If your social media engagement has been dropping and you’re convinced you’re doing something wrong — I want you to stop beating yourself up. Because here’s the thing: it’s probably not you. The game itself has changed.
And if you’re still measuring the success of your mental health marketing by likes and comments, you may be reading the wrong scoreboard entirely.
The Numbers Don’t Lie — But They Do Mislead
Let’s look at what’s actually happening out there. Instagram’s median engagement rate dropped approximately 26% between 2024 and 2025 — falling from around 7.3% down to 5.4%. Social Insider’s Social Media Benchmarks report states that per-post comments fell 16% on Instagram and 24% on TikTok over the same period for the 70 million social media posts they surveyed. And yet — people are spending more time on social media than ever. The average person logs 2 hours and 21 minutes a day on social platforms, according to DataReportal’s 2025 global study.
More eyeballs. Fewer likes. Fewer comments. What’s going on?
The answer is AI — and not in the way most people think.
“People aren’t disengaging. They’re engaging differently. AI-driven algorithms have trained us to consume more and interact less — and if you’re only watching the like count, you’re going to miss the whole story.”
Social platforms have fundamentally restructured how their AI systems decide what gets seen. They’re no longer primarily rewarding likes and comments. They’re prioritizing saves, shares to DMs, watch time, and what the algorithms call “meaningful interactions.” Instagram’s algorithm now weighs saves and shares more heavily than likes. TikTok is rewarding watch time and content completion over any surface engagement. Facebook’s “Andromeda” AI is literally studying what users scroll past — not just what they react to.
What does that mean in plain language? People are watching your content. They’re saving it. They’re sending it to a friend via DM. They’re sitting with it. They’re just not hitting the heart button the way they used to — because the platforms themselves have trained that behavior out of them. The feed moves faster. The content is more curated. And with an ocean of AI-generated content flooding every platform, users have gotten more selective and more passive with their public reactions.
They’re consuming more. Commenting less. And your “low engagement” post might be doing more work than you know.
What’s Actually Happening to User Behavior
Here’s what we’ve seen. Engagement is becoming more private. Saves, DMs, and shares are increasing — but those interactions don’t show up in your public metrics. Someone sees your post about managing anxiety in recovery. They don’t comment. They save it. They send it to their sister. That’s two people you’ve just reached — and your analytics told you nothing happened.
“A save is someone saying ‘I need to come back to this.’ A DM share is someone saying ‘this is for you.’ Neither shows up in your like count — but both are exactly the kind of trust-building that leads a person in crisis to finally make the call.”
This matters enormously in mental health marketing. Think about who your audience is. Someone researching treatment options for themselves or a loved one is not going to publicly like your post about addiction recovery. They’re not going to comment “this really resonated with me” under your video about trauma therapy — at least not right away. The stigma is still real. The vulnerability is real. They’re watching quietly, saving your content, and building trust over time.
The algorithms know this, by the way. Platforms have recognized that for sensitive topics — health, mental wellness, family challenges — private engagement is actually a stronger signal of genuine connection than a public thumbs-up. That’s a reality that maps perfectly onto behavioral health marketing, and it changes what you should be chasing.
Stop Watching the Vanity Metrics. Start Tracking These Instead.
So if likes and comments aren’t the right yardstick, what should mental health and behavioral health clinic owners actually be measuring? Here’s what we track at Beacon and what we advise our clients to track:
Website traffic from social. Are people clicking through? That click is far more valuable than a like. It means someone was curious enough to want to know more — and your website is where the real conversion work happens.
Content saves and DM shares. Most platforms now report these in your analytics. Watch them. A high save rate means your content is genuinely useful. That’s the whole goal.
Inbound call volume and form submissions. Every new inquiry that comes in is a data point. Are those numbers moving? Track where those inquiries are coming from. If your social presence is working, you’ll see it here.
Cost per new patient inquiry. This is the metric that connects marketing activity to actual business outcomes. Not cost per click. Not cost per impression. Cost per new person who reached out to get help.
Google Business Profile views, clicks, and calls. For local behavioral health practices, especially, your Google profile is often the last thing someone looks at before they decide to call. Those metrics tell you whether your broader visibility is translating.
Review volume and quality. Reviews matter deeply in healthcare — but I want to be honest with you about something that doesn’t get talked about enough in this space: getting them in mental and behavioral health is a completely different challenge than in almost any other industry, and it requires a level of care that most review strategy advice completely ignores.
HIPAA and PHI regulations mean clinics have to be extraordinarily thoughtful about how — and even whether — they invite clients to leave reviews. You cannot follow up an appointment with an automated “how’d we do?” email the way a dentist or a chiropractor might. The moment you do anything that could identify someone as a patient, you’re in legally and ethically murky territory. This is not the place to wing it.
And even when you navigate the compliance piece carefully, you’re up against something else entirely: the very real stigma that still surrounds mental health care. Generational dynamics play a huge role here. Many clients — particularly older generations — are intensely private about the fact that they’re even in therapy. The idea of leaving a public Google review feels like announcing it to the world. They won’t do it, and honestly, you shouldn’t pressure them to.
Then there’s the flip side. Younger generations, particularly Gen Z, often identify openly with their mental health diagnoses and will enthusiastically share their therapist’s name across every platform they’re on. That willingness creates its own set of considerations around how you engage with that kind of public visibility.
Reviews are still part of your trust ecosystem, and they still matter for local search visibility. But in behavioral health, the path to earning them is slower, more nuanced, and far more dependent on the genuine quality of the experience you create — because the clients who feel safe enough and confident enough to leave one are the ones you really had to earn.
“Marketing doesn’t stop when a patient walks in the door. The experience they have — and whether they tell someone about it — is part of your marketing strategy. Track that too.”
The Real Reason This Matters
I want to zoom out for a second. Because this isn’t just about optimizing your metrics dashboard. It’s about something much bigger.
The people you’re trying to reach are often in real pain. They’re searching quietly. They’re saving your posts at 2 in the morning. They’re sending your content to their mom or their brother who they’re worried about. They’re building up the courage to call. And every piece of content you create — every video, every blog, every thoughtful Instagram post — is either part of that journey toward help, or it isn’t.
If you’re making decisions about your marketing strategy based on whether a post got 47 likes, you’re optimizing for the wrong thing. You might be pulling back on the exact content that is quietly reaching the people who need you most.
“Marketing is human-to-human connection, not conversion. The conversions follow when you get the connection right.”
The platforms have changed. User behavior has shifted. AI is reshaping how people consume content and what they do with it. But the fundamental truth of behavioral health marketing hasn’t changed at all: you are trying to build enough trust that someone in one of the hardest moments of their life feels safe enough to reach out to you. That doesn’t always look like a like or a comment. Sometimes it looks like a saved post and a phone call three weeks later.
Track the metrics that lead to that phone call. Let go of the ones that just feel good.
I’d love to hear from you — what metrics have you started paying attention to that surprised you? Have you seen a disconnect between your social engagement numbers and the actual inquiries coming in?
Ready to know which numbers actually matter for your clinic’s growth? Let’s take a look together.
