Amazon allows individuals to write public comments and
reviews for all of the products they sell and the businesses use Amazon to sell
their own merchandise. I, like most folks, religiously read these reviews and
use them to inform my purchasing decisions. When I have a particularly strong opinion, I will even contribute a review of my own.
For some time I have been trying to quietly promote the idea
that users of mental health and substance abuse services should have a similar
ability. People who use these services should have an open forum that allows them
to publically tell the world what they liked – or did not like – about a
particular provider or service. Ideally, like Amazon, these comments should be
available within the context of a search for a specific treatment service as in
MIMH’s Substance
Abuse and Mental Health Information Online system or SAMHSA’s Substance abuse treatment facility
locator. For the consumer the advantages of this are easy to see. They could
select a provider based on the shared experiences of others rather than simply
figuring out which provider is close to home. Like asking your friends to
recommend a restaurant, you would benefit from others’ experiences.
Consumer concerns
What are the down sides of this? From the consumer
perspective I think the major difficult would be authority – that is “can I
trust this information.”
Authority is present if you know the individual commenter and
trust their opinions. For the most part on the web it is unlikely. However, we
can look at the individual’s other comments – a history of their behavior – and
get a sense of whether or not we trust them. Amazon supports this sort of
authority by letting you look at all an individual’s comments. If they all say “this is the best thing since sliced bread” or “this is the worst product ever
foisted on the human race” you have little trust in their ability to
discriminate between a good and bad product. If however, you read a set of
balanced comments, some positive some negative, your level of trust in their
opinions will increase. For the current topic, comments relating to mental
health and substance abuse providers, I suspect that there would be relatively
few comments that cross a range of provider/service combinations that authority
based on user history would be relatively weak.
Authority can also be demonstrated if there are a lot of
comments about a provider/service. Here the consumer perceives the general
direction of most of the comments getting a sense of authority from the
convergence in this wider community participation. Rather than trusting the
authority of an individual commenter they trust the authority of the community.
The more comments, the more authority.
Provider concerns
Providers, on the other hand, have different concerns. For
example, “What if someone who was never in our care trashes our services?” Who
would do this? Perhaps a unscrupulous competitor hoping to drive individuals to
their own services. Could this happen – yup. Would it be a problem – well that
would depend but at least two factors mitigate the potential deleterious
effects of such an attack.
First, if it were only one of many comments AND if it contrasted
with the trends of those comments it is unlikely that anyone would give it much
authority. That is this negative voice would be overshadowed by the more numerous
positive and balanced comments. Even if there was only one comment, this
negative one, as described above it would have little authority on its own and
therefore little impact.
Second, perhaps a more useful response toward this sort of
attack, as well as the legitimate negative comments of a dissatisfied consumer,
is the notion of transparency. We all know that every business and every
service will have unhappy users. In
the past business have tried to hide this fact and their errors but the new radical
transparency movement has turned that notion on its head. Rather than
hiding negatives business talk openly about them – perhaps apologizing for a mistake or talking about practices that address, resolve, or prevent the issue. As a consumer I can learn more useful information by seeing how a problem is addressed then from any other individual comment. Have a problem – that is to be expected –
deal with it in a forthright, reasonable, and ethical manner – then you are someone
with whom I will do business.
So yes there are negatives in allowing individual to comment
on their experiences with mental health and substance abuse providers (or
really any business). However, these negatives cannot only be managed but can
serve to enhance the provider in the eyes of the consumer.