MuchBetter.Help
A few weeks ago I received a picture sent out during that existentially painful moment called mental health week to Lyft drivers. In support of actual mental health they offered their drivers (although denying their status as such) a 50% discount on a subscription to BetterHelp.
That’ll make it better.
If the offer was extended to Uber drivers, since both companies share the same investors, they could pay for their therapy with their Uber drivers’ credit card. And if they don’t have the money to pay their UberTherapist their UberCard offers pay-day-loans in advance of being dynamically paid. Not technically slavery but one giant leap into the matrix of Angerland that awaits those of us trying to make sense of work under platform capitalism.
It is within this complex and mind bending industrial landscape that Worker Info Exchange is holding a series of podcasts for Uber drivers as part of its campaign in the UK and the Netherlands against Uber for dynamic pay practices. Dynamic pricing introduced in 2023 through AI technologies allows the platform to adjust prices and (get this) driver pay depending on a range of factors that we don’t know about. The reason why dynamic pay as a form of AI management is so concerning is what happens next - financial instability, falling rates of pay, and gaming of the algorithm and an inherent algorithmic bias about who stands to lose out the most to the automated wage theft that dynamic AI systems are designed to operationalise.
The creation of DynamicPay.org and the collective legal action demanding data and algorithmic transparency for Uber drivers was set up to make sure that the algorithmic and AI harms to drivers can be evidenced and subsequently compensated. Meticulous important organizing work that underlines just quite how biblical the fight to regulate platform work is going to be. As the heroic efforts of trade unions and worker organisations within the International Labour Conference this month to adopt minimum standards for decent work in the platform economy shows us, this isn’t just about platform workers, its about the impact on all forms of work under this economic model and attempts to make it more decent for all of us.
As part of this campaign to encourage Uber drivers to sign up to the group action, WIE is doing a weekly live podcast for drivers. The first podcast Can UK Drivers Resist Uber? with Mark MacGann, Uber whistleblower and Veena Dubal, Professor of Law UC Irvine and James Farrar from WIE talking about algorithmic bias and the inside workings of Uber, and the legal cases being taken against labour platforms.
The second podcast recorded last week The Great Uberisation: The Algorithmic Takeover of Work with James, Martin Smith and me talking about UberTherapy. We talked about the process of uberization and what is happening now around AI and automation, drawing the parallels between drivers and therapists in a way that only that amount of collective experience can do with a confidence and clarity that is actually useful. To listen to the full discussion The Great Uberisation click here.
UberTherapists don’t yet work under a system of dynamic pay, but the platform and AI architecture that makes this possible is already in place owned in the main by the same big players and financing as Uber drivers. So there is no reason to be cheerful that this is not going to happen in the emerging industrial relations of therapy including the threat of large scale automation as we culturally and clinically start to argue that people prefer a Claude to actual people.
A few weeks ago we ran an event at The Relational School with Jumanah Younis and Claudia Coussins, with the gracious hosting by Robert Downes, and opened up a conversation about what lies ahead for our sector as uberization takes hold and started to plan for organizing UberTherapists.
In the discussions someone I love asked an important question about whether we could imagine a time when therapists went on strike – and instead of seizing onto this by saying YES and banging on about the Kaiser Permanente hunger strikes in California who last year tried to push back the platformization of mental health – I let my recent experience of 5 weeks of strike action and all that means lead me down an organizing cul-de-sac and a complete absence of hopeful imagination.
So here it is. This is my answer to the question about whether we can imagine a time when therapists will be prepared to go on strike.
A MuchBetterHelp is becoming visible through the relationality and strategic action of platform workers in other sectors. Coalitions of multiple unions and worker networks, consumers and B2B clients will over time establish the possibility of improving rates and working conditions for future UberTherapists. This is based on the probably obvious statement that if you want people to be safe to say what is on their mind you have to protect the people helping you to do that. In therapy, the safety of the new consumers of on-demand therapy requires that UberTherapists are able to defend the safe conditions for them to do that by joining a union that can defend them.
The MuchBetterHelp campaign merch might say ‘Free Association requires Freedom of Association’.
Those networks such as ADCU and WIE, that centre their work around the interests of platform workers and the progressive networks of psychotherapists doing the data collection like PsiAN in the US will dominate the future coalitions and campaigns. They will innevitably take the lead on the basis that they have both the data and moral high ground based on years of forming actual relationships with actual platform workers.
They will also be those groups that are open to working with a diverse range of actors across different human rights and social justice campaigns often with critical perspectives on mental health services. We will need to be discerning in working with those networks that are already working in a way that is open to generative coalitions and practices that can navigate this new organizing terrain rather than body block the important relationshps that need building now.
As a sector we must start to design our vision of MuchBetterHelp. This will involve the tried and tested model of setting up a dedicated UberTherapy Observatory, that monitors the digital sector as we enter the age of de-financialisation and automation in health and social care. This research and public engagement work will join the corporate dots between private equity and private medical insurance, digital health providers and AI robotics and the platformisation of private practice in a way that cuts short the time we are now wasting talking about technology out of its business context.
Part of the work of MuchBetterHelp will be to establish a Digital Therapy Kite Mark that centres the interests of consumers and UberTherapists, and their dependency on each other. We all lose if Uber drivers and UberTherapists can’t earn a living which is why our first campaign will be entitled ‘Should it worry you if your therapist uses a foodbank?’ And why if you’re a therapist taking an Uber ride you should tell your driver what you are paying and ask them to join the Dynamic Pay Claim here.
Our imaginings of a MuchBetterHelp in our conversations, networks and relationships is the work of hope that now needs to take place.
On the 26th June 6.30-8pm BST Andrew Samuels, Linda Michaels and Elizabeth Cotton will discuss the new book UberTherapy: The New Business of Mental Health and the politics of digital therapy. Join us to continue the conversation about what a MuchBetterHelp might look like and how we might construct it in all ways and always together here.