Free mental health and personality quizzes are widely available on web pages and social media. While some are whimsical (think “Which Greek God Are You?”), others feign seriousness. These online tests are often used to mine personal information, either for targeted advertising or, more sinisterly, identity theft. Though these usually lighthearted quizzes may be popular, they are not a significant concern for the psychological community. They are clinically worthless, and most users understand that these quizzes are for fun rather than serving any practical purpose.
However, other online quizzes pose as mental health screening tools. They can give the appearance of being confidential and legitimate, and often promise a free mental illness symptoms checklist by providing contact information. Many of the tests claim that people can use them to self-diagnose personality disorders. Others mislead users to believe the quiz can screen for conditions such as obsessive-compulsive disorder (OCD) or major depressive disorder.
People who are reluctant to see a mental health professional or might feel shy about revealing their problems to another person may be drawn to these tests. Since the tests are free, people often feel they have nothing to lose by taking them. Online tests also do not require interaction with another individual, such as a behavioral health professional. The ubiquitous nature of these online, supposed mental health screenings may be raising awareness of mental health issues but at what cost?
Once a person puts stock in a mental health quiz they stumble upon online, a harmless exercise becomes fraught with risk. Online quizzes could be doing harm to those who would benefit from legitimate mental health screening. What consumers are mistaking for legitimate mental health screenings could delay their seeking help from a behavioral health professional or provide someone with an errant “diagnosis” that has no clinical basis. And they may conflate screening tools with a mental health diagnosis test, leading to further confusion.
There’s also a self-reporting bias that can muddy the results when people take a mental health test online that is not clinically validated. People often don’t want to admit, even to themselves, all the difficulties they are currently facing. The answers they submit to a mental health online quiz may reflect more about how they want to think of themselves or appear to others than how they think, feel or behave. A valid and reliable mental health screener will help avoid or factor in this bias in ways that a random, free online test cannot.
Most consumers do not think of evaluating the effectiveness of an online tool in terms of validity and reliability when they use the tool. Even if they try to perform such an evaluation, they may lack the knowledge and expertise to do so. Validating a mental health diagnosis test or assessment tool is a rigorous process. Individual test takers may not understand the concept of content validity — that a test or assessment should measure what it’s intended to measure and only that, not anything else.
Consumers also usually miss the point that tools should be clinically validated as reliable. The more reliable a test or assessment, the better it is at accurately detecting mental health issues and the less it produces false positives. Reliability should be clinically validated through peer-reviewed studies.
Even legitimate online mental health screening tools can be harmful if people use them as standalone self-diagnostic tools. Test takers don’t have all the information they need to make an accurate mental health diagnosis, nor do they have guidance from a behavioral health professional in interpreting the results.
Online mental health quizzes aren’t a replacement for clinically validated, DSM-5 compliant tools provided under the guidance of a clinician. But that's not the only risk or concern of people placing more — or any — stock in online behavioral health quizzes than they should.
There may be a lack of transparency around who is administering or developing the online mental health test. Jack Naglieri, PhD, who co-chaired the American Psychological Association's (APA) "Task Force for Psychological Testing on the Internet," points out that the internet is fertile ground for unethical testing because the people who create some of the tests lack the same professional obligations as APA members and other behavioral health professionals. "It's going to be very difficult to suggest that these people need to be aware of the ethical issue, for example, because they don't have to play by our rules," he says.
Even if the test is validated and administered properly, another challenge is the anonymity of the online test taker. Ethical considerations require that psychologists know something about the people using their assessment tools.
According to the APA, aside from challenges in confirming the test-taker's identity, other problems associated with Internet testing include:
Additionally, screening with only a single online test tool could produce single-source bias. Most individuals benefit from the rich, full psychological assessment clinicians assemble on their patients by gathering information from different tools, such as interviews.
Bottom line: “While offering great potential, online tests of clinical constructs require stringent validation and cautious use,” concludes a column in the Professional Psychology: Research and Practice. It’s incumbent upon the mental and behavioral health community to further the education of the public about the limitations of online tools and encourage professionals to only use clinically validated tools that demonstrate validity and reliability.
Despite the challenges associated with mental health tests provided online, there are many advantages for mental health professionals of digitally delivering validated online screening tools that are peer reviewed and standardized. When used in conjunction with examinations, interviews, patient histories and evaluations, online screeners can be more widely accessible for patients and easier to administer for clinicians. As opposed to pen and paper testing, such digital mental health resources provide real-time access to data for providers. In addition, clinically validated online mental health tests provide convenience for patients who can take online screeners from their home or any other location rather than travel to a provider's location.
Digital tools offer a real chance to expand the usefulness of mental health care — when vetted and used properly. As stated in the American Psychologist, “The Internet provides a tremendous opportunity for testing, and with that opportunity comes a corresponding need for the ethical and professional use of these tests and a responsibility to expand our science to test the usefulness of these interventions.” In addition, the ease of use of clinically validated digital screeners can make clinicians and researchers more productive while providing the documentation essential to establishing the baseline for measurement-based care.
Proem offers a full suite of peer-reviewed and clinically validated digital screening tools. Our digital health solutions are DSM-5 compliant and kept current with any changes in rules and best practices. We offer diagnostic screeners, digital diagnostic interviews, severity measures, outcome measures and a wide variety of assessment tools for children and adults. Our solutions fit into any behavioral health provider's workflow and helps today's mental health professionals make more informed, data-driven clinical decisions and track behavioral health outcomes.
To learn more about why a growing number of organizations are choosing Proem's digital mental health assessment solutions, schedule time with one of our specialists.