So You've Been Cyber Stalked? A Hidden Driver of Mental Health Barriers to Care
An guide to countering stalkers
I’m a psychiatrist. I have been stalked. I have had death threats made against me—in a Tarisoff phone call— on my actual birthday! The worst part? It can often be done anonymously. Wondering who could be after you…can be nightmarish! This newsletter post reviews the data on stalking (particularly among mental health pros), and some steps one can take to protect yourself.
Online stalkers and trolls often think they can hide behind fake names, fake accounts, and the right to free speech!
The truth? Stalking is a crime with severe penalties— both as a civil matter and in criminal law. Let’s address the grim issue of criminal cyberstalking. Many, many health professionals are stalked. Mental Health Professionals—therapists, nurses, psychologists, and psychiatrists are particularly vulnerable.
Cyber Stalking is a Violent Crime
It’s a violent crime; he just used cyber tools to carry it out,” said Special Agent Christopher Petrowski of the FBI’s Houston office.
The criminal law, updated in 2013, states:
The amended law in part makes it illegal to use “any interactive computer service or electronic communication service” to conduct activity that places a person “in reasonable fear” of death or serious bodily injury, or that causes or could cause “substantial emotional distress.” The law states the actions must be intentional.
Cyberstalking is punishable by up to five years in prison and a fine of $250,000. A life sentence can be imposed if the cyberstalking results in the death of a victim.
These crimes are devastating to victims—which is, of course, the point:
When someone walks in with a story like that, it’s very emotional and difficult to figure out right away,” Petrowski said. “They’re hurting. This went on for more than a year.”
A Big Problem
Among physicians, psychiatrists are the most frequent victims:
The highest stalking prevalences were found among psychiatrists (26.5%), followed by obstetrician-gynecologists (16.3%) and surgeons (15.9%). No stalking was reported among … nuclear medicine physicians.
Over 1/4 of all psychiatrists have been stalked!
… to the degree that it was reported—this doesn't count cases that were not reported, of course!
The emotional consequences of stalking were identified as anxiety or fear20,28,29,31; difficulty sleeping20,28; depressive symptoms, including a loss of enjoyment;28 feelings of hopelessness and powerlessness; reduced concentration; loss of energy and motivation20; anger or aggressive thoughts or urges20; alcohol or other substance use28; psychiatric symptoms that persisted for one month or longer22; and psychological distress, loss of control, and frustration.31 One study20 reported that 18 percent of victims were physically harmed, most commonly by being hit or grabbed, although three had been stabbed; however, it did not separate physicians from other mental health workers.
Of physicians stalked, 18% being physically assaulted is horrifying.
56,536 Psychiatrists are practicing in the US. Assuming the accuracy of the above rates on using the above data, roughly 14,986 have been stalked. Of those, 2,697, by extrapolation, have been physically assaulted by those stalkers.
If you are wondering why it’s hard to find a psychiatrist…this might be a contributing factor.
For perspective—the number assaulted is more than as many new psychiatrists and dermatologists in an entire year of the NRMP:
It can just shy of a year of US seniors becoming new doctors if you include reported stalking of all psychiatrists:
Stalking is a big problem for us all…and impacts the helpers we need more than ever.
It’s plausibly higher for physicians than other kinds of psychiatric professionals:
The global cumulative incidence of stalking of 11 percent among mental health workers confirms previous hypotheses that these professions are at risk of this form of victimization (7).
Although it's worth noting nurses are very frequently the victims of stalking, in one UK sample (albeit with reporting bias plausible):
The findings reveal that: (1) 50% (n = 56) of MHNs who completed the questionnaire had been stalked; (2) on the whole, victims were female (78.6%) and stalkers males (82.1%); (3) stalkers were from a variety of social groups including mental health service users and MHNs; (4) victims were threatened, followed, physically assaulted and received unwanted communication
What Do We Know About Stalking More Broadly?
Most stalkers don’t “go the distance”—only 10% continue for five or more years.
However, given the conversion rates from “virtual” to physical violence, “waiting it out” is a terrifying experience.
Reporting to law enforcement is available from the DOJ:
It is often the case that action is hard to compel authorities to take for victims. When evaluating the motives of cyber stalkers:
Further, both cyber stalkers and traditional stalkers are motivated by an obsession with having power, control, and influence over their victims. One of the distinctions between cyber stalkers and traditional stalkers is cyber stalkers' proficiency with computers and the use of the Internet, which may include knowledge about how to avoid detection through anonymity aided by simple and inexpensive tactics, such as connecting to several different Internet service providers and the creation of a number of screen names.
What to Do?
The “paper trail” ends up mattering. When threats are made online, the jurisdiction in the US falls with the FBI because the internet is interstate commerce.
You can report it online or by phone if you have been stalked—" IC3” is the shorthand for federal cybercrime.
The website for FBI reports is here.
These reports are severed should only be filed if it’s a genuine report:
Once a complaint has been filed with the IC3, it cannot be canceled.
This report isn’t the place for evidence—you need to save that for later if a case is opened:
While you may cut and paste information into your complaint (e.g., email headers), you must be sure to keep all original documents in a secure location. In the event that a law enforcement or regulatory agency opens an investigation, they may request the information directly from you
The FBI has a 90% case close rate, but practically it means they only open issues they are likely to close.
If you or someone else is in immediate danger, please call 911 or your local police.
This means local police. The FBI can see past reports made to law enforcement, so the reports add up if the stalking continues.
The most crucial threats are those to life or limb or statements that could reasonably cause one to fear for safety. “You are a horrible murderer” —bad, but defamatory, not criminal enough. “Maybe you should watch your back! You never know when bad things could happen…” is less specific but more threatening, for example.
Pictures that are threatening—I saw someone post a noose about a colleague on Twitter!— these things also “count”‘.
I will have another article about civil action related to online defamation in a follow-up, and what to do if itifou don’t know who is doing the stalking.
Please, report cyberstalking. It is a driver of burnout for physicians and victims of any kind.
Carrie Goldberg, Esq. has a great book on the topic:
Victims don't get to choose if they are victimized. We can choose to report staking.