Mentally ill patients using social networks for communication

Mentally ill patients using social

networks for communication and

exchange of informationFIP World Congress 2014 Bangkok

Cody Midlam, PharmD, CGP

Intro

Social Networks have created a new

way for people suffering from mental

illness to communicate with one another

about their illness

Understanding how and why patients

use these tools better prepares

pharmacists to help them manage their

illness

Objectives

1. Define mental illness and how patients with these conditions use social networks

2. Describe the number of patients using these networks and their attributes

3. Investigate if these tools are successful or damaging to the management of a patient's mental illness

4. Describe how can pharmacists have a constructive role in this process

What is Mental Illness?

The World Health Organization defines mental disorders as◦ Broad range of problems, with different

symptoms… generally characterized by some combination of abnormal thoughts, emotions, behaviour and relationships with others

◦ Examples are Schizophrenia

Depression

Disorders due to drug abuse

Anxiety

References: The World Health Organization. Health topics. Mental disorders. Accessed online August 24, 2014 at:

http://www.who.int/topics/mental_disorders/en/.

What is Mental Health?

The absence of a mental disorder

AND

◦ A state of well-being in which every

individual

Realizes his or her own potential

Can cope with the normal stresses of life

Can work productively and fruitfully

Is able to make a contribution to her or his

community

References: The World Health Organization. What is mental health? Online Q&A Published 2 September 2007.Mental disorders.

Accessed Online August 24, 2014 at http://www.who.int/features/qa/62/en/

Social Networks (historical)

Social Network is a term commonly

used in psychology/ sociology to

define a person's family, neighbors,

and friends with whom they are

socially involved

Social Networks (electronic)

A website where people connect to

share personal or professional

interests

◦ “Online Patient Community”

Examples include

◦ Facebook, Patients Like Me, Inspire,

Medhelp

Online Patient Communities

Dedicated Social Network for patients

suffering from the same condition

◦ Most focus on many conditions, some

focus on mental health only

Psych Central is dedicated to mental health

issues only

PsychCentral

Reference: Author’s Screenshot. “PsychCentral Home Page”. Accessed online August 29, 2014 at: http://psychcentral.com/

Who Uses Social Networks?

As of

January

2014 74% of online

adults are

using social

networks in

the US

References: Social Networking Fact Sheet. Pew Research Internet Project. Accessed Online August 29, 2014 at:

http://www.pewinternet.org/fact-sheets/social-networking-fact-sheet/

Why Social Media?

In most countries, mental health

services are short on financial and

human resources

Mental health AWARENESS is key

◦ Social media offers an inexpensive way to

reach many patients

In One Voice

◦ Goal to use social media to spread awareness about mental health 223 personal videos were uploaded

58,000 people visited the site

28,000 self-assessments were made

References: 1. Author’s Screenshot. Minecheck.ca. Accessed Online August 10, 2014 from http://keltymentalhealth.ca/blog/2012/02/update-mindchecks-one-voice-campaign. 2. Livingston, James, Cianfrone, Michelle, Korf-Uzan, Coniglio, Connie. Another time point, a different story: one year effects of a social media intervention on the attitudes of young people towards mental health issues. Social Psychiatry and Psychiatric Epidemiology. June 2014, Volume 49, Issue 6, pp 985-990.

Using Twitter Hashtags

#IWILLLISTEN

Sponsored by the National Alliance on

Mental Illness of New York City

(NAMI)

References: Author’s Screenshot. “#IWILLLISTEN” Accessed online August 10, 2014 at http://naminyc.iwilllisten.org/

Social Networks: Connection and

Help Individuals with mental illness are

◦ MORE likely to engage in social network

activities that promote connectivity and

making friends online

◦ More likely to report wanting resources on

independent living skills and overcoming

social isolation

References: Gowen, Kris, Deschaine, Gruttadara, Darcy, Markey, Dana. Young Adults with Mental Health Conditions and Social

Networking Websites: Seeking Tools to Build Community. Psychiatric Rehabilitation Journal 2012, Volume 35, No. 3, 245–250.

Most Enjoyable Features



Desired Features



Desired Topics



Is It Good or Bad?

Sufferers of mental Illness find others

with similar histories online. Peers who

‘get them’

Negative behaviors may be reinforced in the community. It is hard to leave as the social network offers

a sense of community

Negative Effects of Social Media

Some sites promote unhealthy

behavior and in some cases, self

harm

◦ #thinspo hashtag inspires unhealthy

eating habits among women

Other sites describe how to do self-harm,

ie; cutting, and even suicide

References: Walser, Adam. Social media, movie stars may be driving teens to cutting. Published July 1, 2013. Accessed Online August 24,

2014 at: http://www.abcactionnews.com/news/local-news/i-team-investigates/social-media-movie-stars-may-be-driving-teens-to-cutting

A Depressive Spiral?

Peer support social network and depression

References: Takahashi Y, Uchida C, Miyaki K, Sakai M, Shimbo T, Nakayama TPotential Benefits and Harms of a Peer Support Social Network Service on the Internet for People With Depressive Tendencies: Qualitative Content Analysis and Social Network Analysis. J Med Internet Res 2009;11(3):e29. Accessed online August 29 at: http://www.jmir.org/2009/3/e29/

Anxiety Online

Social anxious individuals prefer to meet one another online◦ One study finds this may actually result in

more anxiety when they meet face-to-face

“If you are predisposed to anxiety it seems that the pressures from technology act as a tipping point, making people feel more insecure and more overwhelmed.“

References: 1. Face to Face Versus Facebook: Does Exposure to Social Networking Web Sites Augment or Attenuate Physiological

Arousal Among the Socially Anxious?, doi:10.1089/cyber.2012.0498, Shannon M. Rauch et al., published in Cyberpsychology, Behavior,

and Social Networking, 4 March 2014. 2. Donnely, Laura. Facebook and Twitter feed anxiety, study finds. The Telegraph. Accessed

Online August 24 2014 at: http://www.telegraph.co.uk/technology/9383609/Facebook-and-Twitter-feed-anxiety-study-finds.html

Positive Effects

Public outreach and educational

programs reach young people

◦ au.ReachOut.com (AUS)

Provides resources for Australian youth (<25

years old)

Community forums available

Contains resources for professionals as well

References: Stewart, Erin. Mental illness: opening up online. Published June 23, 2014. Accessed Online August 24, 2014 at: http://www.abc.net.au/rampup/articles/2014/06/23/4030027.htm

Building Community

Social networking can improve

◦ Social connectedness

◦ Decrease isolation

◦ Enhance subjective wellbeing through the

practice of mutual feedback and self-

disclosure



Best practices: An example

What makes Reachout.com effective?

◦ Moderation of online forums

Site is overseen by professional staff

Certain triggering comments are not allowed

◦ Variety of tools

SMS texts to provide tips

Apps to track your daily progress and mental

fitness

Affect on Pharmacy Industry

Websites that host Online Patient

Communities often gather data for

pharmaceutical companies and advertise

their products to users

◦ “We accept advertising from many different

companies, including pharmaceutical

companies who develop, research and

sell psychiatric medications for many of

the mental disorders listed on this site. We

want you to be clear that we do accept

pharmaceutical company funding.”

References: Psych Central Disclaimer and Disclosure. Accessed Online August 24, 2014 at: http://psychcentral.com/about/disclaimer/

Example from Psych Central

References: Author’s Screenshot. Psych Central Medication Library. Accessed online August 24, 2014 at: http://psychcentral.com/drugs/

Example: Focus on Geodon

References: Author’s Screenshot. Psych Central Medication Library: Geodon. Accessed online August 24, 2014 at: http://psychcentral.com/drugs/

How can Pharmacists Help?

Provide accurate and non-biased

information about drug therapies

Monitor social networks for cues for

poor mental health

◦ Social networking profiles can provide

insight into the mental health of patients

Activity provides a more complete clinical

picture of a patient’s mental health

References: Elizabeth A. Martin, Drew H. Bailey, David C. Cicero, John G. Kerns "Social networking profile correlates of schizotypy“.

Psychiatry Research, January 2013, doi:10.1016/j.psychres.2012.06.031

How can Pharmacists Help?

Patients with mental illness are currently

using social networks

◦ Online Patient Communities

◦ Following use patterns of general population

Pharmacits should be aware of the

different social networking sites

frequented used by these patients, ask

patients about their use of social

networking, and encourage safe and

responsible online behaviors



Thank you

Cody Midlam, PharmD, CGP

◦ [email protected]

Questions?

References 1. The World Health Organization. Health topics. Mental disorders. Accessed online August 24, 2014 at: http://www.who.int/topics/mental_disorders/en/.

2. The World Health Organization. What is mental health? Online Q&A Published 2 September 2007.Mental disorders. Accessed Online August 24, 2014 at http://www.who.int/features/qa/62/en/

3. Hampton, Keith, Sessions Goulet, Lauren, Ja Her, Eun, Raine, Lee. Social Isolation and New Technology. Pew Research Internet Project. Accessed Online, August 24 2014 at: http://www.pewinternet.org/2009/11/04/social-isolation-and-new-technology/

4. Face to Face Versus Facebook: Does Exposure to Social Networking Web Sites Augment or Attenuate Physiological Arousal Among the Socially Anxious?, doi:10.1089/cyber.2012.0498, Shannon M. Rauch et al., published in Cyberpsychology, Behavior, and Social Networking, 4 March 2014.

5. Donnely, Laura. Facebook and Twitter feed anxiety, study finds. The Telegraph. Accessed Online August 24 2014 at: http://www.telegraph.co.uk/technology/9383609/Facebook-and-Twitter-feed-anxiety-study-finds.html

6. Author’s Screenshot. Minecheck.ca. Accessed Online August 10, 2014 from http://keltymentalhealth.ca/blog/2012/02/update-mindchecks-one-voice-campaign.

7. Livingston, James, Cianfrone, Michelle, Korf-Uzan, Coniglio, Connie. Another time point, a different story: one year effects of a social media intervention on the attitudes of young people towards mental health issues. Social Psychiatry and Psychiatric Epidemiology. June 2014, Volume 49, Issue 6, pp 985-990.

8. Author’s Screenshot. “Search for #mhsm”. Twitter.com. Accessed August 10, 2014.

9. Author’s Screenshot. “#IWILLLISTEN” Accessed online August 10, 2014 at http://naminyc.iwilllisten.org/

10. Walser, Adam. Social media, movie stars may be driving teens to cutting. Published July 1, 2013. Accessed Online August 24, 2014 at: http://www.abcactionnews.com/news/local-news/i-team-investigates/social-media-movie-stars-may-be-driving-teens-to-cutting

11. Donnely, Laura. Facebook and Twitter feed anxiety, study finds. The Telegraph. Accessed Online August 24 2014 at: http://www.telegraph.co.uk/technology/9383609/Facebook-and-Twitter-feed-anxiety-study-finds.html

12. Stewart, Erin. Mental illness: opening up online. Published June 23, 2014. Accessed Online August 24, 2014 at: http://www.abc.net.au/rampup/articles/2014/06/23/4030027.htm

13. Gowen, Kris, Deschaine, Gruttadara, Darcy, Markey, Dana. Young Adults with Mental Health Conditions and Social Networking Websites: Seeking Tools to Build Community. Psychiatric Rehabilitation Journal 2012, Volume 35, No. 3, 245–250.

14. Psych Central Disclaimer and Disclosure. Accessed Online August 24, 2014 at: http://psychcentral.com/about/disclaimer/

15. Author’s Screenshot. Psych Central Medication Library. Accessed online August 24, 2014 at: http://psychcentral.com/drugs/

16. Author’s Screenshot. Psych Central Medication Library: Geodon. Accessed online August 24, 2014 at: http://psychcentral.com/drugs/

17. Elizabeth A. Martin, Drew H. Bailey, David C. Cicero, John G. Kerns "Social networking profile correlates of schizotypy“. Psychiatry Research, January 2013, doi:10.1016/j.psychres.2012.06.031

18. Social Networking Fact Sheet. Pew Research Internet Project. Accessed Online August 29, 2014 at: http://www.pewinternet.org/fact-sheets/social-networking-fact-sheet/

19. Reference: Author’s Screenshot. “PsychCentral Home Page”. Accessed online August 29, 2014 at: http://psychcentral.com/

Mentally ill patients using social networks for communication

Healthcare

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