Anna, from the Victorian town of Geelong, is in her 50s and has been seeking professional help for her mental health for around 30 years.

She says she sees her psychologist and psychiatrist face to face and doesn't find online services particularly helpful. That doesn't stop her social media feed being flooded with ads. 

"I get a bit frustrated because a lot of these things I've seen ads for are really giving false hope. A lot of them say 'easily accessible mental health care', whereas they're not really," Anna says. 

"They're either very expensive, [or] you don't get the same person regularly, and other things that I know personally are not helpful for my mental health." 

Endless targeted advertising 

Social media users who click on mental health advertising, visit websites or search for key words relating to mental health are likely to be bombarded with ads relating to mental health apps and services. Even if you don't actively engage with services, behavioural analytics activated by your clicks may mark you as a target for these ads. 

Shortly after beginning to research this article, my Instagram account was flooded with ads for mental health apps promising to 'get rid of anxiety completely' or 'improve sleep efficiency within seven days'. I was also invited to 'take a test to train my brain', and benefit from MindBuddy, a service that likens itself to popular language learning app Duolingo, "but for depression".

Nonprofit mental health service providers, often funded by the government, also use targeted advertising to reach clients and those in need

It's not just profit-seeking mental health apps trying to get your attention. Nonprofit mental health service providers, often funded by the government, also use targeted advertising to reach clients and those in need. 

But is filling social media feeds with mental health ads actually helping those in distress? And what are the ethics behind tracking people's online behaviours to make inferences about their mental health?  

Some find that online services are not as affective as face-to-face counselling.

Big data, small targeting

Mental health advocate Simon Katterl says that, while people in distress receiving ads for mental health services may have benefits in some cases, the risks and potential downsides need to be carefully considered. 

"There are questions to be asked about how that data was obtained in the first place and whether people were really fully informed and consenting to that information being shared about them for targeted advertising purposes," he says. 

"When you put it within a commercial context, it's unclear whether the services are meeting their needs or exploiting their anxieties and distress. Part of that is that we don't regulate digital mental health technologies particularly well in this country," Katterl adds. 

Concern about behavioural analytics 

Piers Gooding, a Latrobe University professor who focuses on the legal side of health policy, says the growing capacity of behavioural analytics to infer mental health status is a concern. 

"The rise of big data and automated decision systems has certainly increased the likelihood of inferences and predictions being drawn from the behaviours, preferences and the private lives of individuals," he says. 

"So there are things that people might be entering into their devices that aren't explicitly about seeking help for a mental health condition which may be used to kind of infer some kind of mental-health status about that person. There are questions about whether the law currently adequately protects against the misuse of that kind of data," Gooding says.

What we don't have here in Australia is that same level of confidence that our data is being used in a way that won't leave us worse off

Chandni Gupta, Consumer Policy Research Centre

Chandni Gupta, digital policy director of the Consumer Policy Research Centre, says behavioural analytics are embedded in the online advertising strategies of social media platforms. Privacy laws haven't kept pace with the growing technology. 

"At the moment our privacy protections are purely based on notification and consent. Everything is wrapped up in privacy policies or terms and conditions and a very much 'take it or leave it' approach," she says. 

"While other jurisdictions have very specific obligations on privacy, what we don't have here in Australia is that same level of confidence that our data is being used in a way that won't leave us worse off," Gupta adds. 

Nonprofits using targeted advertising

We sent questions to some of the biggest nonprofit mental health service providers in Australia to get a better understanding of how they used targeted advertising alongside so many for-profit players. 

Lifeline says it predominantly uses geographic targeting after natural disasters to ensure residents of certain areas know that help is available. 

Beyond Blue says it prefers to rely on organic social media traffic, but needs to use targeted advertising due to the lack of transparency from social media companies. 

"Social media companies aren't transparent about how their proprietary algorithms decide which posts they show to which people, which means it's really hard to be visible to people who might need help without using paid targeted options," a spokesperson says. 

It's really hard to be visible to people who might need help without using paid targeted options

Beyond Blue spokesperson

"We are very mindful that overexposure to mental health messages can carry risk in some circumstances. As such, we carefully design our social media content with input from mental health experts and people living with and managing mental health issues themselves. This helps us ensure the material is not triggering, pressuring or alarming," they add. 

Youth mental health service ReachOut says there is evidence that young people are more likely to seek professional help after seeing mental health advertising on social media. 

"There has been an increase in commercialised mental health apps, often built and marketed on a limited or unclear evidence base. This poses risks to users. Access to free, trusted and evidence-based services that meet national safety and quality standards is vital for young people," says a ReachOut spokesperson. 

In times of distress, people needing help can feel overwhelmed by too many choices.

Paid apps defend advertising

The paid mental health app Headspace also defended their targeted advertising practices. 

"Like most apps, Headspace advertises on select social media platforms like Meta, Snap, and TikTok with the goal of helping people get connected to mental health and mindfulness support," says a Headspace spokesperson. 

"We are not a data broker, meaning we don't sell data for money. The limited data we share with third parties includes safeguards, such as encryption or hashing. We also limit data sharing to only what is necessary to enable our advertising, and exclude health information." 

We also sent questions to the paid mental health therapy platform Betterhelp, who did not respond.

Overwhelmed by options

Targeted mental health advertising may have its place, but with so much of it popping up on social media without firm regulations in place, it seems likely that its potentially harmful effects are not well understood.

Anna Brooke, chief research officer at Lifeline Australia, says there is research to show that in times of distress people needing help can face a kind of paralysis when overwhelmed by too many decisions and options. 

"Having options can be a good thing, because it gives people choice, but then there are a lot of services out there that might not be of a good quality and people might have too many options to actually make a decision in times of needing help," she says. 

Stock images: Getty, unless otherwise stated.

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