Online Mental Health Assessments - Can you trust them?

January 10, 2024 | Dr. Joel L. Young

If you’ve ever spent an afternoon Googling things like, “Do I have depression?” you’ve probably encountered a bevy of quizzes promising to diagnose you in just a few minutes with everything from bipolar to personality disorders. Everyone deserves to know as much about their own mental health as possible. And having an idea of what might best explain your symptoms can help you advocate for yourself to your doctor or therapist. Understanding the signs and symptoms of mental illness can be tricky, though, and diagnosing mental illness is about more than just checking off a few symptoms and writing a prescription. Here’s what you need to know to get the most out of mental health assessments while avoiding misdiagnosis and unnecessary labels.

Mental health assessment 101: How clinicians diagnose mental illness

Lab tests can rule out some potential causes of mental health symptoms, like hypothyroidism and poisoning. But they can’t diagnose mental illness. With at least 70 recognized mental health diagnoses in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, it can be difficult to rule in or out every diagnosis, even for knowledgeable providers.

This is why clinicians rely on diagnostic criteria. The DSM lists specific criteria for each mental illness. This includes both a list of specific symptoms, and a list of symptoms that might indicate another illness. For example, a person who has delusions and hallucinations can only be diagnosed with schizophrenia if their symptoms are not from drugs, alcohol, or a brain injury, and the symptoms have lasted longer than 6 months.

Because diagnosis relies on a complex list of symptoms, it’s not generally possible for a person to diagnose themselves. You might think you have depression, and a three-question depression test might agree. But has it ruled out bipolar? Assessed for life circumstances that might better explain your symptoms? Weighed the potential role of trauma? Without looking at the whole picture, a list of a few symptoms just isn’t enough to diagnose mental illness.

Can You diagnose mental illness online?

Artificial intelligence can’t diagnose mental illness just yet. For a firm diagnosis, you need the wisdom of a clinician who knows how to make sense of the symptoms they’re seeing. But a good online mental health assessment can give a preliminary indication of the mental health condition or conditions a person might have. With the right questions, it’s easy to rule out a number of diagnoses, and identify a handful of conditions a person is at high risk of having. Armed with this information, a person can then see a clinician, share their symptoms, and discuss which diagnosis is the most likely fit.

Benefits of online assessments

While online mental health assessments can be wrong or even harmful, they also offer significant benefits. Some reasons to consider an online assessment include:

They’re anonymous. A person may feel more comfortable sharing all of their symptoms with an online tool than with a real person. This may allow for a more accurate diagnosis, and avoid wasted time if a person is reluctant to initially disclose all of their symptoms to a new provider.
They may help a person talk to their provider about their health. A preliminary diagnosis can help with researching a condition, and may make a person feel more comfortable sharing their symptoms.
They can destigmatize mental illness. By presenting mental illness as common and treatable, online tools may encourage people to seek help.
They can save money. Mental health care is expensive, and many people still struggle to get coverage through their insurance. By saving time and offering diagnostic insights, a quality online mental health assessment may improve access to mental health care to people without insurance, as well as those who are under-insured.
They offer an alternative approach to mental health. Many people are reluctant to try therapy or see a psychiatrist. By providing information about mental health, confidential online assessments may provide people with objective information that encourages them to seek mental health care.

How to choose a good mental health assessment

Quality mental health assessments don’t turn mental illness into a joke or a party game. So steer clear of cartoony gimmicks that promise to diagnose every test-taker with a personality disorder. Instead, look for these hallmarks of a quality assessment:

People with mental health credentials developed the assessment.
The assessment relies on scientific evidence, explains how it assigns a diagnosis, and provides links to additional research.
The assessment is long enough to get accurate data. A five or ten-question test can’t possibly diagnose someone.
The assessment draws upon data in the DSM, screening people for the most common symptoms of the most common diagnoses.
The assessment is confidential, and provides information about how your data is used.
The assessment is clear and well-written, does not use stigmatizing language, and does not judge or mock test-takers.
You’re able to contact the developers of the test with additional questions.
The test is continuously re-evaluated and revised based on new scientific evidence.
The test creators do not have an agenda, such as selling you a supplement or selling your data to a third party.
The test provides clear disclosures about how it works, and informed consent.

As part of choosing an online mental health assessment, it’s important to be mindful of the limitations of these tools. They can’t diagnose you, and they certainly can’t treat you. They’re educational, and can help you have a more substantive and useful conversation with your doctor. Treat them as the tools they are, and you’ll avoid misdiagnosis and perhaps expedite your path toward an accurate diagnosis.