The isolation of the coronavirus pandemic upended people’s lives—and made internet connection even more essential. In Access to Care, the Daily Dot asked TikTok mavericks and Reddit newbies how they give and receive healthcare and community support online, a year into the pandemic.
In these stories, therapists turn to TikTok to reach audiences at home, unemployed workers find support on Reddit, Black college students grapple with lack of community on a virtual campus, and young consumers order birth control via Instagram. The winding, and sometimes invisible, thread of Access to Care links them together.
In yet another dancing video on TikTok, a creator has managed to engage thousands of viewers just by smiling and moving along to a Young Thug song. But this time, it is a therapist at work: more specifically Dr. Kojo Sarfo, a psychiatrist from Ghana, West Africa, using the platform to reach young people in an open conversation about mental health.
Sarfo, who goes by the username @dr.kojosarfo on TikTok, has over 841,300 followers and 14.3 million likes on the platform with many videos talking about eating disorders, trauma, and depression intermixed with clips of his personal life and funny videos of him dancing.
“My goal is to take the unconventional route to show that you can make mental health fun,” Sarfo told the Daily Dot. “Fortunately for me, people were very receptive to the message.”
As therapists become more prevalent on TikTok, sharing mental health advice for handling anxiety and offering unfiltered looks at their own lives, the world of therapy and getting help from home is changing rapidly.
The Daily Dot spoke to three TikTok therapists, some of whom have quit their full-time jobs to make short-form content about mental health. These creators use their background as therapists and psychologists to talk about therapy, mental health issues and tips for managing anxiety on a platform that allows them to connect with millions of young people going through their own mental health struggles.
No filter therapy
Dr. Courtney Tracy is a California-based clinical psychologist who runs her own mental health business with a focus on adult addiction and mental health treatment. She also has 1.5 million followers on TikTok and posts regularly as the @the.truth.doctor, calling herself “your no-bs therapist.”
Tracy joined TikTok in January 2020 to find out more about the authenticity of creators on TikTok compared to other social media platforms and observe younger generations using the app to talk openly about their mental health struggles.
“There's a normalization being found on TikTok where people are, their honest selves without consideration for if it's unprofessional or whether their friends are going to think it is funny. It’s no filter and that is the type of therapist that I am,” Tracy said.
For Tracy, the unfiltered approach many creators take on TikTok fits her personal brand as a therapist and content creator. She appears in many videos in her pajamas, using cuss words, showing her tattoos, and explaining psychoeducation in basic terms so anyone can understand it.
By approaching mental health in this way, Tracy feels it normalizes therapy and makes it less scary for people who are struggling with their mental health. As therapists offer a more open, honest look at their own lives, viewers are less intimidated to seek help, Tracy explained.
“It's painting a more authentic picture of what therapy can look like,” said Dr. Lindsay Fleming, @lindsay.fleminglpc.
Fleming has 433,100 followers on TikTok with 10.1 million likes and creates content advocating for young people to talk more about their mental health.
For Fleming, being a therapist on TikTok has allowed her to connect even more with her clients who have experienced hate on the internet after another creator went viral for changing the wording in one of her videos to make it sounds like she was suggesting teens kill themselves.
“I have a new found understanding for my clients who have been bullied on social media because I've had those experiences too now,” Fleming said. “In high school, when something like this happens, that is your whole world so it really helped me build that perspective.”
After leading a mental health workshop for middle school girls, Fleming downloaded TikTok in March 2020 at their request and began posting videos to help them. After her initial success, she began creating content with a broader audience in mind, hoping to show viewers a different kind of therapist and the importance of anyone seeking help to find the best fit for their needs.
In a recent video with over 182,100 views, Fleming dances on screen while playing both the part of her patient, dressed in a grey hoodie, and herself as a therapist in business casual attire. The video centers around a conversation on intrusive thoughts and how to deal with them, while being comical to engage young viewers.
In the clip, Fleming encourages viewers to ignore the intrusive thoughts rather than fight them.
“The only power they have is that they scare you. Take that power away,” the video reads. For viewers, this advice resonates with what they are feeling at home.
“I struggle a lot with intrusive thoughts with OCD, but ignoring them and sitting with the uncomfortable feeling is the only way to overcome them,” one user commented.
By using trendy songs or funny dancers in her videos, Fleming hopes the image of a more relatable therapist also inspires younger therapists to be themselves and find their own style with which to help their patients.
Filling the gaps of mental healthcare
As creators on TikTok show what real therapists can look like, Sarfo explained he feels it breaks down the stereotype of a therapist often portrayed on television: someone of an older generation, typically white, in a quiet office interrogating their patient.
Talking about mental health issues in a less professional manner also breaks down the stigma against them and can help minorities groups, who may have previously felt that therapy wasn’t a suitable option, to consider getting help, Sarfo said.
“I'm actually very thankful that I'm a part of it because especially being a minority as well, you know, within our community, nobody wants to talk about mental health,” he said. “So we normalize it and people are able to talk about it. It is really life changing. I feel like we've done more good collectively online maybe than we've done in our practices. So that’s big.”
During the COVID pandemic, young people aged 11 to 17 struggled more than any other age groups and had the most frequent thoughts of suicide and self harm recorded in the past seven years, according to a study by Mental Health America. For so many young people affected, social media became a source of comfort as an increasing number of therapists and psychiatrists on TikTok offered help in less than 60 seconds without the discomfort of an office visit.
For Rhyia Bibby, a third-year student at Northeastern University, therapists on TikTok help fill a massive gap in access to mental health care. Bibby serves as an executive board member at Active Minds, a nonprofit focused on mental health awareness among college students, and has been going to therapy since high school both in person and virtually.
By teaching users about mental health issues on social media, Bibby feels therapists are breaking down barriers that once limited people from getting the help they need.
“Making some of these therapeutic ideas accessible on widely viewed platforms like TikTok is great. You have to preface that with its not the same [as therapy], but it’s a great addition to their holistic mental health approach,” Bibby said.
Bibby explained college students are more open to having a conversation about mental health and getting help than they were a few years ago.
“I hope that therapists continue to operate in a more hybrid capacity, because I also can speak to the fact that talking to someone about sensitive subjects through a screen is an experience that takes some getting used to,” Bibby said.
According to Bibby, the pandemic has made mental health a more universal topic of conversation.
“This pandemic has inspired a lot of people to be really open about their struggles and in turn, helped people come to the realization that what they're struggling with is not unique to them. That they're not alone. They're not a freak. They're not broken for struggling with any of this stuff because you know, we're all struggling our way through it together,” Bibby said.
This message of community can be found among the therapists on TikTok, who rely on each other for support and inspiration to create content that is both deeply personal and helpful to anyone struggling with mental health.
Sarfo discussed the drive to create his channel to inspire others who may be struggling with mental health but don’t see anyone they can relate to as a therapist on TikTok.
After first downloading the app in October 2019, Sarfo was not originally sold on the platform because he did not understand the algorithm or see anyone else that looked like him creating content.
“So I was like, ‘I don't see no Black male therapists on the app,’ but I realized that that's why I needed to keep going,” Sarfo said.
Sarfo explained his initial surprise at how the app, which he first believed was only for children, has the power to bring so many people together. The community of therapists on TikTok is very tight-knit and welcoming as creators encourage more therapists to talk about mental health issues on the platform to normalize the subject.
“I really feel like we're going through a huge shift right now,” Sarfo said. “We are kind of like the pioneers and the Guinea pigs, because it's not the most professional. But when you take away some of that professionalism and you retain the ethical component, I think that's where you start to see some of the progress and you see a lot of people start to open up.”
He favors this modern approach to therapy is one he favors because of how many people he is able to reach with his videos rather than helping just one patient at a time.
Funding the future of therapy
After his initial success on TikTok, Sarfo quit his full-time job working as a clinician and psychotherapist at a psychiatric care hospital in Virginia and moved to California to create TikToks full time. For creators on TikTok, the platform launched the Creator Fund to distribute revenue based on the number of views and the levels of engagement each video has.
The fund is designed to help creators based in the U.S., U.K., Germany, France, Spain or Italy with at least 100,000 followers and 100,000 views in the last 30 days to make money off of their TikTok account and promote more activity on the app, according to the company’s website.
Looking to the future of therapy and mental health treatment, Tracy said TikTok therapists are leading the way in helping people manage their own struggles from home and recognize when to seek help if the issues become debilitating.
“When people say that people shouldn't help themselves, I say, ‘Why not?’ If you can give yourself that education about how your own body and your own mind works," she said. "Then you're capable of taking care of yourself because you know exactly what the therapist knows. You just need to go see a therapist when it's so debilitating that it's affecting your life significantly."
By giving users easily digestible information to better understand mental health issues, Tracy feels TikTok therapists are helping the internet communities take better care of themselves.
In a recent video with 2.5 million views, Tracy explained high functioning anxiety by using the point of view of someone with the condition and reenacting a conversation between herself as the patient and the doctor. In the clip, Tracy wears a white coat in her role as the therapist to easily break down the intense anxiety someone may be feeling on the inside even when they seem complete fine to those around them.
In the comments of the video, users shared that they related completely to what Tracy was describing.
“The thing is though everything you said applies to me even the symptoms, but I’m too scared to talk to anyone because I think they will think I’m doing it for attention which I’m not and they won’t believe me,” one user explained.
As one of 2,985 comments on the video, Tracy’s TikTok helped many realize they are not alone with their mental health issues.
“The presence of TikTok therapists normalizing mental health struggles for regular people," Tracy said. "Therapists themselves are actually going to contribute both to an increase in mental health diagnoses and a decrease because I think more people are going to be open to getting diagnosed and the people who are already diagnosed are going to be getting more and proper treatment from the correct type of therapist that they need."
Sarfo predicts as therapists on TikTok continue to normalize mental health and their roles on the platform in a less professional setting, more therapists will shift away from the traditional approach of in-office visits with patients.
“I actually believe that things are never going to be the same in regards to therapy because now that people have gone online and they've seen that they can have a different approach, the way people approach it is going to change,” Sarfo said.
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