Note they are mostly to do with insurance issues.
fwiw I don’t think most of this problem is due to insurance issues, though I agree that the US healthcare system is very weird and falls short in a lot of ways.
This also isn’t specific to mental health: one might retort to donors to AMF that they should be funding improvements in (say) health treatment in general or malaria treatment in particular.
I don’t think this analogy holds up: we’ve eradicated malaria in many developed countries, but we haven’t figured out mental health to the same degree (e.g. 1 in 5 Americans have a mental illness).
I suspect that if there were a really strong ‘pull’ for goods/services to be provided, then we would already have ‘solved’ world poverty, which makes me think distribution is weakly related to innovation.
World poverty has been decreasing a lot since 1990 – some good charts here & here.
M-Pesa and the broad penetration of smartphones are examples of innovations that were quickly distributed. The path from innovation to distribution is probably harder for services.
I usually do link posts to improve the community’s situational awareness.
This is upstream of advocating for specific actions, though it’s definitely part of that causal chain.
I’m not sure what you mean by going from 0 to 1 vs 1 to n. Can you elaborate?
The link in my top-level comment elaborates the concept.
how much better MH treatment could be than the current best practice
Quick reply: probably a lot better. See ecstatic meditative states, confirmed by fMRI & EEG.
See also Slate Star Codex on the weirdness of Western mental healthcare: 1, 2, 3, 4, 5
how easy it would be to get it there
Quick reply: not sure about how easy it would be to achieve the platonic ideal of mental healthcare – QRI is probably more opinionated about this.
Given how much of an improvement SSRIs and CBT were over the preexisting standard-of-care, and how much of an improvement psychedelic, ketamine, and somatic therapies seem to be over the current standard-of-care, I’d guess that we’re nowhere close to hitting diminishing marginal returns.
how fast this would spread
Quick reply: if globalization continues, the best practices of the globalized society will propagate “naturally” (i.e. as a result of the incentives stakeholders face). From this perspective, we’re more limited by getting the globalized best practices right than we are by distributing our current best practices.
From the part I excerpted:
“You should read it right now (or at least read this Vox interview), if you want to think through the contours of a civilizational Singularity that seems at least as plausible to me as the AI Singularity, but whose fixed date of November 3, 2020 we’re now hurtling toward.”
The EA implications of the 2020 US presidential election seem obvious?
See also Dustin & Cari’s $20m grant to the 2016 Clinton campaign.
My guess is that it’s more efficient to study full time while living in the country. I think living there increases motivation, means you learn what you actually need, means you learn a bunch ‘passively’, and lets you practice conversation a lot, which is better than most book learning, and you learn more of the culture.
Being there definitely increased my motivation to learn the language, even though I didn’t know any Chinese beforehand and wasn’t intending to learn any.
We appreciated the focus on LMICs because the treatment gap for mental health conditions is especially high in these countries (WHO Mental Health Atlas, 2017), particularly in low-resource (e.g. rural) settings.
What do you make of the argument that it’s more important to go from 0 to 1 on mental health, rather than from 1 to n ?
Could imagine that mental health in developing countries will resemble mental health in developed countries more and more as a result of economic growth. Developing countries become more similar to developed countries overall, and adopt the best mental healthcare practices of developed countries as part of this.
If mental health in developed countries currently misses out on a lot of upside, it would be way more leveraged to focus on realizing that upside (0 to 1), rather than propagating current best practices (1 to n), because the best practices will propagate regardless so long as the developing world continues to develop.
My essay on consequentialist cluelessness is also about this: What consequences?
Posting these links here for cross-reference:
Remembering the passing of Kathy Forth (a)
If I Can’t Have Me, No One Can (a) [Content warning: a suicide note that deals heavily with sexual violence]
Overall, my sense is that MDMA and psychedelics might have a chance to substantially decrease malevolent traits if these substances are taken with the right intentions and in a good setting—ideally in a therapeutic setting with an experienced guide. The biggest problem I see is that most malevolent people likely won’t be interested in taking MDMA and psychedelics in this way.
Our estimates of the likelihood of malevolent people being interested probably hinge on our theory of where malevolence comes from.
e.g. if we think malevolence mostly arises as a maladaptive coping response to early trauma, you could imagine interventions that resolve the trauma and replace the maladaptive response with a more prosocial & equally fit response (and malevolent people being interested in those interventions).
But if we think malevolence is mostly a genetically-mediated trait, it’s probably harder to change.
I haven’t poked the literature on this yet.
I wrote up a steelman summary of Gupta’s position on another thread after someone pointed out that capitalism is just a coordination mechanism (and one that is overall better than the other coordination mechanisms we’ve tried).
Here’s the summary:
Western society used to be pretty bad at coordinating, but had a basic meaning-making orientation (Christianity) and functional methods of laundering personal responsibility (e.g. Catholic confession, e.g. Protestant predestination).
With industrialization, and then again with the computing revolution, western society got a lot better at coordinating.
Alongside industrialization & modernization, western society began to lose its meaning-making orientation and its methods of laundering responsibility began to lose efficacy.
So now we’re in a place where we’re much better at coordinating than we were before, but we don’t have wholesome targets to coordinate towards, and we’re for the most part operating as though our legacy structures of managing personal responsibility are still intact.
This is bad.
Lately some of our coordinating power has turned towards “colonizing” spiritual practices of other cultures, i.e. it’s trying to adopt a version of them that could replace our legacy personal-responsibility-management structures.
This isn’t going very well, because the spiritual structures we’re interested in are a fundamentally different shape than the ones we’re trying to replace, and we’re more interested in shoehorning the new (from our perspective) structures into the legacy forms rather than adapting our expectations to the new structures (adapting our expectations would be much harder).
This all rhymes with Vervaeke’s stuff (though I haven’t gone deep down the Vervaeke-hole yet).Also rhymes with The Wizard and the Prophet (Gupta is a hardcore prophet, in that framing).
Thank you for doing this! I was excited to see your piece, and have been thinking about it.
Regarding objective measures, there will be ‘Minority Report’ style objections to actually using them in advance, even if they have high predictive power (which might be tricky as it relies on collecting good data, which seems to require the consent of the malevolent).
You could imagine scenarios where we apply objective measures to children, embryos, and/or couples who are considering having children.
This would avoid some of the free-choice problem around who takes the test, though it doesn’t really get around the Minority Report problem. Also there’d still be selection at the parent level (some would-be parents would decide to not get tested).
Interesting that we don’t do anything like this for psychopathy currently, as far as I know. (Psychopathy appears to be somewhat genetic.)
Whether we assume conflict theory or mistake theory is also relevant here.
The Institutional Investor hyperlink is broken. Here’s one that works: https://www.institutionalinvestor.com/article/b1j0mvcy9792vt/Why-Value-Investing-Sucks
I would also hope for this!
It feels fraught though – Chinese leadership seems to have a very different view of what constitutes the good, and a very different vision for the future.
Considering the reverse sharpens the point further:
“If a Chinese think tank, funded by a founder of Tencent (or Huawei, etc.), convened a consortium of AI practitioners & policy wonks (almost all of whom were racially & nationally Chinese), and this consortium produced recommendations on how to distribute the benefits of AI for the common good, what would the EA community think of that work?”
If you were an AI strategist in China, and knew that Asians outnumbered whites in many top CS programs in the US, would you be skeptical about an overwhelmingly white ecosystem producing research on topics like “distributing the benefits of AI for the common good”?
This is a great point.