Psychiatry and online social media: potential, pitfalls and ethical guidelines for psychiatrists and trainees
Abstract
Objective: This paper proposes ethical guidelines for psychiatrists and psychiatry trainees when interacting with social media. Methods: A three-stage process was followed in the development of these guidelines. A literature review provided situations and possible broad rules as to how social media could be ethically engaged. A roundtable discussion by a panel of invited psychiatrists, psychiatry trainees, psychologists, e-health practitioners, lawyers and consumers was held to discuss the situations and to better formulate the ethical principles upon which psychiatrists could act. These vignettes and principles were then broadly discussed at a seminar held at the 2011 RANZCP Congress. Finally, this paper was circulated to the original invitees for final comment. Results: A set of recommendations for working with social media were developed. Conclusions: The new social media provides important avenues for communication, education and treatment. These avenues pose ethical and practical dilemmas that can be resolved by the application of established ethical principles. Practical recommendations for navigating social media are proposed.
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Doctors' concerns about legal issues and privacy in online communication are comparable to those in other countries and remain unaltered despite guidelines published by professional organizations.
“These concerns are comparable to those shown in other countries [27] and remain unaltered despite the development of guidelines for social media published by professional organizations before and during the study period [35-39].”
From How Doctors View and Use Social Media: A National Survey (2014) · cites this paper as [35]
Cites
Online Posting of Unprofessional Content by Medical Students
Chretien, K. C. (2009) · JAMA · doi:10.1001/jama.2009.1387 · Cited by 448 · see citing works
The Intersection of Online Social Networking with Medical Professionalism
Thompson, L. A., Dawson, K., Ferdig, R., Black, E. W., Boyer, J., Coutts, J., & Black, N. P. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0538-8 · Cited by 425 · see citing works
Privacy, professionalism and Facebook: a dilemma for young doctors
MacDonald, J., Sohn, S., & Ellis, P. (2010) · Medical Education · doi:10.1111/j.1365-2923.2010.03720.x · Cited by 245 · see citing works
Professional Boundaries in the Physician-Patient Relationship
Gabbard, G. O. (1995) · JAMA · doi:10.1001/jama.1995.03520420061039 · Cited by 201 · see citing works
Ethics and law for the health professions
Braunack‐Mayer, A., Elkin, S., Norris, P., & Wilson, H. J. (2005) · Journal of Bioethical Inquiry · doi:10.1007/bf02448598 · Cited by 199 · see citing works
Practicing Medicine in the Age of Facebook
Jain, S. H. (2009) · New England Journal of Medicine · doi:10.1056/nejmp0901277 · Cited by 179 · see citing works
Medical professionalism in the age of online social networking
Guseh, J. S., Brendel, R. W., & Brendel, D. H. (2009) · Journal of Medical Ethics · doi:10.1136/jme.2009.029231 · Cited by 165 · see citing works
Facebook activity of residents and fellows and its impact on the doctor–patient relationship
Moubarak, G., Guiot, A., Benhamou, Y., Benhamou, A., & Hariri, S. (2011) · Journal of Medical Ethics · doi:10.1136/jme.2010.036293 · Cited by 138 · see citing works
The YouTube Generation: Implications for Medical Professionalism
Farnan, J. M., Paro, J. A. M., Higa, J., Edelson, J., & Arora, V. M. (2008) · Perspectives in Biology and Medicine · doi:10.1353/pbm.0.0048 · Cited by 113 · see citing works
Social media and the medical profession
Mansfield, S. J., Morrison, S. G., Stephens, H. O., Bonning, M. A., Wang, S., Withers, A. H. J., Olver, R. C., & Perry, A. W. (2011) · Medical Journal of Australia · doi:10.5694/j.1326-5377.2011.tb03149.x · Cited by 112 · see citing works
Ethics and Law for the Health Professions.
Kerridge, I., Lowe, M., & McPhee, J. (2005) · Flinders Academic Commons (Flinders University) · Cited by 100 · see citing works
Dual Relationships in Mental Health Practice: Issues for Clinicians in Rural Settings
Scopelliti, J., Judd, F. K., Scopelliti, J., Judd, F. K., Grigg, M., Hodgins, G. A., Fraser, C., Hulbert, C. A., Endacott, R., & Wood, A. H. (2004) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2004.01486.x · Cited by 76 · see citing works
Web searching for information about physicians
Gorrindo, T. (2008) · JAMA · doi:10.1001/jama.2008.44 · Cited by 54 · see citing works
Facebook friend request from a patient?
Devi, S. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60449-2 · Cited by 43 · see citing works
The Facebook Phenomenon: Boundaries and Controversies
Luo, J. S. (2009) · Primary psychiatry · Cited by 19 · see citing works
Sleeping with the Past: The Ethics of Post-Termination Patient-Therapist Sexual Contact
Ryan, C. J., & Anderson, J. (1996) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048679609076091 · Cited by 13 · see citing works
Self-citationGraham, N., & Moore, P. (2010) · BMJ · doi:10.1136/sbmj.a1658 · Cited by 8 · see citing works
Overview of Psychiatric Ethics IV: The Method of Casuistry
Robertson, M. S., Ryan, C. J., & Walter, G. (2007) · Australasian Psychiatry · doi:10.1080/10398560701378582 · Cited by 5 · see citing works
Self-citationSanctity, Secrecy, and Silence: Dilemmas in Clinical Confidentiality
Pinals, D. A., & Gutheil, T. G. (2001) · Psychiatric Annals · doi:10.3928/0048-5713-20010201-08 · Cited by 2 · see citing works
Privacy, Boundaries Fade With Social Media
BOSCHERT, S. (2011) · Clinical Psychiatry News · doi:10.1016/s0270-6644(11)70196-5 · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Ethical Issues in Online Psychotherapy: A Narrative Review
Stoll, J., Müller, J. A., & Trachsel, M. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00993 · Cited by 340 · see citing works
How Doctors View and Use Social Media: A National Survey
Brown, J., Ryan, C., & Harris, A. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3589 · Cited by 190 · see citing works
“These concerns are comparable to those shown in other countries [27] and remain unaltered despite the development of guidelines for social media published by professional organizations before and during the study period [35-39].”
ResultSelf-citationHilty, D. M., Yellowlees, P., Parrish, M. B., & Chan, S. R. (2015) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2015.05.006 · Cited by 88 · see citing works
The Future of Digital Psychiatry
Hariman, K. W., Ventriglio, A., & Bhugra, D. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-1074-4 · Cited by 62 · see citing works
Perceptions of nursing students regarding responsible use of social media in the Eastern Cape
Nyangeni, T., Du Rand, S., & Van Rooyen, D. (2015) · Curationis · doi:10.4102/curationis.v38i2.1496 · Cited by 56 · see citing works
The Ethical Implications of Social Media: Issues and Recommendations For Clinical Practice
Baier, A. L. (2018) · Ethics & Behavior · doi:10.1080/10508422.2018.1516148 · Cited by 56 · see citing works
Mental Health Practitioners’ Use and Attitudes Regarding the Internet and Social Media
Deen, S. R., Withers, A., & Hellerstein, D. J. (2013) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000438184.74359.88 · Cited by 50 · see citing works
Chan, D. H. S. (2015) · Journal of Health & Medical Informatics · doi:10.4172/2157-7420.1000200 · Cited by 49 · see citing works
Social Media/Networking and Psychiatric Education: Competencies, Teaching Methods, and Implications
Hilty, D. M., Zalpuri, I., Stubbe, D. E., Snowdy, C. E., Shoemaker, E. Z., Myint, M. T., Joshi, S. V., & Liu, H. Y. (2018) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-018-0061-7 · Cited by 38 · see citing works
Social media, social avatars and the psyche: is Facebook good for us?
Brunskill, D. (2013) · Australasian Psychiatry · doi:10.1177/1039856213509289 · Cited by 28 · see citing works
White, E., & Hanley, T. (2022) · Counselling and Psychotherapy Research · doi:10.1002/capr.12577 · Cited by 26 · see citing works
Current ethical dilemmas experienced by therapists who use social media: A systematic review
White, E., & Hanley, T. (2023) · Counselling and Psychotherapy Research · doi:10.1002/capr.12678 · Cited by 24 · see citing works
Haeny, A. M. (2013) · Ethics & Behavior · doi:10.1080/10508422.2013.860030 · Cited by 17 · see citing works
Migliorini, C., Lam, D. (. S., & Harvey, C. A. (2021) · Early Intervention in Psychiatry · doi:10.1111/eip.13230 · Cited by 16 · see citing works
Smith, K. M., Jones, A. L., & Hunter, E. A. (2021) · Ethics & Behavior · doi:10.1080/10508422.2021.1977935 · Cited by 12 · see citing works
Yoo, D. W., Bhatnagar, A., Ernala, S. K., Ali, A. F., Birnbaum, M. L., Abowd, G. D., & Choudhury, M. D. (2023) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3579479 · Cited by 11 · see citing works
Ethics of the Use of Social Media as Training Data for AI Models Used for Digital Phenotyping
Jaiswal, A., Shah, A., Harjadi, C., Windgassen, E., & Washington, P. (2024) · JMIR Formative Research · doi:10.2196/59794 · Cited by 8 · see citing works
Basevi, R., Reid, D., & Godbold, R. (2014) · University of Hertfordshire Research Archive (University of Hertfordshire) · Cited by 11 · see citing works
Social Media Use in Psychiatric Graduate Medical Education: Where We Are and the Places We Could Go
O'Hagan, T., Roy, D., Anton, B., & Chisolm, M. S. (2015) · Academic Psychiatry · doi:10.1007/s40596-015-0372-3 · Cited by 10 · see citing works
Reading the Mind: A Social Media-Facilitated Collaboration of US and UK Graduate Psychiatry Trainees
Lal, R., Peters, M. E., Kan, C., & Chisolm, M. S. (2015) · Academic Psychiatry · doi:10.1007/s40596-015-0286-0 · Cited by 8 · see citing works
Psychiatrists’ Perceptions of Facebook and Other Social Media
Lis, E., Wood, M. A., Chiniara, C., Biskin, R. S., & Montoro, R. (2015) · Psychiatric Quarterly · doi:10.1007/s11126-015-9358-2 · Cited by 8 · see citing works
The Rise of Influencer Practices Among Psychologists: From Therapy Rooms to Instagram Reels
Sarı, B. (2025) · Social Media + Society · doi:10.1177/20563051251353741 · Cited by 6 · see citing works
Hilty, D. M., & Mucić, D. (2015) · Springer eBooks · doi:10.1007/978-3-319-20852-7_1 · Cited by 6 · see citing works
Lee, Y. J., Hwang, J., Lee, S. I., Woo, S.-I., Hahn, S. W., & Koh, S. (2019) · BMC Medical Education · doi:10.1186/s12909-019-1771-z · Cited by 4 · see citing works
Fan, S. (2015) · Focus on Health Professional Education A Multi-Professional Journal · doi:10.11157/fohpe.v16i3.85 · Cited by 3 · see citing works
Social Media and Clinical Practice: What Stays the Same, What Changes, and How to Plan Ahead?
Snowdy, C. E., Shoemaker, E. Z., Chan, S. R., & Hilty, D. M. (2015) · Springer eBooks · doi:10.1007/978-3-319-20852-7_8 · Cited by 3 · see citing works
Technology and the Brain: Lessons from Patient Care, Social Media and the Internet
Hilty, D. M. (2017) · Psychology and Cognitive Sciences - Open Journal · doi:10.17140/pcsoj-3-128 · Cited by 2 · see citing works
Decelis, K., & Falzon, R. V. (2021) · Counselling and Psychotherapy Research · doi:10.1002/capr.12413 · Cited by 2 · see citing works
Digital psychiatry: implications for patients and services
Pandarakalam, J. P. (2021) · British Journal of Hospital Medicine · doi:10.12968/hmed.2021.0382 · Cited by 2 · see citing works
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Luo, J. S., & Ing, K. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822201-0.00012-5 · Cited by 2 · see citing works
Hope on YouTube: Mixed Methodology Bridges Mental Health YouTubers and Viewers’ Perspectives
Ziavras, S., & Diamantaki, K. (2024) · European Conference on Social Media · doi:10.34190/ecsm.11.1.2063 · Cited by 1 · see citing works
The use of social media in social care: a systematic review of the argument-based ethics literature
Vandemeulebroucke, T., & Bolte, L. (2025) · Medicine Health Care and Philosophy · doi:10.1007/s11019-025-10269-4 · Cited by 1 · see citing works
Looi, J. C., Allison, S. C., & Bastiampillai, T. J. (2023) · Australasian Psychiatry · doi:10.1177/10398562231186244 · Cited by 1 · see citing works
Maintaining Professional Dignity in the Age of Social Media
김정아, & 반유화 (2018) · Korean Journal of Medical Ethics · doi:10.35301/ksme.2018.21.4.20 · Cited by 1 · see citing works
Maintaining Professional Dignity in the Age of Social Media
Kim, C. J., & Yoo Wha, B. H. A. N. (2018) · Korean Journal of Medical Ethics · doi:10.35301/ksme.2018.21.4.316 · Cited by 1 · see citing works
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Guidelines for the responsible use of social media by nursing students
Nyangeni, T. (2015) · Nelson Mandela University Research Repository
When Patients Appear in the News: Clinical Considerations for Mental Health Professionals
Morris, N. P. (2020) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000245
Hariman, K. W. (2022) · doi:10.1093/med/9780198861478.003.0030
Mucić, D., & Hilty, D. M. (2024) · Springer eBooks · doi:10.1007/978-3-031-59936-1_1
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- Authors
- Frankish, K., Ryan, C., & Harris, A.
- Affiliations
- Westmead Hospital (AU)
- The University of Sydney (AU)
- Venue
- Australasian Psychiatry
- Publisher
- SAGE Publications
- Published
- 2012-06
- Volume
- 20
- Issue
- 3
- Pages
- 181-187
- ISSN
- 1039-8562 (ISSN-L)
- 1440-1665
- OpenAlex
- W2013242952
- Cited by
- 42
- References
- 20
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 5 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 2 · 2015: 11 · 2014: 2 · 2013: 3
- FWCI
- 5.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australasian Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Social Media in Health Education
- Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- social media, psychiatry, moral norms, professional ethics, psychiatric trainees, online communication, e-health, ethical principles, professional boundaries
- MeSH terms
- Confidentiality, Ethics, Medical, Humans, Physician-Patient Relations, Psychiatry, Guidelines as Topic, Privacy, Social Media
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