IEEE Technology and Society Magazine - March 2021 - 82

AI for a Fair, Just, and Equitable World

it can be used free of charge, making help available to socioeconomically disadvantaged people;
it can be available 24/7, meaning patients do not
have to wait for their next therapy; people are more
comfortable disclosing their feelings and personal
information to an application than to a person [29],
[30]; technology is available in remote locations,
and so on. Technology can, therefore, reduce burden on the health care system and its practitioners
as well as reduce barriers to mental health care
access overall, by complementing rather than
replacing professionals [16], [23], [31]. Potential
benefits and risks are more thoroughly discussed in
the following section.

Potential benefits and risks
This section addresses the implications that PT for
mental health has in terms of advancing equality for
mental health care access and equality, in general.
These implications are divided into those that offer
potential benefits in relation to existing problems
and obstacles toward equality and those that appear
to be potential risks of this technology in achieving
equality. Regardless of the possible benefits of using
PT, we do not believe it represents a replacement
for holistic health care, but should work as a complement in a comprehensive, systemic approach to
public health. Other problems, seemingly unrelated
to equality, but crucial for the technology to reach
its potential, are also briefly considered at the end
of the section.
There are a number of potential benefits PT offers,
as described in the following sections.

Cost
The cost of service of mental health care professionals (from psychotherapists to clinical psychologists and psychiatrists) varies from country
to country and is further dependent on the country
regulations and subsidies. But the cost to the patient
mostly depends on the number of practicing professionals available in a given country. Regardless, the
cost presents a barrier to people from lower socioeconomic backgrounds [32]. PT for mental health can
be realistically made free of charge (and many times
is [25]) due to the much lower costs attached to it.
There are three major factors that contribute to this:
1) scalability, which means that one PT system can
be adopted, theoretically, by any number of people (the only cost that comes with scalability is the

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server cost, which is marginal compared to human
labor)-in contrast, one mental health professional
is limited to a certain number of people; 2) the ability of more people to produce effective PT due to
existing research that thoroughly reports effective
designs; and 3) the number of people capable of
producing such systems is much larger than the
number of professionals that can offer help. We
acknowledge that comparing the cost of a human
health worker to the cost of an application does
not fit in the holistic approach to designing mental
health care solutions [33]. However, the application may as well lower the cost lower of collecting
health data on people from disadvantaged socioeconomic backgrounds, that would offer an insight
otherwise overlooked. The application can also
be used to relieve stress on health care by making
it available to patients whose conditions are not
severe enough to be prioritized (i.e., early triage
system).

Availability
The problem of availability can be classified into three as follows: 1) location-based; 2)
time-based; and 3) cost-based availability. Location-based availability refers to people with mental health issues in locations that have no direct
access to mental health professionals physically
or even computerized access to therapy with
communication technologies [34]. Using PT for
mental health may not be a permanent solution
in such cases, but it may offer either one of the
few available reliefs or be used as a transitional
remedy toward a better access to health care.
Time-based availability refers to people with mental health issues needing therapeutic help at times
when the chosen professional is unavailable. PT
for mental health is available around the clock,
making their use complementary with the chosen
mental health professional. Patients continuously
report these needs and such complementary uses
already exist [35]. Cost-based availability refers to
people with mental health issues needing therapeutic help but not having the means to access
it more than the minimum recommended amount
of hours per week [36], where consensus points
to 1 hour per week. Studies [36], [37] show that
more frequent therapy results in better outcomes
and complementary use of PT for mental health
can bridge that gap for people who are not able to

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IEEE Technology and Society Magazine - March 2021

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