Mental health content creators define their own ethics

Rayne Fisher-Quann, online content creator, at his home in Toronto, August 18, 2022 (Hao Nguyen for The Washington Post)
Rayne Fisher-Quann, online content creator, at his home in Toronto, August 18, 2022 (Hao Nguyen for The Washington Post)

In the face of explosive demand and little protection, creators of mental health content are defining their own ethics.


Issey Moloney enrolled in treatment through the UK’s National Health Service when she was just 12 years old. She was on the waiting list for four years.

Meanwhile, social media has helped her feel less alone, says the now 17-year-old living in London. As her pandemic separated her from her real-life friends, she connected with people online. Eventually, she started making her own content. Currently, she has 5.9 million of her TikTok followers (about 85% of which are young women between the ages of 14 and 18) and a collection of videos about her friends, relationships and mental health. I have.

Some of her clips are generic, such as a short ode about the relationship between a psychotic patient and Pasta, while others address actual diagnoses such as “signs of BPD” and borderline personality disorder. Sometimes people ask her to deal with certain conditions. She spends at least a week trying to research, checking websites and message boards, and conducting direct message interviews with people with specific diagnoses. She adds her disclaimer. [panic attacks] Not everyone feels the same way. ”

She has no formal training and often talks about feelings that are somewhat universal, such as anxiety and depression. Her commentators occasionally accuse her of simply denouncing “being a teenager” as morbid or encouraging her self-diagnosis.

In real life, information and care about mental health is sparse. According to the American Psychological Association, one in three counties in the U.S. doesn’t have a licensed psychologist, and Americans say cost is the biggest barrier to seeking mental health help. . But on the internet, mental health tips are everywhere. According to analytics firm Sprout Social, his TikTok videos with #mentalhealth in the caption have been viewed more than 43.9 billion times, and mentions of mental health on social media are increasing year by year.

The growing popularity of this subject means that mental health content creators are filling a gap in healthcare. But social media apps aren’t designed to prioritize accurate and helpful information, critics say. Young people could see their deepest struggles fall prey to advertisers and self-promoters. Defines ethics.

“I don’t want to give anyone bad advice,” Moloney says. “I met some [followers] People who have just started crying and saying “thank you”. It may seem small, but it can have a big impact on someone. ”

With rates of depression and anxiety soaring during the pandemic and diminishing accessible care options, creators have released a series of videos, including first-person accounts of life with mental illness and videos listing the symptoms of bipolar disorder. shared the content of. Often their follower count ballooned.

For teens, navigating the mental health pitfalls of Instagram is part of everyday life

Creators and viewers alike said this content was helpful. They also acknowledge that accepting it entails the following risks: Misinformation and harmful self-diagnosis. Some prominent accounts have been criticized for sharing advice that most experts don’t endorse. Conflict of interest. Much online content simply conveys what listeners want to hear, and relatively rare conditions such as Narcissistic Personality Disorder can be very difficult for commenters to diagnose by diagnosing the person they dislike the most. is getting a lot of attention, the creators say. And thanks to algorithms, people who show interest in this kind of content see more content.

Creators can sometimes struggle to deal with a flood of messages from followers or control how their audience interprets their content.

“It’s absolutely disgusting to see people getting themselves drawn into the commodifiable subject matter for defining ‘mental illness’ and being to some extent devoured by algorithms that encourage people to go down this pipeline. It’s strange,” said Rayne Fisher-Quann. , she has been candid about her 225,000 followers and her struggle with mental illness on her TikTok. “There’s absolutely a concerted effort going on to actually harness mental illness, especially in young women. It’s a very marketable commodity right now.”

Professional organizations such as the American Counseling Association publish some social media guidelines, but they tend to misinterpret or ignore the demands of the creator economy, therapists say. Non-professionals, on the other hand, can say almost anything, with little result. Young people can’t always tell the difference between an expert and a hacker, creators say.

“Even if the therapist isn’t on social media, the client is on social media. Clients are influenced by what they see on social media and bring it directly into the session.” Therapist.

Training is precious. So is experience, says the creator.

Many creators are unprofessional and many have said they have failed professionally before.

Fisher-Quann’s inbox is full of questions to whisper to your best friend in the middle of the night. Does having a queer sexual experience mean that I am gay?

She may answer if the question relates to her experience. The 21-year-old author and cultural critic sometimes doesn’t have an answer to his message. He occasionally gets messages that he is contemplating suicide. But it hurts to know that they may not get the real-world help they need, Fisher-Kwang said.

“I’m reluctant to basically tell people to institutionalize themselves because of that institutional failure,” she said. I’m also very critical of capitalist platforms that ultimately offer very short-sighted advice.”

Deciding who to consider an expert is not always easy. A creator with her 159,000 followers on Instagram, her Klara Kernig describes herself as an “expert in people-pleasing” in her own biography. She earned that title through her experience, she said.

After dropping out of her dream doctoral program against her family’s wishes, Kernig began learning about codependency, trauma, and “people pleasing” from books and the internet. , creates unique mental health content, including “5 Things We Think Are Good People-Pleasing Behaviors.”

“I don’t want to discredit the therapist, but I want to say that there are other ways to educate people and get that information,” she said. I hope my community and the therapists there will lovingly point it out.”

Some creators take it upon themselves to challenge content that is not backed by research. Inna Kanevsky, a psychology professor at San Diego Mesa College, is a TikTok creator with 1.1 million viewers who frequently rebuts what she sees as irresponsible claims in videos posted by other creators. Some of the subjects of her criticism state that Kanefsky speaks to them, invalidates their experiences, and misunderstands their intentions.

“It’s funny because people say, ‘You’re passive-aggressive,'” Kanevsky said. “And I’m like, ‘No, I’m aggressive—aggressive.’ If I make a pointless post, I will let you know. ”

Creators control their content, not their interpretation

Creators argue that there is an important difference between providing therapeutic advice and creating relevant content. But those lines can quickly fade.

In addition to creating posts for her 129,000 Instagram followers, Siddiqi also works with clients on video calls. They often send her posts from other mental health creators and discuss them during sessions. She helps them evaluate the information and decide if it applies.

Posts lead to good conversations and deeper insights, Siddiqi Said. But she worries about where algorithms will send people later and whether audiences will have enough time to reflect. She said it’s easy to do or label yourself or others unfairly.

Attention deficit hyperactivity disorder (ADHD) and hyperactivity disorder (ADHD) and mental health. She said she wasn’t too worried about self-diagnosis because perfectly healthy people are generally not the ones scrolling through information about symptoms and treatments. Due to the disregard for people’s concerns, many people who actually have the disease do not receive a formal diagnosis.

“You don’t need an ADHD diagnosis to benefit from our tips, tricks and strategies,” says Tsipura.

Audiences consider context and know not to accept every word a creator utters as truth, says licensed therapist and Instagram creator with 1.5 million followers, Nedra Grover Tauwab. As with any marketplace, consumers are responsible for deciding whether or not to buy what a particular creator is selling, she said.

Who is responsible for evaluating mental health content?

In the world of online mental health guidance, there is little liability for platforms and creators if something goes wrong.

In June, Instagram launched a pilot called the Wellbeing Creators Collective. It said it would fund and educate about 50 U.S. creators to help them produce “responsible” content about their emotional well-being and self-image. The program is led by a panel of outside experts, the company said.

Linda Chamalaman, senior research scientist and director of the Youth, Media and Wellbeing Research Lab at the Wellesley Center for Women, said: is a member of that committee, that Overall, participants seem deeply concerned about using their platform for good.

According to a spokesperson, TikTok is “committed to fostering an environment that supports those who choose to share their personal wellness journeys, while eliminating medical misinformation and other policy violations.” There are.”

“If you need help, we encourage you to seek professional medical advice,” she said in a statement.

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

“Young people need evidence-based sources other than the Internet, such as parents and schools,” says Miller.

Often these resources are not available. As such, it’s up to creators to decide what mental health advice to incorporate, says Fisher Quan. The distorted incentives of her condescending healthcare providers and social media platforms didn’t make it easy for her, but she believes she can get better, and her followers She thinks she can.

“It all has to come out of self-awareness and a desire to be better. Community can be very helpful for that, but it can also be very harmful for it,” she said. .

Linda Chong of San Francisco contributed to this report.

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