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MikeJohnson comments on Anti-tribalism and positive mental health as high-value cause areas - Effective Altruism Forum

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Comment author: MikeJohnson 18 October 2017 11:38:59PM *  2 points [-]

QRI is very interested and working hard on the mental health cause area; notable documents are Quantifying Bliss and Wireheading Done Right - more to come soon. There are also other good things in this space from e.g. Michael D. Plant, Spencer Greenberg, and perhaps Enthea.

On the tribalism point, I agree tribalism causes a lot of problems; I'd also agree with what I take you to be saying that in some senses it may be a load-bearing part of an Evolutionary Stable Strategy (ESS) which may prove troublesome to tinker with. Finally, I agree that mental health is a potentially upstream factor in some of the negative-sum presentations of tribalism.

I would say it's unclear at this point whether the EA movement has the plasticity required to make mental health an Official Cause Area -- I believe the leadership is interested but "revealed constraints" seem to tell a mixed story. I'm certainly hoping it'll happen if enough people get together to 'start the party'.

(Personal opinions; not necessarily shared by others at QRI)

Comment author: e19brendan 23 October 2017 04:34:25PM 5 points [-]

Can you say more about the "revealed constraints" here? What would be the appropriate preconditions for "starting the party?" I think it can and should be done - we've embraced frontline cost-effectiveness in doing good today, and we've embraced initiatives oriented towards good in the far future even in the absence of clear interventions; even so, global mental health hasn't quite fit into either of those EA approaches, despite being a high-burden problem that is extremely neglected and arguably tractable.

Mental health interventions will become more cost-effective on an absolute scale, as we advance knowledge and implement better, and on a relative scale, as we largely overcome the burden of communicable diseases like malaria. The EA community should rally around the possibility of accelerating the development and dissemination of mental health interventions. It is quite exciting to see the work of some EAs in this space, and I think EAs could bring real value to the academic and nonprofit leaders involved in global mental health. It may be that working on this issue is more valuable at this point than merely funding this cause, but that's a broader strategy discussion. I'm excited to join other EAs in building the case for the relevance of mental health to the movement.

Comment author: MikeJohnson 24 October 2017 08:38:32PM *  4 points [-]

Can you say more about the "revealed constraints" here? What would be the appropriate preconditions for "starting the party?" I think it can and should be done - we've embraced frontline cost-effectiveness in doing good today, and we've embraced initiatives oriented towards good in the far future even in the absence of clear interventions; even so, global mental health hasn't quite fit into either of those EA approaches, despite being a high-burden problem that is extremely neglected and arguably tractable.

Right, I think an obvious case can be made that mental health is Important; making the case that it's also Tractable and Neglected requires more nuance but I think this can be done. E.g., few non-EA organizations are 'pulling the ropes sideways', have the institutional freedom to think about this as an actual optimization target, or are in a position to work with ideas or interventions that are actually upstream of the problem. My intuition is that mental health is hugely aligned with what EAs actually care about, and is much much more tractable and neglected than the naive view suggests. To me, it's a natural fit for a top-level cause area.

The problem I foresee is that EA hasn't actually added a new Official Top-Level Cause Area since... maybe EA was founded? And so I don't expect to see much of a push from the EA leadership to add mental health as a cause area -- not because they don't want it to happen, but because (1) there's no playbook for how to make it happen, and (2) there may be local incentives that hinder doing this.

More specifically: mental health interventions that actually work are likely to be weird- e.g., Michael D. Plant's ideas about drug legalization is a little weird; Enthea's ideas about psilocybin is more weird; QRI's valence research is very weird. Now, at EAG there was a talk suggesting that we 'Keep EA Weird'. But I worry that's a retcon, that weird things have been grandfathered into EA but institutional EA is not actually very weird, and despite lots of funding, it has very little funding for Actually Weird Things. Looking at what gets funded ('revealed preferences') I see support for lots of conventionally-worthy things and some appetite for moderately weird things, but almost none for things that are sufficiently weird that they could seed a new '10x+' cause area ("zero-to-one weird").

*Note to all EA leadership reading this: I would LOVE LOVE LOVE to be proven wrong here!

So, my intuition is that EAs who want this to happen will need to organize, make some noise, 'start the party', and in general nurture this mental-health-as-cause-area thing until it's mature enough that 'core EA' orgs won't need to take a status hit to fund it. I.e., if we want EA to rally around mental health, it's literally up to people like us to make that happen.


I think if we can figure out good answers to these questions we'd have a good shot:

  • Why do you think mental health is Neglected and Tractable?

  • Why us, why now, why hasn't it already been done?

  • Which threads & people in EA do you think could be rallied under the banner of mental health?

  • Which people in 'core EA' could we convince to be a champion of mental health as an EA cause area?

  • Who could tell us What It Would Actually Take to make mental health a cause area?

  • What EA, and non-EA, organizations could we partner with here? Do we have anyone with solid connections to these organizations?

(Anyone with answers to these questions, please chime in!)

Comment author: Gregory_Lewis 25 October 2017 06:08:44PM 3 points [-]

FWIW, my impression of EA leadership is that they (correctly) find that mental health isn't the best target for currently existing people due to other things in global health, and it isn't the best thing for future people, due to dominance of X risk etc. I don't see a huge 'gap in the market' for marginal efforts re global mental health for really outsized impact.

Openphil funds a variety of things outside the 'big cause areas' (criminal justice, open science, education, etc.), so there doesn't seem a huge barrier to this cause area getting traction.

Funding weird stuff is a bit tricky, as only a tiny minority of weird things are worthwhile, even ex ante: most are meritless. I guess you want to select from a propitious reference class, and to look for some clear forecast indicators that can allow it to be promptly dropped from the portfolio. It doesn't strike me as crazy that there's no current weird project candidate that clears the bar as being worth speculative investment.

Comment author: MichaelPlant 25 October 2017 07:13:51PM *  2 points [-]

FWIW, my impression of EA leadership is that they (correctly) find that mental health isn't the best target for currently existing people due to other things in global health

Can you say what you think is more valuable? If i'm looking at GW's top charities, the options are AMF or SCI. AMF is about saving lives, rather than improving lives, so that's a moral question as to how you trade those off. I'm not really sure how to think of the happiness impact of SCI. GW seem to argue it's worthwhile because it increases income for the recipient, but I'm pretty sceptical increases in income, even at low levels, improve aggergrate happiness (see this paper on Give Directly that found it didn't increase overall happiness)

Comment author: Gregory_Lewis 27 October 2017 12:19:46AM 1 point [-]

I don't think mental health has comparably good interventions to either of these, even given the caveats you note. Cost per QALY or similar for treatment looks to have central estimates much higher than these, and we should probably guess mental health interventions in poor countries have more regression to the mean to go.

Some hypothetical future intervention could be much better, but looking for these isn't that neglected, and such progress looks intractable given we understand the biology of a given common mental illness much more poorly than a typical NTD.

Comment author: MikeJohnson 27 October 2017 06:33:26PM 1 point [-]

I don't think mental health has comparably good ... [c]ost per QALY or similar.

Some hypothetical future intervention could be much better, but looking for these isn't that neglected, and such progress looks intractable given we understand the biology of a given common mental illness much more poorly than a typical NTD.

I think the core argument for mental health as a new cause area is that (1) yes, current mental health interventions are pretty bad on average, but (2) there could be low-hanging fruit locked away behind things that look 'too weird to try', and (3) EA may be in a position to signal-boost the weird things ('pull the ropes sideways') that have a plausible chance of working.

Using psilocybin as an adjunct to therapy seems like a reasonable example of some low-hanging fruit that's effective, yet hasn't been Really Tried, since it is weird. And this definitely does not exhaust the set of weird & plausible interventions.

I'd also like to signal-boost @MichaelPlant's notion that "A more general worry is that effective altruists focus too much on saving lives rather than improving lives.." At some point, we'll get to hard diminishing returns on how many lives we can 'save' (delay the passing of) at reasonable cost or without significant negative externalities. We may be at that point now. If we're serious about 'doing the most good we can do' I think it's reasonable to explore a pivot to improving lives -- and mental health is a pretty key component of this.

Comment author: Gregory_Lewis 27 October 2017 07:32:52PM 0 points [-]

1-3 looks general, and can in essence be claimed to apply to any putative cause area not currently thought to be a good candidate. E.g.

1) Current anti-aging interventions are pretty bad on average. 2) There could be low hanging fruit behind things that look 'too weird to try'. 3) EA may be in position to signal boost weird things that have plausible chance of working.

Mutatis mutandis criminal justice reform, improving empathy, human enhancement, and so on. One could adjudicate these competing areas by evidence that some really do have these low hanging fruit. Yet it remains unclear that (for example) things like psilocybin data gives more a boost than (say) cryonics. Naturally I don't mind if enthusiasts pick some area and give it a go, but appeals to make it a 'new cause area' based on these speculative bets look premature by my lights: better to pick winners based on which of the disparate fields shows the greatest progress, such that one forecasts similar marginal returns to the 'big three'.

(Given GCR/x-risks, I think the 'opportunities' for saving quite a lot of lives - everyone's - are increasing. I agree that ignoring that - which one shouldn't - it seems likely status quo progress should exhaust preventable mortality faster than preventable ill-health. Yet I don't think we are there yet.)

Comment author: MikeJohnson 27 October 2017 11:03:22PM 1 point [-]

I worry that you're also using a fully-general argument here, one that would also apply to established EA cause areas.

This stands out at me in particular:

Naturally I don't mind if enthusiasts pick some area and give it a go, but appeals to make it a 'new cause area' based on these speculative bets look premature by my lights: better to pick winners based on which of the disparate fields shows the greatest progress, such that one forecasts similar marginal returns to the 'big three'.

There's a lot here that I'd challenge. E.g., (1) I think you're implicitly overstating how good the marginal returns on the 'big three' actually are, (2) you seem to be doubling down on the notion that "saving lives is better than improving lives" or that "the current calculus of EA does and should lean toward reduction of mortality, not improving well-being", which I challenged above, (3) I don't think your analogy between cryonics (which, for the record, I'm skeptical on as an EA cause area) and e.g., Enthea's collation of research on psilocybin seems very solid.

I would also push back on how dismissive "Naturally I don't mind if enthusiasts pick some area and give it a go, but appeals to make it a 'new cause area' based on these speculative bets look premature by my lights" sounds. Enthusiasts are the ones that create new cause areas. We wouldn't have any cause areas, save for those 'silly enthusiasts'. Perhaps I'm misreading your intended tone, however.

Comment author: Gregory_Lewis 28 October 2017 09:25:08AM 1 point [-]

Respectfully, I take 'challenging P' to require offering considerations for ¬P. Remarks like "I worry you're using a fully-general argument" (without describing what it is or how my remarks produce it), "I don't think your analogy is very solid" (without offering dis-analogies) don't have much more information than simply "I disagree".

1) I'd suggest astronomical stakes considerations imply at that one of the 'big three' do have extremely large marginal returns. If one prefers something much more concrete, I'd point to the humane reforms improving quality of life for millions of animals.

2) I don't think the primacy of the big three depends in any important way on recondite issues of disability weights or population ethics. Conditional on a strict person affecting view (which denies the badness of death) I would still think the current margin of global health interventions should offer better yields. I think this based on current best estimates of disability weights in things like the GCPP, and the lack of robust evidence for something better in mental health (we should expect, for example, Enthea's results to regress significantly, perhaps all the way back to the null).

On the general point: I am dismissive of mental health as a cause area insofar as I don't believe it to be a good direction for EA energy to go relative to the other major ones (and especially my own 'best bet' of xrisk). I don't want it to be a cause area as it will plausibly compete for time/attention/etc. with other things I deem more important. I'm no EA leader, but I don't think we need to impute some 'anti-weirdness bias' (which I think is facially implausible given the early embrace of AI stuff etc) to explain why they might think the same.

Naturally, I may be wrong in this determination, and if I am wrong, I want to know about it. Thus having enthusiasts go into more speculative things outside the currently recognised cause areas improves likelihood of the movement self-correcting and realising mental health should be on a par with (e.g.) animal welfare as a valuable use of EA energy.

Yet anointing mental health as a cause area before this case has been persuasively made would be a bad approach. There are many other candidates for 'cause area No. n+1' which (as I suggested above) have about the same plausibility as mental health. Making them all recognised 'cause areas' seems the wrong approach. Thus the threshold should be higher.