Abstract
Background:
While mental disorder is an ‘intrinsically social phenomenon’, social psychiatry has been reportedly declining. Addressing public interests in social psychiatry was among the suggestions to address this decline. In recent years, public interest in social psychiatry can be explored using Google Trends, an increasingly important infodemiological tool.
Objective:
This study determined changes in global online public interest in social psychiatry from January 2004 to December 2021 using Google search volumes.
Methods:
Search query using this keyword, ‘Social Psychiatry (Topic)’, was made using the Explore feature of Google Trends. The Region and Time Filters were set to ‘Worldwide’ and January 2004 to December 2021, respectively. Afterward, the search volumes, country ranking, queries, and topics returned by the Google Trends system was described and compared.
Results:
There was a generally decreasing trend in search volumes for social psychiatry where it decreased almost 10 times between 2004 and 2021. Only 11 countries were listed in Google Trends’ ranking with the top countries including Austria, Germany, and Switzerland. Search-related topics and queries were about social psychiatry related concepts, related academic discipline, human resources, social interventions, and education activities
Conclusions:
The findings suggest that there is a decreasing public interest in social psychiatry. To improve this, social psychiatry can address public expectation through improving its connection with allied social sciences, increasing its educational activities, and expanding its social intervention services.
Introduction
Mental disorder is an ‘intrinsically social phenomenon’ (Morgan & Bhugra, 2010). It both shapes and is shaped by social experiences and circumstances. Given these, social psychiatry is essential in the continuous survival of psychiatry as a whole (Morgan & Bhugra, 2010). However, it has certainly seen ‘better days’ (Pilgrim & Rogers, 2005). This has been partly attributed to the ‘decade of the brain’ during the latter part of the 20th century. With the hope of triumphalism and optimism over the psychiatric management of mental disorders through advances in neuroscience, biological psychiatry has predominated the psychiatric discipline in many places across the globe (Lie & Greene, 2021; Morgan & Bhugra, 2010). Pilgrim and Rogers (2005) also posited that the decline of social psychiatry is linked to its ‘recent failure, compared to earlier days, to draw on insights from the social science’. Nonetheless, social psychiatry has much to contribute including the understanding of how our ever-changing social context and milieu affect mental health (Lauber, 2008; Ventriglio et al., 2016). Thus, there is a need to understand the sustainability and advancement of social psychiatry, not only for its survival but for the survival of the wider discipline of psychiatry as a whole. To address these, Uchtenhagen (2008) suggested that social psychiatry must meet the public demands and interests of its stakeholder. Thus, there is a need to understand public interest regarding social psychiatry in contemporary times.
In recent years, big data analysis and infodemiological research are increasingly utilized to elucidate changes in health-related awareness, behavior, and interest (Mavragani & Ochoa, 2019; Nuti et al., 2014). Google Trends, a public repository of google engine searches, has been an important tool and is extensively used in search volume analysis since it has the largest global market share among internet search engines (Arora et al., 2019; Mavragani & Ochoa, 2019; Nuti et al., 2014; Statista, 2022). It has been used to monitor and assess changes in public awareness and interest in several health-related concepts including treatment, vaccination, HIV, COVID-19, and mental health (Knipe et al., 2020; Moalong et al., 2021; Nuti et al., 2014; Zhao et al., 2021). Given these, Google Trends can be used to explore and determine changes in the public interest in social psychiatry.
Methods
This descriptive infodemiological study used search volumes of online users from the Google search engine. It determined changes in global online interest in social psychiatry from January 2004 to December 2021. The data gathered were Search Volume Indices (SVI) and related queries from Google Trends. The data is publicly available and there was no human participant involved. Thus, this study does not necessitate local ethical approval.
Data and measures
Google Trends’ automated algorithm determines the SVI through automatically anonymizing users’ data, categorizing their search queries, and aggregating these searches together as a single topic (Google, n.d.). The resulting number for each month is scaled from 0 to 100 which is normalized against the highest search volume in the specified period and location. Wherein, 0 corresponds to the lowest search volume while 100 corresponds to the highest search volume (Google, n.d.; Moalong et al., 2021). For this study, monthly SVI was used as a measure of online public interest for social psychiatry.
Top and rising search-related queries and topics are the terms and topics online users searched for concerning a keyword. These can be used to assess the changes in other search interests regarding the keyword over a period (Google, n.d.; Moalong et al., 2021). For this study, topics and queries were used to note changes in other public interests related to social psychiatry.
Data collection and analysis
The keyword, ‘Social Psychiatry (Topic)’, was used in the Explore feature of Google Trends to aggregate related searches for social psychiatry (available at: http://www.google.com/trends, accessed 24 February 2022). This is because a ‘Topic’ keyword such as, ‘Social Psychiatry (Topic)’, can aggregate terms that share the same concept in any language (Mavragani & Ochoa, 2019). With this keyword, Google Trends was set up using a Region filter of ‘Worldwide’ to determine global searches for the keyword. The Time Range filter was set from January 2004 to December 2021.
After, the ranking of countries listed in Google Trends was described and compared using their SVIs. Afterward, the trend of changes in SVIs was noted. Lastly, the top and rising related queries and topics were descriptively compared.
Results
The global search volume trend for social psychiatry
Table 1 showed that a total of 11 countries were ranked and listed by the Google Trends system for the keyword ‘Social Psychiatry (Topic)’. The top three countries with the highest SVIs were German-speaking European countries including Austria, Germany, and Switzerland.
Interest by region for ‘Social Psychiatry (Topic)’ from January 2004 to December 2021.
The global search volume trend is shown in Figure 1. Search volumes during this period were normalized against the highest SVI in August 2004. SVIs commenced at 87 in January 2004 and ended at 9 in December 2021 with a generally decreasing trend. This indicates that searches for social psychiatry decreased almost 10 times between 2004 and 2021.
Graph depicting trend of worldwide Google search volume over time for the keyword ‘Social Psychiatry (Topic)’ from January 2004 to December 2021.
Top and rising search-related topics for social psychiatry
As shown in Table 2, the top search-related topics concerning social psychiatry revolved around related concepts such as ‘psychiatry’ and ‘social’, groups such as ‘society’ and ‘congress’, academic disciplines such as ‘epidemiology’ and ‘social work’, publications such as ‘academic journal’, human resources such as ‘Psychiatrist’ and ‘specialist’, localities with social psychiatry services such as ‘Hamburg’, social interventions such as ‘psychotherapy’, and education such as ‘further training’.
Related topics and queries returned for ‘Social Psychiatry (Topic)’ from January 2004 to December 2021.
Almost all rising search-related topics increased by >5,000%. These were similar to the top topics including social psychiatry-related human resources, social interventions education, specialist, academic discipline, and localities. Notably, there was an increase in searches for new social interventions such as ‘assisted living’ and ‘Day hospital’, other academic disciplines such as ‘sociology’, social service providers such as ‘Bundesagentur für Arbeit’, and other localities such as ‘Graz’ and ‘Lower Saxony’.
Top and rising search-related queries for social psychiatry
Top search-related queries refer to the most popular terms used by individuals who searched for social psychiatry. Table 2 revealed that most of these queries were in the German Language. Similar to topics, it included social psychiatry concepts such as ‘sozialpsychiatrie’ and ‘psychiatrie’. Likewise, there were also searches for related academic disciplines such as ‘gemeindepsychiatrie’, ‘diakonie’, and ‘sozialpädagogik’. Social interventions such as assisted living and psychotherapy were also noted in the German language, ‘psychotherapie’ and ‘betreutes wohnen’. Similarly, acronyms of social service providers were also observed such as ‘spz’. Social psychiatry related educational activities and societies were also noted including ‘mhh’ and ‘sosyal psikiyatri kongresi’.
Over time, almost all rising search-related queries increased. These queries were similar to the top topics although there were notably lower terms for social psychiatry concepts and more terms related to other academic disciplines such as ‘psychologie’, ‘sozialpsychologie’, and ‘sozialpädagogik’. All of these terms were also in the German language.
Discussion
The findings suggest that there is a decreasing interest in social psychiatry among the general public between 2004 and 2021. This supports previous notions by Pilgrim and Rogers (2005) that social psychiatry may have seen ‘better days’ in terms of its public influence. This decreasing interest is further reflected by the relatively low number of countries and regions listed by the Google Trends systems for the keyword for Social Psychiatry. These indicate that there were inadequate search volumes for social psychiatry in the other regions and countries not listed in Google Trends. Thus, it can be posited that public interest in social psychiatry in these non-listed regions is low.
Nonetheless, certain German-speaking countries such as Austria and Germany observed a rising interest in social psychiatry. This growth in interest in these countries may be due to specific commitments to social psychiatry. For instance, an Austrian national university, the University of Vienna, is focused on social psychiatric research while the German Society for Social Psychiatry members uphold that ‘psychiatry is social psychiatry or it is no psychiatry’ (Fleischhacker & Wancata, 2007; Priebe & Finzen, 2002).
The top and rising queries and topics revealed that the public may be seeking a better understanding of social psychiatry concepts and its related disciplines such as epidemiology and social work. These searches may represent the inherent multidisciplinary and team-based approach of social psychiatry in providing its healthcare services and social interventions. These also support the previous notions of Pilgrim and Rogers (2005), wherein, they posited that to maintain social psychiatry’s significance it must remain connected and draw its insight from its allied social science disciplines.
There were also searches for academic publications and educational activities related to social psychiatry. These may indicate that there is increasing interest to better understand social psychiatry and its implication in modern-day society. Likewise, social service providers and social interventions were also highly sought by online users. These may indicate that these online individuals may need these services. Notably, most of these search-related topics and queries were in the German Language. These suggest that social psychiatry remains influential among speakers of this language. This is further supported by the related searches for localities where German is considered the main language such as Hamburg. It was also noted that there were no rising searches for social psychiatry concepts while social interventions searches remained rising. These suggest that the public may better appreciate the salience of social psychiatry in contemporary times through its societal applications and interventions.
Limitations
While this study is the first study, to the author’s knowledge, that explored global search volumes regarding social psychiatry, several limitations should be considered. First, the findings reflect only the interest of those who use the Google search engine and have internet access (Moalong et al., 2021). Thus, it may not fully reflect the interest of the general population. Second, the online users’ demographic characteristics cannot be determined since the users with these search volumes are automatically anonymized by the Google Trends system (Google, n.d.; Mavragani & Ochoa, 2019). Hence, it cannot be ascertained whether the findings of this study were skewed toward certain population groups such as health and allied health professionals. Third, the keyword, ‘Social Psychiatry (Topic)’, inputted in Google Trends represents the aggregated searches for terms and idioms related to social psychiatry. Given Google Trends’ automated aggregation feature (Google, n.d.; Mavragani & Ochoa, 2019), the exact terms and idioms included under this keyword are unknown. Thus, future studies can explore public interest in other specific and prominent terms related to social psychiatry such as global mental health, public mental health, and cultural psychiatry. Lastly, online search volume analysis is a surrogate measure for public interest and awareness. Thus, there is a need for traditional measures such as surveys, for a better and more comprehensive understanding of public interest in social psychiatry (Moalong et al., 2021).
Conclusion
Overall, there is a decreasing public interest in social psychiatry. To address this, Uchtenhagen (2008) suggests that social psychiatry must meet public expectations. This study highlighted that these may be addressed through improving its connection with allied social sciences, increasing its educational activities, and expanding its social intervention services. As a start, it might be useful to replicate and build on the successes of countries with continuously rising interest in social psychiatry including Germany, Austria, and Switzerland. Nonetheless, further research is needed to comprehensively understand public interest in social psychiatry in contemporary times.
