this hype, we examine four ethical and epistemic gaps surrounding the growth of digital mental health: the evidence gap, the inequality gap, the prediction-intervention gap, and the safety gap. We argue that these gaps ought to be considered by policy-makers before society commits to a digital psychiatric future.