Mental health messages on TikTok: Analysing the use of emotional appeals in health-related #EduTok videos

Abstract

Objective:

This study aimed to evaluate how health educators use emotional appeals on the social media site TikTok to promote well-being, engage audiences and reduce mental health stigma.

Design/Method:

Our research team conducted a quantitative content analysis of 400 TikTok videos centred on health education. We evaluated the frequency of mental health content compared with general health education content and associated views, engagement and use of emotional appeals.

Results:

Mental health content frequently appeared in #EduTok health videos and earned significantly greater reach than general health content. However, videos discussing mental health earned less engagement and relied less on emotional appeals. Mental health content mainly relied on affiliation, hope and sorrow message appeals, although the presence of these appeals did not significantly affect engagement. General health content utilised personal stories, expert credentials and emotional appeals more frequently than mental health content.

Conclusion:

Evidence from this research suggests that mental health educational content underperforms general health videos and underutilises emotional appeals on TikTok. Health educators must critically analyse and adjust message strategies to enhance audience reception, taking note of success across health topics. We discuss the implications for how practitioners can use TikTok to reduce stigma and promote positive mental health with emotionally engaging content, especially among young audiences.

Keywords

Emotional appeals health education mental health social media TikTok

Introduction

Mental health concerns currently affect an estimated 10%–20% of young people worldwide (Binagwaho and Senga, 2021). The World Health Organisation (2023) defines mental health as ‘a state of well-being in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community’ (para. 2). Despite having the highest prevalence of mental health concerns, young adults under-utilise mental health services (Adams et al., 2014). This lack of engagement is attributed to several factors including limited access to resources, feeling of hopelessness and perceived stigma to help seeking, in addition to external constraints such as economic, cultural and racial disparities (Gulliver et al., 2010). These obstacles underlie the need to understand how health practitioners can use alternative approaches for sharing mental health education messages, especially those that can address traditional help-seeking barriers (Naslund et al., 2020).

Social media, including popular video-sharing platforms such as TikTok, have emerged as important tools for connecting at-risk and in-need populations with health education resources (Guidry et al., 2020). The appeal of such platforms lies not only in the accessibility and anonymity they provide but also in their potential to evoke emotional responses through entertaining and inspiring content (Basch et al., 2021). This is important given that emotions play a role in shaping how people react to and interact with the content they encounter on social media (Merga, 2021). Emotions here may be defined as ‘internal, mental states representing evaluative, valenced reactions to events, agents, or objects that vary in intensity’ (Nabi, 2010: 153). There is an overall lack of research on how to best use TikTok and similar video-based platforms to promote mental health, and theory-driven research could play a key role in assisting health educators identify the best strategies to emotionally engage the audiences they wish to reach (Auxier and Anderson, 2021; Clement, 2020).

In this study, we analyse how content creators use TikTok to share mental health education content, contextualised within the framework of emotional contagion theory. This theory posits that emotions can be transmitted through observation, imitation and direct experience (Coviello et al., 2014). Social media has the potential to impact a user’s emotional state, to experience a range of emotions, through content exposure (Escobar-Viera et al., 2020). Research suggests that emotions conveyed when sharing mental health messages can affect whether audiences will approach or avoid new information (Horan et al., 2012). Yap et al. (2019) conducted an analysis to explore how healthcare professionals communicate messages about mental health, focusing on the use of emotional appeals in formal campaigns on YouTube. Their study examined the inclusion of eight distinct emotional appeals including hope, affiliation, humour, heroic, ease/convenience, fear, guilt/shame and sorrow appeals. Building on Yap et al.’s (2019) work, in this paper, we explore how these appeals are used on TikTok in general health and mental health content and analyse how these emotional contexts are associated with video views and social media engagement. The findings from this study can enhance understanding of how health educators can promote emotional and mental health content on social media, ultimately leading to more effective communication of critical information. The following review provides an overview of mental health promotion on TikTok including affordances of the platform, emotional cognition theory and audience engagement.

Affordances of TikTok and its affective atmosphere

TikTok has rapidly gained popularity as a short-form video creation and sharing app. To understand how health information circulates on TikTok with the platform affordances, it is useful to consider the concepts of affective atmospheres coined by Anderson (2009). Videos on the platform typically range from 15 seconds to 10 minutes, with shorter clips being the most popular (Southerton and Clark, 2022). TikTok provides different built-in features that allow users to create content using elements such as additional sound effects, lip-sync, emojis, hashtags, preset video effects and so on. In addition, it also features a unique logic design that encourages imitation and replication of short videos (Zulli and Zulli, 2022). Dancing and meme-making have been popular viral content among its user base (Abidin, 2021), who are predominantly young, with 28% of global users being under the age of 18 and over 60% under 30 (Iqbal, 2022).

An affective atmosphere is an intangible, yet influential mood or feeling present in a shared space (Southerton, 2021). The affective atmosphere of TikTok may refer to the feelings that arise from the interactions of individuals with content and its features, which are constituted by the platform’s affordances. For example, TikTok uses an algorithmically curated ‘For You’ page as the default feed users see upon launching the app. This feed is the user’s affective atmosphere and is tailored to each user’s preferences, considering their past activities, interactions and viewing history and creating a sense of togetherness and community based on shared engagement (Kaye et al., 2022). However, algorithm-based atmospheres can have drawbacks. A Wall Street Journal (2021) investigation into TikTok found that when someone watches videos that express negative emotions such as despair or sadness, the platform’s algorithm will prioritise and inundate audiences with more content with similar emotions in their ‘For You’ feed. Fredrickson’s (2000) broaden and build model suggests that health interventions that have positive emotional valence are essential for helping individuals counter negatively valenced emotions including sorrow, fear and anger. Experiencing a range of emotions including positive, mixed and negative emotions is a normal and necessary aspect of an individual’s daily life (Carstensen et al., 2000). Considering the potential for emotional contagion on social media and frequently evolving popularity of new platforms, there is a need to know the extent to which mental health education videos online are using emotionally charged messages and how these messages are reaching and engaging audiences (Guidry et al., 2020).

Emotional appeals and emotional contagion theory

The affective atmosphere of TikTok is strongly influenced by message characteristics, including emotional appeals, which are widely used to enhance audience engagement (Lee and Hong, 2016). This study aims to describe what are the characteristics of the affective atmosphere of the platform and how emotional appeals in TikTok content such as affiliation, humour, joy, shame, fear and guilt are engaged with. According to emotional contagion theory, social interactions can impact the transmission of emotions from one person to another, leading to behavioural synchronisation (Hatfield et al., 1993). Understanding the emotional appeals of TikTok videos that drive emotional contagion can help message designers develop effective engagement strategies.

The literature on message appeals used in the virtual environment, particularly for mental health messages disseminated through social media, is limited. Only a few studies have explored this topic, but they offer important insights. Bail (2016) found that emotional posts about autism spectrum disorder were viewed as more than purely informational posts. Lister et al. (2015) suggested that adding humour appeals to healthful eating messages increases shares on Facebook and Twitter. However, few studies, to the best of our knowledge, have explored message appeals in the context of mental health communication on social media. Hui et al. (2015) found that Facebook advertisements about depression with happy faces had a higher click-through rate than those with sad faces, indicating that positive message appeals are more effective for attracting attention. In Yap et al.’s (2019) study, the researchers found that while sorrow was the most frequently used appeal to generate comments, it was negatively correlated with the number of likes and shares the content received. In contrast, the use of affiliation and hope appeals appeared to resonate more with the audience, as indicated by a positive impact on the number of shares. This suggests these two appeals could potentially engage a larger audience and support the broadening and building of emotional perspective (Fredrickson, 2000). Together, these findings inform this study, which also seeks to analyse audience engagement as a primary outcome.

Mental health promotion and TikTok

Research highlights how social media platforms may be potential channels for addressing mental health care barriers as the platform affordances of TikTok enable health educators to present information in an appealing way shaping the culture and the affective atmosphere. By doing so, TikTok creates a space for anonymity and confidentiality for young people who suffer from mental health issues and may not access other resources. In addition, these platforms contribute to diversifying voices and parasocial relationships, creating intimacy among health educators and the users of the platform (Southerton, 2021). For instance, studies highlight how doctors and health educators use platform-specific affordances such as video features and audio memes to enhance relatability and strengthen connections with their audience (Stein et al., 2022).

Overall, there remains a need for health education providers to share formal, credible content online as this is frequently absent. Guidry et al. (2020) analysed depression, suicide and self-harm content on Pinterest and found that posts rarely originated from official health sources. Moreover, posts often featured melancholic quotes that could potentially exacerbate feelings of despair and isolation and the promotion of similarly valenced emotional content. In this study, we evaluate the short-form video platform TikTok, as a channel for mental health education content. Significantly, research has shown that teenagers, a crucial audience of electronic health content, prefer engaging video content when seeking information compared with text-based information (Chan and Allman-Farinelli, 2022). Studies have found that short videos are widely favoured for their ability to deliver messages quickly (Ye et al., 2022), as well as the fact that they are easier to follow for young adults (Lim et al., 2022), thereby enhancing effectiveness for health-related educational purposes (Tuong et al., 2012). Health professionals must find engaging ways to connect with audiences (Petteway, 2020) and there is an opportunity for research to be specifically conducted on audience engagement with mental health promotion (McCashin and Murphy, 2023).

Audience engagement

Views and engagement (e.g. likes, comments and shares) on social media provide direct and quantifiable means of assessing user interest and reach of content. In this study, we operationalise views as a metric indicating how many people a video reaches. In addition, we define social media engagement as the degree of attention, interest and interaction that TikTok users demonstrate towards video content on the platform. These metrics can serve as a proxy for content visibility and, to a lesser extent, the resonance of content with an audience (Cho et al., 2014; Neiger et al., 2013; Park et al., 2016).

Importantly, the presence and frequency of health content on social media can provide insight into the topics that are being discussed and shared and may be indicative of user interest. When users frequently search for, view, or interact with specific health-related content, the platform’s algorithms may learn to prioritise similar content, effectively creating a feedback loop that can amplify the topic’s presence. The volume of unique user-generated posts on a health topic is another indicator of how interested an audience is in a subject or organisation (Kohler et al., 2023; Neiger et al., 2013). Different metrics are associated with different levels of engagement across different social media platforms (Cho et al., 2014; Neiger et al., 2013). For example, Yap et al. (2019) highlight that liking content is an easy way to express emotional sentiments about a post. However, individuals may be more prone to view content passively without liking it if they perceive stigma being associated with publicly liking content related to a perceived deviant topic (Jones, 2015). Thus, evaluating both the views and social media engagement with content can provide distinct outcomes for descriptive analysis.

Overall, engagement can encompass a spectrum of emotional responses, recognising that both positive and negative appeals can foster deep and meaningful interactions. Hence, exploring the frequency of content, how often it is viewed by individuals, and their engagement behaviours can provide important insights into audience reception. We identified three research questions (RQs) to address these general inquiries:

Research questions

RQ1: To what extent is mental health content present in TikTok health education videos, and how do audiences engage with this content?

RQ2: What types of emotional message appeals are used in mental health TikTok education videos compared with other health topics, and which appeals generate the highest engagement?

RQ3: How is credibility communicated in mental health education content on TikTok?

Methods

To answer the proposed RQs, we conducted a quantitative content analysis of 400 TikTok videos that included the terms ‘health’ and ‘EduTok’ in the video hashtags. EduTok is an educational initiative, in which individuals are encouraged to share health-related educational content. These two search terms allowed us to explore the presence of emotional appeals across educational health content on TikTok to have a baseline of appeal effectiveness. Our team, which consisted of the three corresponding researchers, used the data extraction tool Octoparse to obtain our sample. This tool collected a total of 884 links to videos that included our chosen hashtags and then we used a random digit generator to select a random sample of videos to code. Our dataset primarily included English language content. The research team collected data in April 2022, which was before the availability of the TikTok Research API.

Content coding and intercoder reliability

Over the course of 2 months, two researchers on our team met to develop a codebook based on best practices for quantitative content analysis (Jordan et al., 2010). We used established codes from former research, with message appeal codes directly adapted from Yap et al.’s (2019) work (see Figure 1). The codebook also included formal categories of health behavioural targets adapted from the World Health Organisation’s list of disease prevalence and former research from Guidry et al. (2020). Our coding for the concept of mental health considered videos showcasing ability realisation (i.e. content that highlights or encourages the realisation of an individual’s abilities or potential including motivational talks, skill-building activities, or personal development strategies); coping strategies (i.e. videos that offer strategies, tips or advice on managing everyday stress, such as mindfulness techniques or stress relief exercises) and videos that discuss mental illnesses (i.e. depression, anxiety and bipolar disorder), including potential discussions of symptoms, experiences, stigma reduction and promoting understanding and support for mental health conditions. We also coded whether videos included individuals’ personal medical experiences, and if content creators included medical credentials in the creator’s bio, the video caption or the video itself. The primary researchers (SIJ and NHO) tested the code and met several times to refine concepts and establish code validity. After a period of training, we independently coded 50 posts to reach intercoder reliability (see Table 1 for code definitions and Krippendorff’s alpha coefficients; Hayes and Krippendorff, 2007).

Figure 1.

Example mental health content. (a) A video that used a combination of affirmation appeals and fear appeals to suggest self-help podcasts that can decrease excessive social media use. (b) A video that used affirmation and efficacy appeals to promote an idealised wellness lifestyle (e.g. ‘how to be “that girl”’). (c) A video that used sorrow appeals to discuss how pain affects well-being.

Table 1.

Krippendorff alpha coefficients.

Construct	Codebook definition	A
Message appeals (adapted from Yap et al., 2019)
Affiliation	Feelings of love, belonging and togetherness, including self-love	0.791
Hope	Feelings of hope and reassurance	0.832
Humour	Feelings of fun, happiness, laughter, joy, light-heartedness, cheerfulness, comedic	0.872
Heroic/successful	How engagement in behaviour reflects a brave, noble, admirable deed	0.780
Ease/convenience	Describes how little effort is needed to engage in behaviour	0.891
Fear	Feelings of terror, dread, anxiety, panic and alarm	0.852
Guilt/shame	Feelings of shame and remorse	1.000
Sorrow	Feelings of sadness, worry, loss, misery and unhappiness	0.884
Message characteristics
Credentials	Poster identified health or medical credentials	0.841
Expert advice	Poster positions themselves as an expert and shares advice, tips or information and	0.749
Personal story	Poster shares a patient testimonial or personal health story	0.791

Plan of analysis

Social media engagement data including views (e.g. how many people viewed the chosen videos) and engagement (e.g. how many people liked the videos) were our primary outcome variables of interest. These metrics are sensitive to extreme outliers, so we evaluated median rather than mean differences using nonparametric Mann–Whitney U tests (Guidry et al., 2020). This strategy allowed us to analyse how engagement differed based on the presence or absence of mental health topics and message appeals. Then, we used Chi-square tests to see the expected and actual counts for mental health content with comparison groups, including message appeals and user characteristics. Social media engagement data are measured at the ratio level, as they have a meaningful 0. All other concepts that we used in this research were evaluated using nominal-level codes, with 0 representing absent and 1 representing present. All nonparametric tests used relied on independent samples, with our inquiries focusing on instances when mental health topics were either present or absent.

Results

The first research question asked about the extent to which mental health content is present on TikTok and how audiences engage with this content. Of the content present within our sample, 26% of videos (n = 104) discussed issues related to mental health. Other main health issues included diet (n = 112), exercise (n = 82), sexual health (n = 55) and other (n = 106) (Figure 1). All other mentions had less than 10 observations. These issues included topics such as COVID-19, cancer, violence prevention and cardiovascular health.

In analysing video views and engagement, we found that videos that did not mention mental health issues received statistically significantly more likes, shares and follows than content that did mention mental health. There were no statistical differences between mental health content and general health content for views and comments (see Table 2).

Table 2.

Post-engagement analysis.

Median views and engagement scores for the presence or absence of mental health topics
	mental health	Mental health	Mann-Whitney U	p-Value
	Topic present	Topic absent	Mann-Whitney U	p-Value
Views	6,230.00	23,450.00	13,643.00	0.08
Likes	519.5.00	1,784.00	12,930.00	0.01*
Comments	14.5.00	36.00	13,808.50	0.11
Shares	15.00	48.00	13,353.00	0.04*
Followers	54,500.00	84,500.00	13,291.00	0.03*
Median views scores for emotional appeal present or absent in mental health videos
	Median views	Median views
Appeal	Topic present	Topic absent	Mann-Whitney U	p-Value
Affiliation	40,550.00	2,581.00	1,612.00	<0.05*
Hope	8,186.50	6,230.00	1,139.50	0.93
Humour	111,500.00	4,257.00	1,002.00	0.10
Heroic	435,400.00	5,593.00	593.00	0.17
Ease	33,900.00	5,593.00	324.00	0.67
Fear	3,817.50	7,592.50	529.00	0.81
Shame	2,050.00	7,949.50	396.50	0.41
Sorrow	2,135.00	10,500.00	919.00	0.47
Median engagement scores for emotional appeal present or absent in mental health videos
	Median likes	Median likes
Appeal	Topic present	Topic absent	Mann-Whitney U	p-Value
Affiliation	2,039.00	338.00	1,581.00	0.06
Hope	911.00	507.50	1,121.00	0.82
Humour	4,721.00	373.00	935.00	0.28
Heroic	46,000.00	507.50	585.50	0.20
Ease	9,083.50	507.50	339.50	0.52
Fear	232.50	599.00	519.00	0.73
Shame	307.50	599.00	438.00	0.72
Sorrow	290.00	707.50	920.00	0.48
Median views scores for emotional appeal present or absent in general health videos
	Median views	Median views
Appeal	Topic present	Topic absent	Mann-Whitney U	p-Value
Affiliation	422,050.00	12,550.00	9,152.50	0.002**
Hope	54,400.00	17,500.00	7,064.00	0.19
Humour	54,800.00	8,024.00	12,365.00	0.005**
Heroic	327,400.00	17,900.00	2,806.50	0.20
Ease	112,600.00	17,000.00	6,059.00	0.10
Fear	88,300.00	13,900.00	8,252.50	0.01**
Shame	11,300.00	29,900.00	2,861.00	0.94
Sorrow	13,550.00	27,750.00	3,860.00	0.76
Median engagement scores for emotional appeal present or absent in general health videos
	Median likes	Median likes
Appeal	Topic present	Topic absent	Mann-Whitney U	p-Value
Affiliation	46,200.00	866.50	9,239.00	<0.001***
Hope	3,542.50	1,226.50	6,961.00	0.27
Humour	3,463.00	829.00	11,868.50	0.03*
Heroic	19,700.00	1,498.00	2,919.50	0.11
Ease	4,227.00	1,227.00	6,190.50	0.05*
Fear	5,467.00	1,050.00	8,149.00	0.02*
Shame	1,862.00	1,743.00	3,201.50	0.40
Sorrow	2,134.50	1,697.00	4,142.00	0.73

p-value is less than 0.05, **p-value is less than 0.01, ***p-value is less than 0.001.

Regarding appeals, posts that relied on affiliation, humour and fear received significantly more views than posts that did not include these appeals. Furthermore, posts that included affiliation, humour, heroic, efficacy and fear appeals received more likes than those that did not include these appeals. Results from a Chi-square analysis showed an association between posts that included mental health and the use of affiliation appeals and sorrow appeals (Table 3), whereas non-mental health posts were associated with humour appeals and ease/efficacy appeals. Hope, heroic, fear and guilt appeals were used equally between mental health and non-mental health topics.

Table 3.

Observed frequencies of videos for mental health presence and message appeals.

	Affiliation appeal present
Mental health present	42	40.30% of 104	χ² (1) = 15.11, p < .001, φ^a = 0.19
Mental health absent	62	20.94% of 296
	Hope appeal present
Mental health present	32	30.80% of 104	χ² (1) = 8.08, p < .004, φ = 0.14
Mental health absent	52	17.60% of 296
	Heroic appeal present
Mental health present	10	9.6% of 104	χ² (1) = 1.83, p = .176
Mental health absent	17	5.7% of 296
	Humour appeal present
Mental health present	19	18.30% of 104	χ² (1) = 13.79, p < .001, φ = –0.18
Mental health absent	113	38.20% of 296
	Ease/efficacy appeal present
Mental health present	6	5.8% of 104	χ² (1) = 4.84, p = .028, φ = –0.11
Mental health absent	41	19.9% of 296
	Fear appeal present
Mental health present	12	11.50% of 104	χ² (1) = 3.21, p = 0.07
Mental health absent	57	19.30% of 296
	Guilt/shame appeal present
Mental health present	10	9.6% of 104	χ² (1) = 3.21, p = 0.07
Mental health absent	21	7.1% of 296
	Sorrow appeal present
Mental health present	26	25% of 104	χ² (1) = 14.12, p < 0.001, φ = 0.12
Mental health absent	30	10.1% of 296

Phi (φ) effect sizes are featured for statistically significant relationships. All effects were within the small to moderate range.

Finally, nearly half of the posts in the sample were either framed as an expert opinion (n = 47) or as a personal health story (n = 50), and these frames were used similarly across the sample of mental health and non-mental health videos. The results of a Chi-square test showed an association between the portrayal of medical credentials and post content, as posts that did not mention mental health had a higher proportion of videos in which qualified medical professionals were present (see Table 4).

Table 4.

Observed frequencies of videos for mental health presence and message characteristics.

	Credentials present
Mental health present	20	19.20% of 104	χ² (1) = 12.589, p < .001, φ = –0.178
Mental health absent	113	38.17% of 296
	Framed as an expert opinion present
Mental health present	47	45.20% of 104	χ² (1) = 2.806, p = .09
Mental health absent	162	54.70% of 296
	Personal health story present
Mental health present	50	48% of 104	χ² (1) = 7.757, p = .005, φ = 0.139
Mental health absent	97	32.77% of 296

Phi (φ) effect sizes are featured for statistically significant relationships. All effects were within the small to moderate range.

Discussion

This study provides both practical and theoretical insights into how TikTok is used to promote mental health content. The emotional appeal messages used in formal mental health campaigns have often been evaluated (Donovan et al., 2016; Livingston et al., 2013; Wright et al., 2006). However, it is crucial to comprehend the kinds of messages that are widely disseminated through more informal channels, such as those posted on TikTok and other social media platforms (Latha et al., 2020). Mental health messages on TikTok have the potential to reach in-need, at-risk and young audiences in a virtual place where they spend an increasing amount of time. These informal channels may help to reduce stigma about depression, anxiety and other mental health concerns (Yap et al., 2019). Taken together, our findings can critically improve how psychologists, counsellors, therapists and clinicians use TikTok and other video-based social media to share evidence-based mental health advice and information.

The data from this study suggest that TikTok users willingly share their personal mental health stories, and this content often incorporates positive affiliation appeals and sorrow appeals. However, personal stories are mostly posted by people who do not have medical credentials and are talking based on their personal experiences, not in terms of psychological and medical diagnoses, treatments or research findings. Two main takeaways from these findings are that personal stories help engage more with the audience, but they also hold the potential of promoting information that is not necessarily correct. Future study may try to investigate the extent to which mental health-related personal stories use health belief model constructs (Rosenstock, 1974) and how content aims to influence health behaviours such as interpersonal disclosure or help-seeking.

Our data also reveal that general health-related videos utilised more qualified medical professionals and consequently received more statistically significant likes, shares and follows than content that focused on mental health issues. This suggests that mental health education videos might try using more professional figures in addition to highlighting personal stories in order to reach higher engagement. Our review of platform affordances suggests that message types that get more viewed and liked algorithmically circulate more within the affective atmosphere. In this study, we found that positive appeals, specifically affiliation and heroic appeals, get circulated more than negative appeals. However, an increase in views did not translate to engagement. This is consistent with Yap et al.’s (2019) research that investigated engagement with emotional appeals on YouTube. Findings revealed that mental health videos with positive appeals were viewed most, but only sorrow appeals generated comments. Our findings thus suggest that health educators should use more positive appeals if the goal is to reach a larger audience and raise awareness. Affiliation appeals overall were highly engaged with for general health content, and comparing strategies across topics may be of interest in future studies.

Furthermore, for general health content, efficacy appeals received higher engagement, yet were under-utilised, and this finding did not translate to mental health content. Public health advocates and practitioners may wish to consider the use of more uplifting and efficacious messages to responsibly engage audiences with mental health education content. Overall, there is an opportunity for health educators and practitioners to use TikTok to promote mental health, as most of the videos in our sample came from laypeople. However, while it is important for individuals to share their stories and reduce stigma related to mental health, it is equally important for messages to prominently feature evidence-based resources and evidence that comes from properly credentialed professionals and educators.

Limitations

There are several limitations to this work. First, the study used a quantitative content analysis to consider the views and engagement associated with mental health content. It is important to recognise that TikTok users may be engaging with content in ways that cannot easily be quantified, and future research may consider the use of other methods of data collection and analysis including evaluating digital trace data (Ohme et al., 2023) or through diary studies (Barthorpe et al., 2020). These could provide a user eye view of content resonance.

Our finding that videos featuring mental health content received a high number of views but moderate engagement may suggest that individuals are seeking out content on mental health topics but are refraining from digitally interacting with it. Because of the stigma associated with mental health topics (Jones, 2015), a high number of views can be translated into a passive form of engagement. Future studies may analyse both self-stigma and perceived other stigma associated with mental health content engagement.

In addition, in this study, we evaluated the presence or the absence of credibility claims without analysing the factual components of these messages. Future research should consider exploring the factual component of these messages including credibility claims. This will help explain why individuals engage or choose not to engage with mental health information on TikTok in terms of the quality of the content.

Conclusion

Mental health problems including depression and anxiety are worldwide public health concerns (Simbar et al., 2018). The COVID-19 pandemic has worsened conditions of stress, loneliness, hopelessness and despair (Dobson et al., 2021). An emerging body of research suggests that there are circumstances in which frequent engagement with social media content can be detrimental to mental health and increase depressive states through emotional contagion (Pantic et al., 2012). Critically, the results of this suggest that social media can also be a part of the solution in providing support and education for mental health concerns. Our findings also confirm that there is no one-size-fits-all when it comes to formulating effective media content to promote mental health. Study findings suggest the need to understand how health professionals can best engage with young people using TikTok and short-form video. In summary, our results suggest the need for credible information sources and an increase in affiliation, heroic, hope and efficacy-based appeals.

Footnotes

Funding

The author(s) received no financial support for the research, authorship and/or publication of this article.

ORCID iD

Sultana Ismet Jerin

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