Mental health content creators are defining their own ethics

Online content creator Rayne Fisher-Quann at her home in Toronto on August 18, 2022.  (Hao Nguyen of The Washington Post)
Online content creator Rayne Fisher-Quann at her home in Toronto on August 18, 2022. (Hao Nguyen of The Washington Post)

Faced with explosive demand and few safeguards, creators of mental health content are defining their own ethics


Issey Moloney signed up for treatment through the NHS when she was 12 years old. She was on the waitlist for four years.

Meanwhile, social media has helped her feel less lonely, said the 17-year-old, who lives in London. Since the pandemic has isolated her from her real-life friends, she has connected with people online. Eventually, she started producing her own content. She now has 5.9 million followers on TikTok — about 85 percent of whom are young women between the ages of 14 and 18 — and a series of videos about friends, relationships and mental health.

Some of her clips are general, such as a brief ode to the relationship between a psychopath and spaghetti, while others deal with real diagnoses, such as “Signs You May Have BPD” or Borderline Personality Disorder. Sometimes, people ask her to address specific situations. She tries to do research for at least a week, check websites and message boards, and interview people with specific diagnoses via direct message.She added a disclaimer: “Everyone deals with [panic attacks] Different, not everyone feels the same. “

She has no formal training and often talks about feelings that are common to some extent, such as anxiety and depression. Commentators occasionally accuse her of merely pathologicalizing “being a teenager” or encouraging self-diagnosis.

In real life, mental health information and care is scarce. In the U.S., one-third of counties do not have a licensed psychologist, and Americans say cost is the biggest barrier to seeking mental health help, according to the American Psychological Association. On the internet, however, mental health tips are everywhere: TikTok videos with #mentalhealth in the title have garnered more than 43.9 billion views, according to analytics firm Sprout Social, and social media mentions of mental health are increasing every year.

The growing popularity of the topic means that creators of mental health content are filling a void in healthcare. But critics say social media apps aren’t designed to prioritize accurate, useful information, but only the content that elicits the greatest response. Young people can see their deepest struggles become fodder for advertisers and self-promoters. With no roadmap even for licensed professionals, mental health creators are defining their own ethics.

“I don’t want to give anyone wrong advice,” Moloney said. “I have encountered some [followers] Who just started crying and saying “thank you” or something. As small as it may seem, to others, it can have a big impact. “

With rates of depression and anxiety soaring and available care options dwindling during the pandemic, creators share a range of content, including first-person accounts of life with mental illness and listings for bipolar disorder Video of symptoms. In many cases, their followings have exploded.

For teens, coping with Instagram’s mental health pitfalls is part of everyday life

Both creators and viewers say the content is helpful.They also acknowledge that embracing it carries risks, such as Misinformation and harmful self-diagnostics. Some high-profile accounts have been criticized for sharing advice not supported by most professionals.Many creators sell courses and books or form advertising partnerships, opening doors conflict of interest. Creators say that much online content simply tells listeners what they want to hear, while relatively rare conditions like narcissistic personality disorder receive a lot of attention, with reviewers diagnosing the people they dislike the most. And because of the algorithm, people who show interest in this type of content see more of it.

Sometimes creators find themselves juggling a flood of information from followers or struggling to control how viewers interpret their content.

Rayne Fisher-Quann said, “Seeing myself drawn into a commoditized object that allows people to define ‘mental illness’ has in a way made me swallowed up by the algorithms that encourage people to go down this pipeline, It’s absolutely bizarre.”, she spoke openly about her struggle with mental illness with her 225,000 followers on TikTok. “There’s definitely a concerted effort to really capitalize on mental illness, especially among young women. It’s a very marketable commodity right now.”

Therapists say that while professional organizations like the American Counseling Association publish some social media guidelines, they tend to misunderstand or ignore the needs of the creator economy. Meanwhile, laypeople can say almost anything with little consequence. The creators say that young people can’t always tell the difference between an expert and a hacker.

“Even when therapists aren’t on social media, so are their clients, and those clients are influenced by what they see on social media, which they bring directly into the conversation,” Instagram creator and licensed Sadaf Siddiqi speaks therapist.

Training is valuable. The creators say the same goes for experience.

Many creators are not experts, and many say they have been failed by experts before.

Fisher-Quann’s inbox is full of questions you’d whisper to your best friend in the middle of the night: Do these difficult feelings mean I’m suffering from depression? Does having a strange sexual experience mean I’m gay?

If the question involves something she’s been through, she may respond. Other times, the messages went unanswered, the 21-year-old author and cultural critic said. People occasionally message her that they are contemplating suicide, and she says she directs them to professional resources. But it’s painful knowing that they may not be able to get the real-world help they need, Fisher-Quann said.

“I don’t feel comfortable basically telling people to institutionalize themselves because of institutional failures,” she said. “But I’m also very critical of capitalist platforms where people present themselves as experts and give advice that can end up being very short-sighted.”

Deciding who’s an expert isn’t always easy. Creator Klara Kernig, who has 159,000 followers on Instagram, describes herself in her biography as “an expert on likability.” She said she earned the title through experience.

After dropping out of her dream doctoral program against her family’s wishes, Kernig began learning about interdependence, trauma and “pleasing others” from books and the internet, she said. Now she’s healthier, she says, and has produced her own mental health content, including “5 pleasant behaviors that we think are good.”

“I don’t want to discredit therapists, but I also want to say that there are other ways to educate people and get this information,” she said. “Maybe I even put something wrong there, and then I want my community and the therapists out there to point that out to me in a loving way.”

Some creators themselves challenge content that research doesn’t support. Inna Kanevsky, a psychology professor at San Diego Mesa College and a TikTok creator with 1.1 million viewers, routinely refutes claims she considers irresponsible in videos posted by other creators. Some of her critics say Kanevsky has spoken lightly to them, invalidated their experience or misinterpreted their intentions.

“It’s funny because people say, ‘You’re passive-aggressive,'” Kanevsky said. “And I thought, ‘No, I’m being aggressive.’ If you’re talking nonsense, I’ll tell you.”

Creators control the content, but not its interpretation

The creators insist that there is an important distinction between giving treatment advice and producing relevant content. But the lines blur quickly.

In addition to posting for her 129,000 Instagram followers, Siddiqi treats clients via video calls. They often send her posts from other mental health creators to discuss during their meetings, and she helps them evaluate the information and decide if it’s applicable.

These posts lead to good conversations and deeper insights, Siddiqi Say. But she worries about where the algorithm will then send people and whether viewers will have enough time to reflect. People without real-life support can easily misinterpret mental health content or label themselves or others unfairly, she said.

Made about Attention Deficit/Hyperactivity Disorder (ADHD) and Mental Health. She said she’s not too concerned about self-diagnosing because perfectly healthy people typically don’t scroll through information about symptoms and treatments. In addition, healthcare professionals routinely ignore people’s concerns, she said, and as a result, many people with real illnesses are never formally diagnosed.

“You don’t need a diagnosis of ADHD to benefit from tips, tricks, and strategies,” Chipra says.

Nedra Glover Tawwab, a licensed therapist and Instagram creator with 1.5 million followers, says viewers know to think about context and not take every word a creator says. As with any marketplace, consumers are responsible for deciding whether or not they buy what a particular creator is selling, she said.

Who is responsible for evaluating mental health content?

In the world of online mental health coaching, platforms or creators have little responsibility if something goes wrong.

Instagram launched a pilot program in June called the Well-being Creator Collective, which it says provides funding and education to about 50 U.S. creators to help them produce “responsible” content about emotional health and self-image . The company said the program was guided by an external committee of experts.

Linda Charmaraman, Senior Research Scientist, Director of the Youth, Media and Welfare Research Laboratory at the Wellesley Women’s Center, is a member of the committee and says That Overall, participants seem to be very concerned about using their platform permanently.

TikTok said it was “committed to fostering a supportive environment for people who choose to share their personal health journeys, while eliminating medical misinformation and other violations of our policies,” a spokeswoman said.

“We encourage individuals to seek professional medical advice when they need support,” she said in a statement.

Ideally, social media apps should be an item in a collection of mental health resources, says Jody Miller, a researcher at the Johns Hopkins School of Education who studies the relationship between young people, technology and stress.

“Young people need evidence-based sources of information other than the Internet from parents and schools,” Miller said.

Usually, these resources are not available. So it’s up to creators to decide which mental health advice they include, Fisher-Quann said. It’s not easy for her with condescending healthcare providers and the distorted incentives of social media platforms. But she thinks she can get better — and so can her followers.

“It all has to come from a place of self-awareness and a desire to be better. The community can be very helpful for this, but it can also be extremely harmful to it,” she said.

Linda Chong in San Francisco contributed to this report.

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