3 Telehealth Red Flags

A “hot” “mental glow-up” is on offer from an influencer if you click on a link—not to buy the latest beauty or self-improvement product on the TikTok Shop, but to take a short mental health quiz that may lead to a diagnosis. Videos across social media platforms portray brighter, newly productive people (initially depicted as overworked and overwhelmed) after welcoming their branded aesthetic medication package at their doorstep. The before/after trope brings to mind beauty and weight loss ads, but these ads promise to medically transform your mind.

Telehealth ideally provides remote care to those who would have trouble accessing it otherwise. Issues of telehealth advertising on social media arise, however, when they sell oversimplified and optimizable versions of complex and serious mental health issues like depression, anxiety, or ADHD.

In recent years, telehealth companies that advertise on social media and help shape our popular understanding of mental health have made headlines, with executives being fined and arrested for unauthorized distribution of controlled substances.

A massive market opened up for these medications when restrictions on telehealth prescribing of controlled substances (including some psychiatric meds requiring careful medical oversight) were lifted near the start of the COVID-19 pandemic, when access to medical care was low and need was high.

The need for mental health care and the social media push for self-diagnosis created conditions for a perfect storm of therapy tech startups, some of which have since been alleged to treat therapists as underpaid gig workers, push employees to recklessly diagnose clients and prescribe medications with little oversight, and sell patient data, including to social media companies. Recorded patient therapy sessions are reportedly being used to train AI therapy models.

Subscription telehealth companies spend millions to advertise on social media, with mental health influencers making sponsored posts about specific diagnoses and treatments alongside their other mental health content. Celebrities are also popular spokespersons. If you have ever listened to a podcast, you are likely intimately familiar with their advertising.

It’s a tricky issue to approach because, on one hand, people engaging with mental health content for the first time may learn about and access new treatment options. This can feel powerful and life-changing.

On the other hand, a profitable industry has emerged in the partnership between social media and therapy tech that can push people toward diagnoses and treatments in ways that may be scientifically misleading and medically irresponsible.

I have compiled some red flags that can help evaluate mental health telehealth companies on social media. The presence of these indicators does not mean the company is doing something illegal or that good therapists cannot be found there. My points are meant to help critically evaluate the social media claims and point to where we should ask more questions in our mental health care, both within and outside of telehealth.

There are glaring red flags like hidden fees and platforms that are too quick to prescribe a cocktail of meds with little clinical evaluation or medical oversight. But I want to focus on broader and more insidious social media mental health discourses that can enable these kinds of practices.

The following is a partial list excerpted from my book. If promotional content (and much social media content by nature is promotional) depicts mental health and care in the following ways, we should consider whether the affiliated services can adequately address mental health suffering:

Shared singularity: The presentation of traits or symptom-based content as simultaneously universally experienced and algorithmically just “for you.” Mental health experiences of these diagnoses are highly heterogeneous—extremely complex and varied for everyone. But, as we do with astrology, we grasp onto what makes sense for us and ignore the rest; we have a bias toward making things fit, and diagnostic content is created that highlights universal experiences, which often include both an experience and its opposite (e.g., “you’re either oversensitive or don’t care at all”). Paradoxically, thousands and thousands of comments on these kinds of videos will all testify that this video is clearly just for them.

Quick fix: Traits or symptoms that are presented as easily diagnosed, treated, or optimized for personal improvement. Anyone who experiences a particular kind of suffering or struggle can benefit from one simple solution that requires very little time, money, care, support, or oversight. Not only will identifying one’s disorder lead to feeling better, but, with these treatments, it can be leveraged as a glow-up or superpower. Particularly branded diagnoses on social media (including depression, anxiety, and ADHD) often include discourses of a “high-functioning” label that is reframed as productively empowering.

Symptom-centered: Failure to acknowledge or address any external life factors that may be contributing to mental health distress; strong focus on pathology. Symptoms are presented in every case as effects of some concrete disordered condition that you have or are, and you know you have it based on your symptoms alone. Left out of the discussion is any variation of causes or the possibility that life circumstances may have contributed to suffering.

An uncomfortable problem is that oftentimes it is not just social media or tech companies presenting mental health in these limiting and potentially harmful ways. Apps and influencers leverage existing issues in mental health care, both in addressing their gaps and transplanting their flaws into platform logics and economies.

Social media breathes new life into older issues like "cosmetic pharmacology," Peter Kramer’s 1997 proposal in Listening to Prozac that psychopharmaceuticals could potentially be used for self-optimization (subsequent criticism proposed that their marketing was indeed moving in that direction). Likewise, teletherapy can exaggerate some existing problems in mental health care while trying to fix others.

This is why, when we evaluate the problems of digital mental health, it is imperative that we, at the same time, confront those pernicious issues underlying mental health models and mental health care across the board.

Excerpt reprinted from Mood Disorder: How Social Media and Therapy Tech Are Shaping Mental Health by Holly Avella, courtesy of University of California Press. Copyright 2026.

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