How Accurate Are Online Mental Health Tests?

Woman sitting at computer, considering some optionsMental health tests that offer online diagnoses are increasingly popular. These tests promise to help people understand their psychological needs and may serve as a springboard for discussion with a mental health provider. But do these online mental health assessments offer an accurate diagnosis? That depends on several factors.

Mental Health Diagnosis or Fun Quiz? Knowing the Difference

Spend a few moments on Facebook and you’ll quickly find dozens of quizzes. Answer a few questions and find out which dictator you most relate to, what color your soul is, or how many pets you should have. You may also find quizzes that promise to diagnose health issues sprinkled among the cornucopia of strange quizlets. These quizzes promise to measure what personality disorder you have, how “OCD” you are, or what your fundamental mental health problem is.

These quizzes often conflate clinically validated mental health diagnoses with personality traits or quirks. A person who prefers the company of others or who doesn’t like abandonment is slapped with a borderline label, while a person who loves paper planners or who maintains an orderly home is labeled obsessive-compulsive.

Quizzes that turn mental health diagnoses into labels or personality traits are not reliable. In addition, they often stigmatize the very conditions they claim to diagnose. Some signs you’re taking one of these mental health quizzes include:

  • Everyone who takes the test gets a diagnosis.
  • The test does not disclose how it arrives at its diagnosis.
  • The test is short.
  • The test features a lot of jokes.

How Online Self-Assessments Work

The process of diagnosing someone with a mental health condition is exhaustive. Even experts continue to debate which criteria warrant which diagnosis. The right diagnostic criteria are so important that the American Psychiatric Association (APA) routinely updates the Diagnostic and Statistical Manual of Mental Disorders (DSM), its diagnostic guide.

It’s impossible for a quiz that asks a handful of questions to offer a clear diagnosis. Researchers have, however, developed a number of clinically validated assessment tools. These tools are fairly adept at detecting signs of various mental health conditions. They work by gathering symptoms of mental health conditions, such as depression and anxiety, and constructing questions based on those symptoms. The highest quality tools ask the same question in several different ways to ensure an accurate outcome.

Some online mental health assessments are based on clinically validated diagnostic tools that clinicians use. For example, some assessments present questions drawn from the Patient Health Questionnaire (PHQ-9), which doctors often use to diagnose depression. Some clinically validated diagnostic tools are as reliable as medical tests such as imaging scans or blood work.

Quizzes that turn mental health diagnoses into labels or personality traits are not reliable. In addition, they often stigmatize the very conditions they claim to diagnose.

Can You Get a Mental Health Diagnosis from an Online Assessment?

Only a mental health provider can offer an accurate mental health diagnosis. It’s important to view online assessments as tools for self-help, not as a way to get a diagnosis. These quizzes may encourage people to seek counseling or serve as a starting point for a discussion with a mental health provider.

Online self-assessments often suffer from two key shortcomings:

  • Test reliability: This is a measure of how well these tools detect mental health issues and how frequently they diagnose a mental health issue in someone who does not actually have a diagnosis. Tests that have been clinically validated in peer-reviewed studies are more reliable. The more studied a test is, the more reliable it is likely to be. Even the best tests, however, cannot substitute for the professional judgment of an expert.
  • Self-report reliability: Online diagnostic tools rely on self-reports. It can be hard to assess oneself honestly. For instance, a person might not want to admit they have trouble making friends, that they spend too much money, or that they struggle with communication skills. So some tests may end up being a measure of how a person wants to appear—or what they think of themselves—rather than how well they are actually functioning. Higher quality tests attempt to address this issue with well-worded questions.

For most people, there’s no harm in trying online self-assessments for mental health. They can draw attention to common mental health issues and may even reduce stigma. But when these tests turn mental health into something amusing or funny, they can actually increase stigma, making people less likely to seek treatment.

People must also be cautious about privacy issues. Some apparently fun tests are actually clever ruses designed to gain personal information. This information can then be sold to marketers or even used to guess a person’s password. Look to see where the test came from and carefully review any disclosure statements before proceeding with any online test.

What to Do With an Online Diagnosis

If you receive a “diagnosis” from an online test, this doesn’t necessarily mean you have a diagnosis or that the one you’ve received is correct. Try taking the test again on a different day. Sometimes tests capture how a person is feeling in the moment rather than their overall level of wellness.

People who are concerned about their mental health should talk to a mental health expert like a therapist or psychiatrist. Talking about the results of an online test can even be a helpful way to get the conversation started. Try mentioning what the test said or sharing your answers to some of the test’s questions. It’s also important to focus not only on what the test says, but on what currently troubles you. Do you feel anxious? Angry? Sad? Alone? This can help your provider narrow down the diagnosis and decide what, if any, treatment might be most helpful.

Signs of Mental Health Issues

Everyone struggles with stress, anxiety, and sadness from time to time. Difficult emotions don’t necessarily mean a person has a mental health diagnosis. Because there are dozens of common mental health issues, it’s impossible to determine whether a person has a diagnosis based on a single list.

Instead, it’s helpful to assess how well you’re functioning. Do issues such as anxiety or depression cause relationship problems or interfere with daily functioning? Do you feel like you’re getting worse or that you can’t change or control your thoughts? If so, therapy may help. Even when a person does not have a diagnosable issue, therapy can support people through the processes of exploring painful emotions, fixing broken relationships, and setting achievable goals.

References:

  1. Beidas, R. S., Stewart, R. E., Walsh, L., Lucas, S., Downey, M. M., Jackson, K., . . . Mandell, D. S. (2015). Free, brief, and validated: Standardized instruments for low-resource mental health settings. Cognitive and Behavioral Practice, 1(22), 5-19. doi: 10.1016/j.cbpra.2014.02.002
  2. Daw, J. (2001). Psychological assessments shown to be as valid as medical tests. Monitor on Psychology, 7(32), 46. Retrieved from http://www.apa.org/monitor/julaug01/psychassess.aspx
  3. Rothke, B. (2017, August 7). Just say no to Facebook quizzes. Retrieved from https://www.csoonline.com/article/3214264/fraud/just-say-no-to-facebook-quizzes.html
  4. Screening tools. (n.d.). Retrieved from https://www.integration.samhsa.gov/clinical-practice/screening-tools
  5. Wilkie, D. (2013, September 11). How reliable are personality tests? Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/employee-relations/pages/how-reliable-are-personality-tests.aspx

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