Conference Agenda

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Session Overview
Health 2: Mental Health
Thursday, 03/Nov/2022:
3:30pm - 5:00pm

Session Chair: Katrin Tiidenberg
Location: EQ-110

32 seat flexible

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Influencer Economies and Uber therapy: A Qualitative Analysis of Social Media and Mental Health Therapy Apps

Holly Avella

Rutgers University, United States of America

In late 2021, Travis Scott received wide backlash when the musician responded to a massive tragedy at his concert in part by offering attendees a promotional deal on the mental health app BetterHelp. Olympian Simone Biles had famously dropped out of the Summer 2021 competition and was both lauded and lambasted through narratives of prioritizing mental health. Biles soon received sponsorship from Cerebral—another therapy app the gymnast now promotes through her social media. These cases and other high-profile influencer issues around therapy apps point to fraught ways that influencer economies and a neoliberal iteration of the psychiatric consumer movement come together in an age of mental health tech startups and the Uberization of therapy. This study takes Instagram and TikTok—social media platforms that have exploded with mental health content since the COVID-19 pandemic—as generative empirical sites to examine influencer marketing of therapy apps. Qualitative content analysis of >250 posts and their engagement content in this ongoing study reveal distinctive strategies and logics of mental health app marketing that work to mitigate key contradictions in modes of treatments and models of mental health. Examined through the analytical lens offered by biomedicalization theory, insights emerge regarding technoscientific identities, health surveillance technologies, and social media diagnostics. A critical psychology orientation asks who is best served by these mental health technologies and who may be left out, contributing to critical discussion around potential pathways to more equitable mental health care through media and technology.


Paula Saukko

Loughborough University, United Kingdom

Most research on social media and mental health takes a social psychological focus on associations between types of use (social comparisons) or content (idealised images of thinness) and negative effects. Drawing on critical media studies research on platforms, this presentation shifts the conversation towards exploring how social media platforms or mechanisms shape vulnerable users’ experiences of use and content. Interviews with people with eating disorders (EDs) (n=31) highlighted three key experiences: (i) messaging apps that afforded interpersonal communication with chosen trusted audiences and modes of interaction enhanced wellness, whereas platforms and features pushing interaction and extensive, competitive connections were distressing and shunned, (ii) diet influencers, reeled by algorithms, were especially harmful for people with EDs who sought to steer their feeds towards recovery influencers, which however could rehash triggering aesthetic codes informed by the attention economy; (iii) social media support groups, coaches and mental health advice were deemed useful, however the sheer plenitude of offer and business models also created a minefield. The findings map onto historical intertwining of the countercultural quest to open a space for user-generated content and interaction and commercial entrepreneurialism, both characterised by libertarianism. The participants sought to carve out spaces in social media with trusted friends and alternative vernacular content. Yet, the platforms catapulted them out of their comfort zones into harmful interactions and content streams. The problem here is not specific use or content, but libertarian and commercial social media infrastructures that do not afford safe spaces for vulnerable people with eating disorders or others.

Platform power and experiences from the margin: adolescents’ online vulnerability and mental health

Richard Graham1, Line Indrevoll Stänicke2, Tine Jensen2, Sonia Livingstone3, Reidar Schei Jessen2, Elisabeth Staksrud2, Mariya Stoilova3

1Good Thinking; 2University of Oslo; 3LSE - London School of Economics and Political Science, United Kingdom

Internet and social media use can be both beneficial and harmful for vulnerable youth, offering support and increased self-knowledge, but also exposure to adverse content. Research on the critical question of what makes a difference between the digital pathways to wellbeing or harm is minimal. However, there is some indication that how adolescents engage with the internet and its particular digital affordances makes a difference to their wellbeing outcomes. In this paper, we offer insights into the role of different dimensions of digital engagement in aiding or worsening internet-related mental health difficulties. We report on findings from cross-national comparative qualitative research with 62 adolescents aged 12 to 22 years old from Norway and the UK who experience internet-related mental health difficulties.

Findings show that young people actively engage with the digital world both by utilising its affordances but also shaping its parameters, sometimes going against the grain of what was envisioned by design. The adolescents we spoke to were generally skilled internet users, but sophisticated skills do not necessarily make for better mental health and wellbeing outcomes. Independent of digital skill, affordances may result in even riskier online engagement shaped by the operation of algorithms. At times this can breach young people’s abilities to counteract and cope with detrimental consequences. In many cases, we find that the algorithms are “out of sync” with adolescents’ state of mind and ability to cope, exacerbating their mental health difficulties. We conclude with reflections on the implications for platform design and therapeutic support.

Moderating mental health: Are automated systems too risk averse?

Anthony McCosker

Swinburne University of Technology, Australia

Across commercial social media platforms and dedicated support forums alike, mental health content raises important questions about what constitutes risk and harm online, and how automated and human moderation practices can be re-configured to accommodate resilient behaviours and social support. In work with three Australian mental health organisations that provide successful discussion and support forums, this paper identifies moderation practices that can help to re-think how mental health content is managed. The work aims to improve safety and resilience in these spaces, drawing insights from successful practices to inform algorithmic and moderator treatment of mental health content more widely across social media. Through an analysis of interviews and workshops with forum managers and moderators, I paper argue that platforms must incorporate strengths-based context (resilience indicators) into their moderation systems and practices, challenging simplistic assessments of mental health content as risk and harm.

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