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Social Media Interventions for Adolescent
and Young Adult Mental Health
The Healthy Minds Network Webinar Series
Session #7, May 2014
Welcome and About The
Healthy Minds Network
The Healthy Minds Network
Research-to-practice network based at University of Michigan
Public health approach to mental health among young people
HMN Research-to-Practice Objectives:
(1) produce knowledge (research)
(2) distribute knowledge (dissemination)
(3) use knowledge (practice)
3
Research-to-Practice Agenda
4
Today’s Webinar
 Overview: Research focusing on ways in which social
media can be used to improve adolescent and young
adult mental health
-Dr. Megan Moreno and Megan Pumper, University of
Washington and Seattle Children’s Research Institute
 Conceptual scaffolding behind the development of a
social media-based intervention
-Blake Wagner III, Healthy Minds Network
 Walkthrough of the tinyshifts social media platform
-Andrew Inscore, Healthy Minds Network
 Discussion
Please submit questions at any point throughout the webinar!
Depression and Social
Media
Megan Moreno, MD, MSEd, MPH & Megan Pumper
Our research team
Our mission as the Social Media &
Adolescent Health Research Team is to
advance society’s understanding of the
relationships between media and
adolescent health towards educating
adolescents, providing better care, and
developing innovations in adolescent
healthcare.
The big question
• Depression is major health concern among
adolescents and young adults
• Many people with depression go undiagnosed
or lack resources
• Can social media offer new
opportunities for early identification,
prevention or intervention of
depression?
Depression and Facebook
Studies to date using Facebook
• Study 1: Epidemiology of displays
• Study 2: Associations between displays and
symptoms
• Study 3: Peer interpretation
• Study 4: Communication preferences
Study 1: Epidemiology of
displays
• Used DSM criteria for major depressive episode
applied to Facebook status updates
• ~25% of profiles include one or more references to
symptoms
• 2.5% of ppts displays met criteria for MDE for
MDE
Study 2: Associations between displays
and symptoms
• Participants coded as “displayers or non-displayers”
• All participants completed PHQ-9
Study 3: Peer interpretation
• Focus groups with college students
• “What do you think when you see a
reference to depression on Facebook?”
Results
“It’s like they don’t feel comfortable enough
to say it in person but they really want
someone to reach out to them… It’s easier
to talk about it on Facebook where you’re
not directly complaining to someone. And
then if someone wants to help you they
will.”
Results
“If I was a close friend I would definitely say
something. But I know there are people that
have all these friends on Facebook and talk
to them maybe once a year. If they had
something in their status update I wouldn’t
really think anything of it because I don’t
really know them.”
Study 4: Communication
preferences
• How do college students want to be approached
regarding displayed Facebook references to
depression?
• Interviews with college students
• Coding using classical content analysis
Results
• College students were open to being approached
by friends or close peers and preferred the
approach to be in person
• College students were less enthusiastic about
being approached by professors or advisors
and suggested the approach could be initially via
email
• College students were wary of being approached
by university officials or administrators
Results
• For both friends and known adults, taking an
inquisitive and supportive approach of asking
“How are you doing? Do you want to talk about
anything?” or “I saw your Facebook post and was
concerned about you” was noted in several
interviews.
Future directions
• What is real-time association between display and
symptoms among college students with depression?
• Other social media sites?
• Intervention strategies?
Depression and Twitter
Introduction
• Depression is a common and pervasive behavioral health
issue
• Many individuals with depression go untreated
• Prior studies have investigated using FB to identify
individuals with depression, but Twitter is yet to be
studied
The purpose of this study was to examine if and how the topic of
depression is being discussed on Twitter.
Methods
•
Setting: Tweets were collected from www.twitter.com during one week in the
summer of 2013.
•
Content Selection:
• Tweets were collected using the software, DiscoverText
• Search terms= depressed and depression
• 1000 tweets were coded for depression content
•
The codebook:
• A pre-existing codebook was adapted
• Categories of originality of tweet, format, and subject of tweet, as well as other
related factors to depression
•
Analysis
• 3 trained coders evaluated tweets
• Descriptive statistics were used to examine counts within categories
Results
•
The tweets most commonly consisted of: •
• Unoriginal content (60.4%)
Content of Tweets
3.1%
36.6%
Original
Unoriginal
Both
60.4%
• References in first person
(45.1%)
Subject of Tweets
1.0%
34.0%
45.1%
19.9%
Self
Other
General
999
The search resulted in
297,107 tweets.
• ~8% of tweets were
excluded due to
incomplete content
• References to personal
depression symptoms or
experiences (49.4%)
0.8%
5.6%
Format of Tweets
1.0%
Personal statement
Belief about depression
Fact/research
20.9%
22.4%
49.4%
Tip/resource
News
Other
Results
•
Of the tweets that were original and referenced personal information
(n=212), 128 (60.4%) tweets referenced one or more symptoms of
depression.
• 7.8% of these tweets described symptoms increasing in severity
140
120
100
80
60
40
20
0
125
Tweets Referencing Depression
Symptoms (n=128)
10
4
6
6
5
11
0
5
1
Related Factors
n(%)
Increase in symptoms
10(7.8)
Irritability
7(5.5)
Stress
5(4.0)
Rumination
5(4.0)
Discussion
• Depression was referenced on Twitter
• Symptoms discussed in clinical visits were found on this website
• Healthcare providers should be aware that Twitter is a
potential outlet for discussions about depression
Discussion
• Limitations
• Lack of knowledge about excluded tweets
• Search terms selected for depressed mood
• Search was limited to public Twittersphere
• Future research
• Examining the validity of these displays
• Investigating the feasibility and acceptability of reaching out
to individuals via this website
Conclusion
• We present two studies of using social media to
investigate depression
• Conclusions
• Social media is accessible
• Many people display depression on social media
tinyshifts: A pocket guide to young adulthood
Peer insight on
how to flourish and manage the
seemingly unmanageable.
Conceptual Scaffolding
The Theory and Practice of Group Psychotherapy
-Irving Yalom – Stanford 1970
• Universality
• Altruism
• Instillation of hope
• Imparting information
Conceptual Scaffolding
(con.’t)
• 60% seek health information online
• 45%-57% share health-related knowledge on
social media channels
Greene & Kesselheim, 2010; Lane & Twaddell, 2010; WeaverLarisey, Reber, & Paek, 2010
Conceptual Scaffolding
(con.’t)
• 1 in 5 seek out others with similar health concerns
online (Fox, 2011)
• Social support is essential to health and wellbeing
(Cohen & Hoberman, 1983)
• “A positive relationship between having health
concerns and seeking health-related social support”
• Seeking health information on Facebook was linked to
positive health self-efficacy (Oh at al., 2013)
Comments related to seeking
mental health tx
• “I wouldn’t like to speak about my problems. I
really like to do things my own way,
independently.”
• “I’d prefer to talk to someone on the Internet and
then maybe make my way to a counselor or a
psychiatrist.”
Ellis et al., 2013
Acceptability of mobile
health-related apps
• “No one has to know you’re doing it on your mobile.”
• “You can access it whenever you want and it just fits
into your lifestyle.”
• “…I know the times I feel the lowest or most stressed
are not so much sociable hours.”
• “To actually go and meet someone face-to-face would
probably be more difficult than going online…I can do
it in the privacy of my own home, in my own time. No
one is going to pass judgment; no one is going to look
at me.”
Schuster, Drennan, & Lings, 2013
Conceptual Scaffolding
(con.’t)
Gowen et al., 2012 Portland State University
•
Conducted online survey of 207 young people with psychological issues
•
Reported benefits of SNS
-reduces social isolation
-increases social engagement
•
Characteristics of SNS site devoted to people with similar issues:
-info about how to live independently
-how to manage mental health related issues
-high interest in helping others
Introducing: tinyshifts.com
Potential benefits of
tinyshifts
Low response cost
Anonymity/pseudonymity
Confidentiality
24/7 access
Supplement to care
Entry point to care
Potential for prevention and early
intervention
• Research implications (e.g., inform
intervention development)
•
•
•
•
•
•
•
Potential drawbacks of
tinyshifts
• Manual moderating of content
• Negative contagion effect
• Offensive or insensitive responses
tinyshifts film competition
COMING THIS FALL!
Blake Wagner
Contact: inkblots@umich.edu
Andrew Inscore
andrew.inscore@gmail.com
healthymindsnetwork.org
Discussion
About Participating
To pose a question, please submit your question using
the “Chat Room” in the bottom corner of the screen. A
moderator will then read your question to the group.
Discussion
•
What do you see as the long term negative effects of social media
on an individuals ability for interpersonal connection?
•
I work closely with our counseling center and behavioral health
department on campus, so learning more about how to reach
students on campus via social media will be very helpful!
•
Any information the panelists can provide on prevalence of usage
for these interventions would be wonderful. In addition, what do
the panelists see as possible ethical pitfalls in utilizing these types
of interventions with this population?
References
•
Cohen, S., & Hoberman, H.M. (1983). Positive events and social supports as buffers of life change stress. Journal of Applied Social Psychology, 13, pp. 99–
125 0.1111/j.1559-1816.1983.tb02325.x
•
Ellis L.A., Collin P., Hurley P.J., Davenport T.A., Burns J.M., Hickie I.B. Young men's attitudes and behaviour in relation to mental health and technology:
implications for the development of online mental health services. BMC Psychiatry 2013;13:119.
•
Fox, S. (2011). Peer-to-peer healthcare. Pew Internet & American Life. http://www.pewinternet.org/Reports/2011/P2PHealthcare.aspx.
•
Gorham, R., Carter, L., Nowrouzi, B., McLean, N., & Guimond, M. (2012). Social Media and Health Education: What the Early Literature Says. The
Journal of Distance Education, 26, 1-10.
•
Gowen, K., Deschaine M., Gruttadara D., & Markey, D. (2012) Young adults with mental health conditions and social networking websites: Seeking tools
to build community. Psychiatric Rehabilitation Journal 35(3), 245-50.
•
Greene, J., & Kesselheim, A. (2010). Pharmaceutical marketing and the new social media. The New England Journal of Medicine, 363(22), 2087-2089.
•
Lane, S. & Twaddell, J.W. (2010). Should social media be used to communicate with patients? The American Journal of Maternal/Child Nursing, 35(1),
6-7.
•
Oh, Hyun Jung, Carolyn Lauckner, Jan Boehmer, Ryan Fewins-Bliss, and Kang Li. Computers in Human Behavior Vol. 29, No. 5. 2013
•
Schuster, L., Drennan, J., & Lings, I. N. (2013). Consumer acceptance of m-wellbeing services: a social marketing perspective. European Journal of
Marketing, 47, 1439-1457.
•
Weaver-Lariscy, R., Reber, B., & Paek, H. (2010). Examination of media channels and types as health information sources for adolescents: Comparisons
for black/white, male/female, urban/rural. Journal of Broadcasting and Electronic Media, 54(1), 102-120.
•
Yalom, I.D., The Theory and Practice of Group Psychotherapy. New York: Basic Books, 1970.