The document discusses the evolution of mental health online from the early 1990s to present day. It traces the development from early peer-led support groups on platforms like newsgroups and mailing lists, to personal homepages in the Netscape era providing information and support. Over time, online interventions, blogs, social networks and communities emerged, allowing for greater connectivity and information sharing. Today, platforms like PatientsLikeMe and Twitter provide new ways for patients to connect and learn from each other's experiences. The mental health field has benefitted tremendously from these technological advancements over the past 15 years.

1. From Netscape to Twitter:From Netscape to Twitter:
15 Years of Mental15 Years of Mental
Health OnlineHealth Online
John M. Grohol, Psy.D.John M. Grohol, Psy.D.

2. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineDisclosures
Psych Central

3. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineOverview
Pre web
The Netscape Era
E-therapy / Online Interventions
Blogs
Web Support Groups
Social Networking
Mental Health Online Today
Web 2.0 & Social Networks
Health 2.0
E-Patients Movement
Twitter
OLMHAC
Professional Networks & Tools
“Internet addiction”

4. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlinePre web
Feb 1994 newsgroup posting:
I am curious to know what specific signs of
depression are. A person can feel depressed
about a specific incident but not suffer from
Depression (with a capital D) -- How does
someone tell the difference? Is depression
always considered a chemical imbalance? Is it
hereditary? Is it a "mental illness"?

5. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlinePre web
Peer-led support groups in:
• Newsgroups
• Mailing lists
• Commercial providers
(e.g., CompuServe)
• Powerful, but hard to find, hard to use

6. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineThe Netscape Era
Personal homepages like
Andrew’s Depression Page (1997):
When I was finally properly
diagnosed with major depression,
I was compelled to learn more
about this illness. This page
was a result of my search for
understanding. I have had so
many wonderful responses to my
page in the months that it has
been up, and I thank everyone
out there who has taken the time
to let me know what you think.
You have given me a sense of
accomplishment that I would not
have otherwise felt in this
depression dulled existence.

7. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineThe Netscape Era
Information is power
The web opened up the floodgates to
easily accessible information like never
before

8. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineThe Netscape Era
“Web 1.0” / Netscape
(1995 – 2001)
Educational & informational
Personal homepages
Publishing by Anyone –
One to many
Largely still a one-way
conversation
Support groups start to
sprout on web

9. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineJan-1999 to Oct-1999

10. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineMarch 2009 ComScore
Rank Property Unique Visitors
1 Google Sites 151,241,000
2 Yahoo Sites 146,059,000
3 Microsoft Sites 122,323,000
4 AOL 104,416,000
5 Fox 85,057,000
6 Ask Network 72,798,000
7 eBay 70,021,000
8 Wikipedia 61,446,000
9 Facebook 61,224,000
10 Amazon Sites 60,999,000
39 Everyday Health 22,112,000
43 WebMD Health 21,210,000

11. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineEarly Interventions
The Samaritans,
a suicidal helpline
begun in the UK
in 1953
Other
independent
professionals
giving free advice In 2007, the Samaritans made:
• 137,627 email
responses
• 86,475 responses by
SMS text

12. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health Onlinee-Therapy
Online interventions started early
Email
Online clinics
E-therapy today
International Society for Mental Health
Online (ISMHO)

13. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineMetanoia.org
Viewed nearly 8
million times
Ongoing survey:
• 29% helped
• 24% did not help
• 31% not sure

14. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineMetanoia.org
I was looking for efficient methods to kill myself because don't
want to try but die. I'm still not sure how to avoid this but your
words let me a little bit stronger. I'm feeling a lit bit better
today and decided to call the correspondent of Good Samaritans in
my town that I found because of your website.
I think the link to The Samaritans may really help. Your
description about pain outweighing resources hits the nail on the
head. I am so glad to have “someone” to talk to. I was so hoping
for such a thing.
I'm not really suicidal, just going through a tough
time. I found your site on the net, and I just want
to thank you. You have done a wonderful thing by
making that site, whether you realize it or
not. Many people's lives will change because of
you.

15. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineOnline Interventions
Interactive online
programs
• MoodGYM
• MasteringMyLife

16. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineBlogs
On the cusp of
Web 2.0
(2000 – 2005)
Blogs as analysis
Blogs as journaling
Two-way
conversation

17. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineWeb Support Groups
Growing use
because now more
readily accessible /
visible on the web

18. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health Online2000/01 dot.com Bubble
Nearly 50% of dot.com startups went
under
Wiped out $5 trillion in market value of
technology companies
Innovation suffered due to little investor
funding

19. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineSocial Networking
Allow people to connect more easily
with one another in methods not readily
otherwise available
Early Social Networks:
• 2002 – Friendster
• 2004 – MySpace

20. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineMental Health Online Today
Stigma of mental health concerns significantly reduced in past
15 – 20 years
Usage of educational & support resources continues to climb
More professionals taking active role in providing care
More researchers using online tools and studying online
services & behaviors
More customized interventions being provided exactly when
needed (“Information therapy”)
Data is increasingly being collected and analyzed in real-time

21. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineHealth Online Today
3%
5%
7%
9%
11%
17%
22%
24%
39%
44%
4%
8%
11%
13%
16%
25%
33%
36%
58%
65%
Any other health-related online activity
Participated in online support groups or chat
rooms
Emailed health care professionals
Used a doctor's or doctor's office website
Used a hospital website
Received health-related email newsletters
Used a health plan or health insurance website
Searched for Rx information
Searched for general health info
Searched for info on specific diseases or
conditions
eHealth Consumers
Online Adults
Pew Internet, Oct. 2006
Dec 2008:
83% of Internet
users
61% of U.S. adults
have searched online
for health information

22. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health Online
Internet Use for Health Information
(2006)
33%
24%
10%
45%
Internet Print Television Radio
9%Plan
toincrease
18%Plan
toincrease
28%Plan
toincrease
5%Planto
increase
5%
66% plan to keep use
of Internet for Health
Information the same
72% plan to
stay the same
69% plan to
stay the same
74% plan to
stay the same
8%
18%Planto
decrease
17%Planto
decrease
6:1
Ratio
1:2
Ratio
GroupM (WPP) July 2006

23. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineWeb 2.0 & Social Networks
Web 2.0 (2004 – Today)
Mainstream use
of social networks
Most use to keep in better,
more active touch with
friends & family

24. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineHealth 2.0
Social networks for health & mental health
Greater use of patient tools & community
Examples:
• PatientsLikeMe
• MedHelp
• CureTogether
• Psych Central

25. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlinePatients Like Me
Before PatientsLikeMe:
For years I had always taken just 10mg of Baclofen. I was told a long
time ago by my old neuro that "too much Baclofen can cause weak
legs". We'll yes, that maybe true but after 10 years, I probably should
have re-inquired. whoops
Then:
I sign up here. Take a peak at what you guys are doing, and find out
I don't take enough Baclofen to deal with my symptoms. Give the
neuro a call, no problem, and much, much, better.
MS forum
Patient Dosages for Baclofen

26. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health Online
Anyone who
wants to see
what happens
on a 2 month
drug holiday just look at my updated VL
and CD4 count.
After being taken off of old meds to
track down some unwanted side affects.
My VL spiked from undetectable up to
7,360 in a two month period.
Having been on new meds for 28 days
my VL dropped precipitously. As of last
Tuesday 220.
I must say also that a drug holiday is not
what it once was. Not taking 8 relatively
small easy to swallow pills a day just
does not compare to not taking 30 giant
rubberized stick to the back your throat
pills a day. I just kinda feel like I am on
a drug holiday all the time by
comparison.
Patients Like Me
HIV forum Drug Holiday

27. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineMedHelp.org
Professionals
answer
questions
posted in the
community, at
no charge

28. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineCure Together
Like PatientsLikeMe,
collecting and
collating data to
Present the results
in more
actionable ways

29. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlinePsych Central Community
Nearly 100,000 members
in 2 distinct communities

30. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health Onlinee-Patients Movement
e-Patients are equipped, enabled,
empowered and engaged in their health and
health care decisions
Helping people learn to take charge of their
own health / mental health needs
Clinician & patient are equal partners
White Paper at: e-patients.net

31. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineTwitter
140 characters or less of
commentary
Real-time updates, a flowing
public conversation (possibly
archived forever)
Tweet stream analysis has not
been perfected (only popular
tags/tweeters)
Keep updated on mental health
information / news / research

32. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineOLMHAC
On Line Mental Health Action Committee
www.olmhac.org

33. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineProfessional Networks
Have also
grown
since 1994
But lots of
networking &
discussions
still occur on
mailing lists for
professionals

34. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineProfessional Tools
Global Mind
Screen

35. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health Online“Internet Addiction”
Proposed by Young in 1996 APA
presentation based upon compulsive
gambling criteria
Recent analyses of research to-date
suggests sloppy, problematic methodology
Therefore still don’t have any answers; not
likely to be included in DSM-V
Dowling & Quirk (2009); Padilla-Walker et al. (2009); Byun et al. (2009)

36. International Conference on the Use of the Internet in Mental Health •
15 Years of
Mental Health OnlineSummary
We’ve come a long way in a short time
Fundamental changes to the way we
communicate
Powerful tools that are available:
• Anywhere
• Anytime
• To Anyone

37. From Netscape to Twitter:From Netscape to Twitter:
15 Years of Mental15 Years of Mental
Health OnlineHealth Online
John M. Grohol, Psy.D.John M. Grohol, Psy.D.
Twitter: docjohngTwitter: docjohng
Web: psychcentral.com / e-patients.netWeb: psychcentral.com / e-patients.net
Email:Email: docjohn@gmail.comdocjohn@gmail.com