The document discusses how mentally ill patients use social networks. It outlines that 74% of US adults use social networks and patients find them useful for communication and peer support. However, social networks can also negatively reinforce behaviors or promote self-harm. The document recommends that pharmacists be aware of social network use among patients, provide unbiased medication information online, and encourage responsible online behaviors.

1. Mentally ill patients using social
networks for communication and
exchange of information
FIP World Congress 2014 Bangkok
Cody Midlam, PharmD, CGP

2. 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

3. 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

4. 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/.

5. 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/

6. 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

7. 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

8. 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

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

10. 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/

11. 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

12. 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.

13. 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/

14. 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.

15. Most Enjoyable Features
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.

16. Desired Features
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.

17. Desired Topics
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.

18. 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

19. 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

20. 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/

21. 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

22. 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

23. Building Community
 Social networking can improve
◦ Social connectedness
◦ Decrease isolation
◦ Enhance subjective wellbeing through the
practice of mutual feedback and self-
disclosure
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.

24. 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

25. 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/

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

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

28. 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

29. 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
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.

30. Thank you
 Cody Midlam, PharmD, CGP
◦ codymidlam@gmail.com
 Questions?

31. 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/