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Author: Isabella Helton

Leveraging Google’s Technology to Improve Mental Health

Last Tuesday, October 10 was World Mental Health Day. To mark the holiday, the Duke Institute for Brain Sciences, in partnership with other student wellness organizations, welcomed Dr. Megan Jones Bell, PsyD, the clinical director of consumer and mental health at Google, to discuss mental health. Bell was formerly chief strategy and science officer at Headspace and helped guide Headspace through its transformation from a meditation app into a comprehensive digital mental health platform, Headspace Health. Bell also founded one of the first digital mental health start-ups, Lantern, where she pioneered blended mental health interventions leveraging software and coaching. In her conversation with Dr. Murali Doraiswamy, Duke professor of psychiatry and behavioral sciences, and Thomas Szigethy, Associate Dean of Students and Director of Duke’s Student Wellness Center, Bell revealed the actions Google is taking to improve the health of the billions of people who use their platform. 

She began by defining mental health, paraphrasing the World Health Organization’s definition. She said, “Mental health, to me, is a state of wellbeing in which the individual realizes his or her or their own abilities, can cope with the normal stresses of life, work productively and fruitfully, and can contribute to their own community.” Rather than taking a medicalized approach to mental health, she argued, mental health should be recognized as something that we all have. Critically, she said that mental health is not just mental  disorders; the first step to improving mental health is recognition and upstream intervention.

Underlining the critical role Google plays in global mental health, Bell cited multiple statistics: three out of four people turn to the internet first for health information. On Google Search, there are 100 million searches on health everyday; Youtube boasts 25 billion views of mental health content. Given their billions of users, Bell intimated Google’s huge responsibility to provide people with accurate, authoritative, and empathetic information. The company has multiple goals in terms of mental health that are specific to different communities. There are three principal audiences that Bell described Google’s goals for: consumers, caregivers, and communities. 

Google’s consumer-facing focus is providing access to high quality information and tools to manage their users’ health. With regards to caregivers, Google strives to create strong partnerships to create solutions to transform care delivery. In terms of community health, the company works with public health organizations worldwide, focusing on social determinants of health and aiming to open up data and insights to the public health community. 

Szigethy followed by launching a discussion of Google’s efforts to protect adolescents. He referenced the growing and urgent mental health crisis amongst adolescents; what is Google doing to protect them? 

Bell mentioned multiple projects across different platforms in order to provide youth with safer online experiences. Key to these projects is the desire to promote their mental health by default. On Google Search, this takes the form of the SafeSearch feature. SafeSearch is on by default, filtering out explicit or inappropriate results. On Youtube, default policies include various prevention measures, one of which automatically removes content that is considered “immitable.” Bell used the example of disordered eating content in order to explain the policy– in accordance with their prevention approach, YouTube removes dangerous eating-related content containing anything that the viewer can copy. YouTube also has age-restricted videos, unavailable to users under 18, as well as certain product features that can be blocked. Google also created an eating disorder hotline with experts online 24/7. 

Jokingly, Bell assured the Zoom audience that Google wouldn’t be creating a therapist chatbot anytime soon — she asserted that digital tools are not “either or.” When the conversation veered towards generative AI, Bell admitted that AI has enormous potential for helping billions of people, but maintained that it needs to be developed in a responsible way. At Google, the greatest service AI provides is scalability. Google.org, Bell said, recently worked with The Trevor Project and ReflexAI on a crisis hotline for veterans called HomeTeam. Google used AI that stimulated crises to help scale up training for volunteers. Bell said, “The human is still on the other side of the phone, and AI helped achieve that”. 

Next, Bell tackled the question of health information and misinformation– what she called a significant area of focus for Google. Before diving in, however, Bell clarified, “It’s not up to Google to decide what is accurate and what is not accurate.” Rather, she said that anchoring to trusted organizations is critical to embedding mental health into the culture of a community. When it comes to health information and misinformation, Bell encapsulated Google’s philosophy in this phrase: “define, operationalize, and elevate high quality information.” In order to combat misinformation on their platform, Google asked the National Academy of Medicine to help define what accurate medical sources are. The Academy then put together a framework of authoritative health info, which WHO then nationalized. YouTube then launched its “health sources” feature, where videos from the framework are the first thing that you see. In effect, the highest quality information is raised to the top of your page when you make a search. Videos in this framework also have a visible badge on the watch panel that features a  phrase like “from a healthcare professional” or “from an organization with a healthcare professional.” Bell suggested that this also helps people to remember where their information is coming from, acting as a guardrail in itself. Additionally, Google continues to fight medical misinformation with an updated medical misinformation policy, which enables them to remove content that is contradictory to medical authorities or medical consensus. 

Near the end of the conversation, Szigethy asked Bell if she would recommend any behaviors for embracing wellbeing. A prevention researcher by background, Bell stressed the importance of early and regular action. Our biggest leverage point for changing mental health, she asserted, is upstream intervention and embracing routines that foster our mental health. She breaks these down into five dimensions of wellbeing: mindfulness, sleep, movement and exercise, nutrition, and social connection. Her advice is to ask the question: what daily/weekly routines do I have that foster each of these? Make a list, she suggests, and try to incorporate a daily routine that addresses each of the five dimensions. 

Before concluding, Bell advocated that the best thing that we can do is to approach mental health issues with humility and listen to a community first. She shared that, at Headspace, her team worked with the mayor’s office and community organizations in Hartford, Connecticut to co-define their mental health goals and map the strengths and assets of the community. Then, they could start to think about how to contextualize Headspace in that community. Bell graciously entered the Duke community with the same humility, and her conversation was a wonderful commemoration of World Mental Health Day. 

By Isa Helton, Class of 2026

Bolivia’s Lithium is Like White Gold in the Salar de Uyuni

As the world undergoes the great energy transition — from fossil fuels to alternative energy and batteries — rare earth metals are becoming more precious.

Open The Economist, Forbes, or Fortune, and you’ll see an article nearly every day on Lithium, Nickel, or Copper. For investors seeking to profit off of the transition, lithium seems like a sure bet. Dubbed “white gold” for electric vehicles, the lightweight metal plays a key role in the cathodes of all types of lithium-ion batteries that power electric vehicles (EVs). Although EVs produce fewer greenhouse gasses than gas- or diesel-powered vehicles, their batteries require more minerals, particularly lithium. 

On Sept. 26, Duke’s campus welcomed the first in a series of discussions on climate and energy diplomacy focused on the challenges and opportunities of mining and development in South America’s Lithium Triangle. In a room crowded with curious undergraduate and graduate students alike, some lucky enough to have snagged a seat while others stood at the perimeters, three experts discussed the possible future of Bolivia as a major player in the global lithium market. 

Professor Avner Vengosh of the Nicholas School

Duke Distinguished Professor Avner Vengosh, Nicholas Chair of Environmental Quality in the Nicholas School of the Environment, began by highlighting the staggering EV growth in 2020-2022: Sales of electric cars have more than tripled in three years, from around 4% of new car sales in 2020 to 14% in 2022. That number is expected to rise to 29.50% in 2028. Speaking of the critical element to EV production, lithium, Vengosh said frankly, “we don’t have enough.” 

Lithium is mined from two major sources, Vengosh explained. The first is from hard-rock pegmatite, where lithium is extracted through a series of chemical processes. Most of these deposits are found in Australia, the world’s biggest source. The second is from lithium-rich brines, typically found in Argentina, Bolivia, and Chile, also known as the “Lithium Triangle.” These brine deposits are typically found in underground reservoirs beneath salt flats or saltwater lakes. The Salar de Uyuni in Bolivia is the world’s largest salt lake, and the largest lithium source in the world. It stretches more than 4,050 square miles and attracts tourists with its reflective, mirror-like surface. 

Mountains surrounding the Uyuni salt flat during sunrise By Diego Delso, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=47617647
Mountains surrounding the Uyuni salt flat during sunrise, (Diego Delso)

A group of Duke students led by a PhD candidate pursuing research on Bolivian lithium development recently traveled to Bolivia to understand different aspects of lithium mining. They asked questions including: 

  • How renewable is the lithium brine? 
  • Are there other critical raw minerals in the lithium-rich brines? 
  • What are the potential environmental effects of lithium extraction?
  • What is the water footprint of the lithium extraction process?
  • Is water becoming a limiting factor for lithium production?

The Duke team conducted a study with the natural brine in the Salar, taking samples of deep brines, evaporation ponds, salts from evaporation ponds, wastewaters, and the lithium carbonate. Vengosh said that “we can see some inconsistency in the chemistry of the water that is flowing into the chemistry of the brine.”

This indicates that there is a more complex geological process in the formation of the brine than the simple flow of water into the lake. The team also confirmed the high purity of the lithium carbonate product and that there are no impurities in the material. Additionally, the Duke team found that the wastewater chemistry produced after lithium carbonate production is not different from that of the original brines. Thus, there are no limitations for recycling the water back to the Salar system.

After Vengosh shared the findings of the Duke research team, Kathryn Ledebur, director of the Andean Information Network (AIN) in Cochabamba, Bolivia and Dr. Scott MacDonald, chief economist at Smith’s Research & Gradings and a Caribbean Policy Consortium Fellow, discussed Bolivia’s lithium policy. With the largest untapped lithium deposits in the world, Bolivia has constructed a pilot plan for their lithium production, but Ledebur highlighted that the biggest hurdle is scaling. Additionally, with a unique prior-consultation system in place between the central government and 36 ethnic and indigenous groups in Bolivia, natural resources are a key topic of concern and grassroots action. Ledebur said, “I don’t see that issue changing any time soon.”

Another hurdle is that Bolivian law requires that the extraction process is controlled by the state (the state must own 51%). Foreign investors have been hesitant to work with the central government, which nationalized lithium in 2008 despite, critics said, lacking much of the necessary technology and expertise. 

Maxwell Radwin, a writer for Mongabay, writes, “Evo Morales, the former socialist president who served from 2006 to 2019, nationalized the industry, promising that foreign interests wouldn’t plunder Bolivia’s natural resources as they had in the past. Instead, he said, lithium would propel the country to the status of a world power. Morales didn’t just want to export lithium, though; he wanted to produce batteries and cars for export. This complicated deals with potential investors from France, Japan, Russia and South Korea, none of which came to fruition because, among other things, they were required to take on YLB (the state-owned lithium company) as an equal partner.”

Ledebur said, “At this point in time, the Bolivian government has signed three contracts… and I think things will fall into place.” 

Naysayers say that the Bolivian government hasn’t done anything to take advantage of the massive market sitting beneath their Salars and that grassroot consultations don’t work. Ledebur said, “I don’t think that it’s perfect, but it’s happening.”

Duke students will return to Bolivia with professor Vengosh next year to conduct more research on the lithium extraction process. Then, they’ll be able to see the effects of this ‘happening’ first-hand. 

By Isa Helton, Class of 2026

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