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Social media counselling by UNCERTIFIED INDIVIDUAL, what are the consequences?



Social media is filled with accounts that offers mental health tips, support and even consultations. This is possibly making some people forgo consultations with actual psychologist/psychiatrist to seek help. To discuss this matter, we’ve got Prof Dr Muhammad Najib, Psychiatrist at MSU Medical Centre to give his take on this issue.
1. Are you aware of "mental health experts" on social media? For example, Instagram accounts that offer tips and "shoulders to cry on". Is this a dangerous scenario?
I am aware of several such accounts. A few of them appear to be authentic and run by trained mental health experts – psychologist, psychiatrist etc but there is no way to be 100 sure that they are run by those whom they claim to be.

Whatever it is, I think for sure they must have their own motives to create such accounts or pages. Perhaps some of them really wanted to help people who are in trouble and feel more comfortable to seek help online. Others might just want to gain popularity or trying to get attention from prospective clients.

Most worrying though is if some people might be using these platforms to take advantage of people who are desperate or lonely ultimately for all sorts of criminal activities – from extorting money to grooming of children for sexual motives!
Nevertheless, there are authentic online counselling or even “therapy” services around, run by qualified mental health practitioners. In some countries like Japan, some of these services are officially government funded. It is still too early to determine efficacy of such services and the risks involved, but I am pretty sure they do have an important role to assist the “physical” mental health services.
2. How dangerous is it for an uncertified individual to give counselling to someone is suffering from mental health issues?
I think, dangerous or not depends on what sort of “help” or services being offered. Perhaps if those accounts are meant for the public to ask questions or share experiences, they may act as online support group. But of course, people who subscribe to those account are doing it at their own risk.

Often times, if the advice is given by untrained individual, or even “ex-patients” or current sufferers from mental illness who may not have adequate or correct information about the illness – there will be a big risk that the “clients” might be misled into wrong practices.

My most recent experience with a patient was quite intriguing, when she told me that “people” in a social media group had warned her against taking antidepressants for longer than just a few weeks or else she would risk getting irreversible kidney damage!

3. How crucial is face to face meeting between doctor/patient when it comes to solving mental health issues?
Very crucial. In a mental health consultation, many things happen which might not be emulated very well in an online session. For instance, the smile and warmth of a psychologist upon initial introductory remarks alone might already indicate to the client that there is still “hope” in solving his issues.

Nothing will replace the empathy and care that might be shown by an experienced therapist in a session. And that is just the beginning.

More complex matters, for instance sensing reluctance of a client to talk on some important but sensitive issues indicated by that odd body language of a client, or managing a deeply suicidal depressed teenager, or dealing with psychotic patients heavily laden by hallucinations and delusions would all require more individualised approaches or communication with the rest of the mental health system for referrals etc. These cannot be replaced by mere paid online consultation.
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