Ad description
An Instagram post by the TV personality Gemma Collins, @gemmacollins, seen on 22 May 2023, featured a video of Gemma wearing a device. She said, “I am one week into using my Flow Neuroscience device. When I tell you it is amazing – it is literally amazing. Even after one week of use I’m feeling lighter, I’m feeling brighter, I am loving life now I’m off of [sic] my depression tablets and this has been a real game changer for me […] Flow is a new medically approved depression treatment. It focuses on the front cortex of your brain. This ultimately helps you to relax and it also removes negative depressive symptoms. For people that can’t get access to therapy or don’t want to be on antidepressants, they now have a new option, which is Flow. Flow actually works faster and better than antidepressants […] It’s like having your own therapist in the comfort of your own home […] You’re fully in control of your own treatment. You can buy Flow on the Flow Neuroscience website. They even have a money back guarantee, so you can test it and if it doesn’t work for you, you can 100 percent get your money back. I was never relaxed, I was always 100 miles an hour, constantly, like, stressing, and now I am just chill to the bone. Literally, Flow genuinely helps with any daily depressive niggles that I might get […] It will be the best thing that you ever do.”
The accompanying text stated “I’ve been using the @flowneuroscience headset for a week, and I have noticed a real difference in how I’m feeling. According to Flow’s data it reduces depression in 88% of people. And the NHS are trialling it too. Why not give it a go if you’re struggling with your mental health […] consult your GP always without fail and do not stop taking your medication before consulting your GP.”
Issue
The complainant challenged whether the ad discouraged essential treatment for a condition for which medical supervision should be sought, including by suggesting Flow as an alternative to antidepressants.
Response
Flow Neuroscience AB t/a Flow said transcranial direct current stimulation (tDCS) was a non-invasive and non-pharmacological form of brain stimulation, which was used as a treatment option for depression, as well as other psychological disorders.They accepted that medical supervision should always be sought for depression and that it needed to be treated responsibly. They said the ad displayed a clear message for viewers to first speak to their GP before thinking about trying the Flow service or changing their medication. While the content was clearly a reflection of Gemma Collins’ personal experience, which Flow could not dictate, at no point did Gemma recommend that viewers should not consult a medical professional.
They said people experienced depression in many different ways and that it had many possible causes, but that most people were prescribed the same treatments: talking therapy and medication, which did not work for everyone.
Flow said Gemma spoke specifically about her own experience of how Flow had helped her reduce her consumption of antidepressants. They maintained that it was common in influencer marketing for a product to be represented based on the influencer’s personal experience; they were not able to adjust or manipulate a user’s genuine testimonial.
They said, although they disagreed that the ad was irresponsible, they had requested that it be removed from Instagram, and that Gemma Collins had confirmed that she had done so.
Gemma Collins endorsed Flow’s comments. She said the fact that the ad stated to consult your GP “without fail” sent a very clear message. She believed the ad contained only personal observations and proven evidence and did not contain persuasive language. The ad did not discourage essential treatment but, rather, flagged an alternative or supplementary one. She believed that there was nothing irresponsible in expressing that Flow could be used as an alternative to, or in conjunction with, antidepressants. She said she had stopped using her antidepressant tablets a long time before starting to use Flow and that her stopping was in no way linked to Flow.Instagram said they had no comments on the complaint, but if the complainant believed the ad was in violation of their policies, they could report it to them via their standard reporting channels.
Assessment
The ASA acknowledged that Flow provided documentation which they maintained supported the efficacy and treatment claims made in the ad. However, the ASA’s ruling was limited to whether the ad discouraged essential treatment for conditions for which medical supervision should be sought. The ASA did not formally consider or rule on whether the evidence did or did not substantiate the effectiveness of the device.
Upheld
The CAP Code stated that marketers must not discourage essential treatment for conditions for which medical supervision should be sought. For example, they must not offer specific advice on, diagnosis of or treatment for such conditions unless that advice, diagnosis or treatment was conducted under the supervision of a suitably qualified health professional. The ad referred to depression, which was a condition for which medical supervision must be sought, and therefore (regardless of any evidence to substantiate the effectiveness of the device) advice, diagnosis or treatment needed to be conducted under the supervision of a suitably qualified medical professional.
The ad stated “I am one week into using my Flow Neuroscience device […] I’m feeling lighter, I’m feeling brighter, I am loving life now I’m off of [sic] my depression tablets and this has been a real game changer for me […]”. The ASA acknowledged that Ms Collins maintained she had stopped taking antidepressants before starting to use Flow. We considered, however, that the implication was that people who started to use the device would be able to stop their medication shortly after and without medical supervision.
We also considered that the claims in the video “Why not give it a go if you’re struggling with your mental health?”, “If you don’t have access to therapy or don’t want to be on antidepressants” and “you’re fully in control of your own treatment” suggested that the device could be used as an alternative to conventional treatment. In particular, “you’re fully in control of your own treatment” implied that the device could be used at home and that medical supervision was not needed at any stage. “If you don’t have access to therapy” further suggested that consumers could avoid consulting a professional. We considered that the reference to buying the device directly from the website added to the impression that consumers could bypass the medical consultation route. The device was intended for home use and could be purchased by anyone over the age of 18. Therefore, consumers were able to undertake treatment without consulting a medical professional and could use the device at home without their treatment being monitored. We considered that the claims were targeted at both those consumers who were weighing up treatment options at an early point in their illness and those who were currently receiving conventional medication or therapy for depression.
In addition to Gemma Collins’ video presentation, the ad included text in the caption which made further efficacy and treatment claims. We acknowledged that, at the end of that caption, text stated “consult your GP always without fail and do not stop taking your medication before consulting your GP”. However, we considered that this text did no more than suggest that consumers should arrange a consultation with a GP before starting to use the device. The Code required that treatment for depression should be conducted under medical supervision. We considered that a preliminary consultation, which consumers were free to not go ahead with, did not meet the requirement for ongoing supervision, particularly in the context of an ad which presented the device as an immediate alternative to conventional treatments associated with treating depression, such as antidepressants or therapy, which might be complex and potentially longer term, as well as presenting the device as being for home use, without any initial or ongoing monitoring or supervision by a medical professional.
We therefore considered that the text in the caption indicating that a GP should be consulted was insufficient to satisfy the requirement of the Code that ads must not offer treatment for depression unless that treatment was conducted under the supervision of a suitably qualified health professional.In addition to the potential risks of not seeking medical advice before starting treatment for depression, the NHS website stated that it was not recommended to discontinue antidepressant use without supervision by a medical professional because of the potentially serious physical and mental side effects. We considered that the ad trivialised the decision to come off antidepressants or not take them at all and encouraged people to take their treatment into their own hands.
We concluded that the ad discouraged essential treatment for a condition for which medical supervision should be sought and therefore breached the Code.
The ad breached CAP Code (Edition 12) rule 12.2 (Medicines, medical devices, health-related products and beauty products).
Action
The ad must not appear again in the form complained of. We told Flow Neuroscience AB t/a Flow to ensure their future ads did not discourage essential treatment for conditions for which medical supervision should be sought, including depression.
