Mad in America: Rethinking Mental Health18 Feb

UberTherapy and the Enshittification of our Relational Lives: Part 2 of our Interview with Elizabeth Cotton

Elizabeth Cotton is Associate Professor of Responsible Business at the University of Leicester and the founder of Surviving Work, which carries out socially engaged research on mental health and work. She has worked with health teams and trade unions, practiced as a psychotherapist in the NHS, and now runs the Digital Therapy Project, a group of UK and US researchers studying the future of therapy from both sides of the relationship.

In her new book, UberTherapy: The New Business of Mental Health, she explores the effects of reorganizing mental health care around the logic of the app store. Therapy is now something you can scroll through on your phone, match with in seconds, and rate like a ride share. Platforms promise frictionless access and personalized care. What is harder to see is how this new "mental health marketplace" is reshaping what therapy is, how it feels, and who it is really built to serve.

UberTherapy is part political economy, part insider account of therapy work, part literary exploration of what it actually feels like to bring our most distressed selves to the mental health app ecosystem.

In the second part of our conversation, Cotton traces how public austerity and platform capitalism have combined to turn mental health care into a set of digital products, governed by algorithms, data extraction, and dynamic pricing. In this world, qualified human therapists are slowly displaced by AI-driven "solutions," while those who remain are pushed into precarious, low-paid platform work.

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