Since the advent of the Web in the early 1990s, tens of thousands of consumer-oriented mental health Web sites have been created. Over 12 million results come up in the Google search engine when searching for the term “mental health.” Practitioners and their clients can easily be overwhelmed by this sheer volume of information available online.
Questions about the quality of information online are also a concern, especially to mental health practitioners. How do you recommend high-quality Web sites in mental health when there are so many to choose from? This article will describe some common qualities to look for in a site and give you some common starting points to help you find reliable and updated mental health information and support groups online. These are the criteria that Psych Central uses to rate and review websites we include in our peer-reviewed Resource Directory.
Qualities of a Good Site
There have been an abundance of articles published about how to recognize sites that are more likely to contain reliable, quality information. The American Medical Association, for instance, has published an article describing a laundry list of dozens of guidelines for helping to determine quality online health information. Most practitioners and their clients, however, do not have the time nor inclination to evaluate each and every health Web site they come across against dozens of criteria. Most professional guidelines focus on common areas: authorship and affiliation, bias transparency, publication and review dates, and privacy and advertising policies.
Authorship and Affiliation
Every page on the Internet has been authored by someone, somewhere, at some specific time in the past. Unfortunately most pages on most sites do not include this very basic information. Mental health sites often do better in this area, since the authors want to take credit for their work. In evaluating authorship, the reader should look for the author’s name, degrees, and affiliation. (To find the author’s related work, simply copy and paste the author’s name and degrees into a search engine such as Google, putting quotation marks around the whole phrase.)
If authorship and affiliation is not readily evident, the reader should already begin to question the validity of the article. An article written by a Ph.D. from a university discussing a new medication may carry more weight in people’s minds than an article written by someone with no credentials who works for a pharmaceutical company. Authorship also helps one determine possible bias in the article’s presentation of information.
Nearly every author of every article ever written has an unspoken agenda that guides their writing. Psychologists, even researchers, can be influenced by their background and education in psychology. Psychiatrists are often influenced by pharmaceutical marketing materials and their own medical training. As the old saying goes, if the only tool you have is a hammer, you begin to see nails everywhere. Educated Internet users can use this understanding of author’s motivations to help guide the value they place on information they discover online. A research news brief from the National Institute of Mental Health is likely to be less biased than a research news brief from a pharmaceutical company. A press release from a university describing some new therapy research is likely to be more biased than the actual peer-reviewed study.
Sometimes bias is more difficult to discern. Someone selling self-motivation audio cassettes has an obvious bias. Someone selling their psychotherapy services online and therefore subtly shapes their articles (or links to other articles) on their Web site to reflect a more pro-therapy stance results in a more nuanced bias. The key is to understanding that this bias exists in many articles, and so to take much of what is read with a grain of salt.
Publication and Review Dates
All information eventually becomes stale in the mental health arena, so it needs to be constantly updated to reflect the most recent knowledge and understanding we have about mental health disorders. Publication and review dates allow an Internet user to judge how current and relevant the information is likely to be. Current misinformation is still misinformation, so currency is no guarantee by itself of reliable, quality mental health information. But this is one more piece of information an Internet user can look for to help them judge the overall accuracy and reliability of the article they are reading.
Privacy and Advertising Policies
Much ink is wasted describing what to look for in privacy and advertising policies, as though anybody has the time to read through thousands of words on each Web site they surf. Very few people have that kind of time, and even if they did, most large, corporate Web sites write their policies with enough legalese interspersed in them to make them difficult to understand.
What About Quality Badges and “Codes”?
There are a variety of Web badges and online “quality codes” that seek to review certain pieces of information about a health-oriented website, and validate they follow a certain set of minimal quality guidelines. However, in our experience, we’ve found programs such as HONCode to be of very limited value because they have unreliable policing and taking followup action when notified of violations. For instance, one violation we submitted to HONCode in the summer of 2007 still has not been corrected on the offending site, 5 months after the site was reported for multiple violations.
Other similar programs, such as URAC, are simply not widely recognized or implemented to offer any kind of assurance to the average consumer or provider.
We therefore would not recommend relying on any such badge or code as a symbol that the site one is viewing is meeting any type of minimal standard.