It’s Mental Health Month 2023. And as over the years I’ve raised awareness in various ways, I am going to do something new and vulnerable. No, it’s not new that I’m being vulnerable, but I’ve been holding onto this info specifically for a few years. So here it goes—the ethics of talking about mental health on Twitch specifically.

And I say this first and foremost—I am not OK with people coming onto to Twitch to play Dr Phil. It’s not my cup of tea and I don’t think it’s right for the person who is put in a vulnerable seat, even if it does bring attention to mental health stigma. I think the cost is too high.

I am also not ok with companies exploiting mental health (abbreviated to MH going forward) as a means to get into this market, raising funds that don’t end up being used to actually help those in need with half trained coaches and such.

And please don’t ask me to be more specific than that. If you know, you know. If you have the power to fix any of the above things, please do. Otherwise, I will not be feeding a mob. People who can do something already have specifics on the above and are doing all they can to combat it.

That all being said, the ethics around talking about mental health on Twitch are tricky and ever important to uphold—while there’s not a specifically wrong way… Advice that may mean well but is not informed through profession-specific ethics, a board and lots of training has potential to hurt a LOT of people. Add to that the parasocial aspect of streaming [check out research from Dr Kowert and Dr Daniels on this] and things get tricky really fast.

Tons of folks have written about how content creation, specifically streaming often makes the creators MH frontline workers whether they like to or not. But I promise you, the folks who are truly grifting through talking about MH online are few and far between. People may come in for the money, until they realize that algorithms suppress these talks because companies don’t want to be liable for deaths as the idea that you can give someone the “idea” perpetuates. And most of those who do it because they want to help others end up burning out.

Not only does content creation take a HUGE toll on you (working with no breaks, limited feedback and support, in addition to having a mental illness will really do that to you), mental health content creation is 4x that. You take on the problems of your community as well. Imagine how scary it is knowing someone is suicidal? Now make that a monthly occurrence. Hearing about people’s heartbreak, and family abuse etc with no training, usually no content warnings before people detail these things in chat. [Check out research on how COVID affected streamer Mental Health] As well as seeing people need help, wanting to get it, but not have access to it—it takes a toll on you, whether or not you’re trained on how to deal with it—but definitely if you never received such training, as most advocates have not.

For years I held myself to an impossible standard of absolute perfection when it came to this. The result was also that I’d go into other advocate’s streams “policing” what they should and shouldn’t be saying. Textbook garbage behavior on my part. I was so worried about being called out that I called everyone else out first. I was so stressed about gatekeeping that I gatekept as I was writing how gatekeeping is bad.

Cut to 2021. I was getting into some bad burnout territory. I couldn’t keep up with my perfectionism and expectations and I was drowning while pushing everyone else away for not being perfect either. I spoke to every person who’d listen about how I was burning out. I restarted therapy, I felt suicidal again, it was not awesome. I was friends with some not great people. I took actions I still regret and apologize for… And then someone I trusted and cared about told me that despite all of my efforts, I was being a bad advocate. All of that work being perfect and someone still didn’t think I was. It broke me to hear that I was behaving in such a way that they wanted nothing to do with me. That they’d follow up so we could talk. They never followed up. Instead, they removed me from their spaces and told others to avoid me.*

Surprise! I spiraled! I emailed EVERY SINGLE Mental Health Professional I had access to (which was many because at that point I’d interviewed many for my show. I want to say at least 20 people off the top of my head) and asked them to honestly evaluate me. My work. Whether I had passed any ethical boundary. Not one person. Not one could understand where my question was even coming from. I sent VODs and asked friends to review them. I pleaded with my Mods to not sugarcoat anything as they were kind and trying to support me while being honest about anything they saw. Over and over my friends told me I should maybe start therapy again because this panic was unhealthy.

That maybe one person’s critique shouldn’t break your mental health like a house of cards—regardless of whether it was warranted.

That was it. I broke. I took my first long break from streaming and spiraled out further as I felt myself falling out of relevance from the space.

If Depression told me my work didn’t matter. Then falling into irrelevancy, with colleagues unfollowing me, stream numbers dropping was the perfect “proof” I needed to confirm how infinitely awful I knew I was.

But this story does have a happy (for now) ending. I’m ok. Better than ever actually. Priorities shifted. Therapy has been AMAZING. I dove further into research and focusing on content that mattered to me the most. I have clarified my ethical boundaries. I work to support up and coming mental health advocates in finding their voice instead of policing anyone. I do help companies better understand the needs of streamers/creators in my consulting work too. I have a healthier relationship with my work and how important it is to me and where it stands in my priorities.

All of this to say, “fork yes,” it is extremely unethical to give people the impression that you can offer them a therapy-like setting in a live stream.

You know what’s not unethical? Creating a space for people to care about each other. Where we encourage them to remain themselves while caring for others and feeling cared for themselves. Where we offer insight about what we did in similar scenarios. Or compassion when we know we’ve never experienced something but it sure sounds like it sucks to have to deal with that. We need those spaces more than ever. So, if you’re offering that, congrats, that’s a good mental health space.

Some people call those fortnite streams, others horror variety streams, some are make up streams, some are Apex streams, or streams full of Sims challenges. I call those people creating spaces where other folks know they can relax, feel ok being whomever they know themselves to be as long as they promise to let others live their lives unbothered as whoever THEY are. And you cannot tell me that in the age of anti-LGBTQ laws, gun violence, drag show banning and extreme poverty and isolation those online spaces are not exactly what’s needed.

You want mental health awareness? You don’t even have to call it that. You have to create content in a way that doesn’t inhibit or judge others from being themselves. Doing anything that helps reduce suicidality (acceptance, housing), loneliness, offers access to care (even just info on where to get that) is mental health awareness.