As the internet grows and people find new ways to make money online, more anonymous websites are being published by companies who have little background or interest in mental health. And sadly, thousands of people flock to these sites every day, unaware that they may be taking a fake mental health test on depression or ADHD.
Google and other search engines are supposed to be able to determine the quality of health websites, supposedly emphasizing and promoting those with good E-A-T — expertise, authoritativeness, and trustworthiness. That’s what they claim.
So it’s a bit of head-scratcher when looking up results for words like “depression test” only to find a bunch of websites listed that have little or no E-A-T:
Example 1: Mind-Diagnostics.org
Mind-diagnostics.org has no E-A-T whatsoever. It offers a bunch of “scientific” quizzes with no information about their source. Nothing on the site has authorship, meaning you have no idea who is writing these articles. Is it a psychologist or health journalist? Or is it some guy sitting in his apartment in New York City?
There’s no “About Us” section on this website. Its domain registration is hidden behind an anonymous privacy service, to further ensure you can’t research its publisher. The publisher, Mind Diagnostics Inc., also has an accompanying app called “Mental Health Tests.”
Worse yet is the quality of the results it provides. Here’s one sample screen from when a normal person answers their unsourced depression screening test:
It turns out that I could identify the depression screening as the PHQ-9, a common general depression screen used primarily in primary care. I say “general” because it’s a screening test that captures a lot of non-depressed people and categorizes them as possibly depressed. It’s not a great mental health screening tool, but sadly, it is commonly used because it’s only 9 questions long.
No matter what you score in the 0-4 range, you have “minimal depression.” A more accurate way to say this is that you have no depression, because that’s what it really means. It would take a very unique kind of clinical depression to score so low on this screen and still be diagnosed. Numerous research studies conducted on the PHQ-9 conclude that a cut-off score in the 8-11 range is typical (Manea et al., 2012). That means that anything below a score of 8 and a person is not likely to be suffering from depression.
Worse is what follows from this website, under the bold heading, “RECOMMENDED TREATMENT:”
“We recommend online counseling which can be very effective at treating Depression.”
The person who took this screening doesn’t have depression. Depression, as a clinical disorder, can only be diagnosed by a trained mental health professional — not a screening tool such as this. So a recommendation to get treatment right now is completely inappropriate. Even more inappropriate is the recommendation for online counseling.
Why are they recommending online counseling, specifically? Because apparently this website was setup solely as a referral funnel to one of the large online counseling services. The website owner gets a referral fee every time someone signs up through this page. (Full disclosure: Psych Central also obtains some of its revenues through similar referrals, but we never do so at the expense of providing legitimate editorial information or accurate screening results.)
When we reached out to the one email address we could find on the site to ask questions about theses concerns, we heard no response back.1
Example 2: CNVdetox.com
Right below the previous website, we come across CNVdetox.com and their un-sourced, 18-question “Depression Self-Test.” After taking it, you’re supposed to get a checklist of “start a conversation with your provider” (but none was provided to our test-takers):
Its article about depression also lists no authorship, and the website has absolutely no navigation displayed to get to the homepage or learn more about the people behind the test — apparently on purpose, but maybe the site is just broken. Again, according to Google’s quality E-A-T ranking indicators, this site should be nowhere nearly ranked on the very first page of search engine results for “depression test.”
Manually going to the homepage of the site, we find it is yet another “detox and residential addiction treatment” center, one apparently located in Los Angeles.
Addiction treatment centers similar to this one have a very poor, well-documented history of seedy online marketing. We’ve written about it previously here, here, and here. Addiction treatment centers, large and small, used to spend a lot of money and effort gaming Google search results.
CNV Detox is apparently just an alias name for Casa Nuevo Vida “sober living” home. In other words, the depression screening test was seemingly setup in order to eventually funnel potential patients to its treatment services. And yet again, we see a perfect example of an addiction treatment center successfully gaming Google’s E-A-T criteria, scoring on the first page for a broken, unsourced depression test with no authorship, no authoritativeness, and nothing to suggest trustworthiness.
Why the Warning?
As a digital publisher in the online health space for the past 25 years, we’ve seen it all. And we get a little tired of seeing websites such as these gaming Google’s algorithms to score highly in search results when they meet none of the quality indicators that Google tells us they are looking for in a website. It’s either an example of Google’s algorithm not working as they say it does, or some very clever people figuring out ways to suggest E-A-T with none of the usual indicators.
People who click on these links are, in my opinion, going to poor websites offering questionable results. They are setup not to offer quality mental health information or helpful tools, but instead are seemingly just being used as a marketing campaign to drive referrals. I don’t think it’s in anyone’s best interests when dubious websites like these come up in Google search results. Not when there are dozens (even outside of Psych Central) legitimate mental health screening websites that offer sourced and authored materials, and don’t provide inaccurate results or questionable treatment recommendations.
Manea, L., Gilbody, S. & McMillan, D. (2012). Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis. CMAJ. 2012 Feb 21; 184(3): E191–E196. doi: 10.1503/cmaj.110829
- Followup research indicates the owner to be Michael Mayers, an individual with no apparent background, education, experience, or training in psychology or mental health issues; he was in product development at both Argo, a specialty insurance provider, and American Express. There’s no indication of any staff connected to Mind Diagnostics.