What responsibility does a writer have when writing about mental health? Given the ease of google-diagnosis and dissemination of (mis) information, live streaming, digital bubbles and trolling, is there a special need for respect or sensitivity when writing about the personal, and ultimately subjective, topic of mental health?
Perhaps the answer depends on readership.
A couple of months after we started the Rosella Room we did a workshop on best practice writing for the internet. The instructor emphasised that profiling your imagined reader was key to a ‘successful site’ (comment: whatever that is). ‘Who is your audience?’, we were asked. ‘How old are they, where do they live, what is their education level? What are they looking for on the internet?’
Well, our imagined reader is……. Actually we don’t have one. We write about things that interest us and that we imagine might interest (some) others. In any case, mental health is not exclusive to any one demographic or audience.
In thinking and reading about this issue, we’ve noticed that the discipline of Digital or Information Ethics has mushroomed in universities and thinktanks. Hot topics of the day extend to data control, AI, privacy, surveillance etc. And hybrid journalism – sites like the Rosella Room – is increasingly under the microscope.
What is important in this kind of writing? Accuracy is vital. So too is expressing a view supported by evidence. Few would dispute that a writer should strive for honest and fair comment. And there’s at least an expectation that a writer will not plagiarise. None of this is unique to the mental health world. Nor is it unique to digital writing.
Beyond accuracy, honesty and authenticity, does the digital writer have additional responsibilities? What are the norms and ethics in the digital world?
A digital code of ethics?
We’re not aware of any mandatory ethical code for digital writers. Hate speech, and other provocative and offensive online behaviour, has its own set of issues and deserves a separate post. In that context, community standards are enforceable through national criminal, defamation, and media laws. Social media platforms often have their own internal and external guidelines, as do blogging services (including WordPress).
More broadly, we’ve seen a couple of voluntary content codes and protocols for bloggers and other content creators but their provenance is vague and they don’t focus on the ethical side. We’re not aware of any international obligations.
Digital writers could argue no duty is owed towards readers – ‘it’s a free world’ – ‘read it at your own peril’ – ‘close out of the window if you don’t like what you see’. ‘Not our problem’.
But that doesn’t fly when writing about mental health. In the mental health sphere you’re dealing with issues which can have a real impact on people. Not only sticks and stones – words can hurt too. Words have consequences. Words have power. Words can stir up or exacerbate people’s mental health issues. And digital writing can have enormous – and rapid – reach and impact. And if it has an effect, doesn’t that mean the writer, as content creator, has a responsibility?
We’d argue that the subject matter itself gives rise to a need to take care in reporting and commentary. The mode of publishing in an online world only deepens the ethical challenge. Now we’re not arguing for regulation of the internet or a legally enforceable duty of care. Nor do we oppose free speech (Rosella Room is itself an expression of free speech).
A framework might help guide a digital writer. One model for responsible writing is an Australian industry code for media reporting on mental health issues, produced by the public health body Mindframe. The code comprises a series of guidelines for the media on topics ranging from communicating about mental health to portraying mental health on stage and screen (eg avoid perpetuating stereotypes). It has good content but is directed at professional journalists and media organisations.
But who wants another code? The writer controls the data. The writer can exercise care. Determining any impact on mental health is subjective – it won’t be easily captured by content moderator algorithms. Tools to police content are in any case of questionable utility and effect: see here and here for recent articles by MIT emerging technology writers on content controls and on the live streaming of the horrifying New Zealand attack.
We think it’s probably just a matter of being respectful when dealing with a sensitive topic like mental health, but some issues are worth thinking about a bit more.
Sensitive writing about mental health is not just about how you say it. For example, the generalist writer shouldn’t represent themselves, or create a perception, that they can offer medical or therapeutic guidance. The generalist offers comment and is not in the business of diagnosis or treatment. Should they declare this? (See also below Transparency)
And, given that we know people turn to the internet for assistance, and that one’s page may come up through a search engine, should the generalist mental health writer append a list of helplines (e.g Beyond Blue and Lifeline) for crisis support even if they are merely offering comment? At the Rosella Room we don’t do this. Should we? Should we take into account that mental health topics may raise concerns for the reader? How far should we go?
What about readers who don’t like a comment on mental health? What’s the writer’s ethical duty here? See for example our Quack Report: yoni eggs, essential oils and depression which generated a couple of comments on the Rosella Room Facebook page.
Our post reports that a Californian court ordered Gwenyth Paltrow’s ‘wellness’ company Goop to pay compensation for falsely claiming mental health benefits for her products (eg to cure depression) .
One Rosella Room reader, who claimed to be medically qualified, said the products were beneficial and our article was “dangerous”. Interestingly, they’ve now deleted their comment. If a post offends a reader(s) in the mental health context, should the author take it down?
It can work the other way round too. Readers’ comment – post-publication correction – can be a tool to improve digital writing. Readers have proposed helpful changes to a couple of Rosella Room posts (eg in our review of Leigh Sales’ book An Ordinary Day).
Some call for transparency on the internet – writers should reveal any affiliations or commercial interests or declare they are independent and not for profit. We agree with the general principle of transparency but the latter may be overdoing it for small outfits like the Rosella Room. But adding a sentence or two declaring independence would be an easy fix.
In the context of the ethical dimension of mental health-related writing, another question arises: is the value or authenticity of an opinion piece on mental health diminished if you’re not a person with lived experience?* Should the generalist writer declare experience or its absence? An ethical challenge here is impartiality and the notion of independence.
What do you think of the ethical challenges in writing about mental health in the digital age?
In the mental health context, is there an ethical duty to take care in how and what you write about online?
Any moral philosophers or media specialists out there? Let us know your thoughts.
* We’re not a fan of the clunky term ‘people with lived experience’ but recognise that it captures a critical dimension of the mental health sector. (see our earlier post on terminology The Patient is MIA)