Mental health discourse and social media: Which mechanisms of cultural power drive discourse on Twitter

• Published in: Social science & medicine (1982) Vol. 263; p. 113250
• Main Authors: Pavlova, Alina, Berkers, Pauwke
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2020; Pergamon Press Inc
• Subjects: Audiences; Budgets; Cognitive-behavioral factors; Cognitive-emotional currents; Cultural power; Disability; Discontent; Discourse; Discourse analysis; Emotional energy; Energy; Health care expenditures; Health Policy; Health problems; Humans; Mapping; Marginality; Mass media; Mental disorders; Mental Disorders - epidemiology; Mental Health; Mental health care; Mental health policy; Panel data; Power; Sentiment analysis; Social Media; Social networks; Social Stigma; Stigma; Topic modeling; Topics; Cultural power; Topic modeling; Emotional energy; Stigma; Social media; Mental health; Discourse analysis; Cognitive-emotional currents
• ISSN: 0277-9536; 1873-5347; 1873-5347
• DOI: 10.1016/j.socscimed.2020.113250

The global burden of mental health disorders has increased steadily during the past decade. Today, mental illness is the leading cause of total years lived with disability. At the same time, global mental health policies and budgets fall short of addressing the societal burden as mental health discourse languishes in the shadows due to stigma. As social media have become an increasingly popular source of information, they create opportunities as well as threats for mental health discourse. On the one hand, social media can help to bring awareness to stigmatized topics as they give marginalized members of society the possibility to share experiences and voice their discontent. On the other hand, mental health discourse on social media may lead to stigmatization. To date, little is known about social media mental health discourse and what drives it. This study addresses these research gaps by (1) mapping the mental health discourse on Twitter and (2) analyzing mechanisms of cultural power through which some mental health topics take prevalence over the others. Drawing on Twitter data, this research employs innovative methods of topic modeling, sentiment analysis, and panel data regression analyses. Theoretically, it combines, in a multidisciplinary fashion, concepts such as emotional energy and cognitive focus from sociology and bandwagon behavior from economics. Our findings show that low-cost attention mechanisms are ineffective in fostering online mental health discourse, whereas emotional energy and discursive variability have a positive influence by engaging audiences, creating online solidarity, and speaking to worldviews of audiences from different walks of life. Social media mental health discourse is also shown to be quite diverse and more stigma-neutral than such discourse in traditional media. •Emotional energy (engagement, confidence, and solidarity) drives mental health discourse on Twitter.•Low-cost attention generating mechanisms are ineffective in fostering online mental health discourse.•Online mental health discourse is subject to cognitive-emotional currents and requires content variability.•Discursive diversity drives general mental health discourse, subject-focused tweets drive the retrievability of a topic.•Stigma-related online mental health discourse is driven by sensationalism and positive emotions through the use of sarcasm.