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Social Media & PsychiatryIris Thiele Isip Tan MD, MSc
@endocrine_witchProfessor, UP College of MedicineChief, UP Medical Informatics Unit
Growing social media by mkhmarketing, https://flic.kr/p/e1yRKg
22 Jan 2015
I am the Endocrine Witch. I am a netizen!
Facebook by Dimitris Kalogeropoylos, https://flic.kr/p/8kvsXB
Are there guidelines to
direct personal use of social
media by psychiatrists?
Twitter avatar by Ape Lad, https://flic.kr/p/71pTYY
How can the professional use of social
media help psychiatric
practice?
Should social media be used to monitor the
psychiatric patient?
Self snitch by Poster Boy, https://flic.kr/p/bwSEPg
Psychiatrists on social media?#TaoLang
In the meantime, I’m going to ask Dr. E. to change his privacy settings so the nice robots at Facebook can’t make the connection between us - or at least they won’t tell me about it if they do. That way, I can stop thinking about his personal life and get our sessions back to what they should be, which is all about me.“
Steven Petrow, www.washingtonpost.com
To what extent should patients’ potential access to online information shape psychiatrists’ use of social media?
Appelbaum P & Kopelman A.Social media’s challenges for psychiatry
World Psychiatry 2014;13(1):21-23
Disclosure of patient-related information even when patients are not directly identified, can raise doubts among the public about the privacy of their medical interaction.
selfie_stick by Ton Schulten, https://flic.kr/p/q8ppyD
[25/365] On the couch (Explored) by Pascal, https://flic.kr/p/8DVMLy
Negative comments about the healthcare system in general or a particular facility can shake patients’ trust and deter them from seeking care.
Appelbaum P & Kopelman A.World Psychiatry 2014;13(1):21-23
Content showing doctors “behaving badly” may call clinical judgment into question, raising doubts in patients’ minds about the quality of the treatment they will receive.
[25/365] On the couch (Explored) by Pascal, https://flic.kr/p/8DVMLy
Online news by Mike Licht, https://flic.kr/p/7XkhM7
Unreflective and excessive
self-disclosure by psychiatrists, especially when
they are engaged in psychotherapy, is another
concern... Crucially, the psychiatrist may be wholly
unaware if and when any self-disclosure has occurred, and
therefore never be able to address its significance with the patient.
Appelbaum P & Kopelman A.World Psychiatry 2014;13(1):21-23
girl 1 by Krzysztof Isbrandt, http://www.freeimages.com/photo/767957 “
Individuals whose presence among a psychiatrist’s friends becomes known (eg, via a wall post) are revealing their connection to the psychiatrist and other friends may surmise than an individual is a patient.
A beautiful friendship by Viktor Hertz, https://flic.kr/p/9oUtHV
“Mossman D & Farrell H. Facebook: Social networking meets professional duty. www.currentpsychiatry.com
Position statements such as this one tend, by their nature to propagate a string of warnings and prohibitions. The RANZCP recognizes that social media and internet presence can offer a range of benefits and enhance the therapeutic relationship between doctor and patient.
“The Royal Australian & New Zealand College of Psychiatrists
Position Statement 75 Aug 2012
Psychiatrists should be aware of, and manage, their online presence and image (This may include Google-ing oneself regularly).
The Royal Australian & New Zealand College of Psychiatrists Position Statement 75 Aug 2012 If it’s on the Internet, it isn’t private by DonkeyHotey,
https://flic.kr/p/9RYZvc
Psychiatrists should exercise judgment and caution when posting information online, including being mindful of maintaining confidentiality and professional boundaries with patients.
The Royal Australian & New Zealand College of Psychiatrists Position Statement 75 Aug 2012
“
“
The Royal Australian & New Zealand College of Psychiatrists Position Statement 75 Aug 2012
Psychiatrists should understand all the privacy settings for all social media applications that they use, and apply the strictest settings when posting personal information.
Facebook & privacy by Tim Wayne, https://flic.kr/p/9qZKm4
“
InformationRelationships, religious views, home address & tel. no. may be readily viewable to the general public and patients
PhotosIntoxication, sexually explicit material, risk-taking behavior
Wall postsBlatant comments about patients, disgruntlement with institution or supervisors
Mossman D & Farrell H. Facebook: Social networking meets professional duty. www.currentpsychiatry.com
Security settingsLack of privacy restrictions
“Friends” Friending patients and supervisors
“Like” “Liking” groups that contain pornographic material or other controversial topics
Facebook Errors: What to Avoid
Facebook by Dimitris Kalogeropoylos, https://flic.kr/p/8kvsXB
Are there guidelines to
direct personal use of social
media by psychiatrists?
Twitter avatar by Ape Lad, https://flic.kr/p/71pTYY
How can the professional use of social
media help psychiatric
practice?
Should social media be used to monitor the
psychiatric patient?
Self snitch by Poster Boy, https://flic.kr/p/bwSEPg
Professional use of social media for psychiatrists
Benefits of Social Media in Mental Health PracticesDavid Ballard, Psyd, MBAwww.psychiatrictimes.com4 Dec 2012
Extend your reachBuild your practiceHelp people find youUse consistent brandingEstablish professional relationshipsConnect with others
Drowning in social media by mkhmarketing, https://flic.kr/p/dZxNRq
Geography of Twitter replies by Eric Fischer, https://flic.kr/p/avgZqq
For psychiatrists, being aware of topics that generate interest on social media sites not only fuels ideas for your own “tweets” or blog posts, but helps you anticipate concerns raised by your patients.
Brody D, Social Media for Psychiatrists: Ignorance is Not Bliss 7 Sept 2012 www.psychiatrictimes
“
Brody D, Social Media for Psychiatrists: Ignorance is Not Bliss 7 Sept 2012 www.psychiatrictimes
A strong social media presence also helps generate referrals.Networking with colleagues on sites such as LinkedIn may also generate referrals.“
LinkedIn pen by Sheila Scarborough, https://flic.kr/p/azPUMz
http://psychiatrist-blog.blogspot.com/
We have the ability to disseminate knowledge of evidence-based strategies, provide context to mental health stories in the media, and dispel myths. There are certainly people who are putting false, misleading and potentially harmful information on the Internet.
Peek H, Social Media: An Opportunity for Psychiatrists 4 Aug 2014 www.physicianspractice.com
“
Multiple Tweets Plain by mkhmarketinghttps://flic.kr/p/dVaqmj
Tweet chat Pre-arranged chat through tweets that include a predefined hashtag to link those tweets together in a virtual conversation
- Susan Gunelius http://weblogs.about.com/od/twitterfaqs/f/TwitterFAQTweetChat.htm
My Storify: Creating Healing Environments #HCLDR Chat. By Dan Dunlophttp://thehealthcaremarketer.wordpress.com/2014/04/17/my-storify-creating-healing-environments-hcldr-chat/
My Storify: Creating Healing Environments #HCLDR Chat. By Dan Dunlophttp://thehealthcaremarketer.wordpress.com/2014/04/17/my-storify-creating-healing-environments-hcldr-chat/
My Storify: Creating Healing Environments #HCLDR Chat. By Dan Dunlophttp://thehealthcaremarketer.wordpress.com/2014/04/17/my-storify-creating-healing-environments-hcldr-chat/
My Storify: Creating Healing Environments #HCLDR Chat. By Dan Dunlophttp://thehealthcaremarketer.wordpress.com/2014/04/17/my-storify-creating-healing-environments-hcldr-chat/
The goal of the Healthcare Hashtag Project is to make the use of Twitter more accessible for providers and the healthcare community as a whole.
By lowering the learning curve of Twitter with a database of relevant hashtags to follow, we hope to help new and existing users alike to find the conversations that are of interest and importance.
- Symplur.com
Partners
Screenshot from www.symplur.com/healthcare-hashtags
“
Facebook by Dimitris Kalogeropoylos, https://flic.kr/p/8kvsXB
Are there guidelines to
direct personal use of social
media by psychiatrists?
Twitter avatar by Ape Lad, https://flic.kr/p/71pTYY
How can the professional use of social
media help psychiatric
practice?
Should social media be used to monitor the
psychiatric patient?
Self snitch by Poster Boy, https://flic.kr/p/bwSEPg
Monitor the psychiatric patient on social media?
Social-media-despair by Gary Koelling, https://flic.kr/p/6DtPYC
In the world of mental health, we’re not far from the day when scrolling through your Twitter feed might be a practitioner’s last step before pulling out the prescription pad.
“http://www.slate.com/articles/technology/future_tense/2014/11/
amanda_bynes_twitter_using_social_media_to_track_mental_health_problems.html
http://www.slate.com/articles/technology/future_tense/2014/11/amanda_bynes_twitter_using_social_media_to_track_mental_health_problems.html
While monitoring social media without consent is obviously unethical, a patient who’s willing to examine her social media
presence might find an ally in the data.
Dr. Jan KalbitzerCharite-University Medicine Berlin
Sad by Kristina Alexanderson, https://flic.kr/p/9g5Gg8
http://time.com/1915/how-twitter-knows-when-youre-depressed/
Predicting Postpartum Changes in Emotion and Behavior via Social MediaDe Choudhury M, et al. CHI ’13 Proceedings of the SIGCHI Conference on Human Factors in Computing Systems pp 3267-3276
P: 376 Twitter accounts of new mothers (validated by key phrases in tweets)
I: Changes in tweets (social engagement, emotion, social network & linguistic style)
O: Predictive model for postpartum depression
M: Cross-sectional
Sad young woman by beermug, http://www.freeimages.com/photo/1414071
Sad young woman by beermug, http://www.freeimages.com/photo/1414071
De Choudhury M, et al. CHI ’13 Proceedings of the SIGCHI Conference on
Human Factors in Computing Systems pp 3267-3276
The predictive models can classify mothers who will change significantly following childbirth with an accuracy of 71% ... could be valuable tools in public health ...
“... people may be uncomfortable with others performing and sharing these predictions, even if the inferences are based solely on data that they have shared openly with the public.
Tracking Suicide Risk Factors Through Twitter in the US Jashinsky et al. Crisis 2014;35(1):51-59
P: 37,717 at-risk tweets (keywords/phrases from suicide risk factors) filtered from Twitter stream I: No. of “suicide tweeters” vs national data of suicide ratesO: Correlation
M: Cross-sectionalHeadshot by Martin Gommel, https://flic.kr/p/4cZBj4
Depressive feelingsI feel so worthless today.
Prior suicide attemptsI tried to commit suicide before ... several times.
Jashinksy et al. Crisis 2014;35(1):51-59
Psychological disorders... what to say but yes, I’ve been diagnosed with anorexia since late 2009 and early 2010.
Example tweets for suicide risk factors
Depression symptomsI’ve been sleeping a lot lately. I take like 6 hour naps.
Drug abuseDear Prozac, time for upping in your dosage.
Suicide ideationI have had thoughts on suicide and running away from home ... and sometimes I still do.
Headshot by Martin Gommel, https://flic.kr/p/4cZBj4
An association exists between the proportion of Twitter users determined to be at risk for suicide and actual suicide rates.Twitter may be a viable tool for real-time monitoring of suicide risk factors on a large scale.
“Jashinksy et al. Crisis 2014;35(1):51-59
Samaritans Radar applaunched 29 Oct 2014
Algorithm looks for specific keywords and phrases within a tweetSends an email alert to user with link to tweet detected
Offers guidance on best way of reaching out and providing support
The Samaritans has no legitimate purpose to collect this information, let alone to share it with other unknown and untrusted people without the subject’s knowledge or consent.While this could be used legitimately by a friend to offer help, it also gives stalkers and bullies an opportunity to increase their levels of abuse at a time when their targets are especially down.
Adrian ShortCampaigner, Change.org
Hopeless by spekulator, http://www.freeimages.com/photo/612222
“
P: 200 public Facebook profiles from sophomore/junior undergrads
I: Analysis of personally written text: “status updates”
O: Prevalence of displayed depression symptoms and major depressive episode (MDE) criteria
M: Cross-sectional
Depressed moodErika is really really really unhappy.
IndecisivenessLisa is not sure about anything ... can’t make up my mind.
Moreno et al. Depress Anxiety 2011;28)6:447-55
Feelings of guilt, worthlessness, negative self-appraisal Kate hates herself right now.
DSM-IV criteria for Major Depressive Episode and examples from FB data
Increase or decrease in appetiteAmy has no appetite right now.
Decreased interest or pleasure in activities Jane doesn’t feel like getting up today, or doing anything.
Recurrent thoughts of death or suicidal ideationNone in this dataset
Sleep problemsAnn needs to stop being lame and so tired so that she can go out and socialize more instead of having to sleep so much.
Loss of energyJoe has lost his motivation.
39.365 #106 in explore ! fact by Ashley Rose, https://flic.kr/p/5anfdu
25% of FB profiles displayed depressive symptoms and 2.5% met criteria for MDE.
Those who receive online reinforcement from friends are more likely to discuss depressive symptoms publicly on Facebook.
“
Moreno et al. Depress Anxiety 2011;28)6:447-55
You could be mislabeling millions of people. There would be all sorts of negative consequences. And then you can have sophisticated employment consultants who will do the vetting on people’s psychiatric states, derived from some cockamamie algorithm, on your Twitter account. “
Dr. Allen J. Frances Professor Emeritus Duke University School of Medicine
Facebook by Dimitris Kalogeropoylos, https://flic.kr/p/8kvsXB
Are there guidelines to
direct personal use of social
media by psychiatrists?
Twitter avatar by Ape Lad, https://flic.kr/p/71pTYY
How can the professional use of social
media help psychiatric
practice?
Should social media be used to monitor the
psychiatric patient?
Self snitch by Poster Boy, https://flic.kr/p/bwSEPg
Social Media Class by mkhmarketing, https://flic.kr/p/e1HpQq
With these precautions, which should be inculcated as part of psychiatric training, the twenty first century psychiatrist should be able to be a cautious but vigorous participant in the social media revolution.
Appelbaum P & Kopelman A.World Psychiatry 2014;13(1):21-23
“