[wutbrodo]

> I stepped back from a group chat because the fellows in it swore by “Mental Health TikTok,” where therapists give mental health advice. This is concerning to me

What's concerning about this? I don't mean this rhetorically: I'm genuinely curious, as I've heard people say similar things recently.

It seems to me that, like metabolic health, there's a pretty large body of basic mental health advice that's safe and salutary, and that doesn't displace heavy-duty mental Healthcare for those who need it (in the same way that healthy recipe tips don't displace insulin shots).

[28433552]

It was apparent in the group chat I was in that these guys were replacing heavy-duty mental healthcare with tips provided by unverified sources on TikTok. A chat where we went to vent about our frustrations turned into peer-to-peer mental health diagnosis informed by these TikTok doctors, telephoned through these regular, non-doctor participants.

It struck me as the kind of thing that leads people to, for example, ingeste chloroquine phosphate [0] on the advice of a celebrity.

[0]https://www.theguardian.com/world/2020/mar/24/coronavirus-cu...

[wutbrodo]

> It was apparent in the group chat I was in that these guys were replacing heavy-duty mental healthcare with tips provided by unverified sources on TikTok

Gotcha, thanks for clarifying!

[Rd6n6]

Mental health discussions and advice are traditionally given under strong privacy guarantees

[wutbrodo]

You've mixed together two-way (discussion) and one-way (advice) mental health communication. Your point only applies to discussion, and the tiktok example only involves advice.

Concretely, what privacy concern do you see in watching a video with mental health tips? Do you think this privacy concern similarly extends to reading a Wikipedia article on (eg) CBT techniques?

Or am I misunderstanding, and "Mental health tiktok" involves users describing their mental health issues in videos that they post, and a back-and-forth with those who are claiming to "treat" them?

[lawtalkinghuman]

I'd trust Wikimedia's privacy policy a hell of a lot more than I'd trust TikTok's.

Also, the English Wikipedia article on cognitive behavioural therapy cites Cochrane reviews, psych textbooks and a whole volley of journal articles from prestigious journals like the Lancet and the Journal of the American Medical Association etc. describing clinical trial results, plus guidance from the UK's National Institute of Health and Clinical Excellence.

Presumably, the TikTok version makes up for this by having a better dance routine.

[wutbrodo]

> I'd trust Wikimedia's privacy policy a hell of a lot more than I'd trust TikTok's

Yes, of course. I wasn't clear, but I was referring to going through a search engine, not going directly to Wikipedia.

> Presumably, the TikTok version makes up for this by having a better dance routine.

I'm afraid you've completely misunderstood what this subthread is about. The _quality_ of medical information and the privacy concerns involved in finding it (whether through Google or via tiktok's algorithm) are completely different topics. To be honest, I can't imagine how anyone could read these comments and come away thinking any comparison was being made (let alone equivalence being drawn) between quality vs privacy concerns.

[lawtalkinghuman]

I was being snarky about the quality of the information, but the privacy issue is the important one.

If the key variable is the search engine, then, yes, you probably don't want to be feeding details of your possible mental health problems into Google. Maybe DuckDuckGo would be preferable. Once you've put your symptoms or diagnosis into a search engine, where you end up is going to likely not be the main issue. If you type, say, "autism spectrum disorder" into Google, Google will make certain assumptions about you regardless of whether you end up clicking on a Wikipedia link, an NHS.uk link, some academic paper on bioRxiv, or a TikTok video with someone describing their autism diagnosis.

[Rd6n6]

It’s 2 way. The tracking and profiling algorithms infer a lot by watching people. The viewers might not realize it’s two way though

[wutbrodo]

That's an extremely expansive definition of "two-way", to the point of meaninglessness. If you were to bite this bullet, you'd also preclude the type of extremely basic work to get informed that any patient should be doing when engaging with the healthcare system (including for physical health). Basic research about your health problems doesn't even preclude putting full faith in your doctor and his recommendations; they're helpful in the general case for even understanding conversations with him. And this type of web search provides infinitely more "two-way" loss of privacy than signal from tiktok recommendations.

This is worth elaborating on, since I know HN tends to have a bizarre fantasy conception of the medical system where patients arent supposed to understand anything that's happening. I have to wonder if the HNers contributing to this conception have ever engaged with the medical system, or if they have, I have to pity those that they're responsible for.

There are plenty of doctors in my family, and I've been responsible for managing both chronic and severe acute health issues for family members. Every single one of the doctors I've been in contact with would be shocked by the notion that patients shouldn't be informing thenselves at a basic level. This goes quadruply for basic preventive measures like nutrition, exercise, or basic mental health practices: there's a reason that "an ounce of prevention is worth a pound of cure".

[gentleman11]

I don’t think you want mental health information going where it could be used against you.

Eg,

> Cheng believes the website that doxed him by publishing his personal information online was started by pro-Beijing supporters in Hong Kong.

> “I feel fear,” he admitted. His family, too, was scared and told him not to walk home alone anymore. But part of Cheng remains defiant as he considers the doxing website a component of a larger campaign to incite fear in protesters as mass demonstrations continue into their third month.

https://www.buzzfeednews.com/article/rosalindadams/hong-kong...

https://mashable.com/article/doj-accuses-zoom-employee-china...

[wutbrodo]

The parent comment clarified in response to my original question that they were referring to "heavy duty" mental health advice, of serious issues.

The premise of my pushing back against privacy concerns was mental health advice of the basic, fundamental kind: mindfulness, productive thought patterns, healthy work habits, sleep hygiene, etc etc etc.

Even taking for granted that tiktok's access to this information is scarier than eg Google's, the signal they can glean from this type of usage is little more than "I get anxious sometimes", not things like "I have bipolar disorder". I don't think it's controversial at all to say that getting advice for serious mental disorders via social network isn't a good idea for multiple reasons (again, this is why I clarified with the OP of the story what sort of mental health advice they were seeking).

To make it clear by analogy: one maintains their physical health through a million 24/7 day-to-day decisions, and nobody would blink twice at getting information about eg yoga or healthy recipes from YouTube or other non-medical sources. OTOH, trying to treat your pneumonia or MS via YouTube or tiktok would be an obvious disaster. Similarly, there are a million and one day-to-day actions one takes to maintain their mental health, eg mindfulness or other basic CBT techniques. Researching these independently is not just harmless, it's what people _should_ be doing, regardless of whether they're also seeking treatment (and the privacy concerns are similarly minimal). Again in stark contrast, serious mental health issues shouldn't be treated via casual research.