Digital Age: Mental Health, Cognitive Robotics, and AI

On the 9th of April 2025, Seiara Imanova organised an event, along with Andrew Hicklin, called "The Digital Age: Mental Health, Cognitive Robotics & AI", held at the Edgbaston campus, University of Birmingham as well as online. This post is a report of the event.

Speakers of The Digital Age event

The goal of the event was to highlight just how important the digital world has become, and the ways it’s shaping so many areas of our lives. As technology continues to shape how we communicate, understand who we are, and engage with systems of care, it’s crucial that we pause and critically examine what this means for fields like mental health, psychiatry, and beyond.

Seiara Imanova introduced Lucienne Spencer

The event began with an insightful presentation by Lucienne Spencer (University of Oxford), titled “Social Media & Shifts of Ontic Power in Mental Health”, which explored how digital spaces, such as social media platforms, can act as catalysts for shifts in psychiatric authority. In other words, online platforms like TikTok, Instagram as well as AI powered chatbots, are changing who gets to define, talk about, and influence mental health and psychiatry. Dr. Spencer highlights that although this shift could be considered a kind of ontic empowerment for people with mental ill health, re-shaping diagnostic categories in digital spaces carries the risk of distorting and diluting their original meaning.

Spencer’s presentation was followed by another incredible talk by Alan Winfield (University of Bristol), titled: “The Ethical Roboticist - From robot ethics to ethical robots”. Winfield looked at questions such as what do robot ethicists actually do, what kinds of harm can robots and AI cause, as well as ways for setting an ethical standard and regulations. Perhaps most striking was his demonstration of The AI Incidents Database, which highlighted why ethics was important in robotics, and how AI is already causing harm in the real world.

Alan Winfield's presentation

Last but most definitely not least, the third presentation was given by Paris Lalousis (King’s College London) titled: “Artificial Intelligence in Mental Health: Challenges, Pitfalls, and Opportunities” which is based on the excellent work he does at his AIM Lab at King’s. In contrast, Lalousis discussed the growing need for AI in healthcare, particularly in psychiatry, by highlighting the limitations of current neuroscientific approaches, such as the constraints of neuroimaging, the challenges posed by diagnostic ambiguity and high comorbidity rates between psychiatric conditions. 

Presentation by Paris Lalousis

Lalousis argued that intelligent systems hold significant potential to address these gaps. He presented his study on how the use of machine learning can better predict remission for patients with mental disorders such as schizophrenia or bipolar, and a glimpse into precision medicine.

The event hoped to achieve its goal which was to foster meaningful reflection on both the possibilities and ethical tensions that arise as human experience becomes more entangled with algorithmic and artificially intelligent systems. You can watch the live recording of the event below.

Metaphor and Epistemic Injustice in Schizophrenia

Today we interview Francesca Ervas and Lina Lissia on their project entitled: “Metaphor and Epistemic Injustice in Mental Illness: The Case of Schizophrenia” funded by PRIN, an Italian funding scheme to support research project of national interest. The project investigates epistemic injustice in metaphorical communication in the case of mental illness. A series of seminars has been planned as part of the project and the final meeting will be a conference held in Cagliari on 22-24 October 2025.

Metaphorical communication

Lisa: What are the research interests that gave rise to this project? 

Francesca and Lina: The project was born due to a common interest in metaphor as a way to express the self/mental illness relationship. The link with epistemic injustice, defined as the injustice towards a person as a knower, came later, and was based on the idea that metaphor can precisely be seen as an epistemic device. We were interested in both forms of epistemic injustice, as Miranda Fricker defined them in 2007: 1) as a failure to attribute credibility to people with mental illness (testimonial injustice), and 2) as an attempt to marginalize their epistemic resources thus not recognizing their ability to interpret their own experience of illness (hermeneutical injustice). 

The project builds on understanding and empirically investigating both the cognitive and social mechanisms behind testimonial and hermeneutical injustice, where people with mental illness often face epistemic challenges in credibility and interpretation. We hypothesized that metaphor can have a role as a communicative tool to overcome the ineffable and inarticulate nature of the mental illness experience and, notwithstanding social stigmas and interpretive difficulties, to reach an affective attunement with the relevant others (families, friends, doctors, healthcare professionals, other people in their social lives, etc.). 

Lisa: What are the main objectives of your project?

Francesca and Lina: Focusing on schizophrenia, the project analyzes the cognitive and bodily mechanisms at the root of the failure to attribute credibility (testimonial injustice) and interpretive capacities (hermeneutical injustice) to people with mental illness, when they communicate their illness to other people via metaphors vs. their literal counterparts.

We hypothesized that affective attunement in communication is a cooperative enterprise that needs to overcome both patients’ difficulties in embodying metaphors in illness communication and interpreters’ negative social and moral stereotypes, which concur to create the case for epistemic injustice.

The project involves three research units: the University of Cagliari (UniCa), the University of Messina (UniMe), and the University of Chieti (UniCh), respectively exploring:

1. the interpreter’s perspective (UniCa, Prof. Francesca Ervas, PI of the project)
2. the mental-ill speaker’s perspective (UniMe, Prof. Valentina Cuccio)
3. the mental-ill speaker/interpreter interaction (UniCh, Prof. Francesca Ferri)

Such factors help us understand the cognitive mechanisms responsible for the missing attunement between people with mental illness and interpreters. 

Metaphor is proposed as a valuable resource to foster a better attunement between the speakers with schizophrenia and the interpreters and to possibly prevent or overcome epistemic injustice in illness communication. Metaphor is indeed a necessary tool for people with schizophrenia to express their illness and themselves in relationship with the illness, but also for relevant others to access what the speaker feels as meaningful to articulate of their experience of illness.

Working together

Lisa: Does your project involve different disciplines and perspectives? 

Francesca and Lina: The three research units have different disciplinary backgrounds and methodologies: philosophy of language and experimental pragmatics (UniCa); philosophy of mind and psycholinguistics (UniMe); cognitive neuroscience and psychiatry (UniCh). UniCa and UniMe embrace a theoretical-philosophical approach to the problem of epistemic injustice in the case of metaphor. 

All the units adopt an experimental approach to empirically investigate the cognitive mechanisms at the basis of the problem, focusing on schizophrenia. However, each unit tackles the very same problem from different angles and via different empirical methodologies. Check the members and the disciplinary background of all our teams.

Lisa: What do you expect the impact of this project to be?

Francesca and Lina: Results will significantly advance the understanding of the theoretical, linguistic and cognitive aspects of metaphor use in mental illness communication, with interdisciplinary scientific and academic impact and social impact on public policies and health institutions. A social campaign, based on the experimental data on metaphors production/understanding and the active engagement of stakeholders, will also be designed and produced, with an impact on the general public. 

Finally, the outcomes have the potential to lead to the development of novel rehabilitative interventions and novel social behaviors to prevent epistemic injustice.

The Metaphor and Epistemic Injustice in Schizophrenia project team:

Francesca Ervas, Martina Montalti, Valentina Cuccio, Alice Guerrieri, Francesca Ferri, Lucienne Huby, Lina Lissia.

Special Issue: Renewing Phenomenological Psychopathology

 

The Renewing Phenomenological Psychopathology project is an International Exchange Award funded by the Wellcome Trust that acts as a catalyst for innovative and interdisciplinary in the field of phenomenological psychopathology. The project leaders are Professor Matthew Broome and Professor Giovanni Stanghellini. 

Through this grant, we created a network of diverse international scholars from across disciplines and career stages. This was formed through awards (including international exchange fellowships, small grants, and knowledge exchange events). The aim of the project is to revitalize phenomenological psychopathology for the 21st century as a democratic discipline with a historicised and inclusive account of the experience of mental illness.

While we had made some significant headway in disrupting this field, more work needed to be done. For this reason, we sought to create a special issue on the theme of Renewing Phenomenological Psychopathology. Through this special issue, we ask: What is the future of phenomenological psychopathology? We invited contributors to shake up previously sedimented ideas in phenomenological psychopathology and reconstruct this vital phenomenological tradition. Due to the volume of high-quality submissions, the special issue was split into two parts. 

The first part focused on how phenomenological psychopathology can be applied in new ways to gain a deeper understanding of specific psychiatric conditions. One of the core achievements attributed to phenomenological psychopathology has been a richer understanding of an array of psychiatric experiences that had previously been limited to biological accounts. However, not only has our understanding of these conditions drastically transformed since the conception of phenomenological psychopathology in the early 1900s, but entirely new conditions have been recognised and defined. 

Section one of the special issue explores the following mental health conditions (or neurodiversities): Schizophrenia, Depression, Autism and Post-Traumatic Stress Disorder. The papers in the first section either challenge hitherto engrained ideas attached to a given condition or apply phenomenological psychopathology to conditions that have been overlooked by the discipline thus far. 

The second section of the special issue strives to revitalise the very methodology of phenomenological psychopathology. Although the vestiges of phenomenology can be found across disciplines, phenomenological psychopathology has done little to engage with fields outside of philosophy and psychiatry. Advances in disciplines such as anthropology, sociology, neuroscience, critical race theory, and linguistics offer exciting new opportunities which are missed by such a guarded approach.

The second section of the special issue coalesces around three key themes. The first theme involves addressing and ameliorating inequalities in phenomenological psychopathology. The second theme involves examining the role of value and virtue in phenomenological psychopathology. The third theme focuses on fusing phenomenological psychopathology with new approaches across disciplines. 

After a long period of obscurity, phenomenological psychopathology has re-emerged. A new focus on the patient’s voice has given the approach a valued place among once more dominant methodologies. The aim of this special issue is not to sever our roots. Rather, we hope to bring all that is fruitful in the tradition of phenomenological psychopathology into the present, opening it up to new possibilities.

Dr Lucienne Spencer is a Postdoctoral Researcher in Mental Health Ethics located within the Neuroscience, Ethics and Society (NEUROSEC) Team in the Department of Psychiatry, University of Oxford. Her research primarily focuses on phenomenology, epistemic injustice and the philosophy of psychiatry.

How Psychiatrists Navigate the Complexities of Diagnostic Reasoning

 

With mental health problems being more openly discussed in public, and individuals with mental health issues becoming an increasingly important and sometimes critical voice in mental health care, the way psychiatrists practice their craft has also become an object of deeper interest for a broader audience. One central aspect of psychiatric practice is diagnostic reasoning. 

When you visit a psychiatrist because you are suffering, you expect them, among other things, to determine whether you suffer from a mental disorder and, if so, which one. While it's crucial to recognize that this is part of a psychiatrist's job description, what is not trivial is the further question: how exactly does a psychiatrist arrive at the diagnostic conclusions they write in their reports and communicate to their patients? How does the psychiatrist know what the patient’s mental disorder is?

A swift response that someone at least vaguely familiar with psychiatry might give is, “Well, they ask the patients for their symptoms and compare these to the list of mental disorders in the DSM/ICD, which tells them what the diagnosis is,” or something along those lines. Though tempting to close the matter here, it is not that easy. Criteria and symptom lists do not apply themselves to patients; it has to be judged whether they apply to the patient. Furthermore, patients are imperfect sources of information. Imperfect in the sense that they will not automatically and correctly tell you all their symptoms, and sometimes they may claim to have symptoms but misjudge their problems. 

For example, some patients think it is normal to be socially isolated as they have been so for many years, so they will not mention social isolation as one of their problems. On the other hand, patients may say they ruminate about something, while the pattern of cognition that constitutes their “rumination” is more accurately classified as generalized worrying, in the language of psychopathology. These cases show that the process of psychiatric diagnostic reasoning implies more complicated patterns of reasoning and information gathering. A truism for any clinician supporting this is: You can't just pick up a DSM and be good at diagnostics; diagnosing is a skill to learn.

Just picking up the DSM isn't enough; diagnosing is a skill!

If this is so, how does proper psychiatric diagnostic reasoning work? Not many philosophers of psychiatry have attempted to provide a theory of this practical aspect of the epistemology of psychiatry. Some work can be found among scholars committed to the Phenomenological Tradition of psychiatry, some in the works of those focusing on the interpersonal quasi-hermeneutic sense-making processes between clinicians and patients, and finally, some thoughts are to be found among philosophers of psychiatry approaching the field from the perspective of philosophy of science.

In my recent book “How Does The Psychiatrist Know?”, the first book-length treatment of psychiatric diagnostic reasoning, I side with those approaching it from a philosophy of science perspective. I argue we should consider how the procedures of clinical psychiatric diagnostics typically look, i.e., what is taught in many of the central textbooks on psychiatric diagnostics and the standards of the leading psychiatric expert communities. Based on this, psychiatric diagnostic reasoning can largely be seen as a cognitive modelling process, quite similar to the procedures we see in scientific modelling.

For clinicians, philosophers, and anyone else willing to dig through an academic textbook to get an idea of the whole story I put forward, the book is available open access.

 

Adrian Kind is a postdoctoral researcher at the Charité Medical University in Berlin, Germany. He holds a PhD in Philosophy and master degrees in Philosophy as well as Psychology. He is a psychodynamic psychotherapist in advanced training. His main areas of interests are philosophy of psychiatry, philosophy of psychology and philosophy of medicine. He also works on philosophy of sports and philosophy of religion.

Behind the Stigma: the podcast

Today's post is by Seiara Imanova. 

When I began my Master’s in Psychology at King's College London, I quickly realized there was a significant gap between the advancements in mental health research and how that knowledge is communicated to the public. This inspired me to start my podcast, Behind the Stigma, with the goal of bridging the divide between academic discussions in psychology, neuroscience, and mental health, and making them accessible to the general public.

Logo of Behind the Stigma

Although psychology is a science, in the way that it uses empirical research and rigorous methodologies to understand phenomena, its practical applications—especially in clinical work—are often deeply rooted in subjectivity (biases, power dynamics, and social hierarchies etc). This is particularly evident when we examine the lived experiences of individuals, especially those from marginalized groups. These groups are often silenced or undervalued, a concept known as epistemic injustice.

Epistemic injustice refers to how certain individuals or communities have their knowledge and experiences systematically dismissed or ignored. Below are a few episodes where we tackle these critical issues:

Race, Culture & Social Equalities in Mental Health with Hári Sewell

In this episode, Hari Sewell, founder and Director of HS Consultancy, offers insights into the systemic forces driving racial disparities in healthcare. For example, he explains how societal attitudes shape patient outcomes by highlighting the disproportionate detention rates of Black individuals in psychiatric wards compared to their white counterparts. Also, how unconscious biases subtly influence clinical decision-making, affecting everything from patient engagement to the formulation of treatment plans. His insights underscore the urgent need to confront these systemic issues in order to build more just and equitable mental health practices.

Returning to Wholeness: A Story with Psychiatric Nurse Neseret Bemient

In this episode, Neseret Bemient, a former psychiatric nurse in Canada, shares her profound journey toward wholeness and alternative healing. Neseret reflects on her experiences in psychiatric care, revealing how her role often involved navigating a system that frequently dismissed the voices of patients. Diagnosed with medication-induced bipolar disorder, she discusses the ways in which her history and lived experiences as a refugee was an important factor in understanding her wellbeing. Neseret emphasizes the importance of integrating spirituality and holistic approaches into practice, shedding light on the issues within psychiatric care. She urges us to recognize and validate the diverse experiences and knowledge of individuals diagnosed with mental health conditions.

Philosophy of Psychiatry with Lisa Bortolotti 

In this episode, philosopher Lisa Bortolotti delves into the distinctions between delusions and irrational beliefs, as well as exploring implications for agency in youth mental health. She discusses her research examining how young people navigate clinical encounters within mental health settings, highlighting how practitioners often undermine or dismiss young people's contributions due to negative stereotypes, which can lead to epistemic injustice by discrediting their experiences. By advocating for a greater focus on individual agency and integrative approaches, she highlights the necessity of validating diverse experiences in mental health, with practices that validate young people's voices and nurture their sense of agency, ultimately encouraging better mental health outcomes that involve users in decision making. 

Through the podcast, I strive to create a platform for meaningful dialogue around mentalhealth. I believe that by fostering understanding and empathy, we can work together to create a more equitable mental health landscape for all.

Seiara Imanova is a doctoral candidate at the University of Birmingham. Behind the Stigma has explored a range of topics, including AI and mental health, the effects of antidepressant, psychedelics as a therapy, and institutional racism.

Dan Degerman joins EPIC

Excellent news for project EPIC! Dan Degerman, currently a Leverhulme Early Career Fellow, will join EPIC as a Senior Research Fellow based in the Philosophy Department at the University of Bristol. We asked Dan a few questions about current interests and future plans.

Dan Degerman

Hi Dan! What are your main research interests?

Hello! I am interested in issues at the intersection of mental health, emotions, and politics. 

For example, my first monograph, Political Agency and the Medicalisation of Negative Emotions, examined how the growing tendency to talk and think about emotions like anger and fear in terms of mental health problems affects our ability to act politically. It did so through a series of case studies of political movements and events – ranging from the Brexit referendum to the psychiatric service user/survivor movement – in which people’s capacity to participate in public life was called into question.

Since completing the book, I have been focusing on experiences of powerlessness among individuals with mental illness, particularly in terms of how symptoms, diagnoses, and stigma may lead such individuals to speak or be silent. These are, of course, issues that are closely related to epistemic injustice in healthcare as well as my case study on the EPIC project.

Why do you think it is important to study epistemic injustice in healthcare?

Being ill tends to increase our dependence on others, not only family members and healthcare practitioners, but also on, for example, friends, colleagues, and teachers. Over a remarkably short and fruitful period, scholars working on epistemic injustice in healthcare have provided rich insights into how people with ill health can be silenced in the relationships that arise and change through illness. This work has been and continues to be vital to empowering patients and improving healthcare.

However, a worry I have with the growing scholarship on epistemic injustice, in general, is that silence tends to feature in it only as a socially imposed harm and, accordingly, something that should be broken. Such a narrow understanding of silence overlooks the range of meanings and functions of silence for people with ill health, some of which may be restorative or empowering. And, by acting on it carelessly, we risk compounding the epistemic and other harms that such people face.

To realise the practical potential of epistemic injustice as a concept for patients and healthcare practitioners and to ameliorate the harms that this concept highlights, we need a better understanding of silence in ill health and its relationship to epistemic injustice. This is what I will aim to provide in my case study by examining how people with bipolar disorder – who may have a unique and conflicted relationship to silence and speech – experience and use silence in their lives.

What are you working on right now?

I’m working on a series of papers that will inform the conceptual framework of my case study. The first sets out an epistemic case for recognising a substantive political right to silence.

American crime shows might mislead us into thinking that this right is already legally protected. The phrase ‘You have the right to remain silent’ is probably among the most famous in the English language. In the UK – where what we do not say can be used against us in court – we do not have that right. However, even if we did, a right to remain silent in criminal contexts is too circumscribed to provide the protection that we need for our silence in a democracy.

A political right to silence must be able to protect our ability to be silent across various contexts because there are often good epistemic reasons for us not to speak. For example, we might feel pressured to lie if we speak, or we might know that what we say will be misunderstood or misused by others. In such circumstances, silence might be the best option. But, in a society like ours where silence is frequently denigrated, it may seem an untenable one.

I think this right could have important implications for people with ill health, who can, for example, be subject to pressure to disclose their illness at their place of work or education.

I’m looking forward to developing this and other ideas over the next few years in the context of the EPIC project.