By commenting on the lives of other YouTube personalities, Chris Boutté grew his mental health YouTube channel, The Rewired Soul, to nearly 100,000 subscribers in the space of a year. His videos are meant to entertain and educate viewers on important topics in psychology, but his tactic of using other YouTubers as examples — without their permission — has drawn the ire of many in the community.

The more a channel grows, the more it attracts criticism, and Boutté found himself at the center of controversy back in January. Then, YouTube personality Trisha Paytas posted a video criticizing Boutté for making so many videos about her, including speculating over whether she should be in a relationship with fellow YouTuber Jason Nash. “It pisses me off so much, he does so many videos about me and Jason and our relationship, as if he’s a relationship expert,” Paytas says in the video. “He does judgments just by looking at our videos ... He acts like he’s such an expert, it’s honestly dangerous and it’s honestly unhealthy.”

Other YouTubers, like Dustin Dailey, Ashlye Kyle, and Viewers Voice then posted similarly critical videos. According to his critics, Boutté, who is not professionally licensed, is running a gossip channel dressed up in the guise of mental health advocacy and profiting by milking the drama of other people’s personal lives. (All these YouTubers declined to comment for this article.) Though Boutté has since made his videos about Paytas private, the controversy brings a classic ethical dilemma around mental health into the digital realm and reveals the challenges around finding an appropriate way to mix mental health, education, and making money on a largely unregulated platform.

Mental health YouTube has three layers: the professionals, the personal narratives, and the advocates. The professionals are licensed therapists like Kati Morton, a marriage and family counselor in California and the queen of mental health YouTube.

Morton says that her experience on the platform has been mostly positive. Many of her viewers from around the world are excited to find the resource, and making mental health videos has challenged her to expand her own knowledge, she says. Other people in this space include Todd Grande, a professor in the counseling program at Wilmington University, and Ali Mattu, a clinical psychologist at Columbia University Irving Medical Center and a member of the American Psychological Association. Both Grande and Mattu run their own mental health YouTube channels; Grande’s channel is just his name, while Mattu’s is called The Psych Show.

“Even psychiatrists don’t comment on the mental health of anyone they haven’t examined”

For these professionals, the channels are a way to do outreach and help people they might otherwise never see. “I absolutely hate that I have limitations on how many people I can see in a week, I hate the fact that it’s so hard to access quality mental health care and there are so many things that can get in the way of being able to see someone like me,” Mattu says. “It’s really meaningful to me to know that I am reaching out to people that might not otherwise be able to get any mental health support.”

The second layer consists of narrative videos from people with first-person experience of a particular mental illness. People who have mental illnesses often feel incredibly isolated, and the internet can be a good way to find advocates and those who can help guide the way, says John Naslund, a research fellow in global health and social medicine at Harvard University. His research has shown that online social media groups of all kinds can be valuable sites of peer support, especially for highly stigmatized conditions like schizophrenia.

At the same time, personal narratives can spread misinformation, often unintentionally. This usually happens when someone talks about a treatment that worked for them, but might not be supported by research. “There’s a difference between ‘I’m sharing my story because it’s my perspective,’ and ‘I’m on Zoloft and it’s the best thing ever,’” says Morton. “I think that’s where it muddies the waters and makes it a little bit more dangerous.”

Both Morton and Mattu think that if the platform provided a way to easily verify someone’s credentials, viewers could more easily identify the trustworthy sources. Still, it’s important not to remove the valuable personal narratives. “My field doesn’t ‘own’ mental health, that would be as ridiculous as saying that only physicians can talk about physical fitness,” says Mattu. “I don’t think it’s a topic that should only be limited to people who have spent an immense amount of years and have a lot of student debt studying it. But YouTube hasn’t quite figured out how to curate this content.” (YouTube declined to comment for the story.)

The final group are mental health advocates like Boutté, who are neither licensed professionals bound by medical ethics nor people who primarily talk about their own mental health. His channel, Boutté says, is about education and trying to be helpful, but when analysis centers on the lives of other people, the boundaries can get tricky.

Boutté is open about having struggled with drug and alcohol use in the past. He doesn’t have formal, advanced training in psychology, but has worked at a drug and alcohol treatment center and is in a program to become a certified alcohol and drug counselor. Nowadays, The Rewired Soul is his main source of income; he makes money off ads shown on the videos, and he has also sold courses that offer mental health advice. (The courses are now free.) He even has a mantra: at the beginning of each Rewired Soul episode, he says the channel is a place where “we talk about the problem, but focus on the solution.” These videos have brought him eyeballs and a devoted fan community.

To his critics, though, Boutté veers out of his lane. Instead of just making videos talking about, for example, “five signs of depression” or “10 tips for dealing with anxiety,” his videos frequently discuss the mental health of other YouTubers. Titles include: “Why Everyone Hates Gabbie Hanna,” “Why Anna Akana Needs Therapy,” “Is Amberlynn Reid a Lost Cause?” and “My Thoughts on Marina Joyce’s Mental Health and Drug Use.” Though these YouTubers sometimes do talk about their mental health, it’s not the focus of their content.

By making these comments, Boutté toes the line of a well-established principle guiding mental health professionals. “Even psychiatrists don’t comment on the mental health of anyone they haven’t examined,” explains John Torous, a psychiatrist at a teaching hospital affiliated with Harvard Medical School. This is the so-called Goldwater rule. The American Psychiatric Association created this rule — which prohibits members from publicly commenting on the mental health of someone they haven’t examined — in response to mental health speculation during Senator Barry Goldwater’s 1964 presidential campaign.

The idea is that though someone might willingly make details of their life public, it can still be hard to know what’s really going on. “We all certainly know that on social media people put up personas and you don’t know the full story just from looking at someone’s social media profile,” says Torous, who was not speaking specifically about Boutté. “So passing any judgment on anyone’s underlying mental health based on social media is fraught with risk and uncertainty.” That’s essentially the criticism that Trisha Paytas made when she posted the video in January condemning Boutté.

Boutté will stick to talking about fictional characters for now

From this point of view, Boutté deserves criticism for making videos that are heavily based on assumption. “My biggest frustration with him was speculating about other people’s mental health without knowing them or having their consent,” says Leif E. Greenz, a mental health YouTuber who makes videos that address topics such as complex post-traumatic stress disorder. Though there may not be anything legally wrong, she says his behavior isn’t ethical. For example, though Boutté adds that he doesn’t speculate on diagnoses unless they have publicly discussed and identified with it, he did say in a video, of Greenz, that “I think she has BPD [borderline personality disorder],” a diagnosis she has never identified as having. “He did the exact same fucking thing for me on his podcast,” she adds. “He diagnosed me, he laughed at me, pulled me apart in front of an audience.”

PrimInk, another critical YouTuber, wrote in an email to The Verge that Boutté’s focus on drama harms the mental health of others: “At the end of the day, when you are dealing with something as private and sensitive as mental health, you shouldn’t be airing out other people’s problems when you have no clue what is actually going on.”

Boutté says his videos are an important form of education that are not about the YouTube personality, but about teaching the viewer. The videos are about commenting on behaviors and trying to share information about what is healthy and what is not, not making moral judgments. To him, the topic of discussion shouldn’t matter so much if the information itself is accurate — and much of that information is fairly standard. Boutté isn’t telling people to take Zoloft or eat a meat-only diet, he’s telling them to get therapy, or recognize potential warning signs. The advice itself is mostly innocuous; it’s just that the entry point to the advice, and the mental health speculation, happens to be the lives of real people.

Imagine, adds Boutté, if he were out in public with his 10-year-old son and saw a couple that were being verbally and emotionally abusive toward each other. Those are real people, too. “What am I going to tell my son when he sees that?” Boutté says. “Am I going to tell him, ‘That’s okay, we don’t know what’s going on?’ Or am I going to tell him and teach him, ‘Don’t talk to a woman that way’? That’s where I’m coming from. These [YouTubers] are influencing people, and if you can relate to this, that might not be healthy.” There is a difference between directly saying that someone has a disorder and speculating on certain behaviors that are modeled for others, he says.

Not everyone agrees with the Goldwater rule, either. Since the election of Donald Trump, some psychiatrists have pushed against the rule, arguing that the president is psychologically unfit and that it’s their duty to try to remove him from office. Todd Grande, with whom Boutté has collaborated, argues that it can be acceptable to talk about public figures for educational purposes. There’s no hard and fast rule for when a private figure turns into a public figure, though he suggests that maybe at around 50,000 subscribers someone has reached a level of fame that makes it more acceptable to comment on their life. Even then, it’s good to ask for consent before making these comments, he adds.

This ethical question is likely at the bottom of YouTube’s priorities, since the company is more concerned with fighting anti-vax information and extremist content. Without the intervention of YouTube, it’s up to the communities to self-police. “We can do what we did, we made videos, we dug up the information ourselves, we shared information with each other,” Greenz says. After Paytas posted asking Boutté to stop making videos about her, the drama channels worked with the smaller mental health channels to make videos calling out what they saw as Boutté’s unethical practices. “That was one of the beautiful things,” she adds. “We all kind of came together to take this dude down because we know that YouTube itself wouldn’t do anything about it.”

Boutté isn’t a psychiatrist and is under no obligation to follow the Goldwater rule, but says he has become more careful about this topic. Back when he had only a few thousand subscribers, it didn’t seem necessary to contact someone about whom he was making a video. Having many more viewers changes that equation and he promises to be more careful in the future. “I will always do them the courtesy of reaching out and giving them a chance to approve it,” he says. He has some other ideas for how to change his channel in the future — but he’s going to stick to talking about fictional characters for now.

Correction April 4, 2019: Ali Mattu is a member of the American Psychological Association. An earlier version of the article incorrectly stated that Ali Mattu was a member of the American Psychiatric Association.