If she had done this a couple of decades earlier, the American entrepreneur might have focused on face-to-face counselling or telephone calls. But because we live in a digital age, Taitt decided to explore whether online support could work instead. That delivered a surprise. Although she had assumed clients would want to do counselling by video conferencing or phone, her market research showed they actually preferred to text.

While texting is a relatively laborious process and can feel fragmented, it has a crucial advantage: women can dispatch short messages to a therapist whenever they feel desperate, say in the middle of the night, without waking anyone else up. That is handy if you have an infant.

“There is benefit in what I call expert anonymity [from a therapist]. You don’t have to show up if you want help, but you can just chat with someone who is not in your network and who can give you practical tips you need in acute moments,” explains Taitt. She points out one grim, little-known statistic about motherhood in the US: suicide is now the biggest cause of death in young mothers due to a plague of mental health issues.

Between April 2021 and 2023, Poppy Seed has logged four million minutes’ worth of text-time (with each interaction lasting an average 37 minutes). But it is not the only group riding this trend. Last summer, the US government launched a revamped National Suicide Prevention Lifeline, which introduced a text-based option. This followed appeals from the Trevor Project, a non-profit aimed at preventing suicide among LGBT+ youth. Like Poppy Seed, it has found that the people it wants to help often prefer text communications.

There are other active text-based services, such as Crisis Text Line (a US non-profit that provides free mental health support) or Shout 85258 in the UK (a suicide prevention line). The latter arranged almost two million text conversations during the pandemic, and continues to grow, Victoria Hornby, head of Mental Health Innovations, which runs Shout, tells me. She thinks it appeals to users, who tend to be young, often LGBT+ and/or cognitively diverse, because it is private, easy to access and, crucially, gives people “more control” over the tempo of the interaction than a verbal conversation.

To some Gen-Xers like me, who did not grow up with mobile phones, this might seem a little shocking. After all, my generation was raised to believe that face-to-face contact was best for difficult or important conversations, followed by telephone calls. So much so, that I find it weird that my teens often prefer to communicate through endless texts than simply pick up the phone.

There is a large body of evidence from psychologists that appears to support Gen-Xers’ instincts. Most notably, studies show that when people hold conversations, communication occurs not via the actual content of the dialogue, but through the tone of voice, body language and reactive functions. That cannot be imparted via the written word, as anyone who has caused offence with an ill-judged text knows.

Moreover, psychologists suspect that the migration to digital communications is one key factor exacerbating the rise of mental health problems, particularly among teens. Jonathan Haidt at New York University has repeatedly argued that the level of teenage depression, self-loathing and isolation has surged in tandem with mobile phone use. My colleague John Burn-Murdoch has documented similar trends, as has the US chief medical officer, Vivek Murthy.

But history shows that innovation is a double-edged sword. Dashing into cyber space can create isolation, bullying and depression, but texts can also deliver good, as Poppy Seed and Shout show. Lockdowns made us all communication omnivores, jumping between platforms at different times for different needs. Some teens I know who are getting help for depression use face-to-face therapy, but also rely on Zoom, supplementing this with texts at moments of crisis. “It depends how I feel,” says one.

By pointing this out I do not mean to minimise the negative aspects of digitisation on our mental health; these are well documented. But the next time you feel tempted to decry the impact of tech on our lives, remember the upsides. The digital genie is not going back in the bottle, so the question is how do we harness the good to reduce the bad?

gillian.tett@ft.com

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This story originally appeared on: Financial Times - Author:Gillian Tett

One of the most disturbing legacies of that awful day has been that the toll of casualties did not end in the days and weeks following September 11. According to the US Centers for Disease Control and Prevention, more than 125,000 responders and survivors are suffering from long-term health problems caused by the attack. These range from lung disease caused by inhaling toxic smoke, to mental health conditions such as post-traumatic stress disorder, or cancers linked to chemicals. An estimated 31,000 have a certified cancer.

Unsurprisingly, premature deaths in this cohort are high. Kerry Kelly, the former chief medical officer of the Fire Department of New York (FDNY), who got caught in a toxic smoke cloud at the WTC on September 11, says that the number of firefighters who have died from long-term 9/11 afflictions “is now approaching, if not exceeding” the 343 who perished on the day itself.

As Hillman observes, when a disaster occurs, “it is easy to understand the immediate effect”. But, although the government spends $15mn a year funding research to help the victims and organisations such as the FDNY are offering healthcare, it is hard to maintain public awareness and get what Hillman calls “support for the long-term effects”.

This has wider lessons for other traumas, says John Howard, administrator of the World Trade Center Health Program. “Every time I see a disaster in the US, we always look at what happened in 9/11,” he says. Take Covid-19.

The World Health Organization currently estimates that, since 2020, almost seven million people around the world have died from Covid. But millions more still suffer from what is called long Covid, defined by the WHO as health problems that linger or develop three months after the initial infection. These can include lung damage, extreme fatigue, brain fog and post-traumatic stress disorder.

Those suffering from long Covid often feel forgotten, in part because the medical establishment is struggling to define, let alone treat, this new condition. As Jana Javornik, a lecturer at Leeds university who suffers from long Covid, told the FT a few months ago, “We are all neglecting that long Covid is not rare and it is a health crisis.”

One reason is that no one knows exactly how many people have long Covid. A study published in the scientific journal Nature in January estimated that 65 million people are currently suffering with the condition, but suggested that the real number is probably much higher.

Another problem is that scientists themselves disagree about how and why long Covid develops. Some medical research groups, such as IGeneX, think that the symptoms seem “similar to chronic Lyme disease, a condition that affects thousands of people a year”. Lyme is also hard to diagnose, and thus often easy to ignore, because it creates slow-burn, half-hidden suffering that attacks the immune system.

What is clear is that many people find it hard to work or function with long Covid. The Institute of Health Metrics and Evaluation recently published a study in Nature that analysed the medical records of 140,000 people in the Veterans Affairs health system who had contracted Covid in 2020, before vaccines were administered. It concluded that long Covid is causing a higher burden of disability than either heart disease or cancer.

So, are there lessons from the post-9/11 experience for Covid? The medical experts handling the former certainly hope so. A key one is that it’s a good idea to create a registry of victims in a consistent way so that scientists can conduct effective research to validate and ease their suffering. This might sound obvious but was not easy to implement after 9/11, given the fragmented nature of US healthcare. It could be even harder for Covid.

Another is that scientists need to keep an open mind, hence the importance of longitudinal studies which track the same individuals over a period of time. A third is that it pays to start lobbying for funding to help victims as soon as possible. These days, the US government’s official 9/11 fund provides considerable help for long-term sufferers, but it took 10 years of campaigning to ensure that the problems did not get ignored. Let’s hope it’s a quicker process for long Covid victims. Silent suffering deserves more noise 

Follow Gillian @gilliantett and email her at gillian.tett@ft.com

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This story originally appeared on: Financial Times - Author:Gillian Tett

Theoretically, it sounded attractive. Covid had shown the cost of ignoring pandemics. It also revealed the astonishing breakthroughs that can occur when governments finally throw resources into finding vaccines, at speed.

In 2016, a campaign body called 314 Action was created to support scientists who want to run for public office. It has already had some success, leading its website to claim, “In 2018, we played a pivotal role in flipping the United States House of Representatives by electing nine first-time science candidates.” It will also be supporting pro-science candidates in next year’s race. But there is still a long way to go and, given how rapidly technology like AI is developing, that is cause for alarm.

The second lesson is that policymakers need to handle the idea of transparency carefully – not just with pathogens, but AI too. Until now, some western AI experts have chosen to publish their cutting-edge research on open-source platforms to advance the cause of science and win accolades. But just as biotech experts realised that publishing pathogen details could be risky, so experts are waking up to the threat posed by AI tools if they fall into malevolent hands.

This story originally appeared on: Financial Times - Author:Gillian Tett

When they were in junior school, my daughters craved these magical devices. They claimed they would become social outcasts without phones because “everyone else has them”. Even other adults seemed to be on their side. Some parents insisted that phones were a “safety” device, enabling kids in trouble to call for help. The tipping point came when a lawyer I know noted that it was good for children like mine, whose parents had separated, to have a phone to stay in contact with the parent who wasn’t around. Eventually, I put aside my scruples and caved in.

The pattern was particularly stark in one of six mental health categories, known as the “social self”, which tracks how we view ourselves and relate to others. Sapien attributed this pattern not only to increased technology use but to decreasing interactions with others. “Given the statistics of five to eight hours a day spent online during childhood, we estimate that this could displace as much as 1,000 to 2,000 hours a year that would otherwise be spent in various face-to-face social interactions,” they write.

This story originally appeared on: Financial Times - Author:Gillian Tett

That means more consolidation looms. And while that is welcome in the longer term (since it is crazy that America has 4,000 plus banks), this could create bumps in the short run.

This story originally appeared on: Financial Times - Author:Gillian Tett