I am not your continuing professional development

I love the community that exists on #MadTwitter. I follow both service users and mental health professionals, several who follow me back. I enjoy our conversations and am genuinely heartened by these mental health professionals allyship when it comes to divisive issues in the mental health system, particularly around how those of us with a ‘personality disorder’ label are treated.

However, I’m noticing a growing trend of professionals who follow service user accounts for their own professional benefit – be that for research or for their own ‘continuing professional development’.

A few months ago, a study was published that collected and analysed tweets from the hashtag #WhyIDidntReport to find the ‘key barriers’ that exist when a person is faced with reporting sexual assault. The ethical questions that are thrown up when researchers choose to mine data from any lived experience tweets are extremely pressing, but to see tweets about sexual assault be used in this way absolutely disgusted me. The idea that they are seen as ‘fair game’ shows how morally bankrupt the field of mental health research has become. It takes mercenary and highly arrogant institutions to show such a blatant disregard for consent, not least for the people who’s consent has already been violated in the most unthinkable way. The trauma of accidentally finding your tweet in that ‘data’ can not be understated.

The second way in which professionals mine Twitter is by using it as ‘continuing professional development’.

This situation recently came to the forefront when I found the professional Twitter account of the psychotherapist who heads up the personality disorder service I’m under. I noticed he was following a mix of professionals and service users. But unusually, almost all the service users were young woman with a BPD diagnosis who posted highly sexualised images of themselves, graphic pornography and advertised their sex work. Some posted pro-anorexia content. One posted an image of their self harm.

I was horrified, particularly by the very graphic pornography he was following. This was not a private, personal account. I firmly believe that we are all entitled to a private life, including a sex life. If the sex you’re having is safe and consensual, I couldn’t care less what you’re into. But this was very clearly his official psychotherapy account, not a personal one, with links to his website and details of his private practice.

I brought this up with the service he leads and they did an internal investigation. They ultimately concluded that because it wasn’t his NHS account and because it did not meet the (somewhat subjective) definition of ‘bringing the Trust into disrepute’ there was nothing they could do. They also went to pains to point out that following Twitter accounts did not signify endorsement.

He has now deactivated the Twitter and claims he was ‘shocked’ to discover the content that these women were posting, despite admitting he was a regular Twitter user. However, although he claims he was ‘shocked’, he has made it clear that following these service users was ultimately defensible because BPD is his ‘clinical interest’. He has so far been unable to answer why he was not following nearly as many people with BPD who didn’t post sexual content. I have also been given no assurances he will not reactivate the account and carry on business as usual once the dust settles. His ‘clinical interest’ apparently means he is entitled to surveil these women in pursuit of ‘knowledge’. My concerns about abuse of power, boundaries and inappropriateness are secondary to his right to pursue his clinical interest at any cost. I am now in the position where the head of the service I’m under, the man with ultimate responsibility over my care, will always be tainted by this problematic Twitter use.

So please, mental health professionals, let me say this message loud and clear: I am not your continuing professional development on Twitter. I don’t care if I fall into the category of your ‘clinical interest’. We are not your data or your knowledge and we are in no way here to advance your careers. We are human beings, often suffering, and the least you can do is treat us this way.

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