Dr. Schueller is the Executive Director of PsyberGuide and an Assistant Professor at Northwestern University’s Feinberg School of Medicine. He is a faculty member of Northwestern’s Center for Behavioral Intervention Technologies (CBITs) and his work focuses on increasing the accessibility and availability of mental health resources through technology.
Last month Google launched a project through partnership with the National Alliance for Mental Ilness (NAMI) to provide a depression test to those who search for depression related terms. I have seen lots of debates about the implications of such a project, including one between Ken Duckworth and Simon Gilbody that was published in BMJ.1 Before I jump into their arguments for and against the use of Google’s online screening tool, I have a couple points of my own to add. First, the depression test itself is not a creation of Google. Google used the Patient Health Questionnaire 9-item scale (often referred to as the PHQ-9). The PHQ-9 is perhaps the most common depression test used in the United States. Odds are if you’ve seen a doctor, you’ve been asked a version of the PHQ-9. It asks people to report on the frequency of common symptoms of depression: low mood, lack of interest, sleep difficulties, eating troubles, low self-worth, difficulty concentrating, motor dysfunctions, and suicidal ideation. Your responses to these nine questions can strongly predict whether you would be considered clinically depressed. Mental health tests are useful because they can help translate experiences you are having into clinical language the treatment providers might use. Duckworth notes that online screening tests can be useful when they create a standard metric. I’ve heard lots of people use the term “depression” to refer to times when they’re feeling really down, and I’ve worked with a lot of people who would never use the term “depression” but experience a greater deal of distress with significant disruption in their lives. Standard tests, like the PHQ-9, however, can help reduce the subjective nature of mental health care. As Duckworth says “If someone calls their doctor to report a PHQ-9 score of 7, or of 17, any professional can triage the person appropriately.”
Gilbody, however, has reasonable concerns. He argues that screening programs should exist only when something will come from the results such as effective treatment and appropriate follow-up. Gilbody argues that Google will not provide these things, which is likely true. PsyberGuide, however, helps provide some identification of evidence-based app resources that could be useful if one is experiencing some of the symptoms captured by the PHQ-9. A mental health test could be the first step to help you select which apps might be appropriate for you and the difficulties your facing.
We’re beginning to work more closely with Mental Health America (MHA) to collaborate around their mental health tests. You can find the tests here and also in our resources section. MHA offers several tests that ask about a variety of mental health symptoms and can help identify a range of mental health conditions: depression, anxiety, bipolar, PTSD, psychosis, and eating disorders to name a few. Just like the Google test, the tests on MHA’s website represent gold-standard measures of clinical practice. For depression, they even use the very same test as Google – the PHQ-9. Taking these mental health tests can be useful to empower you with the language necessary to better understand your treatment options.
A word of caution about tests. They are not replacements for diagnosis conducted by a trained professional. If you take a mental health test you might be encouraged to seek a professional opinion. You might also be informed that you are not experiencing a level of distress that is indicative of clinical levels of a disorder. That does not mean that your distress is not real or causing impairments in your life. Tests, also represent a single point in time. As Gilbody cautions some of transient psychological distress may reduce overtime. PsyberGuide also lists symptom trackers that might contain established mental health tests too. These tools can better give an idea of symptom changes overtime and might better help you know when to consult a professional’s opinion.
Overall, I believe that mental health tests play a key role in getting people the help they need and monitoring progress overtime. We hope that mental health tests provided by MHA can be a useful tool and are excited to help people become more aware of them.
- Duckworth, K., & Gilbody, S. (2017). Should Google offer an online screening test for depression?. BMJ, 358, j4144.