Mental Health Online: Twitter

Compared to Facebook, I didn’t think of Twitter as a useful place for discussing mental health issues. This was partly due to the 140 character limit; I couldn’t see the use of tweets for in-depth discussion compared to something like a blog post or video.

However, when I looked through my twitter feed more closely, there was a lot of talk about mental health. Most of the people talking were advocates; either they wanted to start conversations, to support mental health organisations, or start their own campaigns. And most of these advocates were survivors, using their experiences with mental health to show others why researching mental health matters.


Twitter doesn’t have the same kind of scare-headline news stories as Facebook, and there isn’t any research saying it affects people negatively. However, there is some research on ┬áresponses to individual hashtags. Shepherd et al studied the #DearMentalHealthProfessionals thread, a conversation set up by Amanda O’Connell in August 2013, and found there were four main types of discussion:

  • How mental health diagnosis affects people’s identities, and the way diagnosis affected their options for care.
  • The power imbalance between service users and professionals.
  • The way services offer support and the options they provide for functioning.
  • Relationships and communication between staff and patients, and communication within and between services.

Overall, people focused on how important someone’s own lived experiences are, and how much of an impact compassionate staff and professionals can have.

The conversation wasn’t negatively biased or over-critical; some Tweets were critiques of the mental health system in general, and criticism from personal experiences while others were encouragement and support for staff and services users, and gratitude from helpful experiences.
This was just one spontaneous two-day conversation, but people volunteered a lot of useful and in-depth tweets. Based on this, using Twitter for research seems feasible. The #DearMentalHealthProfessionals study didn’t look at any concrete benefits of using Twitter for the people involved, but it does show how easy getting opinions is. It suggests that Twitter could be useful as a hub: instead of holding everyone’s arguments, it could work as the central location where people pool links to resources and arguments.


Unlike Facebook or Tumblr, there are no “are you ok?” warnings on Twitter, and no built-in links to support. If you see someone send a tweet in crisis, the only way to get it noticed is to flag it as “sensitive material”; this might come across more as censorship than support. From my personal experience using Twitter, it wouldn’t be the best choice for someone experiencing a lot of distress, as it would probably feel inaccessible.

While some mental health organisations, such as SANE, provide links for readers in crisis, there are ways that system could be improved. Many of the links are for making appointments to other services, that may not be available for readers, or may be very confusing for people who have never seen mental health services before. Sharing links to 24/7 resources such as phonelines, and more informal/ welcoming support such online conversations might be more accessible for people in that situation.


As a balance between profession-focused sites like LinkedIn and informal sites like Facebook and Tumblr, Twitter is very useful for charities and organisations. Accounts from organisation staff and fundraisers can show the realities of just how much campaigns are needed, as well as showing the personality of the organisation.

It can also be used for conversations like #DearMentalHealthProfessionals; ideas that open up debates both academic and personal. Conversations between mental health staff and ex-service users could be a way of gaining a lot of information about how things work from “the other side”, in order to teach both people on both sides and people who have no experience with either end. Also, connections between staff in different services and locations may raise awareness of the “postcode lottery” nature of services as well.

P.S.- if you were interested by the #DearMentalHealthProfessionals tag, some similar conversations are;


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