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Mental health is a vital part of human life for it includes the emotional, psychological, and social well-being of individuals. However, in todays society, not everyone is aware of its significance and how it affects a person in dealing with the everyday demands of life which can make people with mental health issues suffer more. This includes depression, generalized anxiety disorder, bipolar disorder, obsessive-compulsive disorder, post-traumatic stress disorder, schizophrenia, and many more (McClellan, Ali, Mutter, Kroutil, & Lanwehr, 2016). Depression is one of the most common health issues of the youth today and is known to carry social stigma. Individuals with mental health illnesses are more likely to live in poverty and have lower educational attainment compared to those without such conditions (McClellan et al., 2016). Therefore, the society should discover ways to lessen stigma and discrimination towards people who suffer with mental health issues.
Public awareness can lessen the struggles of people suffering through social media. It is one of the most powerful tools to reach out to millions of users that are involved and is where they spend much of their time (Drahosova & Balco, 2017). Through the use of social media, people gain knowledge on mental health and its impact to people with mental health illness allowing them to feel understood and accepted. It is also used to raise awareness to the public on how to help ones self or other people to cope with mental health illnesses. In line with the continuous modernization of technology, web-based communities have been an effective means to communicate about depression and its causes which increase the social connection among peers (DeJohn, Schulz, Pearson, Lachmar, & Wittenborn, 2018).
Among all developed social media, people use Twitter more frequently and it is considered as the most widespread platform for mental health since its primary use is to express the users thoughts and perspectives, share personal information, connect with others, and engage with the content regarding mental health. Through the use of Twitter, people are able to engage in a web-based community that can provide people a source of relief, lessen the fear of in-person interaction, and can provide a platform to normalize different discussions about common mental health issues (Lachmar, Wittenborn, Bogen, & McCauley, 2017). It is the major platform of interest when it comes to mental health due to its evident prevalence and popularity surrounding the issue (Berry et al., 2017).
Betton et al. (2015) aimed to illustrate how Twitter has been used by individuals and campaigns to challenge mental health stigma through selected case studies. Interaction on Twitter about mental health featured a dynamic blend of education, contact and protest methods for challenging stigma. Education replaces stereotypes with accurate facts and figures; personal contact between members of a stigmatized group and others undermines prevailing stereotypes; protest highlights injustice and rebukes stigmatizing attitudes. A striking aspect of Twitter is that a spontaneous burst of protest can be initiated by one individual and can be widely shared to both online and offline environments.
Communication about, and efficient search for, a specific topic can be facilitated through the use of hashtags where tweets are labeled such that other users can view contributions to conversations (Berry et al., 2017; Reavley & Pilkington, 2014). According to Martinez-Perez et al. (as cited by Reavley & Pilkington, 2014), individuals with mental illness utilize social networks such as Twitter to obtain information, access support, and raise awareness. Similarly, Berry et al. (2016) implemented a study-specific hashtag to examine the reasons why people use Twitter to discuss mental health problems. The researchers found that themes derived from the content of the tweets highlight the perceived therapeutic benefits of Twitter through the provision of support and information as well as the potential for self-management strategies. The findings from the tweets suggest that individuals may actively use Twitter to discuss mental health as way of developing a sense of belonging within a community, accessing support, challenging stigma and raising awareness, sharing experiences, and as an empowering coping mechanism (Berry et al., 2016; Betton et al., 2015). Moreover, it was found that the numerous tweets and themes identified through the hashtag demonstrated the feasibility of implementing study-specific hashtags to explore research questions in the field of mental health. The collective experiences noted were indicative of the positive role that Twitter can provide in mental health discussions.
Another set of researchers collected tweets on depression and schizophrenia with the use of hashtags. The study aimed to provide insights into how Twitter users share information about depression and schizophrenia, the type of information shared, and the relative proportions of supportive or stigmatizing attitudes among the tweets. It was found that the content of the tweets included personal experience, awareness, links to information, news and research findings, support and advice. The results also showed that majority of schizophrenia and depression tweets aimed to increase awareness and provide resources to information. Attitudes toward both illnesses were largely supportive or neutral, a number of tweets were specifically anti-stigma while tweets that reflected stigmatizing attitudes were significantly small in number. The study offers the opportunity for unobtrusive attitude measurement (Reavley & Pilkington, 2014).
Twitter is highlighted for its potential in supporting social activism where its role can be seen in linking groups together and coordinating activity (Segerberg & Bennett as cited by Shepherd, Sanders, Doyle, & Shaw, 2015). The presented study sought to outline the role of Twitter in providing a discursive space and support for those with experiences of mental disorder. The researchers found that the underlying themes on its role include: therapeutic relationship and developing professional communication; the impact of diagnosis on personal identity and as a facilitator for accessing care; the balance of power between professional and service user; and support provision through medication, crisis planning, service provision and the wider society. Social media appears to have a potentially rich role as feedback medium for mental health care service provision (Shepherd et al., 2015).
Social media platforms have been an efficient platform that is used even more by mental health anti-stigma programs since it can broadly communicate mental health information to those who need, and can influence to others, the information (Betton et al., 2015; McClellan et al., 2016). Based on previous studies, Twitter was specifically chosen as the social media of interest due to its popularity and easy to use platforms where tweets can be categorized based on their content and user information (Berry et al., 2017; Reavley & Pilkington, 2014). Social media not only could complement traditional broadcast sources (eg, radio, TV, newspaper) in spreading public health messages, but is also necessary to reach the growing percentage of the population who are abandoning traditional broadcast media as adoption of internet technologies increases (Schein & Kumanan as cited by McClellan et al., 2016). Twitter use is higher among certain populations especially the youth who can be harder to reach using traditional media sources (Smith & Brenner as cited by McClellan et al., 2016). The researchers therefore concluded that Twitter gives people a chance to discuss mental health problems as it provides a safe space for expressing thoughts that makes Twitter use increase specifically to the youth (McClellan et al., 2016; Shepherd et al., 2015). However, previous studies failed to show how Twitter establishes mental health awareness to its users.
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