Table Of ContentHEALTH, TECHNOLOGY AND SOCIETY
Digital Healthcare
and Expertise
Mental Health and
New Knowledge Practices
Claudia Egher
Health, Technology and Society
Series Editors
Rebecca Lynch
Wellcome Centre for Cultures and Environments
of Health
University of Exeter
Exeter, UK
Martyn Pickersgill
Usher Institute
University of Edinburgh
Edinburgh, UK
Medicine, health care, and the wider social meaning and management of
health are undergoing major changes. In part this reflects developments
in science and technology, which enable new forms of diagnosis, treat-
ment and delivery of health care. It also reflects changes in the locus of
care and the social management of health. Locating technical develop-
ments in wider socio-economic and political processes, each book in the
series discusses and critiques recent developments in health technologies
in specific areas, drawing on a range of analyses provided by the social
sciences. Some have a more theoretical focus, some a more applied focus
but all draw on recent research by the authors. The series also looks
toward the medium term in anticipating the likely configurations of
health in advanced industrial society and does so comparatively, through
exploring the globalization and internationalization of health.
Claudia Egher
Digital Healthcare
and Expertise
Mental Health and New Knowledge
Practices
Claudia Egher
Department of Health, Ethics and Society
Maastricht University
Maastricht, The Netherlands
ISSN 2946-3386 ISSN 2946-3378 (electronic)
Health, Technology and Society
ISBN 978-981-16-9177-5 ISBN 978-981-16-9178-2 (eBook)
https://doi.org/10.1007/978-981-16-9178-2
© The Editor(s) (if applicable) and The Author(s) 2023. This book is an open access publication.
Open Access This book is licensed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing,
adaptation, distribution and reproduction in any medium or format, as long as you give appropriate
credit to the original author(s) and the source, provide a link to the Creative Commons licence and
indicate if changes were made.
The images or other third party material in this book are included in the book’s Creative Commons
licence, unless indicated otherwise in a credit line to the material. If material is not included in the book’s
Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the
permitted use, you will need to obtain permission directly from the copyright holder.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or
the editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.
This Palgrave Macmillan imprint is published by the registered company Springer Nature Singapore
Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721,
Singapore
To Véronique
Series Editors’ Preface
Medicine, healthcare, and the wider social meanings and management of
health are continually in the process of change. While the “birth of the
clinic” heralded the process through which health and illness became
increasingly subject to the surveillance of medicine, for example, surveil-
lance has become more complex, sophisticated, and targeted—as seen in
the search for “precision medicine” and now “precision public health.”
Both surveillance and health itself emerge as more provisional, uncertain,
and risk-laden as a consequence, and we might also ask what now consti-
tutes “the clinic,” how meaningful a concept of a clinic ultimately is, and
where else might we now find (or not find) healthcare spaces and
interventions.
Ongoing developments in science and technology are helping to
enable and propel new forms of diagnosis, treatment, and the delivery of
healthcare. In many contexts, these innovations both reflect and further
contribute to changes in the locus of care and burden of responsibility for
health. Genetics, informatics, and imaging—to name but a few—are
redefining collective and individual understandings of the body, health,
and disease. At the same time, long-established and even ostensibly mun-
dane technologies and techniques can generate ripples in local discourse
and practices as ideas about the nature and focus of healthcare shift in
response to global debates about, for instance, One Health and
Planetary Health.
vii
viii Series Editors’ Preface
The very technologies that (re)define health are also the means through
which the individualization of healthcare can occur—through, for
instance, digital health, diagnostic tests, and the commodification of
restorative tissue. This individualization of health is both culturally
derived and state-sponsored, as exemplified by the promotion of “self-
care.” These shifts are simultaneously welcomed and contested by profes-
sionals, patients, and the wider public. Hence they at once signal and
instantiate wider societal ambivalences and divisions.
This series explores these processes within and beyond the conven-
tional domain of “the clinic,” and asks whether they amount to a qualita-
tive shift in the social ordering and value of medicine and health. Locating
technical use and developments in wider socioeconomic and political
processes, each book discusses and critiques the dynamics between health,
technology, and society through a variety of specific cases and draws on a
range of analyses provided by the social sciences.
The series has already published more than 20 books that have explored
many of these issues, drawing on novel, critical, and deeply informed
research undertaken by their authors. In doing so, the books have shown
how the boundaries between the three core dimensions that underpin the
whole series—health, technology, and society—are changing in funda-
mental ways.
In Digital Healthcare and Expertise, Claudia Egher focuses on an area
that has attracted much promise, hope, and investment—but which nev-
ertheless remains less well studied than might be expected within the
social studies of medicine: digital mental health. This exciting mono-
graph considers compelling questions around the construction and medi-
ation of experiences framed often in psychiatry and beyond as “bipolar
disorder” within digital spaces, with particular analytic attention to the
performance and negotiation of expertise. It provides a bold analysis of
the reconfiguring of (the relations between) forms of online (and offline)
epistemic practices, performances of and claims to knowledge and exper-
tise, and understandings and experiences of the self. Through Digital
Healthcare and Expertise, Egher illustrates the complexities inherent to
shifting understandings and deployments of expertise relating to bipolar
Series Editors’ Preface ix
disorder within online platforms, and presents a novel interpellation of
science and technology studies, medical sociology, and media studies that
will be vital to future analyses of health, technology, and society.
London, UK Rebecca Lynch
Edinburgh, UK Martyn Pickersgill
Acknowledgments
Working on this book has been an incredible adventure, and I am deeply
grateful for all the help and support I have received along the way from
colleagues, family, and friends, from the first stages of my doctoral
research upon which this work is based to the close readings of its penul-
timate draft.
Having immersed myself in the experiences of people diagnosed with
bipolar disorder for many years now, I have acquired a rich understand-
ing of the challenges involved in the management of this condition.
Without wanting to be presumptuous, I would therefore like to first and
foremost express my gratitude to the many people diagnosed with bipolar
disorder, who have written about their states, experiments, joys, and dif-
ficulties on the digital platforms I studied. In the absence of such endeav-
ors, this book would literally not have been possible. I do hope that it
does justice to their tremendous efforts and valuable insights.
I would particularly like to thank Natasha Tracy and Julie A. Fast, who
kindly allowed me to interview them and use materials from their digital
platforms. I can still vividly remember how impressed I was during the
first year of my PhD, when I discovered their blogs and became aware of
the numerous and varied contributions they were making across different
media. I continue to be impressed by their work, and I would like to
express my appreciation for their dedication and considerable efforts to
help improve the lives of other people diagnosed with bipolar disorder.
xi
