By: Marisa Cimolai & Anirudha Paul

Mental health has become much more prioritized now than ever before. Social media is one of the most influential institutions in our society today; thus, it is crucial to explore how mental health is portrayed on platforms, specifically on accounts based on mental health, to determine how viewers are being influenced. This study examines how mental health is portrayed on Instagram through four popular mental health accounts’ most recent posts, focusing on depression, anxiety, and trauma. There are 12 posts, 3 of the most recent from each account. Findings suggest there is coverage on popular Instagram accounts based mainly on strategies to “lift your mood” for anxiety and depression and also awareness regarding the struggles that come with mental illness. This study is guided by agenda-setting theory, which helps us understand that the media shapes public opinion. Overall, the keywording helps us see the picture that accounts on Instagram have painted for mental health. Also, the spiral of silence theory plays a role in this study as we analyze the level of openness for this social issue and how this may change social media users’ expectations and outlook on mental health.

Literature Review

Mental health used to be a topic that was not often discussed, but now it has become crucial in worldwide health discussions. This change shows that people are starting to understand how crucial mental health is for a healthy and productive society. One big thing that affects how people see mental health is how it is shown in the media. The media has an immense power to change how people think about mental health issues, influencing everything from how people feel about these issues to the rules and policies made about them (Link & Phelan, 2014). This review looks into how the media shows mental health and how this affects what people think and feel about it, trying to find out how the media can either make stigma worse or help people understand mental health better.

The way media shows mental health and how it affects what people think is complicated. Some studies show that the media often gives a bad image of mental illness, making people more likely to wrongly judge those with mental health problems (Aguiniga et al., 2016). However, other studies, like those by Beeres et al. (2021), show that media can also help reduce stigma by talking about mental health issues carefully and correctly. This shows that the media can have a significant impact on how people see mental health, which is why it is essential to study it more.

There is much research on this, but we still need to learn more, especially about how digital media, like social media, affects young people’s views on mental health. With increasingly more digital media use, there are worries about wrong information and how well online content is checked (Bizzotto et al., 2023). Some studies are starting to look into this, showing that we need to understand better how digital media affects how people think and feel about mental health, especially in young people and teenagers (Lin et al., 2021).

It is important to know what we mean by “mental health,” “stigmatization,” and “media portrayal.” Mental health is about being well in your mind, handling stress, working well, and being a part of your community. Stigmatization is when people are poorly treated or seen as less because of their mental health (Link & Phelan, 2014). Media portrayal is how mental health is shown in news, movies, TV shows, and online. Understanding these terms helps us study how different media types influence people’s views on mental health and stigma.

We used theories like the Agenda-Setting Theory and the Spiral of Silence Theory to help understand how media affects what people think about mental health. Agenda-Setting Theory says that the media helps decide what topics are important for people to discuss. The Spiral of Silence Theory suggests that people might not talk about their views if they are afraid of being left out or judged, which can make it harder to deal with mental health stigma. (Keyton, J, 2014).

The big question that arises to us is, “How does the way media shows mental health affect the stigma around it in different groups of people, and what does this mean for people fighting for mental health and making policies?” This question aims to look deeper into how media influences mental health stigma and find ways to help people think more positively about mental health. By looking into this, the review hopes to help society understand mental health better and show how important the media is in changing how people think and talk about mental health, aiming to reduce stigma and make people more understanding and supportive (Curran et al., 2023; Markiewitz & Jungblut, 2023).

Method

This study focuses on keywording within these Instagram posts that point toward mental health or illness. These keywords fit into different categories such as 1) general terms relating to mental health/illness (i.e. struggle), 2) terms that point towards progress (i.e. awareness), 3) actual information about mental illness (strategies, statistics, etc.) and 4) naming mental illnesses (depression, anxiety etc.). This study analyzes two kinds of mental health accounts, one being personal and the other organizational. What defines a personal account is one person’s name being listed and one person’s face being posted on the account. What defines an organization is that there are no references to a specific person owning the account, meaning there could be more than one person managing the account and posting content. The four examined accounts are @fightthroughmentalhealth, @letstalk.mentalhealth, @mentalhealthwithmaddy, and @mentalhealthceo. All four accounts have mental health in the handle, which makes it very clear that they are based on this issue. The details of these accounts will be discussed as a result of this study. This study examines key wording from the following 12 Instagram posts (descriptions): “Does anyone else do this?” Do you agree?” “All of this” (Fight Through Mental Health, 2024); “Which do you wish your parent/caretaker…,” “Please share to raise awareness…,” “Let’s talk sunlight…” (Let’s Talk Mental Health, 2022); “Hi friends!…” “In honour of #internationalwomensday…,” and “In honour of #bellletstalk…” (Furgiuele, M, 2024); “Here’s how you can get anxiety…” “Drop comments if this helps…” and “Drop comments if you can relate” (Yap, 2024).

Results

The validity and activity of these accounts can be determined through the number of followers, posts, and comments. The account @fightthroughmentalhealth has 1,142 posts and 933 thousand followers, with three posts within three days. The account @letstalkmentalhealth has 1,768 posts and 1.5 million followers, with at least a two-month gap between posts. The personal account @mentalhealthwithmaddy (run by Madison Furgiuele) has 575 posts and 66 thousand followers, with a one-day gap between each post. Lastly, the account @mentalhealthceo (run by Ron Yap) has 1,242 posts, 262 thousand followers, and posts daily. Of the 12 posts examined, 33% had more than 50 comments, and 90% had at least 15 comments.

Most (68%) of the 12 posts contain general terms relating to mental health/illness (category 1). These keywords include mental health (33%) and struggle (35%). Six (50%) of the 12 posts contain words related to recovery and progress (category 2). Awareness was also present in three (25%) of the 12 posts, along with recovery (16.7%) and help (8.3%). Only 1 (8.3%) of these 12 posts contained statistics about mental health (category 3). This duplicate post is also the only post discussing gender-specific issues related to mental illness. Anxiety (16.7%), trauma (16.7%), and depression (8.3%) are keywords found in the posts. Thus, 41.6% of the 12 posts fit into category 4. The posts from the personal accounts focused more on words fitting into category 4 (66.7%), whereas 33.3% of posts from organizational accounts contained wording that fits into category 4. Only 16.7% of posts from the organizational accounts contained hashtags, whereas 100% of the posts from personal accounts contained hashtags in the description. Other keywords within these 12 posts include broken, love, regulate, worry, guilty, shame, and many more.

Discussion

The keywords found within the 12 posts point toward a particular tone and type of discourse surrounding mental health on Instagram. There is an emphasis on awareness and sharing information. Hashtags play a significant role in awareness and sharing on social media. Interestingly, the personal accounts contained hashtags, while the organizational accounts did not. Personal accounts mentioned specific mental illnesses such as depression, anxiety, and trauma, whereas organizational accounts focused more on general terms. Notably, all posts had at least 15 comments, indicating that users were engaging with the posts. What is particularly interesting is that the account @letstalkmentalhealth has the most followers (1.5M) but has yet to post since 2022. An observation to make is that this account may have been more active closer to the COVID-19 pandemic, as mental health was a significant concern during that time. Also, only one post addressed issues with men who suffer from mental illness (suicide). Overall, personal accounts focused more on personal stories and self-care, and organizations contained information about strategies and statistics.

Limitations

The research into Instagram’s impact on mental health perceptions is subject to several limitations that must be acknowledged. The methodology centred around keyword analysis needs to account for the pivotal role of visual content, which often drives user engagement on the platform. The classification of keywords into distinct categories might not accurately reflect mental health conversations’ multifaceted and dynamic nature. Furthermore, the study’s narrow focus on a select few accounts curtails the broader applicability of the findings to the vast array of mental health discourse on Instagram. This limitation is compounded by the fact that the study did not measure likes, a significant indicator of engagement, thus providing an incomplete picture of how users interact with the content. Another notable limitation is omitting any analysis of campaigns or fundraising efforts associated with these accounts, which could signify a more progressive and active stance on mental health issues. Future research should strive to include a wider variety of Instagram accounts and posts, consider both visual and textual elements, examine the full spectrum of user engagement, including likes, and explore the presence and impact of mental health campaigns and fundraising initiatives to enhance the depth and relevance of the study’s insights.

Recommendations and Conclusion

This study has multiple implications. The research underscores the thematic currents prevalent in social media discourse by revealing the prominence of general mental health terms and those associated with struggle, recovery, and progress. The comparative analysis of personal versus organizational accounts offers a deeper understanding of the varied communication strategies, which could influence public engagement and conceptualization of mental health issues.

From these findings, several recommendations emerge. Media professionals should consider the efficacy of their language use on Instagram, as the words and hashtags employed can significantly impact stigma and the mental health conversation. Moreover, the study highlights the need for campaigns and fundraising efforts to adopt a similarly strategic approach in their messaging to ensure a supportive narrative around mental health.

The research also points to the need for a more holistic measure of engagement beyond keywords and text, suggesting future studies should incorporate the analysis of likes, visual content, and the broader context of campaigns associated with these accounts. This comprehensive approach could provide a richer understanding of how social media can contribute to or mitigate the stigma associated with mental health.

In conclusion, this study provides a snapshot of Instagram’s mental health landscape and delineates a path for future inquiry and action. The research offers a foundational perspective for health professionals, journalists, and social media influencers, informing strategies to enhance mental health literacy, foster progressive attitudes, and ultimately contribute to a more informed and empathetic society. As digital platforms evolve, so must our efforts to understand and harness their potential to positively influence mental health discourse and support.

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Appendix 1

Definitions:

Mental Illness: Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking, and behaviour. Examples include depression, anxiety disorders, schizophrenia, eating disorders, and addictive behaviours. Mental illnesses can disrupt a person’s ability to work, carry out daily activities, and engage in satisfying relationships. Despite their prevalence, these conditions are often misunderstood and stigmatized.

Anxiety: Anxiety is a normal and often healthy emotion. However, when a person regularly feels disproportionate levels of anxiety, it might become a medical disorder. Anxiety disorders form a category of mental health diagnoses that lead to excessive nervousness, fear, apprehension, and worry. These disorders alter how a person processes emotions and behaviour, causing physical symptoms. Mild anxiety might be vague and unsettling, while severe anxiety can seriously affect day-to-day living.

Depression: Depression is a common and serious medical illness that negatively affects how you feel, the way you think, and how you act. It causes feelings of sadness and a loss of interest in activities once enjoyed. It can lead to various emotional and physical problems and decrease a person’s ability to function at work and at home. Depression is more than just a about of the blues and requires long-term treatment for most.

Spiral of Silence Theory: The Spiral of Silence theory, proposed by Elisabeth

Noelle-Neumann, posits that individuals have a fear of isolation, which results from the idea that a social group or society in general might isolate, neglect, or exclude members due to their opinions. This fear of isolation leads to a spiral of silence where individuals are reluctant to express their minority views, particularly on controversial issues, to avoid being ostracized.

Agenda-Setting Theory: The Agenda-Setting Theory suggests that the media does not tell us what to think, but it is remarkably successful at telling us what to think about. This theory, proposed by Maxwell McCombs and Donald Shaw in the 1960s, posits that the media sets the agenda for public discourse by selecting specific issues, events, and topics for extensive coverage. As a result, these are perceived as necessary by the public, influencing public opinion and priorities. The theory underscores the power of the media in shaping the perceived significance of issues in the public mind.

Appendix 2

Code Definitions and Categories: